Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA.
Department of Urology, Mayo Clinic, Rochester, MN, USA.
Int J Equity Health. 2024 Aug 21;23(1):164. doi: 10.1186/s12939-024-02246-9.
Spanish-speakers with non-English language preference and complex medical needs suffer disparities in quality of care, safety, and health outcomes. Communication challenges during prolonged hospitalizations for complex illnesses negatively influence how this group engages in their care and decision-making while hospitalized. Limited literature capturing the perspectives of Spanish-speaking patients in this context exists. Given the impact of language barriers on care and medical decision-making, this study documents the experiences of Spanish-speaking patients with NELP and hospitalized with complex care needs as well as caregivers and community leaders.
Using community-engaged recruitment strategies and semi-structured interviews and a focus group, we gathered insights from Spanish-speaking patients hospitalized for prolonged periods, caregivers, and community leaders from three geographic regions. Data were deidentified, transcribed, translated, coded in duplicate, and analyzed guided by grounded theory using NVivo.
We interviewed 40 participants: 27 patients, 10 caregivers and 3 community leaders. We identified four major themes: (1) Disconnected experiences impeding interactions, communication, and decision-making (2) Inadequate interpreter services (3) Benefits and consequences of family at the bedside (4) Community -informed recommendations.
The study showed that in-person interpreters were preferred to virtual interpreters; yet interpreter access was suboptimal. This resulted in ad hoc family interpretation. Participants noted language negatively impacted patient's hospital experience, including decreasing confidence in medical decision-making. Recommendations from patients, caregivers, and community leaders included expanding interpreter access, bolstering interpreter quality and accuracy, and increasing resources for patient education.
有非英语语言偏好和复杂医疗需求的西班牙语患者在护理质量、安全性和健康结果方面存在差异。在因复杂疾病而长时间住院期间，沟通障碍会对这一群体在住院期间参与护理和决策的方式产生负面影响。在这种情况下，关于西班牙语患者观点的文献有限。鉴于语言障碍对护理和医疗决策的影响，本研究记录了有 NELP 并因复杂护理需求住院的西班牙语患者以及护理人员和社区领导的经历。
我们使用社区参与的招募策略以及半结构化访谈和焦点小组，从三个地理区域的西班牙语患者、护理人员和社区领导中收集了见解。数据经过去识别、转录、翻译、双重编码，并使用 NVivo 指导的扎根理论进行分析。
我们采访了 40 名参与者：27 名患者、10 名护理人员和 3 名社区领导。我们确定了四个主要主题：（1） 沟通和决策的脱节体验（2） 口译服务不足（3） 家属在床边的好处和后果（4） 社区知情的建议。
研究表明，人们更喜欢现场口译员而不是虚拟口译员；然而，口译员的访问量并不理想。这导致了临时的家庭口译。参与者指出语言会对患者的住院体验产生负面影响，包括降低对医疗决策的信心。患者、护理人员和社区领导的建议包括扩大口译员的访问量、提高口译员的质量和准确性，以及增加患者教育资源。
