Session: Developing Culturally-Sensitive Approaches to Patient Care
Using Community Engagement to Explore the Challenges for Spanish Speaking Patients Admitted to the Hospital with Complex Illnesses
Saturday, October 14, 2023
9:00 AM – 10:15 AM ET
Location: Kent A-C (Fourth Floor)
Background: The COVID-19 pandemic disproportionately impacted the Hispanic community, which includes those with non-English language preference (NELP), who speak Spanish. COVID-19 led to increased infection rates, hospital admissions and worse morbidity and mortality outcomes among this population. Furthermore, in-person interpreter services were substantially reduced during COVID-19, resulting in reduced communication mechanisms for hospitalized patients with NELP.
Methods: This multi-site community-engaged study elucidates Spanish speaking patients’, caregivers’, and community leaders’ perspectives about how language barriers impact complex care decision making and experience, including interpreter services. Using focus groups and semi-structured interviews, Spanish-speaking patients with NELP who were hospitalized for prolonged periods with complex illnesses, their caregivers, and community leaders were interviewed (n = 38) by bilingual research study personnel. Following transcription, translation and deidentification, data were coded and analyzed using NVivo.
Results: Participants commented that most healthcare needs were met while hospitalized but communicating and connecting with their healthcare team was challenging. Participants also described healthcare team’s poor awareness of interpretation services and estimation of patient language proficiency. In-person interpretation was rare, so participants utilized video interpretation services, although many preferred in-person to build rapport. Issues with video interpretation included inaccuracy and perceived lack of professionalism during remote interpretation. In the event of interpreter shortages and delays, patients frequently relied on ad hoc family and healthcare team interpretation. During key decision-making, family and clinicians’ perspectives were centered and deeply considered. Participants recommended adding bilingual healthcare team members, bolstering medical interpreter training to improve accuracy, and increasing access to in-person interpreters.
Amelia Barwise, MB, BCh, PhD – Biomedical Ethics Research Program – Mayo Clinic; Andres Guillen Lozoya, MD – Department of Urology – Mayo Clinic; Maria Caruso, MS – Community-Based Research – Mayo Clinic; Maria Porraz Capetillo, CHI – Midwest Practice Admin Services – Mayo Clinic