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Acad Pediatr. 2019 Aug 22. pii: S1876-2859(19)30379-1. doi: 10.1016/j.acap.2019.08.012. [Epub ahead of print]

Spanish Interpreter Services for the Hospitalized Pediatric Patient: Provider and Interpreter Perceptions.

Author information

1
Rady Children's Hospital San Diego and University of California San Diego, Department of Pediatrics, 3020 Children's Way MC 5064, San Diego, CA 92123, USA; The Children's Hospital at Montefiore and Albert Einstein College of Medicine, Department of Pediatrics. Electronic address: itam@montefiore.org.
2
Rady Children's Hospital San Diego and University of California San Diego, Department of Pediatrics, 3020 Children's Way MC 5064, San Diego, CA 92123, USA. Electronic address: mhuang3@rchsd.org.
3
Rady Children's Hospital San Diego and University of California San Diego, Department of Pediatrics, 3020 Children's Way MC 5064, San Diego, CA 92123, USA. Electronic address: aartipatel@rchsd.org.
4
Rady Children's Hospital San Diego and University of California San Diego, Department of Pediatrics, 3020 Children's Way MC 5064, San Diego, CA 92123, USA. Electronic address: k1rhee@ucsd.edu.
5
Rady Children's Hospital San Diego and University of California San Diego, Department of Pediatrics, 3020 Children's Way MC 5064, San Diego, CA 92123, USA. Electronic address: estucky@rchsd.org.

Abstract

BACKGROUND:

Many Americans have limited English proficiency (LEP) and difficulty communicating with healthcare providers, creating inequitable healthcare delivery. Despite widespread interpreter availability in hospitals, perceptions of interpreter services in the pediatric inpatient setting are largely unknown.

OBJECTIVE:

To investigate staff perspectives regarding: 1) roles of the interpreter and provider (attending, resident, nurse) during an encounter, 2) modalities of interpretation, and 3) barriers to services.

METHODS:

Focus groups were conducted with: 1) hospital-employed Spanish interpreters, 2) Pediatric Hospital Medicine attendings, 3) pediatric and internal medicine-pediatric residents, and 4) medical unit nurses. Sessions were audio-recorded and transcribed. Using Atlas.ti©, two investigators created the coding scheme, independently coded the data, and achieved consensus. Qualitative methods were used for thematic analysis.

RESULTS:

Fourteen groups (n=59 participants) were held: 3 interpreter groups (n=10), 3 attending groups (n=14), 2 resident groups (n=17), and 6 nurse groups (n=18). Most believed the interpreter's role was to serve as a conduit (provide word-for-word interpretation), act as a cultural broker, and maintain transparency (not withhold information). All groups felt providers should interact with families as they would with English-speaking families. In-person interpreters were preferred over telephone and video for being more accurate, efficient, and personable. Barriers to accessing services included time needed for interpretation, overconfidence in language skills, variable family dynamics, and identification of LEP families.

CONCLUSIONS:

In-person interpreters are highly valued, fulfilling complex roles. However, operational and human factors limit access to services in the hospital. These findings, along with family perspectives, can be used to optimize interpretation experiences.

KEYWORDS:

Limited English proficiency; Spanish; hospital medicine; interpreters; translation

PMID:
31445969
DOI:
10.1016/j.acap.2019.08.012

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