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BACKGROUND: Spanish-speaking trauma and burn patients have unique needs in their postdischarge care navigation. The confluence of limited English proficiency, injury recovery, mental health, socioeconomic disadvantages, and acute stressors after hospital admission converge to enhance patients' vulnerability, but their specific needs and means of meeting these needs have not been well described. STUDY DESIGN: This prospective, cross-sectional survey study describes the results of a multi-institutional initiative devised to help Spanish-speaking trauma and burn patients in their care navigation after hospitalization. The pathway consisted of informational resources, intake and follow-up surveys, and multiple points of contact with a community health worker who aids in accessing community resources and navigating the healthcare system. RESULTS: From January 2022 to November 2023, there were 114 patients identified as eligible for the Non-English-Speaking Trauma Survivors pathway. Of these, 80 (70.2%) were reachable and consented to participate, and 68 were approached in person during their initial hospitalization. After initial screening, 60 (75.0%) eligible patients had a mental health, social services, or other need identified via our survey instrument. During the initial consultation with the community health worker, 48 of 60 patients with any identified need were connected to a resource (80%). Food support was the most prevalent need (46, 57.5%). More patients were connected to mental health resources (16) than reported need in this domain (7). CONCLUSIONS: The Non-English-Speaking Trauma Survivors pathway identified the specific needs of Spanishspeaking trauma and burn patients in their recovery, notably food, transportation, and utilities. The pathway also addressed disparities in postdischarge care by connecting patients with community resources, with particular improvement in access to mental healthcare. [ABSTRACT FROM AUTHOR]

Background: While clinicians routinely observe issues with safety and quality, they may not always speak up and intervene. Peer feedback supports nurses to speak up about errors or near misses and actively improve nursing care quality. Effective peer feedback requires addressing barriers to speaking up. Purpose: The purpose of this mixed methods study was to evaluate a 'brain-friendly' peer feedback program's effect on clinical nurses' perceptions of peer review. Methods: Nurses were surveyed before and after the implementation of a peer feedback program that integrated social cognitive neuroscience principles. Open comments were analyzed using thematic analysis. Results: Responses to nearly half of survey questions improved. Thematic analysis identified institutional and personal barriers to peer feedback use, revealing the personal and social complexity of speaking up. Conclusions: Social cognitive neuroscience may enhance peer feedback programs. Research using immersive qualitative methods is needed to better understand factors supporting or impeding peer feedback. [ABSTRACT FROM AUTHOR]

Objective: To promote antimicrobial stewardship, many institutions have implemented a policy of reflexing to a urine culture based on a positive urinalysis result. The rehabilitation patient population, including individuals with brain and spinal cord injuries, may have atypical presentations of urinary tract infections. The study objective is to determine the effects of implementing a urine culture reflex policy in this specific patient population. Design: In an inpatient rehabilitation unit, 348 urinalyses were analyzed from August 2019 to June 2021. Urinalysis with greater than or equal to 10 white blood cells per high power field was automatically reflexed to a urine culture in this prospective study. Primary outcome was return to acute care related to urinary tract infection. Secondary outcomes included adherence to reflex protocol, antibiotic utilization and appropriateness, adverse outcomes related to antibiotic use, and reduction in urine cultures processed and the associated reduction in healthcare costs. Results: There was no statistically significant difference before and after intervention related to the primary outcome. Urine cultures processed were reduced by 58% after intervention. Conclusions: Urine culture reflex policy is likely an effective intervention to reduce the frequency of urine cultures without significantly affecting the need to transfer patients from inpatient rehabilitation back to the acute care setting. [ABSTRACT FROM AUTHOR]

Background: Rising admission rates of Hispanic/Latinx families to the neonatal intensive care unit (NICU) have increased the number of non-English-speaking individuals who may wish to participate in research studies. However, a lack of appropriately translated research study materials may limit the opportunity for these families to be involved in research that could impact the care that infants and families receive in the NICU. Purpose: The primary purpose was to pilot test study materials that were transcreated from English to Spanish with the assistance of a bilingual community advisory board with Spanish-speaking parents of NICU infants. Methods: A total of 19 Spanish-speaking parents (15 mothers and 4 fathers) who were representative of the population of interest completed paper-and-pencil surveys, along with a cognitive interview. Preliminary data related to decision-making and goals of care, infant symptoms, and their experiences in the NICU were also collected. Results: The internal reliability of the transcreated study instruments ranged from good to excellent (a= 0.82-0.99). Participants reported that study materials were not offensive and did not make them feel uncomfortable; however, they found some words/phrases to be confusing. Parents had the opportunity to provide suggested wording changes. Implications for Practice and Research: Language barriers and a lack of cultural responsiveness can affect the care that infants and their families receive. More accurate and culturally appropriate transcreation of study materials can remove barriers to research participation and facilitate better communication with non-English-speaking families, which may lead to the development of better-informed evidence-based interventions and clinical practices in the NICU. [ABSTRACT FROM AUTHOR]

Mental health and psychosocial support for Uyghurs living abroad need to be acknowledged as an important component of the humanitarian response. To formulate appropriate interventions for promoting mental health, a comprehensive understanding of identified problems is needed. However, several challenges - including language barriers, community perceptions of mental health, and mental health services - must be addressed. In this field report, we draw from our experiences of the Uyghur diaspora in relation to mental health to present the challenges which need to be addressed. [ABSTRACT FROM AUTHOR]

Advance care planning is important and timely for patients receiving home health services; however, opportunities to facilitate awareness and engagement in this setting are often missed. This qualitative descriptive study elicited perspectives of home health nurses and social workers regarding barriers and facilitators to creating advance care plans in home health settings, with particular attention to patients with few familial or social contacts who can serve as surrogate decision-makers. We interviewed 15 clinicians employed in a large New York City-based home care agency in 2021-2022. Participants reported a multitude of barriers to supporting patients with advance care planning at the provider level (eg, lack of time and professional education, deferment, discomfort), patient level (lack of knowledge, mistrust, inadequate support, deferment, language barriers), and system level (eg, discontinuity of care, variations in advance care planning documents, legal concerns, lack of institutional protocols and centralized information). Participants noted that greater socialization and connection to existing educational resources regarding the intended purpose, scope, and applicability of advance directives could benefit home care patients. [ABSTRACT FROM AUTHOR]

Background: Hospitalized patients with coronavirus disease experienced different challenges at treatment centers; however, there is no evidence in Ethiopia on patients' experiences at COVID-19 treatment centers. Therefore, the aim of this study was to explore the lived experiences of hospitalized patients with coronavirus disease at Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, in 2021. Methods: A qualitative phenomenological study design with a heterogeneous purposive sampling technique was used. Fifteen hospitalized patients participated from March 15 to April 1, 2021. The information was gathered through an in-depth interview technique with an audio recorder. Thematic analysis was used to analyze the data using Atlas Ti version 7.09 software. Result: Hospitalized patients with the coronavirus disease had a variety of experiences with various phenomena. Lived experiences were identified with 2 major themes: the psychoemotional theme has 2 subthemes (psychological and emotional experience), and the context-related experience has 5 subthemes (socioeconomic, patient–health care provider, health facility–related, exposure prevention, and governmental-related factors). Conclusion: The study identified 2 major themes: 7 subthemes and 10 categories. Study participants faced different challenges, mainly hopelessness, anxiety, a lack of caregiver, isolation, a shortage of medications, poor communication between the patient and health care provider, and a lack of health insurance. Therefore, we recommend giving psychological support, improving communication between patients and health care professionals, and ensuring health insurance. [ABSTRACT FROM AUTHOR]

This article explores the reasons for the high prevalence of diabetes among Hmong Americans, who are at greater risk for diabetes compared with non-Hispanic White patients and have a higher prevalence of diabetes than other Asian Americans and other races. Knowledge of this issue may allow medical practitioners to identify, screen, and treat Hmong Americans more frequently and at earlier ages. Although better integration of healthcare services, access, and education are needed, earlier screening may help start the diabetes education process sooner; reduce hospital, ED, and office visits; reduce costs; and prevent end-organ damage. [ABSTRACT FROM AUTHOR]

The Czech government, the Czech Ministry of Health (MoH) and the Czech Ministry of Interior (MoI) have acknowledged mental health and psychosocial support (MHPSS) for refugees from Ukraine as an important component of the humanitarian response. Despite their support to refugees from Ukraine in providing them with the essential basic services such as accommodation, livelihood, health services and education (social determinants of mental health), MHPSS response is still facing some challenges. Main challenges are related to the healthcare delivery system and low mental health awareness among refugees from Ukraine. Shortage of mental health (MH) professionals from Ukraine with the license to practice in Czechia and overwhelmed national healthcare system makes it more difficult for refugees from Ukraine to get adequate and timely MHPSS. Language barriers, low demand for MHPSS among refugees from Ukraine, not fully functional intra and inter-sectoral MHPSS referral system, need for responsible staff care, monitoring, evaluation and reporting of results of MHPSS and introduction of international guidelines into the national MHPSS response are identified as important challenges. Recommendations and solutions to overcome these challenges and improve the outcomes of MHPSS response for the refugee population from Ukraine in Czechia draw from local, regional and global experiences. [ABSTRACT FROM AUTHOR]

There is growing evidence that language discordance between patients and their health care teams negatively affects quality of care, experience of care, and health outcomes, yet there is limited guidance on best practices for advancing equitable care for patients who have language barriers within obstetrics and gynecology. In this commentary, we present two cases of languagediscordant care and a framework for addressing language as a critical lens for health inequities in obstetrics and gynecology, which includes a variety of clinical settings such as labor and delivery, perioperative care, outpatient clinics, and inpatient services, as well as sensitivity around reproductive health topics. The proposed framework explores drivers of language-related inequities at the clinician, health system, and societal level. We end with actionable recommendations for enhancing equitable care for patients experiencing language barriers. Because language and communication barriers undergird other structural drivers of inequities in reproductive health outcomes, we urge obstetrician–gynecologists to prioritize improving care for patients experiencing language barriers. [ABSTRACT FROM AUTHOR]

The article discusses the importance of accessible language services in ensuring equitable quality care. Topics include consequences of miscommunication associated with limited English proficiency (LEP), rationale for failure to use interpreter services, and ways to decrease language barriers. A project which aimed to implement an intervention to increase nurse and healthcare provider use of intepreter services in an inpatient hospital unit and evaluate its immediate effects is also offered.

Background: Admission rates of Hispanic/Latinx families to the neonatal intensive care unit (NICU) are rising, yet knowledge regarding their experiences is limited. Non-English-speaking families are often excluded from research because study measures are not available in their language. The inclusion of these families in NICU research is crucial to understand the impact of cultural and language barriers in infant and family care, and the translation of study measures into Spanish could better ensure that these families' perspectives are included. However, previous research has utilized the standard translation–backtranslation method with which problems have been noted. Purpose: This article describes the planning, preparation, and action phases that were completed with the use of a community advisory board (CAB) to prepare and transcreate research study materials from English to Spanish for pilot testing. Methods: Community members of interest were invited to form the CAB, and 2 meetings were held to review study materials in the English and Spanish versions. Prior to the second meeting, a professional translation company translated study materials from English to Spanish. Results: Feedback from the CAB ensured consistent content and reading levels, and culturally appropriate language usage. The CAB also provided suggestions to the research protocol and advised sensitive methods of recruitment and measure administration. Implications for Practice and Research: More accurate and culturally appropriate transcreation of study measures can reduce barriers to research participation and facilitate better communication with non-English-speaking families in health equity research to better inform evidence-based interventions and clinical practices across diverse groups. [ABSTRACT FROM AUTHOR]

Worldwide, 56.8 million persons are estimated to require palliative care. Critically ill patients benefit from palliative care by improving their quality of life through symptom management. Resistance to palliative care exists from surrogate decision-makers because of low health literacy and communication issues with providers. This research reviewed the literature to identify how health literacy and health care communication influenced palliative care conversations with decision-making surrogates and health outcomes of critically ill patients. The review included articles between 2011 and 2022 using the terms communication , health literacy , palliative care , critical care , intensive care , ICU , surrogate decision maker , family , and caregiver in PubMed, CINAHL, and Google Scholar. Fourteen articles were included. Quality was assessed through Joanna Briggs Institute appraisal tools. Health literacy of surrogates was not found to be significant for patient outcomes. However, there were significant differences between clinician and surrogate communication influenced by surrogates' previous health care experiences. Early communication about prognosis was important for surrogates. Structured communication approaches were preferred by surrogates. Limitations of the review included primarily White participants, small variability of research sites, and a few number of articles. Future research needs to study the effects of surrogate health literacy of critically ill patients on willingness to accept palliative care. [ABSTRACT FROM AUTHOR]

Purpose: Communication access is a human right, but many individuals with communication impairments face challenges accessing their environments. As part of a larger study investigating barriers and facilitators to communication access in the retail/service industry, the purpose of the present study was to investigate the experiences of people with aphasia (PWA) accessing goods and services in their communities. Methods: Nine PWA were interviewed about their experiences accessing retail businesses and services. Interviews were coded and thematically analyzed to identify key themes related to barriers and facilitators to communication during business interactions. Stakeholders on the research team included two PWA, who provided input throughout the research process. Results: Three main themes were found: supporting communication, aphasia awareness and education, and respect for PWA. Codes within each theme comprised facilitators that led to positive experiences and barriers that led to negative business interactions. Discussion/Conclusions: People with aphasia identified tangible ways that retail businesses can be made more communicatively accessible. Stakeholders with aphasia made meaningful contributions to the research process. Future work will investigate how these findings, integrated with business perspectives, can be used to support businesses in applying strategies to become more communicatively accessible. [ABSTRACT FROM AUTHOR]

The article calls for the transformation of trauma care for non-English speakers through the non-English-speaking trauma survivors (NESTS) pathway to help in their recovery, with reference to a study which assessed the NESTS pathway. It discusses the implications of language and cultural barriers and socioeconomic factors in healthcare. It urges for culturally competent care for diverse patient populations to reduce systemic disparities in healthcare accessibility and equity.

Introduction: Employees are often placed within an organization based on their respective roles or duties, which can lead to vertical and horizontal organizational silos. Organizational silos may restrict information, resources, and stymie progress and innovation. This analysis presents a framework to mitigate silos and overcome communication barriers within an organization by increasing collaboration., Methods: The project team examined results from the Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) 2020 Employee Viewpoint Survey Results and conducted 19 key informant discussions with NCCDPHP employees. Participants were asked to provide feedback on (1) understanding silos in the workplace and (2) best practices for reducing silos and fostering collaboration. A thematic analysis was conducted to understand organizational silos, the motivation to reduce silos, and identify best practices and strategies., Results: Respondents felt that siloing exists at the division and branch levels; however, 95% of respondents were motivated to reduce silos. Fifty-eight percent of respondents identified that institutional factors such as the organizational structure (n = 8) and red tape/bureaucracy (n = 3) contribute to siloing. Additional behaviors and actions that perpetuate silos were identified, and efforts to reduce silos were categorized to propose a model: Framework to Foster Collaboration for improving organizational collaborative efforts., Discussion and Conclusion: Key themes included inclusion, shared goals and vision, bi-directional communication, and relationship building and developing trust as critical elements for improving collaboration and creating synergy across teams in efforts to reduce silos in the workplace., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Patients with concomitant limited English proficiency (LEP) and hearing loss may experience communication barriers, not fully mitigated by traditional interpreter services. Although there is no clear consensus on the most reliable and optimal resources for these patients, speech-to-text (STT) applications with translation capability may bridge these barriers. We review the existing literature applying STT translation programs in clinical settings and identify commercially available STT translation resources to evaluate their prospective application in the otology setting., Databases Reviewed: PubMed MEDLINE, Embase, and Web of Science., Methods: A systematic review of English language peer-reviewed literature was conducted, examining STT translation in clinical settings. An additional search identifying STT software with translation capabilities was completed., Results: Seven out of 591 unique citations met the inclusion criteria, and 29 unique STT translation applications were identified, supporting up to 140 languages. Stakeholders endorse positive perceptions of STT translation programs. Facilitators to implementation included time and cost feasibility, whereas barriers included risk of mistranslation and inability to assess accuracy. Ongoing machine-learning efforts are underway for developing and improving STT translation technologies, but there is paucity of literature evaluating their application in patients with hearing loss., Conclusions: Small studies have suggested an acceptable level of accuracy for STT translation programs as adjunctive to standard of care services. Further work should proactively address implementation challenges with special attention to use of these technologies for patients with concomitant LEP and HL, while supporting additional technological advancement for application of these technologies in otology practice., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2024, Otology & Neurotology, Inc.)

Excluding this population perpetuates health inequities. [ABSTRACT FROM AUTHOR]

Half of the foreign-born population in the United States speaks English "less than very well." The extant literature suggests that low-English-proficient (LEP) patients experience poorer healthcare outcomes than do language-concordant patients. It remains unclear which methods of interpreter services are best for communicating effectively and achieving positive health outcomes for LEP patients. This review examines interpretation methods to compare their effectiveness and frequency of use and identifies the remaining gaps in our knowledge. The evidence suggests that any type of professional language service is superior to untrained interpreting and vastly better than not using an interpreter at all. Even with this knowledge, use of interpreter services is unacceptably low and gaps remain. Further research is needed to isolate and examine different methods of interpretation and measure objective health outcomes. In addition, education is needed for interpreters and healthcare providers to ensure the most effective communicative strategies for LEP patients. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare no conflicts of interest.

Objective: To understand medical interpreters' perspectives on surgical informed consent discussions and provide feedback for surgeons on improving these conversations., Background: Informed consent is a critical component of patient-centered surgical decision-making. For patients with limited English proficiency, this conversation may be less thorough, even with a medical interpreter, leaving patients with an inadequate understanding of their diagnosis or treatment options., Methods: A semistructured interview guide was developed with input from interpreters and a qualitative research expert. We purposively sampled medical interpreters representing multiple languages until thematic saturation was achieved. Participants discussed their experience with the surgical consent discussion and process. Interview transcripts were analyzed using emergent thematic analysis., Results: Among 22 interpreters, there were 10 languages represented and an average experience of 15 years (range: 4-40 yr). Four major themes were identified. First, interpreters consistently described their roles as patient advocates and cultural brokers. Second, interpreters reported unique patient attributes that influence the discussion, often based on patients' cultural values/expectations, anticipated decisional autonomy, and family support. Third, interpreters emphasized the importance of surgeons demonstrating compassion and patience, using simple terminology, conversing around the consent, providing context about the form/process, and initiating a pre-encounter discussion. Finally, interpreters suggested reducing legal terminology on consent forms and translation into other languages., Conclusions: Experienced interpreters highlighted multiple factors associated with effective and culturally tailored informed consent discussions. Surgeons should recognize interpreters' critical and complex roles, be cognizant of cultural variations among patients with limited English proficiency, and improve interpersonal and communication skills to facilitate effective understanding., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: The purpose of this study was to explore pediatric physical therapists' (PTs') experiences including successes, challenges, and barriers with cross-cultural communication with Arabic-speaking Middle Eastern children and their families who require interpreter services., Methods: Eight PTs consented to participate in qualitative dyadic interviews. Transcription and interviews were conducted virtually in Microsoft Teams. Quality criteria included member checking for validity and trustworthiness and bracketing to minimize investigator bias. Inductive thematic analysis was used to identify meaning units and major themes., Results: The 6 themes that emerged were: fostering therapeutic relationships, practicing culturally sensitive care, communicating intentionally, experiencing successes, recognizing challenges, and tailoring a physical therapy plan of care. Representative quotations support each theme., Conclusions: Therapists perceive their experiences with Arabic-speaking children, families, and interpreters positively despite challenges related to cultural and language barriers. In sharing their experiences, therapists demonstrated self-reflection, openness to learning, and desire to build strong therapeutic alliances., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

Background: LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, and others) people face a unique set of barriers to receiving quality healthcare. Very little exists in nursing literature that addresses these barriers. Objective: This study aimed to analyze patient experience data to better understand the context of barriers to care that LGBTQ+ patients experience, in addition to institutional responses. Methods : Documentary analysis was employed to review four LGBTQ+ patient experiences that resulted in formal feedback provided to the Office of Patient Relations. Each case was analyzed for content, process, and outcomes. Results : Through the outlined analysis, the study team found three primary themes and five secondary themes across the four cases. The overarching themes identified through the study's case review include (a) lack of provider knowledge, (b) lack of patient-centered care, and (c) lack of institutional infrastructures associated with the provision of affirming care to LGBTQ+ individuals. Discussion : Findings suggest the need for a multipronged approach when addressing the care of LGBTQ+ communities. A combination of provider-level education and institutional capacity building to treat diverse patient populations is necessary for addressing the issues demonstrated within the data. Moreover, further research is needed to identify unique needs of transgender and nonbinary patients and determine efficacy of institutional efforts to build capacity for caring and studying the health needs of LGBTQ+ communities. [ABSTRACT FROM AUTHOR]

Background: Medication adherence is seldom examined in older people from diverse ethnic, cultural, and language backgrounds. Purpose: The purpose of this study was to explore medication adherence among culturally diverse older people with complex health care needs. Methods: Using a mixed-methods design, a consecutive sample of 40 older people living in a culturally diverse, low socioeconomic area completed the Brief Medication Questionnaire; 12 reporting high medication nonadherence were interviewed. Analyses used descriptive statistics and thematic analyses. Results: Participants experienced high medication nonadherence (n = 34, 85%), language barriers (n = 15, 37.5%), financial difficulties (n = 24, 60%), and poor understanding of their medications (n = 34, 85%). Medication nonadherence was attributed to finger dexterity (57.5%), poor vision (85%), and memory problems (87.5%). Interviews revealed 5 themes to explain nonadherence: (1) illness beliefs; (2) experiences of the aging process; (3) challenges for non-English-speaking participants; (4) adherence impediments; and (5) therapeutic relationships. Conclusions: Vulnerable, older people had high medication nonadherence. Targeted interventions may enhance medication adherence in this group. [ABSTRACT FROM AUTHOR]

Critically ill patients usually experience a significant level of pain during rest or during routine care such as turning, wound care, and endotracheal suctioning. Pain assessment is the cornerstone of pain management. Adequate pain assessment and management are major responsibilities of critical care nurses. The purpose of this study was to evaluate the nurses' knowledge, attitudes, and practices toward pain assessment and management of the intensive care unit (ICU) patients who are unable to communicate verbally. A descriptive cross-sectional design was used in this study. The study was conducted at ICUs in 5 hospitals from the north, middle, and south areas of Jordan. A self-administered questionnaire developed by Rose was used in this study. The most important finding in this study was that a large number of ICU nurses do not use assessment tools to evaluate the level of pain in patients who are unable to communicate verbally. Moreover, the nurses have inadequate knowledge about pain assessment and management. As perceived by the nurses, "restlessness" was the highest rated routine indicator of pain (25.1%), followed by "not following commands" (24%). Half of the participants (50%) answered that nurses were the persons who provide the most accurate rating of pain intensity. However, the participants showed positive attitude toward pain assessment and management. [ABSTRACT FROM AUTHOR]

The article focuses on how to complete a successful telehealth visit. Topics discussed include explore how NPs can help their patients adapt to the new and changing healthcare environment and modes of patient care brought on by the pandemic; and Four Habits Model includes groups of skills related to patient outcomes and categorized into habits that help one organize and act during an encounter.

The authors describe the personal protective equipment (PPE) clinicians require when involved in the care of patients with potential or confirmed exposure to highly infectious pathogens, such as the Ebola virus, multidrug-resistant organisms, or severe acute respiratory syndrome coronavirus 2, the cause of COVID-19. They discuss the communication challenges that arise with the various PPE required when caring for patients in high-containment clinical environments and how they and their colleagues in the National Institutes of Health's Special Clinical Studies Unit developed, field-tested, refined, and ultimately implemented policies and procedures that enabled clinicians to communicate effectively with other staff, patients, and external partners, such as governmental agencies, other specialized units, and nonprofit organizations. [ABSTRACT FROM AUTHOR]

Objective: Monolingual Spanish speakers-many of whom identify as Hispanic/Latine-often experience barriers to accessing psychology services, including language access. Integrated primary care (IPC) clinics, where individuals receive psychological services within primary care, aim to improve service accessibility. However, minoritized populations are less likely to engage with these services than non-Hispanic/Latine White individuals. Few studies examine psychology treatment engagement within pediatric integrated clinics for Spanish-speaking families. This study investigated differences in psychology treatment engagement for Spanish-speaking families and the role of patient-provider language concordance within pediatric IPC., Methods: A retrospective chart review examined data from a multiethnic sample of 887 patients (M age = 8.97 yrs, 55.69% male, 64.83% Hispanic/Latine, 6.99% non-Hispanic/Latine White, 41.71% Spanish-preferring) from an urban pediatric IPC clinic serving a high proportion of Hispanic/Latine, Spanish-speaking families. We examined the association between language preference and patient-provider language concordance on service engagement using hierarchical linear regression., Results: Spanish-preferring families were more likely than English-preferring families to engage in psychology services. Working with a Spanish-speaking provider during an initial psychology visit was unrelated to psychology treatment engagement for Spanish-preferring families., Conclusion: Higher engagement for Spanish-preferring families seems to reflect the clinic's reputation as a center for linguistically accessible services. While linguistic accessibility remains important, our study did not detect an effect of language concordance during the initial psychology visit and subsequent treatment engagement. The findings highlight the importance of providing culturally responsive and linguistically accessible mental health services for Spanish-speaking families., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: The author declares no conflict of interest.

Purpose: This project examined nurses' positive and negative perceptions of the technology used in language interpretation for patients who have limited English proficiency (LEP). The intervention was guided by the technology acceptance model, a framework that addresses users' acceptance or rejection of computer-based technology. Methods: A sample of 47 nurses participated. Nurses' perceptions of an existing telephone-based remote interpretation technology were compared with their perceptions of a video remote interpretation (VRI) system. Instruments included a structured questionnaire to collect nurses' demographic and other characteristics and to measure their perceptions of the technology used in language interpretation; open-ended questions were added on how technology affected nursing care and nurses' rapport and communication with patients. Questionnaires on the telephone-based interpretation technology were administered, and after an eight-week trial of the VRI technology, questionnaires on the VRI system were administered. Results: Overall, positive perceptions of VRI were significantly higher and negative perceptions significantly lower compared with perceptions of telephone-based interpretation technology (P < 0.001 for both). Qualitative findings indicated that VRI technology improved communication and was less time consuming for nurses. Conclusions: Nurses preferred VRI technology because of its positive effects on time expenditure and communication. VRI technology is likely to be adopted successfully and ensures increased use of professional language interpretation for patients with LEP. [ABSTRACT FROM AUTHOR]

The article discusses the importance of effective communication, leadership and overcoming barriers during the COVID-19 pandemic. Among the forms of communication are verbal, written, visual and nonverbal. It cites the need for health care leaders to understand the value of information delivery and development of an effective dissemination process. Also cited are factors that can promote trust and credibility such as empathy, commitment and competence.

The health care decisions of families of children who have life-limiting genetic diseases are impacted by multiple factors including religious and ethical values, education and knowledge, emotional trauma, availability of support, and accessibility of care. Palliative care nurses must practice the highest standards by delivering nonbiased, nonjudgmental support to patients and families; however, nurses may experience moral distress if their personal values conflict with a family's decisions and needs. This case focuses on a family receiving communitybased palliative care for a child with a genetic life-limiting disease. They had a family history of this disease, which had caused the deaths of previous children, and the mother had a current unplanned pregnancy. The care team overcame language barriers and cultural obstacles to establish a trusting relationship with the vulnerable pregnant mother. They were able to support her decision to terminate her pregnancy safely by helping her to navigate a complex health care system. Using 5 crucial pillars to assist health care members with the delivery of nonjudgmental family-centered palliative care is recommended: (1) identification of biases, (2) utilization of a culturally safe approach, (3) effective communication, (4) assessment and support, and (5) knowledge of community resources. [ABSTRACT FROM AUTHOR]

With the continuous rise of sentinel and adverse events due to ineffective communication, it is time for health care organizations to start implementing a focus on enhancing effective communication in which will, in turn, improve patient safety and experience, boosting the bottom line. This article identifies and discusses different communication protocols that can be used to enhance the consistency of more efficient and effective communication within a health care organization to overall improve patient care and patient satisfaction. The rising importance of patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems scores required by the Centers forMedicare andMedicaid Services are causing a shift in howhospitals evaluate andmanage their health care organizations today. Following the situation-background-assessment-recommendation and acknowledge-introduce-duration-explain-thank protocols, as well as proper and effective training and educational programs, enhances more effective communication in health care organizations which improves patient safety and increases patient satisfaction. [ABSTRACT FROM AUTHOR]

Communication breakdowns with patients who do not use English as their primary language can hurt the patient-provider relationship and leave patients at risk for health disparities and adverse reactions. An estimated 36 million patients in the United States identify as Deaf and more than 60 million patients prefer to speak a language other than English in primary communication. This article discusses the unique needs of patients who are Deaf or have limited English proficiency, and how to provide qualified interpreters to help improve patient communication and care. [ABSTRACT FROM AUTHOR]

Introduction. Health professions education programs have incorporated Spanish language training in their curriculum to address the needs of a growing Spanish-speaking patient population with limited English proficiency. The purpose of this study was to explore Doctor of Physical Therapy (DPT) student beliefs and attitudes about learning Spanish to contribute to the body of knowledge related to effective language training approaches in health professions programs. Methods. Selected participants were students in their fifth semester in the DPT Program at the University of Texas at El Paso. Sixteen participants completed an online survey that asked their demographics, overall self-assessment of Spanish proficiency when entering the DPT Program and perceived percentages of improvement, and ranked level of agreement with each of the 13 statements concerning beliefs and attitudes about learning Spanish. Descriptive statistics were used to report data from the survey. Eleven subjects also participated in either a beginner or an intermediate focus group to further discuss their responses to the 13 statements in the survey. Verbatim transcripts were generated from each of the focus groups, and investigators completed content analysis to identify themes. Results. While participants in the beginner group reported more improved proficiency relative to baseline, the intermediate group participants anticipate greater improvements in proficiency by the end of the DPT Program. Though distinct themes emerged from each focus group, subjects in each group reported that improvements in their Spanish proficiency were facilitated by these shared themes: (1) constructive learning environment; (2) demographic relevance; and (3) therapeutic relationships. Both groups also identified a need for more formal, integrated Spanish learning opportunities. Discussion and Conclusion. Shared themes underscore the importance of fostering self-efficacy, using engaging learning techniques, and promoting cultural competency when learning a foreign language. These recommendations may help guide the design or enhancement of Spanish language training models in health professions curriculum. [ABSTRACT FROM AUTHOR]

Background: The use of pasteurized human donor milk has increased in recent years due to health benefits and rising number of infants who need pasteurized human donor milk. Little is known about milk donors' experiences or what contributes to their motivation to donate.Purpose: Using existing evidence and the theory of planned behavior as a guide, our purpose was to describe the personal and social aspects of mothers' milk donation to a milk bank in the Midwest United States.Methods: A convenience sample of 50 current human milk donors enrolled in this cross-sectional descriptive study. The investigator-designed online survey consisted of open and closed questions based upon existing evidence and theory of planned behavior for assessing reasons for donation, beliefs about benefits and barriers, social support for donation, donation history, and current experiences. We used the Iowa Infant Feeding Attitude Survey to characterize general breastfeeding attitudes. Data analysis consisted of content analysis for narrative data and descriptive statistics for continuous and dichotomous variables.Findings/results: Six themes represented experiences of discovering donation, reasons and motivations for donating, benefits and barriers to donation, confidence in donating, and support for donation. Practical and altruistic motivations for donation were prevalent. Confidence for donation was instilled by adequate milk supply, growth of the infant, and the milk bank process and professionalism. Support from others was universal.Implications For Practice: Findings can inform education regarding human milk donation. Human milk banks may benefit from identified donation barriers to improve support for donors.Implications For Research: Findings are being used for instrument development for research regarding women's intentions and donor behavior. [ABSTRACT FROM AUTHOR]

Doctors facing communication barriers when assessing patients in emergency departments (ED) is a frequent phenomenon, as the global prevalence of dementia and migration have increased. This study aims to explore how communication barriers influence moral distress as perceived by medical doctors working at emergency departments. Twelve doctors at 2 different EDs in Stockholm, Sweden, participated. Answers on communication barriers were collected from an interview guide on moral distress. Informants' responses were analyzed using qualitative thematic analysis. The results suggest that doctors experience moral distress when assessing patients with communication barriers due to an inability to mediate calm and safety and understand their patients, and due an increased need of resources and difficulties in obtaining consent before conducting examinations or interventions. In conclusion, communication barriers can be a cause of moral distress, which should be considered when developing tools and methods to mitigate and manage moral distress., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Mental health and psychosocial support (MHPSS) for Rohingya refugees in Bangladesh has been acknowledged as an important component of the humanitarian response. Despite this recognition, MHPSS programmes are still facing many challenges. These challenges are related to the care delivery systems, to factors in the affected community or to the humanitarian emergency context. Examples of these challenges include language barriers, monsoon-related events, coordination of MHPSS services and community perceptions of mental health and mental health services. Drawing from local, regional and global experiences, we recommend practical solutions to overcome these challenges and improve the outcome of the MHPSS response to the Rohingya refugee crisis. [ABSTRACT FROM AUTHOR]

Context: Heart failure is a chronic complex syndrome that is common and burdensome. International clinical practice guidelines recommend that healthcare providers communicate palliative care options with patients with heart failure. Objectives: The aim of this study was to conduct an integrative review to evaluate how healthcare providers perceived communication barriers to offering information to individuals in the palliative phase of heart failure. Methods: Four databases and the gray literature were searched from January 1987 to February 2017. Inclusion and exclusion criteria were applied. Studies were graded for strength and quality using a critical appraisal tool, and key themes were extracted and synthesized. Results: Ten articles met the full inclusion criteria. Most studies were qualitative or nonexperimental studies of good quality. Authors of several studies found that healthcare providers lacked basic knowledge about palliative care or did not possess sufficient knowledge to effectively provide care. Poor knowledge of palliative care created a barrier between the provider and the patient. Inadequate education or inexperience in palliative care led to the resistance of health providers to implementing a palliative approach. Conclusions: The results of this review emphasize a lack of knowledge asa barrier to delivering palliative care. Healthcare providers caring for individuals with heart failure need palliative care knowledge, skills, and competencies to ensure that this vulnerable population receives holistic patient-centered care. [ABSTRACT FROM AUTHOR]

With an emphasis on Chinese seniors, this article raises awareness of the importance of cultural competency and how this can impact care delivery, as well as strategies healthcare professionals can use to improve cultural competency in their institution. [ABSTRACT FROM AUTHOR]

Positive patient outcomes depend on clear communication. Understanding healthcare literacy, cultural competency, and health disparities/ inequalities is essential for providing empathetic care to patients and their family members. Guidelines to provide culturally competent care may enhance the patient experience and improve healthcare provider communication. [ABSTRACT FROM AUTHOR]

Improving our knowledge of disability can reduce stereotypes and stigma. [ABSTRACT FROM AUTHOR]

Objective: To explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers., Methods: Patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center were invited to participate in focus groups. Focus groups were held over Zoom, audio-recorded, transcribed in Spanish, translated into English, and reviewed for translation accuracy. Thematic analysis was conducted with deductive and inductive approaches. Three investigators double-coded all transcripts, and discrepancies were resolved through team consensus., Results: Seven focus groups (27 total participants, range 2-6 per group) were held. Three key themes emerged regarding patient experiences and communication preferences when seeking pregnancy care: 1) language concordance and discordance between patients and clinicians are not binary-they exist on a continuum; 2) language-discordant care is common and presents communication challenges, even with qualified interpreters present; and 3) language discordance can be overcome with positive interpersonal dynamics between clinicians and patients., Conclusion: Our findings highlight the importance of relationship to overcome language discordance among patients with limited English proficiency during pregnancy care. These findings inform potential structural change and patient-clinician dyad interventions to better meet the communication needs of patients with limited English proficiency., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

The article discusses the importance of using interpretation services to boost communication accuracy between healthcare staff and patients who need it. Topics covered include an acute-care hospital's improvement of such services, and the use of a flowchart to review English proficiency, and to avail of the interpretation toolbox, notice of services form, and an interpreter during admission, diagnosis, treatment, and discharge. Also noted are protocols for nurses when caring for such patients.

Background: Older hospitalized adults with hearing impairment are vulnerable to adverse outcomes. These patients are at risk for being labeled confused, experiencing a loss of control, experiencing heightened fear and anxiety, and misunderstanding the plan of care. Objective: This qualitative study sought to assess the hospital experience of older adults with hearing impairment in order to formulate suggestions for improving nursing care. Methods: Open-ended interviews were conducted with eight participants, ages 70 to 95 years, who were identified as having a hearing impairment and were admitted as inpatients to a midwestern medical center. Results: Through data analysis, three common themes emerged: health care communication difficulties, passivity and vulnerability, and frustration with family. Conclusions: Nurses will benefit from having a deeper understanding of the hospital experience of this vulnerable population. Efforts to address their needs can be accomplished through the following nursing actions: assess, accommodate, educate, empower, and advocate. [ABSTRACT FROM AUTHOR]

Background: Recruiting racial/ethnic minorities into health research is challenging. Although researchers affiliated with members of the study population (seen as insiders) may increase research participation of racial/ethnic minorities, little is known about who participants see as insiders and how they respond to insider versus outsider researchers. Objectives: The aim of the study was to examine perceptions of Hmong older adults toward insider versus outsider researchers and the influence of these perceptions on their willingness to participate in research. Methods: Participants in a study evaluating use of a culturally and linguistically adapted audio computer-assisted selfinterviewing system with helper assistance (ACASI-H) provided information about what they thought would encourage others in their community to participate in research. ACASI-H was used for collection of health data with 30 Hmong older adults. Participants rated the likelihood of participation if the researcher was Hmong and answered open-ended questions about participation when the researcher was not Hmong. Conventional content analysis was used to analyze open-ended questions. Results: Sixteen (53%) participants reported that they would be "likely" to participate in the research if the researcher was Hmong. Fourteen (47%) participants reported that they would participate in research if the researcher was not Hmong. In addition to ethnic affiliation, trust in the researcher could shift the perception of the researcher toward insider status, thereby increasing willingness of Hmong adults to participate in research. Trust in the researcher and movement toward insider status could be increased by calling out a connection between the researcher and the participant or creating reciprocity. Discussion: Findings suggest that increasing research participation of Hmong (and possibly other) participants, particularly when researchers do not share ethnic membership, can be achieved by building trust. This study also suggests a more nuanced perception of insider status, as a continuum, rather than a dichotomy, may be a more accurate reflection of the relationship between participants and researchers. [ABSTRACT FROM AUTHOR]

The article provides background information about language barriers between nurses and patients and how such barriers influence patient outcomes. Topics covered include the use of practice-based strategies to improve outcomes and reduce readmissions, structured refugee resettlement in the U.S., and the growth in the number of Russian-speaking people in the U.S.