nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 SPANISH FOR HEALTHCARE DANA BARTLETT, BSN, MSN, MA, CSPI Dana Bartlett is a professional nurse and author. His clinical experience includes 16 years of ICU and ER experience and over 20 years of as a poison control center information specialist. Dana has published numerous CE and journal articles, written NCLEX material, written textbook chapters, and done editing and reviewing for publishers such as Elsevire, Lippincott, and Thieme. He has written widely on the subject of toxicology and was recently named a contributing editor, toxicology section, for Critical Care Nurse journal. He is currently employed at the Connecticut Poison Control Center and is actively involved in lecturing and mentoring nurses, emergency medical residents and pharmacy students. Abstract Communicating with patients and families in their native language in a health setting is important for the delivery of safe and appropriate health care. Increasingly, health organizations provide resources for non-English speaking patients and their families. These resources are discussed, including use of common words or phrases, a telephone interpretation service, a medical interpreter on site, and family members. All of these resources are helpful for non-English speaking individuals needing to explain health symptoms or to understand a medical condition and treatment.
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SPANISH FOR HEALTHCARE · the terms “Hispanic” and “Latino” are not the same. Hispanic refers to people born in a country conquered by Spaniards and for whom Spanish is the
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Dana Bartlett is a professional nurse and author. His clinical experience includes 16 years of ICU and ER experience and over 20 years of as a poison control center information specialist. Dana has published numerous CE and journal articles, written NCLEX material, written textbook chapters, and done editing and reviewing for publishers such as Elsevire, Lippincott, and Thieme. He has written widely on the subject of toxicology and was recently named a contributing editor, toxicology section, for Critical Care Nurse journal. He is currently employed at the Connecticut Poison
Control Center and is actively involved in lecturing and mentoring nurses, emergency medical residents and pharmacy students.
Abstract
Communicating with patients and families in their native language in a
health setting is important for the delivery of safe and appropriate health
care. Increasingly, health organizations provide resources for non-English
speaking patients and their families. These resources are discussed,
including use of common words or phrases, a telephone interpretation
service, a medical interpreter on site, and family members. All of these
resources are helpful for non-English speaking individuals needing to explain
health symptoms or to understand a medical condition and treatment.
1. True or False: The terms “Hispanic” and “Latino” are the same, and may be used interchangeably. a. True b. False
2. Approximately ________ of the U.S., population consists of
racial and ethnic minorities. a. one-third b. one-fourth c. two-thirds d. one-tenth
3. True or False: It is NOT appropriate to routinely rely on family
members as interpreters. a. True b. False
4. “Necesitas un intérprete?” means in Spanish:
a. Is your niece the interpreter? b. Do you have an interpreter? c. Do you need an interpreter? d. None of the above
5. According to the Joint Commission, in order for the communication process to be truly effective, it requires a. an interpreter. b. a two-way process: expressive and receptive. c. that the patient be a good listener. d. a two-way process: proclamation and comprehension.
Recognizing and understanding how language barriers influence healthcare
access is a necessary starting point. Health clinicians can consider their
potential role in eliminating this barrier and decreasing health disparities.
With an appreciation of the role language barriers play in disparities in
access, health clinicians can address the degree of cultural relevance in the
design and delivery of healthcare services to ethnic minority populations
whose primary language is not English.
This course has explained how the demographics of the U.S., are changing,
which relates to why the Spanish language is becoming increasingly
important in healthcare. Additionally, some of the disparities in healthcare
and those the Hispanic community may face were described. Lastly, some
commonly used Spanish phrases have been provided that may be used in
situations with Spanish-speaking patients and families when an interpreter is
not available. Given the current healthcare environment and population
changes in the U.S., the information shared in this course will only become
more important in the future.
Please take time to help NurseCe4Less.com course planners evaluate the nursing knowledge needs met by completing the self-assessment of Knowledge Questions after reading the article, and providing feedback in the online course evaluation. Completing the study questions is optional and is NOT a course requirement.
1. True or False: The terms “Hispanic” and “Latino” are the same, and may be used interchangeably. a. True b. *False
2. Approximately ________ of the U.S., population consists of
racial and ethnic minorities. a. *one-third b. one-fourth c. two-thirds d. one-tenth
3. True or False: It is NOT appropriate to routinely rely on family
members as interpreters.
a. *True b. False
4. “Necesitas un intérprete?” means in Spanish:
a. Is your niece the interpreter? b. Do you have an interpreter? c. *Do you need an interpreter? d. None of the above
5. According to the Joint Commission, in order for the
communication process to be truly effective, it requires
a. an interpreter. b. *a two-way process: expressive and receptive. c. that the patient be a good listener. d. a two-way process: proclamation and comprehension.
6. If you wanted to tell a patient that the medication you are
giving to him or her is for his or her pain, in Spanish, you would say, “Esto es para el
a. *dolor.” b. enfermo.” c. cuchara.” d. despacio.”
7. In Spanish, how would you ask a patient if he or she is having problems swallowing?
a. Mastique bien antes de tragar? b. Tienes problemas para comer? c. Tienes problemas para cuchara? d. *Tienes problemas para tragar?
8. Hispanics and Latinos suffer from ___________ at the same
rate as non-Hispanic Whites?
a. asthma b. obesity c. diabetes d. *None of the above
9. According to Betancourt, et al., patients with limited English
proficiency were more likely to
a. have stomach ulcers. b. accelerate surgeries. c. *have IV line infections. d. not be readmitted for chronic conditions.
10. When working with an interpreter, a healthcare provider
should
a. ask the interpreter to summarize what is being said. b. always look at the interpreter when talking. c. *sit facing the patient. d. be aware of the interpreter’s body language.
11. When may an interpreter lead the discussion with the patient
and the healthcare provider?
a. If the interpreter is a properly trained, qualified medical interpreter b. *Never c. On a case-by-case basis d. If a family member is also present
12. Projections reveal that the U.S., population will be _____ Hispanic by 2050.
a. *30.2% b. 24.7% c. 35% d. 20%
13. True or False: Like the overall U.S., population, the most
prominent causes of death among Hispanics and Latinos are heart disease and cancer.
a. *True b. False
14. Language barriers in the Hispanic population have been
associated with
a. fewer poor outcomes for Hispanic patients. b. less patient dissatisfaction by Hispanic patients. c. less medical errors for Hispanic patients. d. *less preventative healthcare for Hispanic patients.
15. Language barriers in the Hispanic population have been
associated with greater
a. emergency room services. b. patient satisfaction. c. *numbers of poor medical outcomes. d. adherence to treatment recommendations.
1. True or False: The terms “Hispanic” and “Latino” are the same and may be used interchangeably.
b. False p. 6: the terms “Hispanic” and “Latino” are not the same. Hispanic refers to people born in a country conquered by Spaniards and for whom Spanish is the primary language, whereas Latino is more inclusive, referring to people born in a country whose language evolved from Latin (the Romance languages).
2. Approximately ________ of the U.S., population consists of
racial and ethnic minorities.
a. one-third p. 6: “…, approximately one-third of the population in the U.S., consists of racial and ethnic minorities, ….”
3. True or False: It is NOT appropriate to routinely rely on family members as interpreters.
a. True p. 9: “Sometimes family members may want to or offer to serve as interpreters. This may be necessary in an emergency situation, but should not be routine practice for the reasons referred to below.”
4. “Necesitas un intérprete?” means in Spanish:
c. Do you need an interpreter? p. 13: Do you need an interpreter? Necesitas un intérprete?
5. According to the Joint Commission, in order for the communication process to be truly effective, it requires
b. a two-way process: expressive and receptive. p. 5: “To be truly effective, communication requires a two-way process (expressive and receptive) in which messages are negotiated until both parties correctly understand the information.”
6. If you wanted to tell a patient that the medication you are giving to him or her is for his or her pain, in Spanish, you would say, “Esto es para el
a. *dolor.” p. 16: “This is for the pain: Esto es para el dolor.”
7. In Spanish, how would you ask a patient if he or she is having
problems swallowing?
d. Tienes problemas para tragar? p. 13: “Do you have problems swallowing?: Tienes problemas para tragar?”
8. Hispanics and Latinos have the same rates as non-Hispanic Whites when it comes to
d. None of the above p. 7: “Like the overall U.S., population, the most prominent causes of death among Hispanics and Latinos are heart disease and cancer; however, they are also subject to some significant health disparities than non-Hispanic Whites, including higher rates of some chronic diseases, such as diabetes, some cancers, high cholesterol and asthma…. In addition, Hispanics are more likely to be overweight or obese and engage in less physical activity compared with non-Hispanic Whites.”
9. According to Betancourt, et al., patients with limited English proficiency were more likely to
c. have IV line infections. p. 8: “Betancourt, et al., (2014), reviewed the literature and concluded that patients who had limited English proficiency were more likely to have IV line infections, falls, and pressure ulcers; were more likely to have a delay in surgery; and, had a greater chance for re-admission for certain chronic conditions for a variety of reasons, all of which were related to an inability to understand English.”
10. When working with an interpreter, a healthcare provider should
c. sit facing the patient. p. 11: “Tips to keep in mind when working with an interpreter include: Sit facing the person (“patient”) … Look at the person and maintain awareness of body language … Avoid looking at the interpreter unless you are directly addressing him/her … Don’t try to save time by asking the interpreter to summarize … It is not the interpreter’s role to lead the discussion.”
11. When may an interpreter lead the discussion with the patient
and the healthcare provider?
b. Never p. 11: “It is not the interpreter’s role to lead the discussion.”
12. Projections reveal that the U.S., population will be _____ Hispanic by 2050.
a. *30.2% p. 6: “Projections reveal the U.S., population will be 30.2% Hispanic by 2050.”
13. True or False: Like the overall U.S., population, the most prominent causes of death among Hispanics and Latinos are heart disease and cancer.
a. True p. 6: “Like the overall U.S., population, the most prominent causes of death among Hispanics and Latinos are heart disease and cancer.”
14. Language barriers in the Hispanic population have been associated with
d. less preventative healthcare for Hispanic patients. p. 8: “Language barriers in the Hispanic population have been associated with less access to healthcare, preventive healthcare, and emergency services; decreased adherence to treatment recommendations; decreased quality of care; fewer interventions performed; fewer admissions; an increased number of medical errors; a greater number of poor outcomes, and; decreased patient satisfaction.”
15. Language barriers in the Hispanic population have been associated with greater
c. numbers of poor medical outcomes. p. 8: “Language barriers in the Hispanic population have been associated with less access to healthcare, preventive healthcare, and emergency services; decreased adherence to treatment recommendations; decreased quality of care; fewer interventions performed; fewer admissions; an increased number of medical errors; a greater number of poor outcomes, and; decreased patient satisfaction.”
The reference section of in-text citations includes published works intended
as helpful material for further reading. Unpublished works and personal
communications are not included in this section, although may appear within
the study text.
1. The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010. https://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf. Accessed September 30, 2016.
2. Jaramarillo J, Snyder E, Dunlap JL, Wright R, Mendoza F, Bruzoni M. The
Hispanic Clinic for Pediatric Surgery: A model to improve parent-provider communication for Hispanic pediatric surgery patients. J Pediatr Surg. 2016;51(4):670-674.
3. American Community Survey Reports: Language Use in the United
States. August, 2013. http://www.census.gov/prod/2013pubs/acs-22.pdf. Accessed September 30, 2016.
4. United States Census Bureau. Quick Facts, United States. https://www.census.gov/quickfacts/table/PST045215/00. Accessed September 30, 2016.
5. Montie M, Galinato JG, Patak L, Titler M. Spanish-speaking limited English proficiency patients and call light use. Hisp Health Care Int. 2016;14(2):65-72.
6. Clayman, M.L., Manganella, J.A., Viswanath, K., Hesse, B.W. & Arora, B.N. (2010.) Providing Health Messages to Hispanics/Latinos: Understanding the Importance of Language, Trust in Health Information Sources, and Media Use, Journal of Health Communication: International Perspectives, 15(S3), 252-263.
7. McGuire, A.A., Garces-Palacio, I.C. & Scarinci, I.C. (2012.) A Successful Guide in Understanding Latino Immigrant Patients: An Aid for Health Care Professionals. Family & Community Health, 35(1), 76-84.
8. Ortman JM, Guraneri CE, US Census Bureau. United States Population Projections: 2000 to 2050. http://www.census.gov/population/projections/files/analytical-document09.pdf. Accessed September 30, 2016.
9. United States Census Bureau. Overview of Race and Hispanic Origin: 2010. 2010 Census Briefs. http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf. Accessed September 30, 2016.
10. Becerra BJ, Arias D, Becerra MB. Low health literacy among immigrant
Hispanics. J Racial Ethn Health Disparities. 2016 Jun 20. [Epub ahead of print]
11. Morse E, Mitchell S. Language-appropriate appointment reminders: assessing the communication preferences of women with limited English proficiency. J Midwifery Womens Health. 2016 Aug 10. doi: 10.1111/jmwh.12494. [Epub ahead of print]
12. Calo WA, Cubillos L, Breen J, et al. Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina. BMC Health Serv Res. 2015 Dec 23;15:570. doi: 10.1186/s12913-015-1235-z.
13. Eneriz-Wiemer M, Sanders LM, Barr DA, Mendoza FS. Parental limited English proficiency and health outcomes for children with special health care needs: a systematic review. Acad Pediatr. 2014;14(2):128-136.
14. Gallagher RA, Porter S, Monuteaux MC, Stack AM. Unscheduled return visits to the emergency department: the impact of language. Pediatr Emerg Care. 2013;29(5):579-583.
15. Dunlap JL, Jaramillo JD, Koppolu R, Wright R, Mendoza F, Bruzoni M. The effects of language concordant care on patient satisfaction and clinical understanding for Hispanic pediatric surgery patients. J Pediatr Surg. 2015;50(9):1586-1589.
16. Fields A, Abraham M, Gaughan J, Haines C, Hoehn KS. Language matters: race, trust, and outcomes in the pediatric emergency department. Pediatr Emerg Care. 2016;32(4):222-226.
17. Sasson C, Haukoos JS, Ben-Youssef L, et al. Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado. Ann Emerg Med. 2015;65(5):545-552.
18. Stoneking LR, Waterbrook AL, Garst Orozco J, et al. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations? Adv Med Educ Pract. 2016;7:467-473.
19. Levas MN, Dayan PS, Mittal MK, et al. Effect of Hispanic ethnicity and language barriers on appendiceal perforation rates and imaging in children. J Pediatr. 2014;164(6):1286-1291.
20. Alas AN, Dunivan GC, Wieslander CK, et al. Health care disparities among English-speaking and Spanish-speaking women with pelvic organ prolapse at public and private hospitals: What are the barriers? Female Pelvic Med Reconstr Surg. 2016 Sep 16. [Epub ahead of print]
21. Ngai KM, Grudzen CR, Lee R, Tong VY, Richardson LD, Fernandez A. The association between limited English proficiency and unplanned emergency department revisit within 72 hours. Ann Emerg Med. 2016;68(2):213-221.
22. Juckett G, Unger K. Appropriate use of medical interpreters. Am Fam Phys. 2014;90(7):476-480.
23. Betancourt JR, Tan-McGrory A. Creating a safe, high-quality healthcare
system for all: meeting the needs of limited English proficient populations; Comment on "Patient safety and healthcare quality: the case for language access". Int J Health Policy Manag. 2014;2(2):91-94.
24. Civil Rights Act of 1964, Pub. L. 88-352, Title VI, Sec. 601, July 2, 1964, 78 Stat. 252.
25. Andreae MH, White RS, Chen KY, Nair S, Hall C, Shaparin N. The effect of initiatives to overcome language barriers and improve attendance: A cross-sectional analysis of adherence in an inner city chronic pain clinic. Pain Med. 2016 Jul 14. pii: pnw161. [Epub ahead of print]
26. Karliner LS, Pérez-Stable EJ, Gregorich SE. Convenient access to professional interpreters in the hospital decreases readmission rates and estimated hospital expenditures for patients with limited English proficiency. Med Care. 2016 Aug 30. [Epub ahead of print]
27. Levine C. Use of children as interpreters. JAMA. 2006; 296(23):2802.
28. Jacobs B, Kroll L, Green J, David TJ. The hazards of using a child as an interpreter. J R Soc Med. 1995;88(8):474P-475P.
29. Code of Massachusetts Regulations. Section 105 - Public Health: Section 130.1105(D).
30. Nápoles AM, Santoyo-Olsson J, Karliner LS, Gregorich SE, Pérez-Stable EJ. Inaccurate language interpretation and its clinical significance in the medical encounters of Spanish-speaking Latinos. Med Care. 2015;53(11):940-947.
31. Lor M, Xiong P, Schwei RJ, Bowers BJ, Jacobs EA. Limited English proficient Hmong- and Spanish-speaking patients' perceptions of the quality of interpreter services. Int J Nurs Stud. 2016;54:75-83.
32. Arthur KC, Mangione-Smith R, Meischke H. Impact of English proficiency on care experiences in a pediatric emergency department. Acad Pediatr. 2015;15(2):218-224.
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