The Patient Experience of Language Discordance and Interpreter Services in the Emergency Department

Author

Keri L. Baker, Virginia Commonwealth UniversityFollow

Author ORCID Identifier

https://orcid.org/0009-0006-0509-1580

Defense Date

2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Terry Jones, Ph.D, RN

Second Advisor

Rachel Wood, Ph.D, RN

Third Advisor

Lana Sargent, Ph.D, RN

Fourth Advisor

Gresilda Tilley-Lubbs, Ph.D, M.A.

Abstract

Background: Clear communication is critical to the interaction of a patient and medical provider. For non-English speaking patients, language discordance, described as the lack of proficiency in a shared language, with the medical team results in a poor patient experience and poor patient outcomes. The predominant solution to language discordance is the use of interpreter services, however these services are underused in the emergency department (ED). Studies examining underuse of interpreter services have primarily focused on the clinician and little is known about the patient’s influence on the use of interpreter services.

Methods: Semi-structured interviews were conducted with 12 Spanish-speaking patients who received medical care in the ED in Roanoke, VA.

Results: Patients preferred to use certified interpreters to facilitate communication however, interpreter services were inconsistently used. When patients experienced language discordance and underuse of interpreter services, they initiated and relied on compensatory adaptations such as ad hoc interpreters, telephone technology, and attempting to speak English to facilitate communication with the medical team. Often, once adaptations were introduced, the adaptations replaced the use of certified interpreter services.

Conclusions: Patients rely on medical providers and healthcare organizations to provide interpreter services. Despite patient requests for certified interpreters, the decision to consistently use an interpreter is made by the medical provider. The dependency of the patient on the medical provider and the healthcare system to provide these services creates a power differential and ultimately, the burden of underuse of interpreter services lies on the healthcare organization.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

3-17-2024