Meaningful Access to Care: Assessing Parental Perceptions of Interpreter Services in Pediatric Urology
Nestor Fernando Suria Cordero, MD, Konrad M. Szymanski, MD, MPH, Rosalia Misseri, MD, Ashley W. Johnston, MD, Shelly King, NP, CPNP, Benjamin Whittam, MD, Kirstan K. Meldrum, MD, Joshua D. Roth, MD, PhD, Martin Kaefer, MD, Richard C. Rink, MD, Pankaj P. Dangle, MD.
Indiana University, Indianapolis, IN, USA.
BACKGROUND: It is important that institutions maintain effective communication with limited English proficiency (LEP) parents and their children, so equal care is provided to each LEP individual in an accurate and high-quality manner. This is critical as communication failures in healthcare may jeopardize the well-being of children, particularly in cases where surgical interventions are considered. The present study aims to investigate the perceptions of Spanish language interpretation services among parents attending pediatric urology clinic. METHODS: We designed a patient-centered survey based on focus group interviews with LEP parents who utilized Spanish-speaking interpreters during their pediatric urology appointments. Parents were surveyed about the quality and accuracy of Spanish-speaking interpreter services. In addition, parents indicated the purpose of their visit and their preferred mode of professional interpretation by ranking three options (audio, video, or in-person). RESULTS: Of the 50 LEP parents enrolled (80% female, 98% Hispanic, and 2% Haitian), 96% used a video interpreter and 4% an in-person interpreter during their pediatric urology visit. Most parents' highest level of education was a high school degree or less (74%). The most common reasons for their visit were post-operative follow-up (orchiopexy or circumcision) (n=11, 23%), cryptorchidism (n=5, 10%), retractile testis (n=6, 13%), hydronephrosis (n=7, 15%), phimosis (n=4, 8%), UTI (n=3, 6%), epididymal cysts (n=3, 6%), and hypospadias (n=2, 4%). When asked about the purpose of their visit, 42% of parents with video interpreters did not provide a specific reason or use precise language to convey the purpose of their visit to pediatric urology clinic. Thirteen percent of parents disagreed with the video interpreter translating the provider's exact words, while 8% disagreed with the video interpreter translating the parent's own exact words. Thirteen percent of parents who used video interpreters agreed that an interrupted connection negatively affected the care of their child. However, parents with in-person interpreters (n=2) agreed that their own words and their provider's words were translated exactly. Additionally, both parents knew the specific reason for their visit. When ranked by preferred mode of interpretation, in-person was more likely preferred (70%) over video (25%) and audio interpretation (5%, p=0.0001). Seventy-four percent of parents agreed or strongly agreed that in-person interpreters or a Spanish-speaking provider (84%) would improve their access to care. CONCLUSIONS: Accurate communication is essential for families with LEP. In-person interpreters are the preferred mode of interpretation for LEP parents in a pediatric urology clinic. Providing in-person interpreter services could improve communication accuracy, address connectivity issues of video interpreters, and ensure understanding of urologic care without losing human connection.
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