| Ali & Johnson (2017) |
“Explore bilingual nurses’ perspectives about provision of language concordant care to LEP patients and its impact on patients and nurses” (p . 424) |
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Nurses comfortable using second language but do not feel valued Bilingual nurses not consulted to help develop interpretation policies RN self-confidence, years of work experience, patient expectations and workforce policies affect care |
“When we speak the same language” “When I speak my patient’s language” What facilitates provision of language concordant care What hinders the provision of language concordant care |
| Ali & Watson (2018) |
“Explore Nurses’ perspectives about language barriers they encounter when providing care to LEP patients from diverse linguistic background and nurses’ perspectives about impact of language barriers on provision of care to LEP patients” (p . e1154) |
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Scheduling, explaining treatment more difficult Professional interpreter useful but difficult to access Interpreter lack of medical terminology Bilingual nurses play important role |
Multi-ethnicities and language barriers The impact of language barriers Communicating via interpreters |
| Alm-Pfrunder et al.(2018) |
“Explore the strategies of nurses working in the ambulance service as regards assessing the needs of patients with limited Swedish-English proficiency” (p . 3700) |
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Encounters with language barriers occurred almost daily Assessments more difficult Alternative means of communicating effective Professional interpreter use difficult in care context, not common |
|
| Amoah et al. (2019) |
“Investigate Nurses’ and Patients’ experiences and views on the barriers to effective therapeutic communication to serve as a spring- board for further studies” (p . 2) |
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Religion and culture important to both RNs and patients Nurses did not always communicate in patient’s preferred language Struggle to serve both tribal and international patients Preconceptions about RN role related to dissatisfaction |
Patient-related barriers Nurse-related barriers Environmental barriers |
| Azize et al. (2018) |
“Identify the dimensions that influence how MIL) nurses and final-year preregistration children’s nursing students make decisions about the assessment of monolingual and English as an additional language (EAL) children following a minor injury and to understand the difficulties that nurses face whilst assessing pain” (p. 1082) |
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Nursing students significantly more likely to call for interpreter than nurses Less likely to use interpreter with English-proficient child Parent more likely to be involved in assessment if English-proficient |
Respondents more likely not to involve parent in assessment with English-proficient child; B = 1.207 p = .009 More likely to use Visual Analog Scale rather than Observe Behavior for English-speaking children more than non-English B = 0.744, p = .016; OR = 2.105, 95% CI (1.16, 3.82). |
| Badger et al. (2012) |
“The aims of the study were to: describe the ethnicity of nursing home residents and staff and explore managers’ perceptions of readiness to meet the needs of diverse residents, including needs at the end of life” (p . 1727) |
Mixed Methods Sample of all nursing homes in region Survey Descriptive statistics SPSS for statistical analysis Interview Framework analysis approach |
Fewer managers reported high perceived knowledge regarding Sikh, Hindu, Buddhist faiths; managers were more likely to report high perceived knowledge of Christianity and Islam Family acted as ad hoc translators or provided staff with tools for care Professional interpreters available in some cases Bilingual staff used as interpreters |
35% of nursing homes cared for non English-speaking patients Qualitative themes: Meeting Dietary Needs Communication Prejudice Supporting Faith and Personal Needs End of Life Care Individualised Care |
| Balakrishnan et al. (2016) |
“Examine the ability of triage nurses to assess language proficiency of patients as compared to patients’ self-reported proficiency … how language discordance impacts communication, door-to-room time, triage level, and patient satisfaction” (p . 370) |
Quantitative Prospective Cohort Non-consecutive convenience sampling Survey Measurements based on 0–5 Likert scale Chi-Square, Mann-Whitney U-Test VassarStats for statistical analysis |
Telephone based translator used in only 1 encounter (2%) Family member used as interpreter in 17 encounters (31%) No significant difference in the likelihood of admission for English or Spanish speaker |
Nurses described complete understanding of English speaking patients and mostly understanding Spanish (IQR 4–5, p < 0.0001) Significant difference between English and Spanish speaking patients perceived communication with nurses (p = 0.002) |
| Barnes et al. (2011) |
“To investigate whether the expected levels of delivery [of the FNP program] are attained and whether the nature of the crucial client-nurse relationship is affected [with an interpreter present]” (p .381) |
Mixed methods Convenience sampling Interviews Student’s t-test, Welch-Sat-terthwaite t-test, Chi-Square, Fischer’s Exact SPSS for statistical analysis |
Interpreter may change essence of program Interpreters may not have skills for certain aspects of the program delivery Clients expressed trust in nurse, some preferred program without interpreter Significant differences in program content delivery and nurse assessed client understanding |
Perceived impact of interpreters on delivery of the program The perceived impact of interpreters on nurse-client relationships Relationships between interpreters and both clients and nurse Percent of planned content covered in visits significantly lower in encounters with interpreter p = 0.014 pregnancy, p = 0.002 infancy Nurse assessed client understanding significantly lower in interpreted visits (p < 0.001) |
| Beckstrand et al. (2010) |
“What are the sizes (intensities) and frequencies of obstacles and supportive behaviors in providing end-of-life care to infants and children as perceived by PICU nurses? What are the perceived obstacle magnitude (POM) scores? What are the perceived supportive behavior magnitude (PSBM) scores?” (p . 544) |
Quantitative descriptive Randomized sample of AACN members who are P1CU RNs Demographics Mail-in survey Measurements based on 0–5 Likert scale Cronbach’s α SPSS for statistical analysis |
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POM scores ranged from 1.99 to 17.73 PSMB scores ranged from 7.26 to 21.15 Language barrier POM 17.73 Giving parents of deceased child time alone with child PBSM 21.15 |
| Bramberg & Sandman (2013) |
“Describe the experiences of home care providers and social workers in communication, via in-person interpreters, with patients who do not share a common language, and to offer suggestions for practice based on this description” (p . 161) |
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Nurses desired objective interpreters but also saw their value as culturally aware Flow of conversation change to adapt Information is lost with an interpreter Confidentiality an issue with ad-hoc interpreter Conversations were focused on health concerns, no time for personal dialogue Harder to read nonverbal cues |
|
| Chae & Park (2019) |
“To explore the organizational level of cultural competence needed for foreign patient care from the perspective of Korean clinical RNs” (p . 198) |
Qualitative exploratory descriptive Purposive, snowball sampling Interviews Demographics Deductive content analysis |
Need for managerial support for increased physical and psychological burden Technology, hospital clothing not fit for non-Korean patients No 24 -h interpreter support, phone translator time consuming Ad hoc interpreters used, accuracy a concern Lack of cultural competence training |
|
| Clayton et al. (2016) |
“Explore the lived experiences of perioperative nurses in a multicultural operating theatre in Melbourne, Australia” (p . 8) |
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Concern if patients understood procedure, discharge instructions Cultural beliefs can have impact on operating room procedure Additional issues around language barriers between staff |
Difficulties in communication affects patient care Difficulties in communication affects the working atmosphere. Social integration could improve communication and the working atmosphere. |
| Coleman, J., & Angosta, A. (2017) |
“Examine the lived experiences of acute-care registered nurses when interacting with patients and their families with LEP” (p . 680) |
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Importance and benefit of nonverbal communication Concerns regarding patient safety Interpreter availability an issue RN frustration with inability to provide highest quality care Desire to provide cultural respect |
Desire to Communicate Desire to Connect Desire to Provide Care Desire to Provide |
| Diamond et al. (2012) |
“Describe how and when physicians and nurses with various levels of Spanish language proficiency use professional or ad-hoc interpreters or their own Spanish skills in common clinical scenarios in the acute care hospital setting” (p . 117–118) |
Quantitative descriptive Purposive, convenience sampling Survey Demographics Descriptive statistics, χ2, Fisher’s exact test, t-tests STATA software for statistical analysis |
Providers used limited Spanish proficiency skills to communicate in clinical encounters Nurses with low Spanish speaking skills more frequently used ad-hoc interpreters or their own limited skills than professional interpreter |
Significant difference in use of professional interpreter, ad hoc interpreter or own Spanish between low, middle, and high proficiency speakers with p < 0.001 for discharge instructions, education on disease, and other patient education Less significant difference between nurses of different proficiency p = 0.07 for symptom management and p = 0.06 for administering medication |
| Eklof et al. (2015) |
“What factors have to be considered when using interpreters in primary health care in the care of immigrants?” (p . 144–145) |
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Nurse expectations of interpreter: cultural knowledge, linguistic knowledge, ethical practice Interpreter seen as cultural bridge and translator Decision to use interpreter based on need, cost Protocols, not nursing judgment, decide who receives interpreter Double time to use interpreter Learn to use interpreter through experience, not education Patient having relationship with interpreter can be positive or negative Request for interpreter of specific gender common for certain culture |
Factors connected with the interpreter Factors connected with the nurse and the health care organization Factors connected with the patients and their culture |
| Fatahi et al. (2010) |
“Explore nurse radiographers’ experiences of examining patients who do not speak Swedish” (p .775) |
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Desire for patients to trust nurses Professional interpreters needed for certain procedures, but if none available nurses used nonverbal communication Not all procedures require interpreter, such as X-ray Scheduling issues, delays made using interpreter difficult Procedures with interpreter slower Staff could be used as interpreters, but workflow was interrupted Cultural beliefs clash with radiology needs such as clothing removal |
|
| Galinato et al. (2016) |
“To describe (a) the perceptions of nurses regarding their communication with patients with LEP, (b) how call lights affect their communication with patients with LEP, (c) the perceptions of nurses on the impact of advancement in call light technology on patients with LEP” (p .2) |
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Difficulty assessing language, especially dialect Hard to communicate how to use call light to LEP patient Misunderstanding of call light can impact care, such as fall risk, pain Flash cards sanctioned by the hospital used as aid Family members, Google Chat, gestures difficult for complex care Interpreter availability an issue Patients prefer family ad hoc interpreter, nurses worry Desire for new call light system, pictures of specific needs Positive response to Eloquence™ |
Barriers to communication Formal tools for communication Gestures and charades Reliance on family Creating a better call light system Acceptability of Eloquence™ |
| Granhagen Jungner et al. (2019) |
“Investigate communication over language barriers in pediatric oncology care …. How language barriers are overcome in different types of communication situations, how do different healthcare professions relate to such language barriers, to what extent are professional interpreters or other communicational tools used, and to what extent are other individuals used to translate?” (p . 1016) |
Quantitative descriptive Convenience sampling Communications over Language Barriers Questionnaire (CoLB-q) survey Descriptive statistical analyses focusing on frequency distributions Cross-tabulations used in certain cases, including chi-square tests Significance set p < 0.05 SPSS for statistical analysis |
100% of respondents used ad hoc interpreters during some encounters. Staff used children, including the patients, family members, and other bilingual providers as ad-hoc interpreters. RNs and nurse assistants used alternative methods such as web-based translators or apps. MDs used professional interpreters more often than RNs who used ad-hoc interpreters RN use of professional interpreter during both intake assessment and patient education rates low All providers believe professional interpreter use increases patient involvement in care |
RN use of professional interpreter during intake: 15.4% often, 34.3% sometimes RN use of professional interpreter during patient education: 17.2% never, 31.7% seldom 88.4% of RN believe use of a professional interpreter improves patient involvement in their care MDs use professional interpreter more than both RN and nurse assistant (p > .001) |
| Hendson et al. (2015) |
“What are the experiences of health care providers in providing care to recently immigrated families (within five years of immigration) whose children were admitted to the NICU” (p . 18) |
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Cultural differences complicate Crisis or transition communication more difficult due to language, time constraint, unintentional stereotype Desire but inability to communicate effectively Misunderstanding of important clinical details Professional interpreter only used in crisis; awkward due to circumstance Unmeasured extra work with immigrant families misunderstood by management Desire for education on other cultures |
Influence of cultural, religious, or ethnic practices Crisis and transition home Themes that heighten the fragility of interactions during crisis Themes that heighten the fragility of interactions during transition home Strategies that health care providers utilized to mitigate the fragility of the interaction |
| Ian et al. (2016) |
“Explore registered nurses’ experiences with caring for non-English speaking patients and further how the experiences influence their clinical practice” (p . 258) |
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Gratitude for supportive institution which provided interpreters (live, phone, video) LEP care more time-consuming, frustrating Improved anticipation of patient needs from experience caring for LEP patients Personal growth and development Time management improvements |
|
| Jackson & Mixer (2017) |
“Examine UTalk’s effectiveness for basic communication between Spanish speaking low English proficiency SSLEP families/guardians and nurses at the bedside on a pediatric medical-surgical unit” (p . 402) |
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Tool found to be helpful by both nurses and pediatric patient parents Both nurses and parents suggested improvements to tool Errors found in professional translation |
|
| Kallakorpi et al. (2018) |
“To describe nurses’ experiences with caring for immigrant patients in psychiatric units” (p . 1803) |
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Some nurses more interested in multicultural care than others Interpreter use was both positive and negative Some interpreters not suited for psychiatric setting Symptoms for asylum seekers differed from Finnish patients |
Nurses’ description of patients’ symptoms and reasons for illness Nurses’ experiences caring for immigrant patients Nurses’ perceptions of culture care |
| Kaur et al. (2019) |
“Assess the feasibility of an online communication skills training intervention to increase cultural competence amongst oncology nurses working with individuals from minority backgrounds” (p . 1951) |
Quantitative Pre and Post Intervention Purposive sampling Pre and post intervention questionnaire non-parametric Friedman’s tests for data not normally distributed Significance p < 0.05 SPSS for statistical analysis |
Most nurses found tool to be helpful (81%) Self-assessed improvements in quality of practice post-intervention Nurses approved of online format |
Increase in belief that it is adopted country’s responsibility to adapt to cultural needs and differences: pretest mean = 22.3, SD = 3.6); post test mean = 25.4, SD = 2.3, X2 = 8.75, P = 0.01 Significant improvements in practice post-intervention p < 0.001 |
| Machado et al. (2013) |
“Identify how the professionals in the nursing staff of a university hospital interact to take care of their deaf patients considering the knowledge of the Brazilian Sign Language (LIBRAS) as a principle, which is indispensable for the planning of nursing care to this clientele” (p. 285) |
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16 participants (43%) had cared for a deaf patient Strategies included lip reading, writing, drawing A single participant mentioned using an interpreter Understanding of Brazilian sign language (LIBRAS) varied |
|
| McCarthy et al. (2013) |
“Describe nurses’ experiences of language barriers and the use of interpreters within the context of an evolving healthcare environment in Ireland” (p . 336) |
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Strategies: simplifying information, nonverbal expressions and communication, interpreters Difficulty to assess, gather history Lack of interpreter continuity, concern about interpreter accuracy Concerns over use of family member as interpreter |
|
| Mottelson et al. (2018) |
“Investigate the attitudes and experiences of the university hospital’s charge nurses regarding the use of video interpretation” (p . 245) |
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The more charge nurses’ departments used video interpreter, the more satisfied Video interpreter technology found easy to use Some charge nurses still found ad hoc interpreters useful |
Pros and cons of video interpretation Professional Concern Administrative barriers to using video interpretation Patient’s health concerns Using Alternative Interpreters 19 departments (24%) did not use video interpreter in 12 months 53 departments (68%) satisfied with video, but still used face to face, including family (47%) or friends (22%) |
| Patriksson et al. (2019) |
“To examine health care
professionals’ use of interpreters and awareness of local guidelines for interpreted communication in neonatal care” (p . 3) |
Quantitative descriptive Convenience sampling Survey Demographics Likert scale Mantel-Haenszel chi- square test and Fisher’s non-parametric permutation test SAS for statistical analysis, SPSS for demographic analysis |
Many providers in all categories reported little awareness about policies for interpreter use. Both RNs and nurse assistants used authorized interpreters less than physicians in emergency situations. In planned communication, nurse assistants used authorized interpreters less than both RNs and physicians No significant difference in use of unauthorized interpreter in emergency situation. In planned communication nurse assistants used unauthorized interpreters significantly more often than RNs and physicians Nurse assistants rated their abilities to communicate with an interpreter significantly lower than RNs and physicians |
Compared with the RNs, nurse assistants had significantly lower awareness of guidelines for interpreter use (p < 0.0001) Significant difference in use of professional interpreters between the provider groups for planned conversation (p < 0.0001) and emergency situations (p < 0.0001) No significant difference in use of unauthorized interpreter between the provider groups during emergency (p 0.38) Physicians use of authorized interpreters significantly higher than RNs (p 0.006) and non-authorized interpreters significantly lower than RNs (p 0.013) |
| Plaza Del Pino et al. (2013) |
“Determine how nurses perceive their communication with their Moroccan patients and identifying relevant barriers that exist for provision of culturally competent care” (p . 2–3) |
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Nurses stereotype patients, prejudice apparent Discriminatory nursing practices Lack of intercultural training Nurses attempt to improve communication |
The cultural boundary The social boundary The language boundary Overcoming borders |
| Rifai et al. (2018) |
“Describe the public health nurses’ experiences of using interpreters when meeting with Arabic- speaking first-time mothers” (p . 575) |
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Both positive and negative experiences with interpreters Interpreters helped foster understanding and create a trusting relationship Nurses sometimes found interpretation quality insufficient Non-native Swedish mothers are less likely to participate in the child health care program |
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| Rosendahl et al. (2016) |
“Understand and systematically describe personal experiences of the care provided to immigrants with dementia and the experiences of their family members and nursing staff “(p . 3) |
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Nonverbal communications (gestures, miming) used Use of mother tongue help patients emotionally, changes emotional assessment Visitors serve in dual role: link to patient’s past and interpreter Family member or bilingual staff interpret |
|
| Ross et al. (2016) |
“Determine the frequency with which nursing, midwifery and allied healthcare staff encounter refugee patients in two public hospitals, how confident they are working with refugees, the effect on their work and any differences between the rural and urban settings” (p . 680) |
Quantitative descriptive Stratified, purposive sampling Questionnaire Demographics Chi-square, Student’s t-test, Spearman’s Rho (rs) and Pearson’s r (r) SPSS for statistical analysis |
70% of respondents desired additional support Confidence in caring for refugees associated with time working or being born overseas Urban providers more confident than rural providers Barriers identified: language, lack of training to use interpreter, patient lack of trust in government systems |
Rural respondents reported enhanced practice from working with refugees (p = 0.025) Rural respondents felt less confident in practice than urban respondents (p < 0.001) Positive correlation between frequency of encounters with refugees and disruption to practice (rs = 0.361, p < 0.001) |
| Savio & George (2013) |
“Find out difficulties that staff nurses experience in communicating with patients from culturally and linguistically different background and the staff nurses’ attitude towards the importance of communication in caring for those patients” (p . 142) |
Quantitative descriptive Convenience sampling Survey Demographic data |
Patients from culturally and linguistically diverse backgrounds presented a major language barrier for nurses. Male nurses reported experiencing more difficulty in communicating with these patients. Educational preparation during school and clinical exposure may help nursing students more effectively delivery transcultural nursing care. |
A majority of nurses (71%) were over the age of 30, 88% were females, 58% diploma holders and only 28% had baccalaureate degrees. 19% of nurses reported experiencing mild difficulties with verbal and nonverbal communication, 79% reported moderate difficulty, and 2% reported severe difficulty. |
| Seale, Rivas, Al-Sarraj et al. (2013) |
“A comparison of fluent English consultations with ones that involve interpreters … explore the moral work done by participants” (p . 142) |
Mixed methods Analysis of data subset from 57 video/audio recorded consultations Interviews/consultations Demographics and language data Coding scheme for transcripts Additional linguistic and keyword analysis SPSS analysis of coded words |
Need to shift the role of the interpreter as an advocate in order to build rapport and make patient feel more comfortable The fluent English speakers able to convey a more positive moral reputation and excuse “bad” behavior English speakers able to act as their own advocate, whereas interpreters sometimes acted as “moral mediators” in order to protect patients, choosing not to translate certain information |
|
| Seale, Rivas, & Kelly (2013) |
“Compare interpreted with fluent same-language consultations” (p . e126) |
Qualitative analysis of nurse-patient interactions Analysis of data subset from 57 video/audio recorded consultations Interviews/consultations Demographics and language data Coding scheme for transcripts Quantitative content analysis Additional linguistic and keyword analysis SPSS analysis of coded words |
Interpreted consultations were as long as same-language consultations but patients said less Patients who required interpreters asked fewer questions and were less inclined to discuss their health Interpreters often mistranslated or did not translate directly from the patient, adding their own comments. Providers also tended to use the third person more in consultations with interpreters as they were talking through the interpreter rather than directly to the patent To aid in effective self-management for patients, reducing the social distance in conversations that require interpreters is necessary |
Patients who spoke English produced 3.6 times the number of words produced by patients in interpreted consultations. Providers were more likely to produce utterances containing humor and to talk about feelings with their English-language patients 307/920 (33.4%) utterances made by patients in the 12 interpreted consultations contained some talk that was not translated, and 674/1644 (41.0%) utterances from the providers contained some talk that was not translated. |
| Shuman et al. (2017) |
“Describe RNs’ and NAs’ perceptions of LEP patients’ call light use and their current communication practices with LEP patients” (p . 590) |
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Less call light use for LEP patients, concern LEP patients do not understand call light purpose Administrators must be responsible to address barriers to communication Professional interpreters difficult to access, time consuming Ad hoc interpreters (family members and staff) used, but may lead to harm, misunderstanding Pictures, apps, gestures used |
Call light use by LEP patients Reliance on family Reliance on interpreter services Limitations of interpreter services Reliance on ad hoc communication aids |
| Silvera-Tawil et al. (2018) |
“To identify the following: (a) current practice regarding communication during standard care interactions between nursing staff and NESB (non English speaking background) patients, and the context of these interactions; (b) specific communication needs of nursing staff and patients during basic standard care interactions; (c) target words and/or phrases used during basic standard care interactions between nursing staff and NESB patients when an interpreter is not present; and (d) potential needs, challenges, technical requirements and uses of a mobile app for nursing staff (p . 4170) |
Mixed methods Focus groups, interviews, observation, survey Content analysis NVivo version 11 for qualitative analysis Inferential statistics Independent t-test Python version 3 |
Nurses identified broad range of patient encounters where assisted communication would be beneficial including social chatting, neuro assessment, call light usage, consent No significant difference in frequency of or length of NESB encounters Significant difference in nursing scoring of confidence of patient understanding and successful communication interaction between NESB vs. English-speaking patients |
Staff’s confidence of the patients’ level of understanding (t[80] = 7.49; p < 0.001) and success of the patient encounter (t[80] = 5.69; p < 0.001) Independent t-test: English speaker vs. NESB number of interactions (t[80] = 1.58; p = 0.12) and length of the interactions speakers (t[368] = −1.37; p = 0.17) |
| Skoog et al. (2017) |
“To elucidate CHS nurses’ experiences of identifying signs of PPD in non-Swedish-speaking immigrant mothers” (p . 740) |
Qualitative inductive Purposive Sampling Demographics Interviews Latent content analysis |
Quality of the patient-provider relationship is essential to effective screening for PPD Nurses lacked cultural knowledge in certain settings, a hindrance to their work Screening tools difficult to translate effectively with or without the use of an interpreter Nurses unable to encourage mothers with positive PPD screens or symptoms to seek external help |
Overarching theme: “a constant challenge for deepening the transcultural caring relationship” with 3 categories
Establishing the transcultural supportive relationship Interpreting the mother’s moods using cultural knowledge Striving—sometimes in vain—when screening for PPD
|
| Squires et al. (2017) |
“Explore a potential vulnerability in home health care service delivery by examining the frequency of language-concordant visit patterns among home health patients as captured in electronic health record and organizational administrative datasets” (p . 161) |
|
Russian speakers had higher visit per case compared to all LEP groups and English for both RN and PT Korean speakers had highest language concordant visit Nurses with language skills visited 20 more patients in 2-year period than monolingual nurses |
18.1% of RN visits, 26.7% PT visits with LEP patients language concordant Spanish speakers largest LEP group, 13.1% RN visits language concordant 8.9% Spanish speakers, 3.0% Korean speakers, 2.5% Chinese speakers had encounters with human interpreter |
| Squires et al. (2019) |
“Examine how providers saw their workloads affected by patient assignments involving limited English proficiency patients” (p . 3) |
Qualitative exploratory descriptive Secondary analysis Purposive, snowball sampling Interview General content analysis, open coding approach Atlas TI 7.3 for coding |
Quality of first visit set the tone for the subsequent visits High quality LEP visit looked and felt similar to English visit Unless bilingual, nurses felt that LEP patients increased workload Distrust of phone interpretation Issues around teaching, infection control with telephone interpreter All providers preferred in person interpreter |
Conditions that contribute to higher workload and longer working days Willingness to address language barriers Barriers contributing to workload when addressing language barriers in home health care |
| Suurmond et al. (2017) |
“To explore those obstacles in pediatric cancer care that lead to barriers in the care process for ethnic minority patients” (p . 2) |
|
Contact with Turkish and Moroccan parents was more difficult than with Dutch parents due to both language and cultural barriers Healthcare providers did not adequately utilize interpreter services Care providers were unaware of stereotypes, prejudices, and the importance of understanding the parents’ perspective |
Language barriers between care provider and parents Experiencing cultural differences between health care staff and parents Reported reaction to barriers |
| Tay et al. (2012) |
“To identify the factors that promote, inhibit or both promote and inhibit effective communication between inpatient oncology adults and Singaporean registered nurses” (p . 2648) |
|
Patients’ negative perception of and lack of respect for nurses affected communication Nurses concerned with accidentally offending patients and limited their communication with patients of other cultures. Language barriers prevented effective communication Nurses fearful and uncomfortable discussing sensitive topics such as death and dying. Cultural taboos increased nurses’ discomfort |
Characteristics of the patient Characteristics of the nurse Nurse-patient interaction Environment |
| Taylor, R. & Alfred, M. (2010) |
“To explore nurses’ perceptions of ways in which the health care organization can support them in the delivery of culturally competent care” (p . 595) |
Qualitative case study approach Random sampling for RN, purposive for manager Interviews Open and axial coding Software for data organization |
Lack of organizational support, no recognition for extra work Interpreter availability problematic Rapport with patient lost Issues for bilingual staff around workload, time away from assignments Concern about translation accuracy Need additional training, more diverse staff Staff desire hiring more interpreters |
Language barrier (interpreter services) Ethnic mix of staff Training or lack of knowledge Patient educational materials Data/expectations, Instruments/resources Rewards Capacity Internal motives |
| Tuot et al. (2012) |
“We placed a dual-handset phone with 24- hour access to professional telephonic interpretation at the bedside of all patients admitted to the general medicine floor of the hospital and assessed change in nurse and physician use of professional interpreters” (p . 82) |
Quantitative descriptive Surveys before and after implementation of dual-handset phone Demographics Clinical scenarios & HCP action on whether or not an interpreter was utilized Descriptive statistics STATA statistical analysis (unpaired t-tests) |
Professional telephonic interpreter use increased in all clinical situations for both nurses and physicians No effect on access to live interpreters, particularly for delicate situations such as end of life discussions |
The number of calls per LEP admission increased 4-fold, from 1.3 to 5.2 without a decrease in in-person interpreter use. Self-reported use of ad-hoc interpreters decreased (37% pre-intervention and 18% post, p = .006) Lower odds of using professional interpreter for more experienced nurses (OR 0.95 increase per additional year) |
| Valizadeh et al. (2017) |
“Identify the factors that influence nurse-to-parent communication in the provision of pediatric culturally sensitive care in Iran” (p . 476) |
|
Country-specific role limitations impacted communication Gender limitations on visitation created language barrier Nurses felt leadership undervalued importance of culture and language Ad hoc interpreters, nonverbal communication used due to poor interpreter access |
Organizational factors
Inefficient policies Professional factors
|
| Watt et al. (2018) |
“Explore the complexities of communication and interpreter use for CALD women prisoners accessing prison health care, with a view to improving service access for CALD women in prison” (p . 1160) |
|
Isolation, difficulty accessing healthcare for non-English speakers Peer support for interpreting, knowledge sharing Nurses opted to use limited English skills rather than interpreter Other nurses valued confidentiality and help from interpreter Access to interpreter difficult Overestimating English skills by RNs Peer interpreters helpful for advocacy but created confidentiality concerns Concern about professional interpreter accuracy Face to face interpreter difficult due to cost, unpredictability of prison setting |
|
| Watts et al. (2018) |
“Explore organizational and systemic challenges encountered by HPs who work with minority cancer patients and caregivers” (p . 2) |
Qualitative Purposive sampling for variation in age, cultural background, length of sentence, health conditions, and healthcare utilization Focus groups Semi-structured interviews Thematic data analysis |
Both women inmates and staff identified communication difficulties as a barrier Barriers were sometimes seen as discriminatory “Peer interpreters” (fellow inmates or other informal interpreters) used instead of trained interpreters, and were subject to coercion, untrained health advice, errors in interpretation, and loss of patient confidentiality |
|
| Whitman et al. (2010) |
“Describe the perceptions of school nurses of the increase in the ESL student population and the challenges they face in communicating with this population” (p . 209) |
Quantitative descriptive Data collected by Alabama Board of Nursing Surveys (online questionnaires) Descriptive statistics Pearson’s chi-squared analysis |
Despite access to trained interpreter, nurses relied on ESL student to translate when speaking with parents Significant differences in experiences by grade level |
32.9% of respondents indicated that they encountered difficulties communicating with ESL students 50.9% had difficulty communicating with the parents of ESL students Significant differences by county in response to having a trained interpreter that can be contacted if needed (p < . 05) and having to rely on the ESL student to act as a translator when speaking to his or her parent (p < .05) Significant difference in grade level in response to nurses having difficulty communicating with ESL students, with elementary nurses experiencing the most difficulty (p < 0.001) |
| Willey et al. (2018) |
“Explore service provision for Victorian regional refugee families from the perspective of MCH nurses and identify whether there are continuing professional development needs and MCH nurses who work with families from a refugee background” (p . 3389) |
|
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How to identify women from a refugee background The Maternal and Child Health nurse role when working with families from a refugee background Interpreting issues Access to other referral agencies |
