Allison Squires1, Sarah Miner2, Eva Liang3, Maichou Lor4, Chenjuan Ma3, Amy Witkoski Stimpfel3. 1. Rory Meyers College of Nursing, New York University, 433 First Avenue, Office 658, New York, NY, 10010, USA. Electronic address: aps6@nyu.edu. 2. Wegmans School of Nursing, St. John Fisher College, Rochester, NY, USA. 3. Rory Meyers College of Nursing, New York University, New York, USA. 4. School of Nursing, Columbia University, New York, NY, USA.
Abstract
BACKGROUND: Increasingly, patients with limited English proficiency are accessing home health care services in the United States. Few studies have examined how language barriers influence provider role implementation or workload in the home health care setting. OBJECTIVES: To explore home health care professionals' perspectives about how workload changes from managing language barriers influence quality and safety in home health care. DESIGN: A qualitative secondary data analysis using a summative content analysis approach was used to analyze existing semi-structured interview data. SETTING: A large urban home health care agency located on the East Coast of the United States. PARTICIPANTS: Thirty five home health care providers [31 registered nurses, 3 physical therapists, 1 occupational therapist]. RESULTS: A total of 142 discrete incidents emerged from the analysis. Overall, home health care providers experienced distinct shifts in how they implemented their roles that added to their workload and time spent with Limited English Proficiency patients and family members. Providers were concerned about interpretation accuracy and perceived it as potentially posing risks to patient safety. Changes in work patterns, therefore, sought to maximize patient safety. CONCLUSIONS: Home health care providers decision-making about how they adapt practice when faced with a language barrier is a sequence of actions based on awareness of the patient's language preference and if they spoke another language. Subsequent choices showed proactive behaviors to manage increased workload shaped by their perceived risk of the threats posed by the quality of interpreter services. Future research should develop quantitative models examining differences in workload when caring for limited English proficiency versus English speaking patients as well as the relationship between visit length and patient outcomes to determine optimal quality models.
BACKGROUND: Increasingly, patients with limited English proficiency are accessing home health care services in the United States. Few studies have examined how language barriers influence provider role implementation or workload in the home health care setting. OBJECTIVES: To explore home health care professionals' perspectives about how workload changes from managing language barriers influence quality and safety in home health care. DESIGN: A qualitative secondary data analysis using a summative content analysis approach was used to analyze existing semi-structured interview data. SETTING: A large urban home health care agency located on the East Coast of the United States. PARTICIPANTS: Thirty five home health care providers [31 registered nurses, 3 physical therapists, 1 occupational therapist]. RESULTS: A total of 142 discrete incidents emerged from the analysis. Overall, home health care providers experienced distinct shifts in how they implemented their roles that added to their workload and time spent with Limited English Proficiency patients and family members. Providers were concerned about interpretation accuracy and perceived it as potentially posing risks to patient safety. Changes in work patterns, therefore, sought to maximize patient safety. CONCLUSIONS: Home health care providers decision-making about how they adapt practice when faced with a language barrier is a sequence of actions based on awareness of the patient's language preference and if they spoke another language. Subsequent choices showed proactive behaviors to manage increased workload shaped by their perceived risk of the threats posed by the quality of interpreter services. Future research should develop quantitative models examining differences in workload when caring for limited English proficiency versus English speaking patients as well as the relationship between visit length and patient outcomes to determine optimal quality models.
Keywords:
Communication barriers; Home care agencies; Home care services; Home health nursing; Language barrier; Limited English proficiency; Nurses; Nursing; Physical therapist
Authors: Yousef Ayatollahi; Xibei Liu; Ali Namazi; Mohammad Jaradat; Takashi Yamashita; Jay J Shen; Yong-Jae Lee; Soumya Upadhyay; Sun Jung Kim; Ji Won Yoo Journal: Res Gerontol Nurs Date: 2018-04-11 Impact factor: 1.571
Authors: Allison Squires; Chenjuan Ma; Sarah Miner; Penny Feldman; Elizabeth A Jacobs; Simon A Jones Journal: Int J Nurs Stud Date: 2021-10-01 Impact factor: 6.612