Caregivers with limited language proficiency and their satisfaction with paediatric emergency care related to the use of professional interpreters: a mixed methods study

Myriam Gmünder; Noemi Gessler; Sina Buser; Ursula Feuz; Jabeen Fayyaz; Anne Jachmann; Kristina Keitel; Julia Brandenberger

doi:10.1136/bmjopen-2023-077716

Caregivers with limited language proficiency and their satisfaction with paediatric emergency care related to the use of professional interpreters: a mixed methods study

BMJ Open. 2024 Jan 12;14(1):e077716. doi: 10.1136/bmjopen-2023-077716.

Authors

Myriam Gmünder¹, Noemi Gessler¹, Sina Buser¹, Ursula Feuz¹, Jabeen Fayyaz², Anne Jachmann³, Kristina Keitel¹, Julia Brandenberger^{4

2

5}

Affiliations

¹ Division of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital University Hospital, University of Bern, Bern, Switzerland.
² Emergency Department, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁴ Division of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital University Hospital, University of Bern, Bern, Switzerland julia.brandenberger@insel.ch.
⁵ Edwin S. H. Leong Centre for Healthy Children, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.

Abstract

Objectives: Communication is a main challenge in migrant health and essential for patient safety. The aim of this study was to describe the satisfaction of caregivers with limited language proficiency (LLP) with care related to the use of interpreters and to explore underlying and interacting factors influencing satisfaction and self-advocacy.

Design: A mixed-methods study.

Setting: Paediatric emergency department (PED) at a tertiary care hospital in Bern, Switzerland.

Participants and methods: Caregivers visiting the PED were systematically screened for their language proficiency. Semistructured interviews were conducted with all LLP-caregivers agreeing to participate and their administrative data were extracted.

Results: The study included 181 caregivers, 14 of whom received professional language interpretation. Caregivers who were assisted by professional interpretation services were more satisfied than those without (5.5 (SD)±1.4 vs 4.8 (SD)±1.6). Satisfaction was influenced by five main factors (relationship with health workers, patient management, alignment of health concepts, personal expectations, health outcome of the patient) which were modulated by communication. Of all LLP-caregivers without professional interpretation, 44.9% were satisfied with communication due to low expectations regarding the quality of communication, unawareness of the availability of professional interpretation and overestimation of own language skills, resulting in low self-advocacy.

Conclusion: The use of professional interpreters had a positive impact on the overall satisfaction of LLP-caregivers with emergency care. LLP-caregivers were not well-positioned to advocate for language interpretation. Healthcare providers must be aware of their responsibility to guarantee good-quality communication to ensure equitable quality of care and patient safety.

Keywords: ACCIDENT & EMERGENCY MEDICINE; Health Equity; PAEDIATRICS; communication.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Caregivers*
Child
Communication Barriers
Emergency Medical Services*
Humans
Language
Personal Satisfaction
Translating