Abstract
Purpose :
Patients with non-English language preference (NELP) have worse health outcomes due to language barriers. Few studies in ophthalmology have shown there are language-related disparities in eye care. Currently, there are no studies in ophthalmology investigating why these disparities exist. The purpose of this study was to use qualitative research methods to 1.) examine provider and staff experiences providing care for Spanish NELP patients and 2.) understand the NELP patient experience in ophthalmology.
Methods :
A single center study was conducted with 10 semi-structured interviews (SSI) with ophthalmologists, ophthalmic technicians, and staff, 8 SSIs with Spanish NELP patients, 13 provider and staff observations, 35 Spanish NELP patient observations, and 55 English patient observations. All interviews were audio recorded and transcribed and translated as needed. Observations were conducted in 3 clinics: resident clinics, Glaucoma clinics, and Retina clinics. A systematic analysis of verbatim transcripts and observation notes identified major themes.
Results :
We found that effective communication between Spanish NELP patients and providers and staff is challenging. All providers and staff discussed issues with time constraints, resource constraints, difficulty building rapport with patients, and a distrust of professional interpreters. For patients, they expressed the importance of having providers who spoke the same language (63%), issues developing rapport with providers and staff (50%), issues with professional interpreters (50%), and issues identifying bilingual providers and staff (25%). Through our observations we found that there are miscommunications unknown by both patients and providers communicating via a professional interpreter. Professional interpreters often omitted details or altered meanings during their translation.
Conclusions :
Our data show that there are language-related disparities to appropriate eye care for Spanish NELP patients. Intervention strategies to increase workforce training on providing care for patients with NELP, Latinx representation in ophthalmology, medical education in Spanish, and integrated electronic health record translation systems may reduce language-related disparities in ophthalmology.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.