Limited English Proficient Patients and Nurses' Experiences With Language Access Services

Persons with limited English proficiency may receive inequitable care due to the absence of language services. Despite health equity initiatives, knowledge gaps exist regarding how and when language access needs are identified, acted upon, and which methods are being used.

The purpose of this study was to explore limited English proficient and deaf obstetrical patients and nurses' experiences with language services to improve delivery of culturally competent care.

This mixed methods study occurred in two phases. In phase 1, demographic and language service data were collected via surveys that were deployed to obstetric patients with limited English proficiency. In phase 2, nurses' experiences with interpretive services were explored via three focus groups to identify facilitators and barriers to care. Quantitative data were analyzed using descriptive analysis methods, while qualitative data were analyzed using grounded theory methods.

Fifty participants receiving obstetric services who had limited English proficiency participated in phase 1. Language services were positively rated with a noted preference for in-person interpreters. Participants identified unique barriers, but felt comfortable discussing concerns, stating nurses listened to them, treated them with courtesy, kindness, and respect. In phase 2, 16 nurse participants identified two major themes: evidence of barriers to accessibility, convenience, and consistency of language access services; and increased need for cultural and linguistic competence.

Findings indicate in-person interpreters are most effective and capture cultural nuances often missed when using a phone/iPad during patient encounters. Language service delivery at various points of care requires further consideration to ensure consistent use during patient encounters. Future research should explore digital health language interventions, while nurses' suggestions to decrease language service barriers should be used to develop policies and programs designed to better meet linguistic needs.