Communication barriers among Spanish-speaking women with pelvic floor disorders: lost in translation?

Abstract

Objectives: The purpose of our study was to evaluate barriers in communication and disease understanding among office staff and interpreters when communicating with Spanish-speaking women with pelvic floor disorders.

Methods: We conducted a qualitative study to evaluate barriers to communication with Spanish-speaking women with pelvic floor disorders among office staff and interpreters. Sixteen office staff and interpreters were interviewed; interview questions focused on experiences with Spanish-speaking patients with pelvic floor disorders in the clinic setting. Interview transcripts were analyzed qualitatively using grounded theory methodology.

Results: Analysis of the interview transcripts revealed several barriers in communication as identified by office staff and interpreters. Three major classes were predominant: patient, interpreter, and system-related barriers. Patient-related barriers included a lack of understanding of anatomy and medical terminology and inhibited discussions due to embarrassment. Provider-related barriers included poor interpreter knowledge of pelvic floor vocabulary and the use of office staff without interpreting credentials. System-related barriers included poor access to information. From these preliminary themes, an emergent concept was revealed: it is highly likely that Spanish-speaking women with pelvic floor disorders have poor understanding of their condition owing to multiple obstacles in communication.

Conclusions: There are many levels of barriers to communications with Latin women treated for pelvic floor disorders, arising from the patient, interpreter, and the system itself. These barriers contribute to a low level of understanding of their diagnosis, treatment options, and administered therapies.

Figures

Figure 1

Barriers in communication and disease understanding among Spanish-speaking women with pelvic floor disorders:

Figure 2

Preliminary Themes and Representative Quotes

Figure 2

Preliminary Themes and Representative Quotes

Figure 2

Preliminary Themes and Representative Quotes

Figure 2

Preliminary Themes and Representative Quotes

Figure 3

Routes of communication with an English-speaking patient are usually directly by the provider or by various informational tools. In comparison, Spanish-speaking patients do not have a direct form of communication, and instead require additional parties or steps in order to receive the same information. Ideally, this is provided by either the use of a certified interpreter or by translated forms, however it is quite common to utilize the aid of a non-certified bilingual interpreter in the form of a family member, office staff member, nurse, or other personnel in the medical center. Each of these additional steps serves as a potential barrier to optimal communication with Spanish-speaking patients.