Journal of General Internal Medicine

, Volume 27, Issue 12, pp 1602–1608 | Cite as

Patient-Reported Quality of Pain Treatment and Use of Interpreters in Spanish-Speaking Patients Hospitalized for Obstetric and Gynecological Care

  • Nathalia Jimenez
  • Gerardo Moreno
  • Mei Leng
  • Dedra Buchwald
  • Leo S. Morales
Original Research

Abstract

BACKGROUND

Assessment and treatment of pain are based largely on patient’s self reports. Patients with limited English proficiency (LEP) may have difficulties communicating their pain symptoms in the presence of language barriers.

OBJECTIVE

To determine whether interpreter use was associated with quality of acute pain treatment among Latina patients with limited English proficiency.

DESIGN

Secondary analysis of two cross-sectional surveys.

PARTICIPANTS

One hundred and eighty-five Latino female patients hospitalized for obstetric and gynecological care who required interpreter services. Patients were classified into two groups according to interpreter availability ('Always' and 'Not Always' available).

MAIN MEASURES

Quality of pain treatment was measured by patient report of 1) overall level of pain control during hospitalization; 2) timeliness of pain treatment; and 3) perceived provider helpfulness to treat pain.

KEY RESULTS

Patients who always received interpreters were more likely to report higher levels of pain control (P = 0.02), timely pain treatment (P = 0.02), and greater perceived provider helpfulness to treat their pain (P = 0.005), compared with patients who not always received interpreters.

CONCLUSION

Use of interpreters by LEP patients was associated with better patient reports on quality of pain treatment, and may also improve clinical interactions related to pain.

KEY WORDS

interpreters limited English proficiency Latinos/Latinas pain pain treatment 

REFERENCES

  1. 1.
    Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Whelan CT, Jin L, Meltzer D. Pain and satisfaction with pain control in hospitalized medical patients: no such thing as low risk. Arch Intern Med. 2004;164:175–80.PubMedCrossRefGoogle Scholar
  3. 3.
    Jamison RN, Taft K, O'Hara JP, Ferrante FM. Psychosocial and pharmacologic predictors of satisfaction with intravenous patient-controlled analgesia. Anesth Analg. 1993;77:121–5.PubMedGoogle Scholar
  4. 4.
    Jamison RN, Ross MJ, Hoopman P, et al. Assessment of postoperative pain management: patient satisfaction and perceived helpfulness. Clin J Pain. 1997;13:229–36.PubMedCrossRefGoogle Scholar
  5. 5.
    Bovier PA, Charvet A, Cleopas A, Vogt N, Perneger TV. Self-reported management of pain in hospitalized patients: link between process and outcome. Am J Med. 2004;117:569–74.PubMedCrossRefGoogle Scholar
  6. 6.
    Jacob E, McCarthy KS, Sambuco G, Hockenberry M. Intensity, location, and quality of pain in Spanish-speaking children with cancer. J Pediatr Nurs. 2008;34:45–52.Google Scholar
  7. 7.
    Mosher CE, Duhamel KN, Egert J, Smith MY. Self-efficacy for coping with cancer in a multiethnic sample of breast cancer patients: associations with barriers to pain management and distress. Clin J Pain. 2010;26:227–34.PubMedCrossRefGoogle Scholar
  8. 8.
    ACOG Committee Opinion No. 295. American College of Obstetricians and Gynecologists. Pain relief during labor. Obstet Gynecol 2004;104:213.Google Scholar
  9. 9.
    Lee WW, Burelbach AD, Fosnocht D. Hispanic and non-Hispanic white patient pain management expectations. Am Emerg Med. 2001;19:549–50.CrossRefGoogle Scholar
  10. 10.
    Orejuela F, Garcia T, Green C, et al. Exploring factors influencing patient request for epidural analgesia on admision to labor and delivery in a predominantly Latino population. J Immigr Minor Health. 2012;14(2):287–91.PubMedCrossRefGoogle Scholar
  11. 11.
    Shin HB, Kominsky RA. Language Use in the United States: 2007. American Community Survey Reports, ACS-12. Washington, D.C.: U.S. Census Bureau; 2010.Google Scholar
  12. 12.
    Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42:727–54.PubMedCrossRefGoogle Scholar
  13. 13.
    Morales LS, Elliott M, Weech-Maldonado R, Hays RD. The impact of interpreters on parents' experiences with ambulatory care for their children. Med Care Res Rev. 2006;63:110–28.PubMedCrossRefGoogle Scholar
  14. 14.
    Zayas LH, Cabassa LJ, Perez MC, Cavazos-Rehg PA. Using interpreters in diagnostic research and practice: pilot results and recommendations. J Clin Psychiatry. 2007;68:924–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Morales LS, Leng M, Escarce JJ. Risk of cardiovascular disease in first and second generation Mexican–Americans. J Immigr Minor Health. 2011;13:61–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Tocher TM, Larson E. Quality of diabetes care for non-English-speaking patients. A comparative study. West J Med. 1998;168:504–11.PubMedGoogle Scholar
  17. 17.
    Wu S, Ridgely MS, Escarce JJ, Morales LS. Language access services for Latinos with limited English proficiency: lessons learned from Hablamos Juntos. J Gen Intern Med. 2007;22(Suppl 2):350–5.PubMedCrossRefGoogle Scholar
  18. 18.
    U.S. Department of Health and Human Services. 2008 H-CAHPS Chartbook (publication number 08-0066-EF). Rockville, MD: Agency for Healthcare Research and Quality; 2008.Google Scholar
  19. 19.
    Hurtado MP, Angeles J, Blahut SA, Hays RD. Assessment of the equivalence of the Spanish and English versions of the CAHPS hospital survey on the quality of inpatient care. Health Serv Res. 2005;40:2140–61.PubMedCrossRefGoogle Scholar
  20. 20.
    Moreno G, Tarn DM, Morales LS. Impact of interpreters on the receipt of new prescription medication information among Spanish-speaking Latinos. Med Care. 2009;47:1201–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Moreno G, Morales LS. Hablamos Juntos (together we speak): interpreters, provider communication, and satisfaction with care. J Gen Intern Med. 2010;25:1282–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Mosen DM, Carlson MJ, Morales LS, Hanes PP. Satisfaction with provider communication among Spanish-speaking Medicaid enrollees. Ambul Pediatr. 2004;4:500–4.PubMedCrossRefGoogle Scholar
  23. 23.
    Andrulis D, Goodman N, Pryor C. What a difference an interpreter can make: health care experiences of uninsured with limited English proficiency. Boston, MA: The Access Project; 2002.Google Scholar
  24. 24.
    Diamond LC, Schenker Y, Curry L, Bradley EH, Fernandez A. Getting by: underuse of interpreters by resident physicians. J Gen Intern Med. 2009;24:256–62.PubMedCrossRefGoogle Scholar
  25. 25.
    Kuo DZ, O'Connor KG, Flores G, Minkovitz CS. Pediatricians' use of language services for families with limited English proficiency. Pediatrics. 2007;119:e920–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Lee KC, Winickoff JP, Kim MK, et al. Resident physicians' use of professional and nonprofessional interpreters: a national survey. JAMA. 2006;296:1050–3.PubMedCrossRefGoogle Scholar
  27. 27.
    Davies B, Contro N, Larson J, Widger K. Culturally-sensitive information-sharing in pediatric palliative care. Pediatrics. 2010;125:e859–65.PubMedCrossRefGoogle Scholar
  28. 28.
    Diamond LC, Reuland DS. Describing physician language fluency: deconstructing medical Spanish. JAMA. 2009;301:426–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Schenker Y, Lo B, Ettinger KM, Fernandez A. Navigating language barriers under difficult circumstances. Ann Intern Med. 2008;149:264–9.PubMedGoogle Scholar
  30. 30.
    Dahl JL, Gordon D, Ward S, Skemp M, Wochos S, Schurr M. Institutionalizing pain management: the Post-Operative Pain Management Quality Improvement Project. J Pain. 2003;4:361–71.PubMedCrossRefGoogle Scholar
  31. 31.
    Gordon DB, Polomano RC, Pellino TA, et al. Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. J Pain. 2010;11:1172–86.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Nathalia Jimenez
    • 1
  • Gerardo Moreno
    • 2
  • Mei Leng
    • 3
  • Dedra Buchwald
    • 4
  • Leo S. Morales
    • 5
    • 6
  1. 1.Department of Anesthesiology and Pain MedicineUniversity of WashingtonSeattleUSA
  2. 2.Department of Family MedicineUniversity of CaliforniaLos AngelesUSA
  3. 3.Department of MedicineUniversity of CaliforniaLos AngelesUSA
  4. 4.Department of MedicineUniversity of WashingtonSeattleUSA
  5. 5.Group Health Research InstituteSeattleUSA
  6. 6.Department of Health ServicesUniversity of WashingtonSeattleUSA

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