Margaret Butler, Health Sciences

Introduction

Recent demographic changes in the United States are requiring health care workers to serve patients, particularly Hispanics, who do not speak English. This is true for the state of Utah as well Citing Immigration and Naturalization Service data, Wright (1993) reported that the number of Mexican immigrants who do not speak English has greatly increased in Utah. This study was conducted in order to determine the needs for interpretation/ translation services in Utah health care facilities.

Method

An eleven-item survey form was created specifically for this study. It was mailed to 104 health care facilities in Utah. This sample was divided into two parts: acute care hospitals and nursing care facilities. A survey form was sent to ail 54 acute care hospitals listed as institutional members of the Utah Association of Health Care Providers (UAHCP). Fifty surveys were also sent to nursing care facilities. The names and addresses of these institutions were obtained from the Utah Association of Health Care Providers, who endorsed the study. Included in the packet of materials sent to each of the facilities was I) the survey form, 2) a letter of endorsement from UAHCP, 3) a letter of explanation, 4) a $1 bill provided as an incentive to return the survey, and 5) a stamped, pre-addressed return envelope.

In addition to the mailed survey, structured interviews were conducted with 10 health care facilities for the purpose of cross-checking and expanding the results of the mailed surveys.

Results

0f the 54 surveys sent to acute care hospitals, 41 were returned for a completion rate of 76%. Likewise, 41 of the surveys sent to the 50 nursing care facilities were returned, a return rate of 82%. The combined return rate was 79%. No follow-up requests were sent to non-responding institutions.

Mailed Surveys

As hypothesized, Spanish is overwhelmingly the language that requires the greatest frequency of interpretation. This is true for both acute care and nursing care facilities. Of the 82 responding institutions, 64 listed Spanish as the language most frequently requiring such service.

Vietnamese was a distant second for acute care facilities, and Japanese was a distant second in nursing care facilities. Navajo and Ute were listed as the most frequently interpreted languages by eight health care facilities. In all, seventeen different languages were listed as “languages most commonly interpreted.”

In response to the question, “What percent of interpretation is in Spanish?,” acute care facilities reported 65% and nursing facilities reported 49%. Regarding the question as to who provides translation, hospitals reported the following providers of translation: “medical staff” 35%, “other staff” 24% and “friends and family” 41%. Interpretation in nursing care facilities was reportedly done by the following: “medical staff’ 33%, “other staff” 28%, and “friends and family” 39%.

In response to the question “What percentage of your medical staff (physicians, nurses, etc.) is bilingual?,” acute care hospitals reported 11%, while nursing facilities reported 13%.

Respondents were asked to rate the availability of interpretation services on a scale of 1 (always readily available) to 9 (very difficult to obtain). The average rating for acute care hospitals was 4. 1, while nursing care facilities rated this question at an average of 4.9. Ten nursing facilities respond with a rating of 7, 8, or 9, suggesting serious availability problems in 24% of these facilities. Only 10% of the acute care facilities experienced such availability problems.

Those included in the survey were also asked to rate the quality of interpretation on a nine point scale (1= excellent, 9= very poor). Acute care facilities obtained a mean rating of 3.4, while the nursing facilities’ mean was 5.3. Only two hospitals rated the quality in the 7-9 range (poor), while nine nursing facilities responded in that range.

Of the entire sample of 82 respondents, only three (one nursing facility and two hospitals) reported having staff who are accredited by the American Translators Association.

Respondents reported the perceived need for “staff training in the translation of medical terms,” on a nine point scale (1 = a great need, 9= no need). The hospitals’ average response was 3.8, while nursing facilities averaged 5.2. Twenty-five hospitals (61 %) reported a substantial need (score of 1, 2, or 3) for such training. Thirteen nursing facilities (32%) reported such a need.

Interview Data

Structured interviews were conducted in ten health care settings as a validity check on the survey results. The results of the interviews generally supported those of the mailed survey. Some interviewees referred to the high number of returned LDS missionaries who had served in non-English speaking countries and who brought back language skills and cultural familiarity to their staff positions. This was seen as a valuable asset. In general, acute care facilities acknowledged the need for additional training in interpretation because of the more life-threatening nature of acute care work.

Discussion

This survey bears out the fact that Spanish is the language most commonly requiring interpretation services in the Utah health care facilities. Attention should also be focused on the need for translation of Japanese and Southeast Asian languages as well as Navajo and Ute.

References

• Wright, L. (1993). Utah is a Land of Promise for Many Mexicans. Salt Lake Tribune, p. A-1, 2.