Advance Care Planning for Spanish-Language Speakers: Patient, Family, and Interpreter Perspectives

Abstract

Language access barriers for individuals with limited-English proficiency are a challenge to advance care planning (ACP). Whether Spanish-language translations of ACP resources are broadly acceptable by US Spanish-language speakers from diverse countries is unclear. This ethnographic qualitative study ascertained challenges and facilitators to ACP with respect to Spanish-language translation of ACP resources. We conducted focus groups with a heterogeneous sample of 29 Spanish-speaking persons who had experience with ACP as a patient, family member, and/or medical interpreter. We conducted thematic analysis with axial coding. Themes include: (1). ACP translations are confusing; (2). ACP understanding is affected by country of origin; (3). ACP understanding is affected by local healthcare provider culture and practice; and (4). ACP needs to be normalized into local communities. ACP is both a cultural and clinical practice. Recommendations for increasing ACP uptake extend beyond language translation to acknowledging users’ culture of origin and local healthcare culture.

The role of acculturation in the process of advance care planning among Chinese immigrants: A narrative systematic review

“…However, research suggests that interpreters often face challenges when balancing strict interpretation with cultural brokering. 42,82 Therefore, we recommend that healthcare professionals understand and value their role in cross-cultural conversations to minimize cultural conflicts and increase mutual understanding. More effort should be made to explore how to reach the balance between interpretation accuracy and cultural sensitivity in the general communication process.…”