Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices

Abstract

Background Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Methods Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1,251 pediatric hospice agencies. Variable selection was guided by Structural Contingency Theory, which posits that organizational effectiveness is dependent upon how well an organization’s structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. Results The majority of hospices provided translation services (74.9%) and interpreter services (87.1%). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Conclusions Findings indicate that nursing unit environment predict provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staff who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency, and ultimately reduce ethnic disparities in end-of-life care for children and their families.

Quantifying the Language Barrier—A Total Survey of Parents’ Spoken Languages and Local Language Skills as Perceived by Different Professions in Pediatric Palliative Care

“…From the perspective of foreign families, language barriers may result in dissatisfaction with care [ 14 ]; difficulties in utilizing health care services [ 14 , 15 ] and reduced quality of care [ 16 , 17 , 18 ]. In the clinical routine in general and particularly in pediatric palliative care, different strategies such as the involvement of (professional) translators are used to overcome language barriers between care providers and patients/families [ 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. The importance of the awareness and education of cultural characteristics is acknowledged by many healthcare providers, but is perceived as insufficient [ 26 , 27 , 28 ].…”

Development and preliminary validation of the Sleep Screening for Children and Adolescents with Complex Chronic Conditions (SCAC)

“…We expected that the scales would be positively associated with the number of CCC diagnoses, as sleep problems may increase with the accumulation of different diagnoses (Feudtner et al, 2021; Lindley et al, 2017). Validation analyses confirmed this association for three of the four scales; why the “Falling and staying asleep” scale did not correlate with number of diagnoses cannot be assessed within the scope of this study.…”

“…It appears, however, that the number of patients with CCC has been increasing over the years (Bjur et al, 2019). CCC often occur cumulatively within one individual (Feudtner et al, 2021; Lindley et al, 2017); these patients are hospitalized more often, especially when multiple concurrent CCCs are present, with longer periods of intensive care time (Arias López et al, 2020; Burns et al, 2010; Lindley et al, 2017). This population also tends to suffer from a wide variety of symptoms of varying severity and distress (Feudtner et al, 2021; Marcus et al, 2021).…”

Theories used by nurses to promote patient safety practices: A scoping review

“…[13] The proposal for changes or innovative approaches in nursing services based on the use of theories includes, according to the literature, interventions related to the communication between healthcare professionals, guidance for safe care for people with a tendency to self-injury, protocols for safe care in the operating room, improving student skills for safe and harm-free care, error analysis strategies and interventions for safe care in the intensive care unit, improving the understanding of patient safety protocols, and supporting theory in the development of clinical records for nurses. [13][14][15][16][17][18][19][20][21][22][23] On the other hand, the use of theories seems to underpin the analysis of organizations' safety culture and serve as a theoretical framework for developing institutional practices and programs focused on forming an organizational safety culture or strengthening safe practices. The authors of the analyzed studies have different options as to how to carry out such analyzes through the use of articles about nursing errors, adverse events notifications, or by analyzing the discourse of nursing professionals and obtaining their perceptions, a theoretical framework for substantiating interventions with a focus on patient safety culture.…”