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Introduction/ Literature Review
In her study, Raynor (2015) aimed at identifying what common concerns non-English speaking patients had when contacting and interacting with their health provider. Raynor argued that while all non-English speaking demographic cohorts experienced difficulties with communication and receiving health services to a certain extent, Latino populations were especially vulnerable.
The literature review encompassed recent studies with the oldest one dated 2010. Part of the studies outlined the broader context for the issue, and namely, ethnic and racial disparities in access to health care. For instance, Raynor (2015) provided a piece of statistics that revealed that the share of Latino residents in North Carolina had doubled between 2000 and 2012 from 4.6% to 8.4%. Many Latino families were struggling with oral health and obesity. Living below the poverty line, lacking a comprehensive insurance plan, and having multiple children aggravated the situation. Other studies focused on a more specific issue – language discordance: while the US government obliged hospitals to assist non-English speaking families, many still relied on family and friends instead of a professional interpreter.
Raynor (2015) conducted an observational cross-sectional study, which is recognized as a good study design if a researcher aims at determining the key characteristics of a target population during a specific period. The sampling method can be described as non-randomized and conventional since the author only contacted the patients admitted to the same facility. While this method is time- and cost-saving for the researcher, its peculiarities might undermine the validity of the findings and decrease the likelihood of inferring the data on larger populations. Raynor (2015) chose the quantitative study design, which allowed for quick calculations and generalizations but lacked the depth and personal connection to the respondents that the qualitative design could have provided. It is possible to point out potential volunteer bias: unhappy patients are more likely to come forward and partake in a study focused on their key concerns. Ethical considerations included ensuring explicit consent and confidentiality of information.
Thirty-eight Spanish and Arabic speaking patients filled in a survey containing 31 yes or no questions concerning access to health care and interpretation services. Raynor (2015) found that more than half of the respondents (62%) left the last appointment with some questions unanswered by their provider. Moreover about half of them were not even sure why they were seeing that particular doctor. The results indicated that many non-English speaking patients experienced difficulties with understanding test results and rationale behind their treatment plan and choice of medication and procedures. The same patients who reported challenges admitted that they did not quite understand their interpreter and would prefer the instructions to be written in their native language.
The findings of the study were in line with the existing paradigm showing that there are certain racial and ethnic disparities in how different demographics go about accessing health care. Some of the results were unexpected: Raynor (2015) did not find that the respondents struggled with obtaining an appointment or transportation. Another surprising finding was that even when an interpreter was available, some participants still could not understand their health provider or did not trust the mediator. The author claimed that there was a need for more clear and understandable medical information, preferably available in various languages. She acknowledged certain limitations such as small sample size and possible confusion from the double negative questions in the survey. In the future, Raynor would like to research the concerns of disadvantaged English-speaking populations and the effects of time constraints on the efficiency of medical interpreters.
Raynor, E. M. (2016). Factors affecting care in non-English-speaking patients and families. Clinical pediatrics, 55(2), 145-149.