Limited English Proficiency Occupational Therapy Patients Receiving Interpreter Services Perception of Quality of Care

NCT03149276 | Completed

• 1 other identifier: 14110802-IRB01
• Study Type: observational
• Target: 8
• Locations: 0 countries
• Sites: N/A

Brief Summary

A systematic literature review from March through June 2014 supports the premise that limited English proficiency (LEP) persons face barriers and disparities to medical care that English-speaking persons do not face. Language barriers have a negative impact on health and health care, including lower health status, lower likelihood of having a primary care provider, lower rate of preventative care, higher use rate of diagnostic tests, higher rate of severe psychopathology diagnoses, and higher risk of drug complications . Additionally, LEP persons experience problems with effective communication with providers, inappropriate diagnoses and treatments, lower comprehension of medication instructions and adherence to regimens, fewer follow up visits, low quality care, poorer health outcomes, and low patient satisfaction. Research has proven a relationship between LEP and health care outcomes, specifically a relationship between positive outcomes and use of professional interpreters. Not sharing a common language creates a barrier to providing safe, effective, client-centered Occupational Therapy (OT) and knowledge of outcome satisfaction for this population. Using trained interpreters would reduce the barriers created by language discordance. This evidence-based project intends to measures the influence of interpreter service on LEP patients' perceived quality of care using a satisfaction survey. Gathered data will be used to consider development and implementation of practice guidelines for use of professional interpreter services for LEP patients receiving OT services at Midwest Orthopaedics at Rush. Development and implementation of practice guidelines that include use of trained interpreters when providing OT services to LEP patients will facilitate a client-centered approach and improve quality of care for this population. The project is also being implemented as part of a degree requirement for the Doctorate of Occupational Therapy Program at Chatham University.

Conditions

Communication Barriers; Occupational Therapy

Outcome Measures

Primary Outcomes (3)

• Pre-Occupational Therapy Satisfaction Survey

  The pre-Occupational Therapy satisfaction survey was developed for this project by the primary investigator to measure perceived satisfaction. The pre-OT satisfaction survey consists of five demographic items and four items that employ a Likert scale rating method. The total quantitative scoring range for the survey is four to twenty, with a score of four indicating the lowest satisfaction and a score of 20 indicating the highest satisfaction. The paper and pencil survey was completed in person by all participants after the initial OT visit. Survey scores of the LEP group were compared to the English-speaking group. Equal or better scores reflect agreement that LEP OT perceive quality of care and satisfaction equal to English-speaking patients.

  Baseline

• Post-4 weeks Occupational Therapy Satisfaction Survey

  The Post-4 weeks OT satisfaction survey was developed for this project by the primary investigator to measure perceived satisfaction. The survey consists of five demographic items and four items that employ a Likert scale rating method. The total quantitative scoring range for the survey is 4 to 20, with a score of 4 indicating the lowest satisfaction and a score of 20 indicating the highest satisfaction. The post-4 weeks OT satisfaction survey contains three additional items, using a Likert scale rating method to explore qualitative experiences. Total qualitative scoring range for the survey is 3 to 15, with a score of 3 indicating a low belief in the benefits of OT and a score of 15 indicating a high belief in the benefits of OT. Scores of the LEP group were compared to the English-speaking group. Equal or better scores reflect agreement that LEP OT patients receiving IS perceive quality of care and satisfaction equal to English-speaking patients.

  4 weeks from baseline

• Occupational Therapy Satisfaction Interview

  Interviews were conducted by the primary investigator, Eileen Turgeon, assisted by Interpreter Services (IS), with each LEP individual following four weeks of OT services and after completion of the post-4 weeks OT satisfaction survey. The interviews were conducted in person. The interview consisted of seven open-ended questions meant to capture the qualitative experience of the use of Interpreter Services during OT service delivery. The literature supports the use of surveys and interviews to gather feedback on LEP patients' perceived quality of care and satisfaction (González et al., 2010; Green et al., 2005; Lee et al., 2002; Shi et al., 2009; Wilson et al., 2005). The primary investigator presented the open-ended questions with the assistance of IS. The recorded interviews were reviewed by this primary investigator for emerging themes to provide insight and additional information.

  4 weeks from baseline

Study Arms (2)

Limited English Proficiency Group

LEP persons were identified by asking, "What language would you like to receive medical information and services in?" Patients were considered limited English proficient when a non-English language was preferred. Interventions included professional interpreter services and occupational therapy.

Other: Interpreter services

English Speaking Group

English speaking persons were identified by asking, "What language would you like to receive medical information and services in?" Patients were considered English speaking when the English language was preferred. Intervention included occupational therapy.

Interventions

Interpreter services OTHER

Also known as: Occupational Therapy

Limited English Proficiency Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Four limited English proficient persons that require occupational therapy services for four or more weeks and four English-speaking persons that require occupational therapy services, for four or more weeks, to serve as a comparison group

You may qualify if:

• Must be age 18 or older
• Must have a current prescription for occupational therapy (OT) that requires service for four weeks or more that span the six-week length of the project
• Agree to sign the project informed consent form
• Agree to complete the pre-OT satisfaction survey in its entirety at the conclusion of their OT initial evaluation and the post-4 weeks OT satisfaction survey at the end of four weeks of OT service
• Agree to use professional interpreter services
• Agree to an interview at the end of four weeks of OT service

You may not qualify if:

• Under 18 years of age
• Does not have a current prescription for occupational therapy (OT) that requires service for four weeks or more that span the six-week length of the project
• Refusal to sign the project informed consent form
• Refusal to complete the pre-OT satisfaction survey in its entirety at the conclusion of their OT initial evaluation and the post-4 weeks OT satisfaction survey at the end of four weeks of OT service
• Refusal of LEP participants to use professional interpreter services
• Refusal of LEP participants to be interviewed at the end of four weeks of OT service

Sponsors & Collaborators

• Rush University Medical Center: lead

Related Publications (36)

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MeSH Terms

Interventions

Occupational Therapy

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics

Study Officials

• Eileen D. Turgeon, OTD

  Rush University Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Occupational Therapist

Study Record Dates

• First Submitted: May 1, 2017
• First Posted: May 11, 2017
• Study Start: January 6, 2015
• Primary Completion: April 15, 2015
• Study Completion: April 15, 2015
• Last Updated: May 12, 2017

Record last verified: 2017-05