Author ORCID Identifier
0000-0003-4505-8356
Date of Graduation
8-2023
Document Type
Thesis (MS)
Program Affiliation
Genetic Counseling
Degree Name
Masters of Science (MS)
Advisor/Committee Chair
Kathryn Leal
Committee Member
Meagan Choates
Committee Member
Myla Ashfaq
Committee Member
Victoria Wagner
Committee Member
Aranza Gonzalez
Committee Member
David F. Rodriguez-Buritica
Abstract
A large population of Americans have limited or no English proficiency (LEP) with about 64% of those being Spanish-speaking. This creates challenges in navigating the American healthcare system, where the majority of providers are solely English-speaking. Studies have demonstrated that when patients have language discordant appointments without interpreters, they are more likely to feel less understood, have questions and comments ignored, and are less likely to receive patient-centered care in communication. It is expected that interpreters improve access to healthcare, especially for Spanish-speaking patients. However, the patient comfort and satisfaction in language discordant genetic counseling appointments has not yet been studied.
Therefore, this study aimed to compare the experiences of Spanish-speaking patients with language concordant (LC) versus language discordant (LD) appointments who receive genetic counseling services in the prenatal and medical genetics settings. In addition to investigating comfort and satisfaction in these two groups, this study set out to explore possible hindrances in care when an interpreter is utilized. A total of 55 LEP Spanish-speaking participants were recruited by genetic counselors and genetic counseling interns across Houston, TX following a genetic counseling appointment. Data was analyzed using descriptive statistics, Fisher’s exact, Kruskal-Wallis and chi-square tests for comparisons in Stata v.17. Open-ended responses were coded to describe themes.
Over 90% of the LC and LD group reported feeling very satisfied with their language services, over 90% were totally satisfied with and over 83% were totally comfortable with their genetic counseling appointment. There was no difference in comfort and satisfaction between LC and LD participants across all variables analyzed. This study demonstrated that the difficulties experienced by those with LD in other healthcare settings are not equally observed in genetic counseling. Genetic counselors are trained to integrate information-giving and psychosocial counseling with a focus in cultural humility to provide patient-centered care. Implementing these components into the training of other healthcare professionals can promote equitable healthcare on a larger scale.
Keywords
Limited English-proficient, Interpreter services, Patient satisfaction, Patient comfort level, Patient-centered care, Hispanic/Latino population, United States, Bilingual healthcare providers, Health disparities, Language preference