Award Date

12-1-2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Committee Member

Tish Smyer

Second Committee Member

Patricia Alpert

Third Committee Member

Alona Angosta

Fourth Committee Member

LeAnn Putney

Fifth Committee Member

Kathryn Hausbeck Korgan

Number of Pages

120

Abstract

Approximately 8.6% of the total U.S. population is considered limited English proficient (LEP), a term that has been used by official US federal policy and will be used throughout this study. In a landmark report, the Institute of Medicine found that minorities received lower-quality health care than Caucasians even when insurance status, income, and other factors were equivalent. These differences were tied to issues such as bias, stereotypes and communication barriers between patients and their caregivers. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals is essential when providing quality health care.

The Joint Commission requires new patient-centered communication standards to be in place, which includes cultural competence and effective communication for the accreditation process, beginning in January, 2012. The literature indicates that language barriers have been associated with medical complications. Existing studies have explored LEP patients' experiences in health care. There are very few studies looking at registered nurses' experiences with language barriers. In particular, the nurses' experiences with LEP patients and their families in an acute-care setting have not been examined.

The purpose of this study was to describe, interpret, and gain a deeper understanding of the lived experiences of acute-care bedside registered nurses caring for patients and their families with LEP. Van Manen's hermeneutic phenomenological method guided the study. The phenomenology research approach provides the most meaningful ways to describe and understand the entirety of the bedside nurses' experiences. This study provided information regarding the lived experiences of acute-care bedside nurses caring for patients and their families with LEP that had not been revealed in the nursing literature. The meanings of the lived experiences were discovered through analysis of 40 acute-care bedside nurse interviews in one acute-care setting.

A convenience, purposive sample of 40 registered nurses who work in bedside care in an acute-care setting were interviewed. Each nurse had a minimum of 3 years of acute-care experience. The sample size was determined by data saturation. Four themes emerged from the data of this research including: Desire to Communicate; Desire to Connect; Desire to Provide Care; and Desire to Provide Cultural Respect and Understanding. Findings from the study have the potential to identify clinically relevant concerns, barriers to communication, resources for effective communication, and needs or concerns of the bedside nurses when providing care.

Strengths, limitations, and recommendations of the study are outlined. This research provides new information regarding the lived experiences of acute-care bedside registered nurses caring for patients and their families with limited English proficiency.

Keywords

Communication in medicine; English language – Foreign speakers; Minorities – Medical care; Nurse and patient

Disciplines

Communication | Nursing | Race and Ethnicity

Language

English


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