460 - Interviewing Spanish Speaking Parents About Communication In The NICU

Poster Number: 460
Publication Number: 460.130

Emily Batton, UC San Diego, San Diego, CA, United States; Samantha Hurst, UCSD - Herbert Wertheim School of Public Health and Human Longevity, La Jolla, CA, United States; Carlos G. Ramos, University of California, San Diego School of Medicine, La Jolla, CA, United States; Leslie A. Catalan, University of California, San Diego School of Medicine, NATIONAL CITY, CA, United States; Michele Freeman, UC San Diego Health, San Diego, CA, United States; Krishelle L. Marc-Aurele, University of California, San Diego School of Medicine, La Jolla, CA, United States

Background: Little is known about how Spanish speaking parents with limited English proficiency (LEP) experience communication in the NICU.

Objective: To explore from whom and in what manner parents with LEP receive information about their baby and to assess parent satisfaction with communication in the NICU.

Design/Methods: We conducted in-person interviews of Spanish speaking NICU parents using a semi-structured interview format. Parents of newborns admitted to the NICU for at least one week who identified Spanish as their preferred language were eligible. Interviews were performed by one of two bilingual providers. All interviews were audio-taped and transcribed. Transcripts were reviewed for errors by certified bilingual Spanish speakers and translated to English. A directed content comparison was performed to identify contextualized segments from each interview that correspond to targeted questions. We collected newborn demographic data, length of stay, and SNAPPE II (Score for Neonatal Acute Physiology-Perinatal Extension II), a predictor of neonatal mortality.

Results: Seventeen interviews were conducted. Average gestational age at birth was 33 weeks, 2 days [25,1 – 41,2] and 50% of newborns were female. Eighty-five percent of SNAPPE-II scores at 12 hours of life were between 0 and 20 (low). The average length of stay was 41 days [9-120 days] and all but one survived to discharge (1 remains admitted). At the time of the interview, the infants were 31 days old on average [3-118 days]. The average interview duration was 8 minutes (5-22 minutes). Parents primarily received information from nurses and reported rarely speaking with doctors. They were more likely to receive information when they were present in the NICU and when they asked. Parents feared that interpreters were inaccurate, but no parent reported ever refusing an interpreter. They reported difficulty expressing doubts to the medical team. Parents experienced delays in communication, which was perceived to be as a result of not speaking English. Parents expressed variable satisfaction with the frequency of information received but almost all reported being extensively involved in their child’s care. Parents requested more bilingual providers be available in addition to electronic interpreters.Conclusion(s): Parents with LEP face unique challenges communicating in the NICU. Our findings can inform neonatal quality initiatives to decrease delays and burdens for families with LEP to receive timely and good communication. Future studies are needed to determine the best strategies to facilitate communication with Spanish speaking families.