The impact of language barriers and immigration status on the care experience for Spanish-speaking caregivers of patients with pediatric cancer

Eduardo R. Zamora, Sapna Kaul, Anne C. Kirchhoff, Vannina Gwilliam, Ornella A. Jimenez, Deborah K. Morreall, Roberto E. Montenegro, Anita Y. Kinney, Mark N. Fluchel

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: An increasing proportion of pediatric cancer patients in the United States are Latino and many have Spanish-speaking immigrant parents with limited English proficiency (LEP). Little is known about how language or undocumented immigration status impacts their care experience. Procedure: A cross-sectional survey was administered to English (N = 310) and Spanish-speaking LEP (N = 56) caregivers of pediatric cancer patients. To assess differences in healthcare experiences between the language groups, t-tests and chi-square statistics were used. Multivariable logistic regression evaluated associations between primary language and knowledge of clinical trial status. Results: Spanish-speaking caregivers were more likely to report higher rates of quitting or changing jobs as a direct result of their child's cancer, and their children were more likely to experience a delay in education. Although Spanish-speaking caregivers reported higher satisfaction with care, 32% reported feeling that their child would have received better care if English was their primary language. Spanish-speaking caregivers were more likely to incorrectly identify whether their child was on a clinical trial compared with English-speaking caregivers. The majority of Spanish-speaking caregivers reported at least one undocumented caregiver in the household and 11% of them avoided or delayed medical care for their child due to concerns over their undocumented immigration status. Conclusions: Language barriers and undocumented immigration status may negatively impact the quality of informed decision-making and the care experience for Spanish-speaking LEP caregivers of pediatric cancer patients. These families may benefit from culturally appropriate Spanish language resources to improve communication and open a dialogue regarding undocumented immigration status.

Original languageEnglish (US)
Pages (from-to)2173-2180
Number of pages8
JournalPediatric Blood and Cancer
Volume63
Issue number12
DOIs
StatePublished - Dec 1 2016

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Communication Barriers
Emigration and Immigration
Caregivers
Pediatrics
Language
Neoplasms
Clinical Trials
Chi-Square Distribution
Child Care
Hispanic Americans
Decision Making
Emotions
Cross-Sectional Studies
Parents
Logistic Models
Communication
Delivery of Health Care
Education

Keywords

  • caregivers
  • communication barriers
  • decision-making
  • language barriers
  • Latino

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

The impact of language barriers and immigration status on the care experience for Spanish-speaking caregivers of patients with pediatric cancer. / Zamora, Eduardo R.; Kaul, Sapna; Kirchhoff, Anne C.; Gwilliam, Vannina; Jimenez, Ornella A.; Morreall, Deborah K.; Montenegro, Roberto E.; Kinney, Anita Y.; Fluchel, Mark N.

In: Pediatric Blood and Cancer, Vol. 63, No. 12, 01.12.2016, p. 2173-2180.

Research output: Contribution to journalArticle

Zamora, ER, Kaul, S, Kirchhoff, AC, Gwilliam, V, Jimenez, OA, Morreall, DK, Montenegro, RE, Kinney, AY & Fluchel, MN 2016, 'The impact of language barriers and immigration status on the care experience for Spanish-speaking caregivers of patients with pediatric cancer', Pediatric Blood and Cancer, vol. 63, no. 12, pp. 2173-2180. https://doi.org/10.1002/pbc.26150
Zamora, Eduardo R. ; Kaul, Sapna ; Kirchhoff, Anne C. ; Gwilliam, Vannina ; Jimenez, Ornella A. ; Morreall, Deborah K. ; Montenegro, Roberto E. ; Kinney, Anita Y. ; Fluchel, Mark N. / The impact of language barriers and immigration status on the care experience for Spanish-speaking caregivers of patients with pediatric cancer. In: Pediatric Blood and Cancer. 2016 ; Vol. 63, No. 12. pp. 2173-2180.
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AU - Kirchhoff, Anne C.

AU - Gwilliam, Vannina

AU - Jimenez, Ornella A.

AU - Morreall, Deborah K.

AU - Montenegro, Roberto E.

AU - Kinney, Anita Y.

AU - Fluchel, Mark N.

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N2 - Background: An increasing proportion of pediatric cancer patients in the United States are Latino and many have Spanish-speaking immigrant parents with limited English proficiency (LEP). Little is known about how language or undocumented immigration status impacts their care experience. Procedure: A cross-sectional survey was administered to English (N = 310) and Spanish-speaking LEP (N = 56) caregivers of pediatric cancer patients. To assess differences in healthcare experiences between the language groups, t-tests and chi-square statistics were used. Multivariable logistic regression evaluated associations between primary language and knowledge of clinical trial status. Results: Spanish-speaking caregivers were more likely to report higher rates of quitting or changing jobs as a direct result of their child's cancer, and their children were more likely to experience a delay in education. Although Spanish-speaking caregivers reported higher satisfaction with care, 32% reported feeling that their child would have received better care if English was their primary language. Spanish-speaking caregivers were more likely to incorrectly identify whether their child was on a clinical trial compared with English-speaking caregivers. The majority of Spanish-speaking caregivers reported at least one undocumented caregiver in the household and 11% of them avoided or delayed medical care for their child due to concerns over their undocumented immigration status. Conclusions: Language barriers and undocumented immigration status may negatively impact the quality of informed decision-making and the care experience for Spanish-speaking LEP caregivers of pediatric cancer patients. These families may benefit from culturally appropriate Spanish language resources to improve communication and open a dialogue regarding undocumented immigration status.

AB - Background: An increasing proportion of pediatric cancer patients in the United States are Latino and many have Spanish-speaking immigrant parents with limited English proficiency (LEP). Little is known about how language or undocumented immigration status impacts their care experience. Procedure: A cross-sectional survey was administered to English (N = 310) and Spanish-speaking LEP (N = 56) caregivers of pediatric cancer patients. To assess differences in healthcare experiences between the language groups, t-tests and chi-square statistics were used. Multivariable logistic regression evaluated associations between primary language and knowledge of clinical trial status. Results: Spanish-speaking caregivers were more likely to report higher rates of quitting or changing jobs as a direct result of their child's cancer, and their children were more likely to experience a delay in education. Although Spanish-speaking caregivers reported higher satisfaction with care, 32% reported feeling that their child would have received better care if English was their primary language. Spanish-speaking caregivers were more likely to incorrectly identify whether their child was on a clinical trial compared with English-speaking caregivers. The majority of Spanish-speaking caregivers reported at least one undocumented caregiver in the household and 11% of them avoided or delayed medical care for their child due to concerns over their undocumented immigration status. Conclusions: Language barriers and undocumented immigration status may negatively impact the quality of informed decision-making and the care experience for Spanish-speaking LEP caregivers of pediatric cancer patients. These families may benefit from culturally appropriate Spanish language resources to improve communication and open a dialogue regarding undocumented immigration status.

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