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The challenges of obtaining a health history from hispanic patients due to language barriers and cultural differences. It highlights the importance of proper medical interpreting services and the impact of acculturation on contraceptive use and cancer screening rates. The document emphasizes the significance of the patient-provider relationship and the need to assess and address barriers to committing to plans of care.
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Hispanic patients run into many barriers when trying to receive care from providers, and often the biggest blockade that they face umbrellas around language barriers that are often present. Language barriers pose challenges in terms of achieving high levels of satisfaction among medical professionals and patients, providing high-quality healthcare, and maintaining patient safety” (Al Shamsi et al., 2020, pp. 1). Patients with limited English language proficiency (LEP) must rely on interpreters to communicate with health care providers who do not speak their language or be subjected to impaired communication (Morales et al., 2006). Although federal guidelines issued by the Department of Health and Human Services Office for Civil Rights encourage federally funded entities to develop and implement plans for improving language access to health care, professional medical interpreters can often times be unavailable for health care encounters, leaving clinicians and LEP patients to communicate with little or no common language, making the provider feel the need to rely on untrained family members, bilingual medical staff, or other ad hoc interpreters (Morales et al., 2006). With this being said, it is vital for nurse practitioners and other healthcare providers to become aware of not only their entities interpreting services available at their
institution, but to also become knowledgeable about the reproable medical interpreting services that are in their area that they practice in order to ensure proper medical care for both Hispanic patients, as well as, other limited LEP patients that they are treating. Another concern or barrier that a provider might face when trying to obtain a health history from a less accultured Hispanic female. Some barriers that have been noted in previous studies include these female patients in statistically have lower percentages of obtaining needed routine screenings as well as being more likely to use no contraception or cyclic hormonal contraception at last sexual intercourse, as compared to Hispanic women classified as high in acculturation (Ronancio, Ward, & Berenson, 2012). Young Hispanic women are only half as likely to use contraception to non- Hispanic white women of the same age (Ronancio et al., 2012). Given this, it is not surprising that 76% of pregnancies among this group are unplanned. In order to reduce the alarming rate of unplanned pregnancies among this population, more information about their contraceptive use is needed (Ronancio et al., 2012). Acculturation is one characteristic that may help explain differences in contraceptive use among young Hispanic women. In a survey study done by Unger (2000), she identified that “moderately accultured women expressed lower intentions to use contraceptives, were less certain that they would be able to use contraceptives consistently for the next 6 months, and reported lower social support for contraceptive use, than did unaccultured women.” Therefore, social norms and low self-efficacy may place moderately accultured Hispanic females at risk for unintended pregnancy and STDs. Lastly, when more moderately accultured Hispanic females are due for a routine cancer screening (more specifically a colorectal exam/screening or a mammogram), research has shown that this group of women fall lower than national averages in obtaining these vital cancer screenings. Research has found that the relationship between past and future mammography thoughts, plans and behavior is mediated by a complex combination of sociodemographic, intrapersonal, and interpersonal factors. However, healthcare factors, operationalized as access and experience, may also influence the relationship between past and future mammography behavior as well (Scheel et al., 2017). For example, women reporting adherence to screening mammography guidelines are more likely to also report greater healthcare access, including having health insurance and a regular provider, and experiences with their providers, including having had a clinical breast examination (CBE) and a provider recommendation (Scheel et al., 2007). These findings emphasize the importance of the patient-provider relationship during a clinic visit and the relevant questions that need to be obtained when conducting a health history on Hispanic female patients. It is important to assess and discuss with the patient any reluctance that they have to the providers recommendations or plans of care. Additionally, assessing barriers that the patient might have in committing to plans of care as it relates to education needs, health insurance access or cultural-related barriers such as unfamiliarity with navigating the U.S. medical system etc., is another vital concern that health care providers need to consider with every patient that comes into their care. References: