Abstract and Introduction
According to the U.S. Census Bureau, Spanish-speakers currently constitute 1 in 10 U.S. households, and the number is expected to rise. To provide responsible and responsive care, many nurses will need to develop communication skills for working with Spanish speakers and be able to find quality, reliable health information in Spanish for their patients and patients' families. A number of efforts have been described in the literature. This article augments prior efforts by providing nurses with resources for learning key words and phrases, sources to increase awareness of and sensitivity to cultural nuances, reliable consumer Web resources for Spanish-speaking patients, and tips for evaluating Spanish language health information on other Web sites.
Nearly 1 in 5 residents of the United States (over age 5) speak a language other than English at home, and nearly half of those individuals do not speak English "very well" (U.S. Census Bureau, 2003). The most common non-English language spoken in the United States is Spanish. In fact, between 1990 and 2000, the number of Spanish speakers in the United States increased 62 %, from 17.3 million to 28.1 million. By 2005, the number was 31 million (U.S. Census Bureau, 2005). Currently, Spanish speakers constitute a ratio of more than 1-in-10 U.S. household residents, and the number is expected to increase. By the year 2050, the projected Hispanic population in the United States will be 102.6 million, 24% of the nation's total population (U.S. Census Bureau, 2005).
With the growing Spanish speaking population, nurses need to develop communication skills for working with Spanish speakers and be able to find quality, reliable health information in Spanish for their patients. A few efforts in this regard have been documented in the literature.
A study some years ago of nurses working with Spanish-speaking migrant farm workers found nurses citing many communication concerns, and wanting to improve communication, but experiencing little help from their agencies in this regard (Padgett & Barrus, 1992). Nurses thought that classes held at their agencies would be the most effective way to learn Spanish. At the same time, a study of bilingual nurses doubling as interpreters, without having formal training as medical interpreters, found that translation errors can and do occur (Elderkin-Thompson, Silver & Waitzkin, 2001).
A study in one hospital emergency department found that interpreters were not used as often as Spanish-speaking patients thought they should be (Baker, Parker, Williams, Coates, Pitkin, 1996). Patients who thought an interpreter should have been used rated their understanding of their disease as substantially lower than both those who actually used an interpreter and those who felt no need for an interpreter (58% vs 82% and 86% respectively). At the same time, the researchers reported that objective measures showed less of a difference, and in fact many of the patients in all groups had a poor understanding of their diagnosis and their treatment plans.
Two recent reports suggest benefits, to health care providers, in using tools such as "translation cards" and a bedside "translation tool." In Vanderbilt Children's Hospital's NICU, illustrated translation cards have provided nurses with phrases commonly used in communication with parents (Dye, 2001). Researchers from the University of Kentucky Medical Center reported that health care providers in a critical care setting participated in developing an English-Spanish translator to be used at the bedside (Bernard et al., 2005). After a seven month trial period, 91% of nurses responding to a survey about the translator reported that it met their needs at the bedside some, most, or all of the time. Use of the translator also contributed to decreased stress perceived by the nurses.
This article provides key resources for nurses wanting to improve communication with Spanish-speaking patients and families. Even nurses who do not speak any Spanish will find the information on the following pages useful:
resources for learning key words and phrases (see Table 1 ),
sources to increase awareness of and sensitivity to cultural nuances (see Table 2 ),
reliable consumer Web resources for Spanish-speaking patients (see Table 3 ), and
tips for evaluating Spanish language health information on Web sites (see Table 4 ).