Point-of-care communication for patients with limited language proficiency: A scoping review of healthcare interpretation applications

Usability of technological tools to overcome language barriers in healthcare- a scoping review

INTRODUCTION

In many healthcare contexts globally, where the languages of care providers and service users do not match, miscommunication can lead to inaccurate diagnoses and subpar treatment outcomes. The development and use of technological tools to overcome language barriers are increasing, but usability and evaluation of these tools vary widely.

OBJECTIVES

This scoping review's objectives are (i) to identify and describe the technological tools used in direct service user-provider communication to overcome language barriers in a healthcare setting, (ii) to identify how the usability of these tools was evaluated, and (iii) to identify the challenges and benefits of using such technological tools.

METHODS AND ANALYSIS

The scoping review followed the JBI methodology. Studies published between January 2019 and July 2024 were identified using a search strategy with variations of the keywords "technological tools," "language barrier," and "health care" in the following six databases and research platforms: PubMed, PsycArticle, Scopus, EBSCOhost, ProQuest, and Web of Science. All literature on individuals using a technological tool to overcome language barriers in a healthcare context was included and exported into the screening assistant software Rayyan. The search was limited to articles written in German or English. The literature was screened twice by three independent reviewers in a blinded fashion, and all relevant data were presented in a descriptive summary.

RESULTS

Based on 16 publications, this scoping review identified 16 technological tools, categorized as fixed-phrase or machine translation apps, to overcome language barriers in a healthcare setting. Usability was assessed in 13 publications applying diverse methods, i.e., surveys, observations, and application data analysis. Technological tools hold potential as a means to address language barriers in healthcare by facilitating communication and supporting diagnostic processes. However, their usability is often constrained by challenges related to translation accuracy, accessibility, and learnability.

CONCLUSION

Future research and policy efforts should focus on standardizing evaluation methods and diversifying development regionally, linguistically, and interdisciplinary. Rather than broadly promoting these tools, emphasis should be placed on ensuring they are reliable and efficient for their intended use to maximize their effectiveness and relevance in specific healthcare contexts.

Patient and nursing staff perspectives on automated scalp cooling (ASC) for chemotherapy-induced alopecia in breast cancer

PURPOSE

Automated scalp cooling (ASC) is available to patients undergoing chemotherapy for breast cancer to decrease chemotherapy-induced alopecia. This study sought to elucidate patient and chemotherapy nursing perspectives on the ASC experience.

METHODS

This is a survey-based study of chemotherapy nursing staff and patients with breast cancer regarding perceived efficacy, side effects, administration, support, and overall opinions of ASC. Chemotherapy nurses across a large, multi-regional tertiary healthcare system completed a one-time survey regarding their experiences in administering ASC. Breast cancer patients who utilized ASC were surveyed along with a control group who underwent alopecia-inducing chemotherapy without ASC use for comparison.

RESULTS

The majority of nursing responses reported inadequate technical support, an increased burden of administering ASC compared to other clinical duties, and that they would not recommend ASC to a family member or friend. Patients who underwent ASC reported significantly less hair loss and were significantly less likely to shave their heads or wear a wig, but this did not translate into significant differences in body image or psychosocial wellbeing responses. Time investment was the most significant burden related to ASC.

CONCLUSION

Patients using ASC reported significantly less hair loss compared to those not using ASC during alopecia-inducing breast cancer chemotherapy, but this did not translate to improved body image. The majority of chemotherapy nurses reported they lacked adequate support in administering ASC and would not recommend it. Enhanced nursing support may provide a means for improving the ASC experience for both nursing staff and patients.

Applying a Language Justice Framework in Research: A Step Toward Achieving Health Equity

People who use languages other than English (LOE) are rarely included in research in the United States. LOE communities face numerous health disparities that are rooted in language injustice and other intersecting oppressions including racism and xenophobia. Equitable inclusion of LOE communities in research is an important step to disrupt health disparities. We propose a new conceptual framework on language justice in research to support researchers in conducting equitable multilingual research. This language justice in research framework comprises six core pillars of best practices required for achieving language justice during all the stages of the research process including conceptualization, budgeting, data collection and analysis, and dissemination. We also present key definitions, examples of how core pillars can be applied, and structural solutions to achieving language justice. The application of the language justice in research framework is designed: (a) to achieve health equity, data equity, and antiracism across the research continuum and (b) to disrupt health disparities in systems and institutions that are disproportionately impacting LOE communities.