3031 - Barriers to Medical Translation in Patients Receiving Radiation Therapy

Purpose/Objective(s):

Millions of Americans have limited English proficiency (LEP), and minority populations with LEP have grown substantially in the last decade. Previous studies showed language barriers contribute to health disparities, and that patient satisfaction and outcomes are worse for LEP patients. The primary objective of this study is to define the impact of medical translation on quality and duration of appointments over the course of RT for Spanish speaking patients. Additional objectives are to identify challenges in medical translation and propose areas of focus for improvement.

Materials/Methods:

This study utilized an IRB approved survey with a convergent mixed-methods design. Quantitative and qualitative responses from respondents were elicited through multiple choice, rating, and open-ended questions. Patients and providers each completed a survey in Spanish and English respectively, upon RT completion. Survey data was collected and analyzed with a survey platform and spreadsheet software. Percentages were used for reporting survey responses, and odds ratios and chi-squared analyses were used to compare responses.

Results:

From July 2023 to February 2025, 30 adult patients who spoke Spanish as their primary language, and who required a translator for consultation and during their treatment course, were included. Median patient age was 51.5 years (IQR 42–62), with 53% being female. The majority of patients (83%) underwent RT for a malignant lesion, most often in the adjuvant setting (47%). 60% received Intensity Modulated Radiation Therapy (IMRT). Median RT duration was 29 days. 87% of patients had limited or no English proficiency, 96% reported having access to an interpreter for all aspects of their care, though 20% noted a dialect mismatch. Overall patient satisfaction with translation services was high during initial consultations (mean 4.77/5), but only 80% clearly understood all follow-up discussions. Providers noted more than half of patient encounters were moderately or much longer (53.%), with 11 responses (37%) indicating that they had slightly or significantly less eye contact with patients compared to English-proficient patients. Overall, translation services positively impacted patient care (69%), but challenges with connection time, quality, and coordination were noted.

Conclusion:

We found overall, medical translation had a positive impact on patient care from both provider and patient perspective, however, opportunities for improvement were identified. Extra care should be taken toward securing the correct dialect whenever possible. The decrease in patient satisfaction after consultation also demonstrates the need to be vigilant that the same standard is applied throughout the treatment course as at consultation.