Information Visualization to Improve Pain Communication Between Providers, Interpreters, and Patients With Limited English Proficiency
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 61
- Locations
- 2
- Primary Endpoint
- Percentage of Eligible Patients Enrolled
Study Overview
Brief Summary
The purpose of this study is to pilot test a pain assessment information visualization (InfoViz) tool to facilitate communication about pain severity, location, and quality to increase mutual understanding between patients with limited English proficiency (LEP), interpreters, and providers during pain assessment. 40 participants will be enrolled and can expect to be on study for up to 4 weeks.
Detailed Description
The purpose of this study is to pilot test a pain assessment information visualization (InfoViz) tool to facilitate communication about pain severity, location, and quality to increase mutual understanding between patients with limited English proficiency (LEP), interpreters, and providers during pain assessment.
The investigators focus on the LEP Hmong because pain is particularly problematic for this group. The Hmong describe pain using visual metaphors that are inconsistent with providers' knowledge and interpreters struggle to translate metaphors accurately between patients and providers. The goals of the study are (1) to examine the feasibility of implementing the pain InfoViz tool, (2) to explore congruency of patient-interpreter-provider triads' mutual understanding (MU) of pain severity, location, and quality, and (3) to evaluate outcome measures selected to capture satisfaction with communication, pain relief, and pain interference with life and explore variables identified in the InfoViz tool conceptual framework (MU of pain assessment information, satisfaction with communication, pain diagnosis and treatment).
The investigators will first collect data from 20 participants under the usual care control condition (i.e., interpreters verbally interpreting and communicating pain descriptions), followed by data collection from another 20 participants under the intervention condition (i.e., interpreters using verbal descriptions and the InfoViz tool).
The investigators believe that the pain assessment InfoViz tool will increase mutual understanding of pain severity, location, and quality between patients, interpreters, and providers, and consequently lead to increased satisfaction with communication, greater pain relief and reduced pain interference with daily life through better-informed diagnosis and treatment.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 13 Years to — (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •age 18 and up
- •Hmong patients that indicate they do not speak English well (LEP)
- •self reported pain
Exclusion Criteria
- •indicate that they speak English well
- •Interpreter Inclusion Criteria:
- •13 years old or greater
- •self-identify as interpreting for a Hmong individual in the health care setting
- •Interpreter Exclusion Criteria:
- •telephone interpreters as they are unable to view and use the InfoViz tool
Arms & Interventions
Usual Care Control
Standard of Care
InfoViz Intervention
Pain information visualization (InfoViz) tool, Trained interpreters will use the InfoViz tool twice, before and during the clinical encounter
Intervention: InfoViz (Other)
Outcomes
Primary Outcomes
Percentage of Eligible Patients Enrolled
Time Frame: up to 1 day
Feasibility with respect to recruitment will be measured by the percent of eligible patients who enroll.
Percentage of InfoViz Tools Completely Filled Out
Time Frame: up to 1 day
Feasibility with respect to tool use will be measured as the proportion of InfoViz tools with pain severity marked, at least one pain location marked, and at least one pain quality marked on the InfoViz tool.
Proportion of Patients Who Complete the Study
Time Frame: up to 4 weeks
Feasibility with respect to retention will be measured by the proportion of patients who complete the study.
Percentage of Items Correctly Performed on the Investigator Designed Fidelity Checklist
Time Frame: up to 1 day
Feasibility will be in part measured by InfoViz tool fidelity. The percentage of items correctly performed by participants on the investigator-designed fidelity checklist will be reported.
Percentage of Congruency in Mutual Understanding: Patient to Interpreter
Time Frame: up to 1 day
One question item from the 6-item Mutual Understanding Scale (MUS) asks participants about their main symptom (i.e., "What was the most important health complaint for which the physician was visited?") and providers to report participants' main symptom (e.g., "What was the most important health complaint for which the patient consulted with you?"). The percentage of congruency between the patient and interpreter response, from 0-100 where 100 is total congruency.
Percentage of Congruency in Mutual Understanding: Interpreter to Provider
Time Frame: up to 1 day
One question item from the 6-item Mutual Understanding Scale (MUS) asks participants about their main symptom (i.e., "What was the most important health complaint for which the physician was visited?") and providers to report participants' main symptom (e.g., "What was the most important health complaint for which the patient consulted with you?"). The percentage of congruency between the interpreter and provider, from 0-100 where 100 is total congruency.
Percentage of Congruency in Mutual Understanding: Patient to Provider
Time Frame: up to 1 day
One question item from the 6-item Mutual Understanding Scale (MUS) asks participants about their main symptom (i.e., "What was the most important health complaint for which the physician was visited?") and providers to report participants' main symptom (e.g., "What was the most important health complaint for which the patient consulted with you?"). The percentage of congruency between patient and provider, from 0-100 where 100 is total congruency.
Secondary Outcomes
- Participant Satisfaction With Communication Answer(up to 1 day)
- Participant Pain Relief Measured Using a 5 Point Verbal Rating Scale(one time post 4-6 weeks after the clinic vist)
- Participant Response to Pain Interference Question(usual care participants assessed at baseline and InfoViz participants assessed at 4 weeks)
- Quality of Communication Answer(up to 1 day)