Interpretive service type did not affect comprehension among Spanish-speaking colposcopy patients

Description #

Among the 38 Spanish-speaking patients, comprehension did not differ significantly by the type of interpretive service received — bilingual physician (n = 19), professional interpreter (n = 10), nurse acting as interpreter (n = 8), or both (n = 1). This is a null result; the authors note it may reflect the very small Spanish-speaking sample being underpowered to detect such differences rather than true equivalence. All Spanish speakers were reported to have received adequate interpretive services. Not tabulated (text-only).

"We did not find any significant differences in comprehension among Spanish speakers using varying interpretive services." (Krankl, 2011, p. 83)

"All Spanish speakers in this study received adequate interpretive services. We did not find any significant differences in patient comprehension among Spanish-speaking groups using varying interpretive services, although our sample size of Spanish-speaking subjects was likely too small to demonstrate such differences if they existed." (Krankl, 2011, p. 84)

Methods Context #

What? #ⓘ

The observable: the summary colposcopy knowledge score compared across self-reported interpretive-service subgroups within Spanish speakers.

"Spanish-speaking subjects were further categorized according to the type of self-reported interpretative services they received: bilingual providers, professional interpreters, or bilingual clinic employees." (Krankl, 2011, p. 81)

How? #ⓘ

Cross-sectional subgroup comparison of knowledge scores among Spanish speakers grouped by interpretive-service type; subjects self-reported the service they received.

"Of the 38 Spanish-speaking subjects, 19 reported having a bilingual physician, 10 reported having a professional interpreter, 8 reported having a nurse who acted as an interpreter, and 1 reported having both a bilingual physician and a nurse who acted as an interpreter." (Krankl, 2011, p. 82)

Who? #ⓘ

The 38 Spanish-speaking colposcopy patients with complete data at two Boston hospitals, subdivided into small interpretive-service subgroups.

"We obtained complete data on 111 English speakers and 38 Spanish speakers." (Krankl, 2011, p. 80)

Caveats #

• Small sample with few Spanish speakers, underpowered to detect interpretive-service differences The study had a small overall sample and, in particular, only 38 Spanish-speaking subjects, who were then further divided into interpretive-service subgroups (19 bilingual physician, 10 professional interpreter, 8 nurse-interpreter, 1 both). The authors state this Spanish-speaking sample was likely too small to detect comprehension differences among interpretive-service types if they existed, so the null interpretive-service finding is a Type II-vulnerable result rather than evidence of true equivalence. The small subgroup sizes also widen uncertainty on the between-group comparisons.
• Single academic-hospital setting with adequate interpretive services limits generalizability The study was conducted only at academic teaching hospitals where all Spanish speakers received adequate interpretive services, which the authors note may not reflect results at other types of clinics — especially those without adequate interpretive services. The null finding on interpretive-service type is therefore specific to a setting where baseline interpretation was already adequate, and may not generalize to settings where interpretation is scarce or absent. Colposcopy is also a relatively simple procedure, so conclusions may not extend to more complex medical information where language could matter more.