Mixed-Methods Exploration of Parents’ Health Information Understanding by Carlee Lehna and Jack Mcneil, Article Critique Example

With the increase in the non-English speaking population in the United States, it is essential that all patients and their care givers understand procedures before any medical intervention is performed. The purpose of this study was to examine how two separate groups of caregivers, English speaking and Spanish speaking, understood the medical care for their children and the various forms included as part of the requirements for this care to be provided. The study was mixed-methods in nature and Creswell (2003) describes this to include elements of qualitative as well as quantitative analysis with the end result being one study exposing both elements in order to gain a better understanding of two views.

In our study, the variables of interest were an independent variable which consisted of one group of English speaking parents and one group of Spanish speaking parents. The dependent variable was found to be the actual transcription of information from the focus groups and interviews as it was transcribed from Spanish into English for analysis. It is because of the language variance that this was found to be a dependent variable. If the transcription is inaccurate, the results would be inaccurate as well.

The analysis process consisted of interview and focus groups that were held in order to ask questions of both the English and Spanish only speaking parents. The results of the questions were transcribed into a written format and coded so they could be qualitatively analyzed. The quantitative analysis consisted of an adaptation of the TOEFL (which was the STOFHLA) that was given to the groups in order to have them demonstrate their literacy knowledge of medical procedures and general medical care. In the study, the second research question was pertaining to the quantitative piece of the research such as age, gender, and level of education. The first question was concerned with how the parents understood the importance of care and consent as far as surgical procedures and general medical care.

The level of significance was tested using the Kuder-Richardson calculation and was adapted for both the English and Spanish version of the STOFHLA test (the alternative to the TOEFL). The significance level for the English STOFHLA was .95 and the Spanish STOFHLA was .97, respectively. This indicates a satisfactory level of confidence for the study.

There were a couple of limits and strength of the analysis process. One limit stated in the article was the nonparticipation of some English and/or Spanish caregivers. It was assumed these caregivers decided not to participate due to illiteracy or embarrassment concerns because of not having the knowledge they felt was needed to answer the questions or participate in the interviews.  A strength noted was the enrichment of the qualitative analysis by the quantitative results. The focus groups were a surprisingly wonderful way to accumulate data from the caregivers who were Spanish. They were forthcoming about what they did not understand and what they found to be helpful. It was also beneficial for them that their native language could be spoken in these focus groups.

It is important to understand the background variables of a patient and the caregiver when performing medical services such as surgical procedures or routine procedures and asking them to sign consent forms. If a staff groups is predominantly English speaking and there are Spanish speaking patients, it is vital to attempt to bridge the language barrier in order to ensure the proper care is being given so the patients and their families feel comfortable and are not unknowingly put in a dangerous position due to something that could be avoided. This could be solved with written materials in their language, picture materials, or audio materials if there is no person who can communicate the language effectively.

References

Creswell, J.W. (2003). Research design: Qualitative, quantitative, and mixed method approaches. (2^nd ed.) Thousand Oaks, CA: Sage.

Lehna, C., & McNeil, J. (2008, May). Mixed-methods exploration of parents’ health information understanding. Clinical Nursing Research, 17(2), 133-144.