Translating and Validating PRISMA-7 Questionnaire in Urdu: A Screening Tool to Identify Frail Individuals.

Frailty is a condition in which the affected individual is more prone to both external and internal stressors and has a higher risk of succumbing to chronic diseases. The aim of this research was to translate and validate the PRISMA-7 questionnaire in the Urdu language. This is a validation study conducted in a hospital in Khyber Pakhtunkhwa, Pakistan. PRISMA-7 Questionnaire was translated into Urdu language using forward and backward translations and was then piloted on a sample of 151 subjects, aged 60 and above, and validated by applying reliability and validity statistics. Amongst the sampling population, frailty was found to be 63.26%. All the items in the questionnaire were significantly different from each other, however, the correlation between each was found to be low. Cronbach's alpha was found to be 0.322. Urdu translated version of PRISMA-7 is not a valid and reliable tool for screening frailty in the elderly population of Khyber Pakhtunkhwa, Pakistan. Key Words: Frailty, Validation, Translation, Frail elderly, Urdu.

Motivations of undergraduate student medical interpreters: Exposure and experience.

BACKGROUND: When patients do not speak the same language as their doctors, they face poorer medical outcomes, decreased doctor-patient trust, and a diminished desire to seek medical care. It has been well established that interpretation is an essential part of an accessible healthcare system, but effective use of such language services relies on both the interpreters themselves and the healthcare teams working with them. This study presents an interdisciplinary examination of the motivations of undergraduate student medical interpreters, a group which serves as a bridge between these roles. While not full-time interpreters, they receive official training and spend time serving patients in local clinics. Further, for those who aspire to careers in medicine, interpreting provides invaluable exposure to the medical field and early professional know-how. METHODS: Semi-structured individual interviews with undergraduate student interpreters were conducted to describe this multifaceted educational experience. A thematic analysis framework was employed to understand how and why they volunteer their time to interpret. RESULTS: Motivations of student interpreters were found to fall under three general categories: (1) personal identity, or connection to family, language, and their career aspirations; (2) community engagement, or the opportunity to make a direct impact on patients at an early stage; and (3) pre-professional experience, both in general and specifically in healthcare. Each of these contributes to the view of a student medical interpreter as a unique contributor to language equity in medicine, as they provide language services in the short-term as well as set themselves up to be linguistically and culturally competent providers in the long-term. CONCLUSIONS: A greater understanding of student motivations adds to knowledge about language mediation and validates the utility of students in this role, encouraging the development of more student interpreter programs. Particularly in communities with high proportions of non-English speakers, these students can contribute to making medical care as inclusive and accessible as possible.

Mental health during ecological crisis: translating and validating the Hogg Eco-anxiety Scale for Argentinian and Spanish populations.

BACKGROUND: Eco-anxiety is increasingly recognized as a shared experience by many people internationally, encompassing fear of environmental catastrophe and anxiety about ecological crises. Despite its importance in the context of the changing climate, measures for this construct are still being developed in languages other than English. METHODS: To contribute to global eco-anxiety research, we translated the Hogg Eco-Anxiety Scale (HEAS) into Spanish, creating the HEAS-SP. We validated this measure in samples from both Argentina (n = 990) and Spain (n = 548), performing measurement invariance and confirmatory factor analyses. Internal consistency of the scale and score stability over time were investigated through reliability analyses. Differences in eco-anxiety across sociodemographic variables were explored through Student's t-tests and Pearson's r tests. RESULTS: The four-factor model of the HEAS-SP comprising affective and behavioural symptoms, rumination, and anxiety about personal impact demonstrated excellent model fit. We found good internal consistency for each subscale, and established measurement invariance between Spanish and Argentine samples, as well as across genders and participants' age. Spanish participants reported higher scores on the affective symptoms and personal impact anxiety factors compared to the Argentinian sample. Also, men reported lower levels than women on the subscales of affective symptoms, rumination, and personal impact anxiety. It was found that the relationship between both age and personal impact anxiety and age and affective symptoms varies significantly depending on the gender of the individuals. Younger participants tended to report higher scores on most dimensions of eco-anxiety. CONCLUSIONS: These findings enhance the global initiative to investigate, explore and therefore comprehend eco-anxiety by introducing the first valid and reliable Spanish-language version of this psychometric instrument for its use within Spanish and Argentinian populations. This study augments the body of evidence supporting the robust psychometric properties of the HEAS, as demonstrated in prior validations for Australian, Turkish, Portuguese, German, French, and Italian populations.

A Review of Disparities in Outcomes of Hospitalized Patients with Limited English Proficiency: The Importance of Nursing Resources.

Language barriers significantly affect communication between patients and health care staff and are associated with receipt of lower-quality care. Registered nurses are well positioned members of the health care team to reduce and eliminate disparities for patients with limited English proficiency (LEP). Current evidence recommends nurses use interpreters or translation devices to overcome language barriers; however, these recommendations fail to recognize that structural system-level factors, such as unsupportive work environments and poor nurse-to-patient staffing ratios, reduce nurses' ability to implement these recommendations. The Quality Health Outcomes Model (QHOM) is a useful framework for understanding relationships between hospital systems, the delivery of care interventions, and patient outcomes. The goal of this manuscript is to use the QHOM and existing empirical evidence to present a new perspective on the long-standing clinical challenge of reducing language-related health outcome disparities by considering the context in which nurses deliver patient care.

Understanding the language barriers to translating informed consent documents for maternal health trials in Zambia: a qualitative study.

OBJECTIVE: Providing comprehensible information is essential to the process of valid informed consent. Recruitment materials designed by sponsoring institutions in English-speaking, high-income countries are commonly translated for use in global health studies in other countries; however, key concepts are often missed, misunderstood or 'lost in translation'. The aim of this study was to explore the language barriers to informed consent, focusing on the challenges of translating recruitment materials for maternal health studies into Zambian languages. DESIGN: We used a qualitative approach, which incorporated a multistakeholder workshop (11 participants), in-depth interviews with researchers and translators (8 participants) and two community-based focus groups with volunteers from community advisory boards (20 participants). Content analysis was used to identify terms commonly occurring in recruitment materials prior to the workshop. The framework analysis approach was used to analyse interview data, and a simple inductive thematic analysis approach was used to analyse focus group data. SETTING: The study was based in Lusaka, Zambia. RESULTS: The workshop highlighted difficulties in translating research terms and pregnancy-specific terms, as well as widespread concern that current templates are too long, use overly formal language and are designed with little input from local teams. Framework analysis of in-depth interviews identified barriers to participant understanding relating to design and development of recruitment materials, language, local context and communication styles. Focus group participants confirmed these findings and suggested potential solutions to ensure the language and content of recruitment materials can be better understood. CONCLUSION: Our findings demonstrate that the way in which recruitment materials are currently designed, translated and disseminated may not enable potential trial participants to fully understand the information provided. Instead of using overly complex institutional templates, recruitment materials should be created through an iterative and interactive process that provides truly comprehensible information in a format appropriate for its intended participants.

Translating and establishing the psychometric properties of the Jenkins Sleep Scale for Arabic-speaking individuals.

BACKGROUND: The Jenkins Sleep Scale is a widely used self-report questionnaire that assesses sleep quality and disturbances. This study aimed to translate the scale into Arabic and evaluate its psychometric properties in an Arabic-speaking population. METHODS: The Jenkins Sleep Scale was translated into Arabic using forward and backward translation procedures. The Arabic version was administered to a convenience sample of 420 adults along with the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) for validation purposes. Reliability was examined using Cronbach's alpha and McDonald's omega coefficients. Confirmatory factor analysis (CFA) was also conducted to test the unidimensional factor structure. Convergent validity was assessed using correlations with PSQI and AIS scores. RESULTS: The Cronbach's alpha and McDonald's omega values for the Arabic Jenkins Sleep Scale were 0.74 and 0.75, respectively, indicating good internal consistency. The 2-week and 4-week test-retest intraclass correlation coefficients were both 0.94 (p < 0.001), indicating excellent test-retest reliability. The CFA results confirmed the unidimensional factor structure (CFI = 0.99, TLI = 0.96, RMSEA = 0.08). The measurement model had an equivalent factor structure, loadings, intercepts, and residuals across sex, age, and marital status. Significant positive correlations were found between the Arabic Jenkins scale score and the PSQI (r = 0.80, p < 0.001) and AIS (r = 0.74, p < 0.001), supporting convergent validity. CONCLUSION: The Arabic version of the Jenkins Sleep Scale demonstrated good psychometric properties. The findings support its use as a valid and reliable measure for evaluating sleep quality and disturbances among Arabic-speaking populations.

Evaluating a conceptual framework for quality assessment of medical interpretation.

OBJECTIVE: We aimed to evaluate a proposed conceptual framework for quality assessment of medical interpretation using actual data from clinical settings. METHODS: A mixed methods approach was used. Routine outpatient encounters involving Portuguese-speaking Brazilian patients, Japanese physicians, and hospital-provided and ad hoc interpreters were digitally recorded and transcribed. A questionnaire survey examining participants' satisfaction was conducted; 111 and 13 encounters by hospital-provided and ad hoc interpreters, respectively, were recorded. Segments of consecutively interpreted utterances were coded as "altered," whereby the interpreter changed the meaning of the source utterance, or "unaltered (accurate)." Frequency and type of alteration were analyzed. The effect of positive interpretation alterations on physician-patient interactions was qualitatively described. RESULTS: Interpretation accuracy was significantly higher for hospital-provided interpreters, but was not associated with overall patient satisfaction. Overall physician satisfaction was associated with accurate interpretation, clinically negative altered interpretations, and positive voluntary interventions (p < 0.05). Positive alterations promoted patient, physician, and interpreter interactions, which helped to achieve clinical outcomes. CONCLUSION: A new conceptual framework for quality assessment of medical interpretation was developed for clinical settings. Healthcare provider satisfaction can provide a measure of interpretation alterations. PRACTICE IMPLICATIONS: Healthcare providers can effectively use the conceptual framework to improve medical interpretation and collaboration with healthcare interpreters.

Consenso de terminología en microscopia confocal de reflectancia en español mediante método Delphi / Reflectance Confocal Microscopy Terminology in Spanish: A Delphi Consensus Study

La terminología usada para describir los diferentes hallazgos en la microscopía confocal de reflectancia (MCR), tanto en lesiones melanocíticas, como en no melanocíticas se ha consensuado en inglés. En el presente trabajo, se proponen los términos en español que mejor interpretan estos conceptos ya descritos para la MCR, mediante el consenso de expertos de distintas nacionalidades de habla hispana y utilizando el método DELPHI para el acuerdo final. Se obtuvieron 52 términos en total, de los cuales 28 fueron para lesiones melanocíticas y 24 para lesiones no melanocíticas. El uso de la nomenclatura propuesta permitirá una homogeneización y mejor entendimiento de las estructuras; una descripción más estandarizada en los registros clínicos y una mejor interpretación de estos informes por otros dermatólogos.(AU)

The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.(AU)

[Translated article] Reflectance Confocal Microscopy Terminology in Spanish: A Delphi Consensus Study / Consenso de terminología en microscopia confocal de reflectancia en español mediante método Delphi

La terminología usada para describir los diferentes hallazgos en la microscopía confocal de reflectancia (MCR), tanto en lesiones melanocíticas, como en no melanocíticas se ha consensuado en inglés. En el presente trabajo, se proponen los términos en español que mejor interpretan estos conceptos ya descritos para la MCR, mediante el consenso de expertos de distintas nacionalidades de habla hispana y utilizando el método DELPHI para el acuerdo final. Se obtuvieron 52 términos en total, de los cuales 28 fueron para lesiones melanocíticas y 24 para lesiones no melanocíticas. El uso de la nomenclatura propuesta permitirá una homogeneización y mejor entendimiento de las estructuras; una descripción más estandarizada en los registros clínicos y una mejor interpretación de estos informes por otros dermatólogos.(AU)

The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.(AU)

Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study.

OBJECTIVE: To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties. METHODS: The Brislin's translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability. RESULTS: The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach's alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855. CONCLUSIONS: The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.

Barriers to use of interpreters in outpatient mental health care: Exploring the attitudes of psychotherapists.

The support of professional interpreters is an essential component of adequate mental health care for migrants with limited language proficiency. Nevertheless, for varied reasons, only a small proportion of outpatient psychotherapists provide interpreter-mediated psychotherapy for migrants. This study explored the perspectives of psychotherapists who have not worked with professional interpreters in outpatient mental health care to identify factors that may prevent the use of interpreters in outpatient care and explore possible incentives to provide interpreter-mediated psychotherapy for migrants with limited language proficiency. Semi-structured interviews were conducted with 13 outpatient psychotherapists in Northern Germany who had not yet worked with professional interpreters in outpatient care. The interviews were audio recorded, transcribed and analysed using a structured content analysis approach. The psychotherapists named structural as well as subjective barriers and concerns. Findings suggest that improving structural factors, such as secure funding, minimal additional work, better preparation and training could facilitate the integration of professional interpreters into everyday treatment. Psychotherapists also mentioned concerns about their own confidence (e.g., insecurities regarding the triadic situation), the patient (e.g., reduced openness), the interpreter (e.g., doubts about suitability, motivation and empathy), as well as the therapeutic process (e.g., unclear allocation of roles). However, positive aspects and opportunities of interpreter-mediated psychotherapy were also described. These could be enhanced by the presence of conducive factors, such as existing trust between all parties and professional cooperation between interpreter and psychotherapist.

Interpreter and limited-English proficiency patient training helps develop medical and physician assistant students' cross-cultural communication skills.

BACKGROUND: The increasing linguistic and cultural diversity in the United States underscores the necessity of enhancing healthcare professionals' cross-cultural communication skills. This study focuses on incorporating interpreter and limited-English proficiency (LEP) patient training into the medical and physician assistant student curriculum. This aims to improve equitable care provision, addressing the vulnerability of LEP patients to healthcare disparities, including errors and reduced access. Though training is recognized as crucial, opportunities in medical curricula remain limited. METHODS: To bridge this gap, a novel initiative was introduced in a medical school, involving second-year students in clinical sessions with actual LEP patients and interpreters. These sessions featured interpreter input, patient interactions, and feedback from interpreters and clinical preceptors. A survey assessed the perspectives of students, preceptors, and interpreters. RESULTS: Outcomes revealed positive reception of interpreter and LEP patient integration. Students gained confidence in working with interpreters and valued interpreter feedback. Preceptors recognized the sessions' value in preparing students for future clinical interactions. CONCLUSIONS: This study underscores the importance of involving experienced interpreters in training students for real-world interactions with LEP patients. Early interpreter training enhances students' communication skills and ability to serve linguistically diverse populations. Further exploration could expand languages and interpretation modes and assess long-term effects on students' clinical performance. By effectively training future healthcare professionals to navigate language barriers and cultural diversity, this research contributes to equitable patient care in diverse communities.

Performance of machine translators in translating French medical research abstracts to English: A comparative study of DeepL, Google Translate, and CUBBITT.

BACKGROUND: Non-English speaking researchers may find it difficult to write articles in English and may be tempted to use machine translators (MTs) to facilitate their task. We compared the performance of DeepL, Google Translate, and CUBBITT for the translation of abstracts from French to English. METHODS: We selected ten abstracts published in 2021 in two high-impact bilingual medical journals (CMAJ and Canadian Family Physician) and used nine metrics of Recall-Oriented Understudy for Gisting Evaluation (ROUGE-1 recall/precision/F1-score, ROUGE-2 recall/precision/F1-score, and ROUGE-L recall/precision/F1-score) to evaluate the accuracy of the translation (scores ranging from zero to one [= maximum]). We also used the fluency score assigned by ten raters to evaluate the stylistic quality of the translation (ranging from ten [= incomprehensible] to fifty [= flawless English]). We used Kruskal-Wallis tests to compare the medians between the three MTs. For the human evaluation, we also examined the original English text. RESULTS: Differences in medians were not statistically significant for the nine metrics of ROUGE (medians: min-max = 0.5246-0.7392 for DeepL, 0.4634-0.7200 for Google Translate, 0.4815-0.7316 for CUBBITT, all p-values > 0.10). For the human evaluation, CUBBITT tended to score higher than DeepL, Google Translate, and the original English text (median = 43 for CUBBITT, vs. 39, 38, and 40, respectively, p-value = 0.003). CONCLUSION: The three MTs performed similarly when tested with ROUGE, but CUBBITT was slightly better than the other two using human evaluation. Although we only included abstracts and did not evaluate the time required for post-editing, we believe that French-speaking researchers could use DeepL, Google Translate, or CUBBITT when writing articles in English.

Versión española del Nordic Musculoskeletal Questionnaire: adaptación transcultural y validación en personal auxiliar de enfermería / Spanish version of the Nordic Musculoskeletal Questionnaire: cross-cultural adaptation and validation in nursing aides

Fundamento. El objetivo de este trabajo es traducir, adaptar culturalmente y validar una versión española del Nordic Musculoskeletal Questionnaire (NMQ) en una muestra de personal auxiliar de enfermería. Metodología. Se realizó la traducción y adaptación cultural del cuestionario y se incluyó dentro de una batería de escalas, cumplimentada por 526 auxiliares de enfermería de centros residenciales para personas mayores del Principado de Asturias. Se analizó la validación de la escala a través de la sucesión del análisis factorial exploratorio (AFE) y el análisis factorial confirmatorio (AFC). La consistencia interna se estimó con el coeficiente ordinal ω de McDonald, complementándose con el análisis de fiabilidad test-retest por medio del coeficiente de correlación intraclase (ICC). La validez de criterio se estimó a través de la correlación de la puntuación total de la prueba con las medidas de calidad de vida, incertidumbre laboral, demanda psicológica y apoyo social en el trabajo. Resultados. Los índices de ajuste de AFE y AFC mostraron que se trata de una prueba unidimensional. Los valores de consistencia interna señalaron una fiabilidad muy alta (ω= 0,81) y el ICC fue excelente (r= 0,95). La validez de criterio mostró una correlación estadísticamente significativa con todos los constructos estudiados, especialmente con la calidad de vida. Conclusiones. La presente versión española del NMQ presenta unas buenas cualidades psicométricas en la población de personal auxiliar de enfermería por lo que podría ser una herramienta válida y fiable en la evaluación de los trastornos musculoesqueléticos. (AU)

Background. The aim of this study is to translate, culturally adapt, and validate a Spanish version of the Nordic Musculoskeletal Questionnaire for a sample of nursing assistant aides. Methods. The questionnaire was translated and culturally adapted. Next, it was included in a battery of tests that was completed by 526 nursing assistants working in residential care homes in the Principality of Asturias (Spain). To assess its validity, the Exploratory Factor Analysis and the Confirmatory Factor Analysis were used. The internal consistency was estimated with McDonald’s Omega coefficient (ω), complemented by the test-retest reliability analysis through the intraclass correlation coefficient. The validity of the criteria was established by the correlation between total score on the test and quality of life measures, job insecurity and psychological demand, and social support at work. Results. The Exploratory Factor Analysis and Confirmatory Factor Analysis adjustment indices confirmed it is a unidimensional test. The internal consistency values indicated very high reliability (ω = 0.81). Similarly, the intraclass correlation coefficient showed statistically significant values and an excellent correlation coefficient (r = 0.95). The validity of the criteria showed a statistically significant correlation with all the constructs studied, particularly with quality of life. Conclusions. This Spanish version of the Nordic Musculoskeletal Questionnaire has good psychometric qualities for a population of nursing aides and therefore may be a valid and reliable tool for assessing musculoskeletal disorders. (AU)

Language inclusion in ecological systematic reviews and maps: Barriers and perspectives.

Systematic reviews and maps are considered a reliable form of research evidence, but often neglect non-English-language literature, which can be a source of important evidence. To understand the barriers that might limit authors' ability or intent to find and include non-English-language literature, we assessed factors that may predict the inclusion of non-English-language literature in ecological systematic reviews and maps, as well as the review authors' perspectives. We assessed systematic reviews and maps published in Environmental Evidence (n = 72). We also surveyed authors from each paper (n = 32 responses), gathering information on the barriers to the inclusion of non-English language literature. 44% of the reviewed papers (32/72) excluded non-English literature from their searches and inclusions. Commonly cited reasons included constraints related to resources and time. Regression analysis revealed that reviews with larger author teams, authors from diverse countries, especially those with non-English primary languages, and teams with multilingual capabilities searched in a significantly greater number of non-English languages. Our survey exposed limited language diversity within the review teams and inadequate funding as the principal barriers to incorporating non-English language literature. To improve language inclusion and reduce bias in systematic reviews and maps, our study suggests increasing language diversity within review teams. Combining machine translation with language skills can alleviate the financial and resource burdens of translation. Funding applications could also include translation costs. Additionally, establishing language exchange systems would enable access to information in more languages. Further studies investigating language inclusion in other journals would strengthen these conclusions.

Language Access Systems Improvement initiative: impact on professional interpreter utilisation, a natural experiment.

OBJECTIVES: This study aims to evaluate the Language Access Systems Improvement (LASI) initiative's impact on professional interpreter utilisation in primary care and to explore patient and clinician perspectives on professional interpreter use. DESIGN: Multi methods: Quantitative natural experiment pre-LASI and post-LASI, qualitative semistructured interviews with clinicians and focus groups with patients post-LASI. SETTING: Large, academic primary care practice. PARTICIPANTS: Cantonese, Mandarin, Spanish, English-speaking adult patients and their clinicians. INTERVENTION: LASI initiative: Implementation of a clinician language proficiency test and simultaneous provision of on-demand access to professional interpreters via video medical interpretation. MAIN OUTCOME MEASURES: Quantitative: Proportion of language discordant primary care visits which were professionally interpreted. Qualitative: Salient themes related to professional interpreter use and non-use. RESULTS: The researchers categorised language concordance for 1475 visits with 152 unique clinicians; 698 were not fully language concordant (202 pre-LASI and 496 post-LASI). Professional interpreter utilisation increased (pre-LASI 57% vs post-LASI 66%; p=0.01); the visits with the lowest percentage of profssional interpreter use post-LASI were those in which clinicians and patients had partial language concordance. In inverse probability weighted analysis, restricting to 499 visits with strict estimated propensity score overlap (100% common support), post-LASI visits had higher odds of using a professional interpreter compared with pre-LASI visits (OR 2.39; 95% CI 1.04 to 5.48). Qualitative results demonstrate video interpretation was convenient and well liked by both clinicians and patients. Some partially bilingual clinicians reported frustration with patient refusal of interpreter services; others reported using the video interpreters as a backup during visits. Views of the care-partner role differed for clinicians and patients. Clinicians reported sometimes having family interpret out of convenience or habit, whereas patients reported wanting family members present for support and advocacy, not interpretation. CONCLUSIONS: LASI increased utilisation of professional interpreters; however, this was least prominent for partially language concordant visits. Health systems wishing to implement LASI or similar interventions will need to support clinicians and patients with partial bilingual skills in their efforts to use professional interpreters. TRIAL REGISTRATION NUMBER: HSRP20153367.

Improving pain communication between limited English-speaking Hmong patients, medical interpreters, and health care providers in primary care: A pilot study.

This pilot study assessed the feasibility of implementing a pain assessment information visualization (InfoViz) tool to address cultural and language barriers among limited English proficiency (LEP) Hmong patients in primary care. We used a static group comparison design to collect data from 20 patient, interpreter, and provider triads under usual care (i.e., interpreter using verbal pain descriptions), followed by another 20 triads under the intervention (i.e., interpreter using verbal pain descriptions and the InfoViz tool). Feasibility outcomes included recruitment and retention rates, InfoViz tool completion, acceptability, and fidelity. We also assessed mutual understanding (MU) and pain electronic health record (EHR) documentation. Descriptive data were calculated and thematic analysis was conducted. Thirty-six LEP Hmong patients (n = 29 female, mean age = 59.03), 27 providers (n = 15 female), and four interpreters participated in this study. The patient recruitment rate was 18% while the retention rate was 81%. Interpreter recruitment rate was 80%, and 75% for retention rate. The intervention fidelity mean score was 83%. In the intervention condition, patient-provider MU of pain severity improved by 30%, coupled with a 28% increase in pain severity EHR documentation compared to usual care. While communication of pain quality did not improve, there was a higher mean number of pain descriptors (3.31 in the intervention vs. 1.79 in usual care) in EHR documentation. All participants had a positive experience with the tool, reporting it as valuable with 100% completeness of all tools. Findings revealed the tool was acceptable and feasible to use among LEP patients-interpreters-providers, providing support for an efficacy study.

Caregivers with limited language proficiency and their satisfaction with paediatric emergency care related to the use of professional interpreters: a mixed methods study.

OBJECTIVES: Communication is a main challenge in migrant health and essential for patient safety. The aim of this study was to describe the satisfaction of caregivers with limited language proficiency (LLP) with care related to the use of interpreters and to explore underlying and interacting factors influencing satisfaction and self-advocacy. DESIGN: A mixed-methods study. SETTING: Paediatric emergency department (PED) at a tertiary care hospital in Bern, Switzerland. PARTICIPANTS AND METHODS: Caregivers visiting the PED were systematically screened for their language proficiency. Semistructured interviews were conducted with all LLP-caregivers agreeing to participate and their administrative data were extracted. RESULTS: The study included 181 caregivers, 14 of whom received professional language interpretation. Caregivers who were assisted by professional interpretation services were more satisfied than those without (5.5 (SD)±1.4 vs 4.8 (SD)±1.6). Satisfaction was influenced by five main factors (relationship with health workers, patient management, alignment of health concepts, personal expectations, health outcome of the patient) which were modulated by communication. Of all LLP-caregivers without professional interpretation, 44.9% were satisfied with communication due to low expectations regarding the quality of communication, unawareness of the availability of professional interpretation and overestimation of own language skills, resulting in low self-advocacy. CONCLUSION: The use of professional interpreters had a positive impact on the overall satisfaction of LLP-caregivers with emergency care. LLP-caregivers were not well-positioned to advocate for language interpretation. Healthcare providers must be aware of their responsibility to guarantee good-quality communication to ensure equitable quality of care and patient safety.

Evaluation of Machine Translation Accuracy Focused on the Adverse Event Terminology for Medical Devices.

The purpose of this study was to evaluate the accuracy of deep neural machine translation focused on medical device adverse event terminology. 10 models were obtained, and their English-to-Japanese translation accuracy was evaluated using quantitative and qualitative measures. No significant difference was found in the quantitative index except for a few pairs. In the qualitative evaluation, there was a significant difference and googletrans and GPT-3 were regarded as useful models.

Somatic Symptom Disorder-B criteria scale (SSD-12): Psychometric properties of the French version and associations with health outcomes in a population-based cross-sectional study.

OBJECTIVE: The 12-item Somatic Symptom Disorder-B Criteria Scale (SSD-12) is a self-reported questionnaire designed to assess the B criteria of the DSM-5 somatic symptom disorder. In this cross-sectional study, we aimed to examine the psychometric properties of the SSD-12 French version and associated health outcomes. METHODS: Participants were volunteers from the population-based CONSTANCES cohort who reported at least one new symptom that occurred between March 2020 and January 2021. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: A total of 18,796 participants completed the SSD-12. The scree plot was consistent with a 1-factor structure, while goodness-of-fit indices of the confirmatory factorial analyses and clinical interpretability were consistent with a 3-factor structure (excluding the item 7): 'Perceived severity', 'Perceived impairment', 'Negative expectations'. The Cronbach's α coefficients of the total and factors scores were 0.90, 0.88, 0.84 and 0.877, respectively. The total score was associated with depressive symptoms (Spearmann's rho: 0.32), self-rated health (-0.46), the number of persistent symptoms (0.32), and seeking medical consultation (odds ratio [95% confidence interval] for one interquartile range increase: 1.51 [1.48-1.54]). Among participants seeking medical consultation, those with higher SSD-12 scores were more likely to have their symptoms attributed to "stress/anxiety/depression" (1.32 [1.22-1.43]) and "psychosomatic origin" (1.25 [1.20-1.29]), and less to "COVID-19" (0.89 [0.85-0.93]). CONCLUSION: While the SSD-12 French version can be used as a unidimensional tool, it also has a 3-factor structure, somewhat different from the DSM-5 theoretical structure, with high internal consistency and clinically meaningful associations with other health outcomes.