Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 5, 2022
Date Accepted: Jan 23, 2023
Overcoming language barriers in paramedic care with an app designed to improve communication with foreign-language patients: A non-randomized controlled pilot study
ABSTRACT
Background:
Communication across language barriers in absence of interpreters is a particular challenge for health care providers. In Emergency Medical Service (EMS) interpreters are mostly not available on rescue scenes. We developed a fixed-phrase translation app with 600 phrases and 18 supported languages in a co-creation process together with paramedics. This paper reports on the results of a pilot study to evaluate the app.
Objective:
To gain insights into the efficacy and feasibility of a multilingual app that helps paramedics to communicate with patients who are not proficient in the local language.
Methods:
A three-armed non-randomized interventional pilot study was conducted in four rescue stations in the German Federal State of Lower Saxony. The interventional group comprised rescue missions with patients with limited German language proficiency (LGP) and used app, control group 1 consisted of rescue missions with German-speaking patients (GSP), and control group 2 were LGP patients without app usage. Primary outcome was paramedics’ perceived quality of communication with LGP patients. Secondary outcome was the ability to obtain necessary information from patients and the ability to provide information to patients. Exploratory, length of time spent on the emergency scene was measured. A linear regression model was applied to assess the impact of the app on perceived communication controlling for demographic and severity of illness.
Results:
A total of 150 LGP patients were recruited into interventional and control group 2, and 27,212 GSP were recruited in control group 1. App usage among LGP patients increased the perceived overall quality of communication by 0.7 points on a 5-point Likert scale (p=0.032). Applying a linear regression model controlling for age, sex, and Glasgow Coma Scale (GCS), the quality of communication increased by 0.9 points (95% CI 0.2 – 1.6, p=0.010). Compared to either GSP or LGP, paramedics spent 6-7 minutes longer on an emergency scene when the app was used (p=0.239).
Conclusions:
Although the small sample size reduces the general transferability, the use of the app shows a relevant and significant improvement in communication with patients with limited proficiency in the locally spoken language in paramedic care. Clinical Trial: German Clinical Trials Register DRKS00016719; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016719
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