Clinical trial NCT04975789: Visualizations to Improve Pain Communication Between Patients, Interpreters, and Providers
Official title: Information Visualization to Improve Pain Communication Between Providers, Interpreters, and Patients With Limited English Proficiency
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Communication
Pain
Keywords: pain assessment
limited English proficiency
mutual understanding
Lead sponsor: University of Wisconsin, Madison
Sponsor class: OTHER
Collaborators: name: National Institute of Nursing Research (NINR)
First posted: 2021-07-23
Enrollment: 61
Sex: ALL
Minimum age (years): 13
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: SUPPORTIVE_CARE

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.

Eligibility criteria: 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

Primary outcomes:
measure: Percentage of Eligible Patients Enrolled
timeFrame: up to 1 day
measure: Proportion of Patients Who Complete the Study
timeFrame: up to 4 weeks
measure: Percentage of InfoViz Tools Completely Filled Out
timeFrame: up to 1 day
measure: Percentage of Items Correctly Performed on the Investigator Designed Fidelity Checklist
timeFrame: up to 1 day
measure: Percentage of Congruency in Mutual Understanding: Patient to Interpreter
timeFrame: up to 1 day
measure: Percentage of Congruency in Mutual Understanding: Interpreter to Provider
timeFrame: up to 1 day
measure: Percentage of Congruency in Mutual Understanding: Patient to Provider
timeFrame: up to 1 day
Secondary outcomes:
measure: Participant Satisfaction With Communication Answer
timeFrame: up to 1 day
measure: Participant Pain Relief Measured Using a 5 Point Verbal Rating Scale
timeFrame: one time post 4-6 weeks after the clinic vist
measure: Participant Response to Pain Interference Question
timeFrame: usual care participants assessed at baseline and InfoViz participants assessed at 4 weeks
measure: Quality of Communication Answer
timeFrame: up to 1 day
Other outcomes:
Locations:
city: Madison
country: United States
facility: Access Community Health Center
state: Wisconsin
city: Madison
country: United States
facility: University of Wisconsin
state: Wisconsin
Study officials:
affiliation: University of Wisconsin, Madison
name: Maichou Lor, PhD, RN
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lor M, Li A, Brown R, Swedlund MP, Hawkins JG, Nolander ET, Chewning B. Improving pain communication between limited English-speaking Hmong patients, medical interpreters, and health care providers in primary care: A pilot study. Res Nurs Health. 2024 Jun;47(3):289-301. doi: 10.1002/nur.22363. Epub 2024 Jan 4.