(526) Bedside nurses' perspectives on the role of language barriers on postpartum pain management

Language barriers can adversely affect medical outcomes. However, knowledge of the role of language barriers on postpartum pain management is limited. Bedside nurses (RNs) spend significant time communicating with patients regarding pain treatment preferences. We therefore evaluated RNs’ perspectives on the role of language barriers on postpartum pain management.

Study Design:

We performed a qualitative study of postpartum bedside RNs at a tertiary academic medical center (9-12/2022). We used a semi-structured guide to facilitate in-depth interviews regarding postpartum pain management, including the role of language barriers. Purposive sampling was used to ensure inclusion of multilingual participants. Data were analyzed using the constant comparative method.

Results:

Of 21 participants, 33% were multilingual, with nine languages represented. Data yielded several themes related to the role of language barriers on postpartum pain assessment and management (Table). Nurses reported the significant time intensity associated with language barriers, leading some providers to forego the use of translator services, which hinders education and reduces the quality of pain management decisions. Participants also noted increased reliance on non-verbal cues in evaluating pain for non-English speaking patients. Even use of translator-mediated conversations were felt to be more limited in their ability to convey empathy and facilitate a connection with patients. Participants perceived non-English speaking patients to be more hesitant to fully express their pain or to ask for pain medications due to guilt regarding inconvenience and time intensity of translator services. Adverse effects of language barriers were particularly noted by multilingual RNs, who shared how communicating in a patient’s preferred language helped bridge gaps.

Conclusion:

Language barriers can hinder accurate pain assessment and may contribute to disparities in postpartum pain management. Increased accessibility to and enhanced quality of interpreter services may improve pain control in this population and promote equitable pain management.