Understanding Korean American Immigrant Women's Interactions with US Healthcare Providers

Background and Purpose: Patients who have limited proficiency in English (LEP) often experience challenges communicating during healthcare encounters which may negatively impact their ability to build a relationship with their provider and receive quality care. Using medical interpreters may be necessary for effective communication with LEP populations, but it does not completely address all communication challenges due to the limited availability of services. Some LEP patients may rely on family members or friends to assist them in communicating with their healthcare providers. However, there is limited research on the communication strategies used by Korean American immigrant women (KAIW) when interacting with their US healthcare providers. This study aims to explore these strategies in depth.

Methods: Semi-structured phone interviews were conducted with 25 KAIW aged between 40 and 79 between October 2020 and July 2021. Each interview lasted for 60-90 minutes in length. Sample interview questions for this study included “How do you communicate with your doctors in the US?”, “How comfortable you are with asking questions about health information to doctors?” The interviews were recorded and transcribed verbatim. We used thematic analysis to analyze the data and develop themes.

Findings: The average study participant was 49.32 years old (SD=7.60) and had lived in the US for an average of 20.17 years (SD=7.85). Eighty percent of participants (n=20) had a college degree. Most participants described their English proficiency as poor or fair. Overall, KAIW perceived their healthcare providers as kind, friendly, and emotionally supportive, however, they were uncertain they could trust them. About half of the participants (n=13) reported they speak directly with healthcare providers, while others (n=6) were assisted by their family members or friends. These women prepared for the doctor’s appointment by taking notes of questions/concerns and looking up English phrases/medical terms before their appointment. During their healthcare encounters, some women felt comfortable asking their healthcare providers for clarification or speaking slowly. This was often due to having a positive relationship with their providers, having a female doctor, or being seen by a Korean American doctor. Despite their efforts, some participants were unsure of the provider’s explanations and whether their providers understood their concerns. Some participants (n=8) had experiences with a medical interpreter service and most of them (n=6) thought the service was not beneficial due to the poor quality of translation. They believe that the location where they live may not have access to competent interpreters, leading them to not utilize the service in the future.

Conclusion: The findings of the study revealed that KAIW are proactive patients who prepare and engage in communications with their healthcare providers, yet there are a few conditions that shape a comfortable interaction with the providers for the best care process and outcomes. The unsatisfactory experience of the participants with interpreter services highlights the need for a reevaluation of current practices. To enhance interpreter services, it is imperative to utilize ad-hoc services, as well as telephone and video interpreting services, such as the VRI (My Accessible Real-Time Trusted Interpreter, MARTTI) system.

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