Table 3 Patient interview results
Domain discussed | Specific themes identified | Exemplar quote | Finding |
|---|---|---|---|
Language and communication | Language proficiency: Lack of services in patient’s native language Translation quality: Poor quality of translation services Access to information: Lack of information in the patient’s native language on what to expect | Sometimes the language. There are some doctors who, when they know that your native language is not English, speak slowly or take more pauses, ask you several times if you understood, and then there are others who don't. It has happened to me that sometimes I leave, not knowing if they really understand what I am trying to say. I believe that language is one of the biggest obstacles. [P008] | Interviewees feel that they are not getting comprehensive information due to language barriers. Additionally, some had bad experiences requesting translation services |
Financial Concerns | Access: Limited access to Federally Qualified Health Centers Cost of services: Inability to pay out of pocket for prenatal care and delivery services | For the time I am going to have a baby, I do not have the information, on what hospital or how much it will cost me. [P002] | Financial issues generate stress and anxiety. Often this is linked to feelings of insecurity due to immigration status |
Social Support | Community support: Lack of community support | The postpartum experience, I would have liked it better if it was in Colombia and not here because here, I am alone. There you are already incredibly supported, your family arrives, takes care of the baby so that you rest, the meals are great, they are more suitable for the moment of recovery, and in general they help you a lot. [P006] | Interviewees expressed feeling that they lack emotional support from family members and the need to have someone that cares for them |
Immigration Status | Awareness of rights: Lack of access to information on how immigration status will influence access to care | Yes, thinking that in case of an emergency there will be costs to get treatment because since one does not have any papers, I thank God that I have not gotten seriously ill, I have not needed to go– To go to the hospital with an emergency, but they tell me that it costs because you do not have papers and it costs to be seen. As I say, thank God I have not needed to go to a hospital; I have not gotten sick. [P011] | Interviewees recognized that they need to seek care eventually but often consider access through the emergency room as their only option |
Cultural Differences | Importance of family: Currently away from extended family Care alternatives: Limited information on potential alternative care Nutrition: Nutritional advice based on staples of an American diet | I have been worried about not having many ultrasounds, here in the United States, only two are done, I did not know if this was normal or not, but doctors have told me that two are enough and necessary unless there are any complications, but I would have liked to see the baby a little more, have many more options to see the ultrasound. [P003] | There is an understanding of traditional medicine, but it is not necessarily considered an essential part of care. There are different expectations on what prenatal care will involve and how it may differ from care in other countries |
Healthcare Navigation | Patient-provider relationships: Differences in a doctor-patient relationship compared to what is expected in Latino cultures Comfort: A feeling of being unable or uncomfortable asking questions Decision making: Limited participation in their own healthcare decisions | In the beginning, it was pretty difficult [to access prenatal care], at some point, because I did not know that I was pregnant, and I came to find out when I was at three months. I did not know how it was here in the United States; how to get [prenatal] care, how to make an appointment, more than anything they told me they spoke to you in English, I don't know any English. For me, it was pretty difficult in that aspect; that's why I started [prenatal] care when I was 28Â weeks pregnant. [P002] | It was difficult for interviewees to find ways to access the healthcare system |
Connection to Local Resources | Community resources: Lack of a local network to support Latino individuals | Yes, yes, I would like, let's say, to be able to expand that network of resources and, above all, that they were Latino. Because we know that this city doesn't have a lot of Latino immigrants and we don't have many services… Yes, we don't have many services specific to Latino people. [P003] | Interviewees emphasized that a critical step is to have a centralized place to access resources available for Spanish-speaking individuals |