Abstract Introduction Patients who speak a language other than English (LOE) may be at higher risk of experiencing ICU delirium due to communication-related barriers to evidence-based delirium best practices. However, few studies have focused on the experiences of patients with LOE in the ICU setting and delirium prevention. The purpose of this study was to explore facilitators and barriers to delirium prevention interventions from the perspectives of LOE patients. Methods We conducted a qualitative study using semi-structured interviews with LOE patients who were admitted to an ICU at an academic medical institution in the Pacific Northwest. All participants were interviewed within 30 days of discharge from the ICU. All interviews were conducted privately in their acute care hospital room with an in-person interpreter. A support person was present if the participant desired. Interviews were digitally recorded and transcribed. Clarke and Braun’s thematic analysis method was used to analyze the data. Results Eight LOE patients and 3 support persons were interviewed across the following languages: Spanish (n = 4), Arabic (n = 1), Russian (n = 1), Cantonese (n = 1), and Tagalog (n = 1). Six participants (75%) stated that they experienced delirium. There were five major themes identified. Theme 1: Communication barriers, including lack of interpreters, misunderstandings with interpreters, or internet connectivity challenges, make it difficult to communicate about basic needs like using the bathroom, pain control, thirst, etc. Theme 2: Difficulty falling or staying asleep related to anxiety about their illness, lack of a medical plan, or memories of their near-death experience. Theme 3: Participants who experienced delirium noted emotional distress. Theme 4: Family members are viewed as necessary facilitators to communicate about care needs as well as to ease anxiety and fear. Theme 5: Participants were very grateful for the care they received and expressed appreciation for how willing the healthcare staff was to help them. Conclusion We identified several themes that reflect unique barriers to evidence-based delirium prevention for patients with LOE. Despite the ICU staff making an effort to use various techniques, communication gaps presented challenges to completing interventions in a timely manner. Being critically ill, not knowing the plan, and acute trauma caused emotional distress. Family engagement was an essential facilitator for these LOE participants, both for communication between the patient and the healthcare team as well as relief of anxiety and fear. Future research should investigate tools to improve delirium prevention for patients with LOE, particularly when family is not present. This abstract is funded by: 1F31NR021096-01A1
Ahrens et al. (Fri,) studied this question.