Experiences of communication in the neonatal intensive care unit for mothers with a preferred language other than English.

Objective: To understand the experiences of mothers with a preferred language other than English (PLOE) in communicating with staff and engaging in the care of their hospitalized infant.

Design: We qualitatively analyzed a previously collected and a prospective dataset comprised of transcripts of 36 interviews with Spanish-, Haitian Creole-, and Brazilian Portuguese-speaking mothers of preterm infants from 3 NICUs. We applied the constant comparative method to develop codes and themes, which were inductively structured using the socio-ecological framework.

Results: We identified themes across socio-ecological levels: Individual (unaddressed language barriers, varied maternal empowerment, and justification of suboptimal interpreter use); Interpersonal (family-staff language concordance facilitating engagement, positive impact of non-interpreted informal interactions, and differential treatment based on maternal language status); Institutional (system-level interpretation barriers and varied interpreter service quality).

Conclusion: Mothers with PLOE face multilevel communication and engagement barriers in the NICU; we discuss potential interventions to improve equity in these areas.