Susanna O'Kula: Language Fluency & Care Transitions BACK

Published by AFAR

The three weeks after my last post proved vastly different from the first few I spent at the Bronx VA: our patient recruitment jumped up to 5-7 a week! By now, I imagine I could administer the baseline questionnaire in my sleep. In addition to study enrollment and follow-up phone calls, I've spent a lot of time doing chart abstraction for the nearly 60 patients now enrolled in the study to better understand "my" population. Even within a geriatrics cohort, the range of the patients' health status amazes me—one chart might show thirteen active medications, six chronic conditions, and a 30-day rehospitalization for a 77 year-old, but the next might display only five medications and a few chronic conditions for an 85 year-old veteran.

When I look specifically at the responses to questions targeting English vs. Spanish fluency, I've found rather unusual responses. The overwhelming majority of patients are English-speaking, but some veterans, usually from Puerto Rico, say that “Spanish” is their primary language or what they mainly speak at home. They attribute their ability to get by in medical settings, however, to their spouse, child, or caregiver’s translating. When I asked one patient to explain why “English” was his primary language but “Spanish” was what was spoken at home, he smiled and explained that his Colombian wife speaks no English. They converse solely in Spanish, so he considers himself bilingual because he also speaks English well. The survey responses suggest "English fluency" and "Spanish fluency" are not black-and-white definitions; instead, the exercise has revealed a diversity of patient care transitions experiences.

This week and next I'm describing my data and testing hypotheses with STATA. Learning how to use this statistical package and write different codes and commands for the predictor and outcome variables I want to analyze has been one of the more humbling experiences of my summer project. I’m lucky to have a patient PI who can answer my many questions! A statistician I am not, but it's been enlightening to attempt to understand how the tables and graphics I see in abstract presentations are actually generated. In the last couple of weeks of my MSTAR project, I’m eager to synthesize the data collected thus far.

This is Susanna O'Kula's second MSTAR Diary. Read her first entry here.