Stephanie Syu Squires

All Publications

• Improving Hospital-to-Home for Medically Complex Children: Views From Spanish-Speaking Caregivers. Hospital pediatrics Squires, S. S., Hoang, K., Grajales, L., Halpern-Felsher, B., Sanders, L. 2024

  Abstract

  Children with medical complexity (CMC) experience increased risk of adverse events during and after hospitalization, and these risks are even greater for CMC whose caregiver has a preferred language other than English. Because many adverse events for CMC may be attributable to communication challenges, understanding caregiver and physician perspectives may help prevent adverse events.We conducted semistructured interviews with Spanish-speaking caregivers of hospitalized CMC and their inpatient attending physicians. Each interview was conducted 24 to 72 hours after hospital discharge. Interviews continued until thematic sufficiency was reached. Interviews were audio recorded, transcribed, and translated verbatim. Investigators independently coded and reconciled codes using constant comparison to develop themes via inductive thematic analysis.We conducted 28 interviews (14 caregivers, 14 physicians). Three themes were identified: (1) barriers exist in providing language-concordant care in planning for transitions from hospital-to-home; (2) both physicians and caregivers perceived logistical challenges in using interpreters at the point of care; and (3) many caregivers felt uncomfortable asking physicians questions related to their child's medical management because of their language barrier. Participants also offered strategies to improve the transition from hospital to home: (1) empower families to ask questions and take notes, (2) consider the use of medical educators, and (3) improve the ability of hospital-based physicians to follow up with patients after discharge.Physicians strive for language-concordant care at each stage of discharge planning. However, unresolved gaps such as the lack of interpreter availability during medical-device education, require attention to promote safe transitions from hospital to home.

  View details for DOI 10.1542/hpeds.2024-007925

  View details for PubMedID 39410907

• Spanish Translation of a Parent-Reported Hospital-to-Home Transition Experience Measure. Hospital pediatrics Squires, S. S., Lion, K. C., Burgara, J., Garcia, Y., Desai, A. D. 2023

  Abstract

  A critical focus of pediatric hospital systems is to improve the quality of hospital-to-home transitions. Although validated patient-reported measures evaluating these improvement efforts exist for English-speaking families, a comprehensive measure to assess transition quality among families who speak a language other than English does not yet exist.We used a team consensus translation approach to translate and culturally adapt the previously validated Pediatric Transition Experience Measure (P-TEM), a caregiver-reported hospital-to-home transition quality measure, from English to Spanish. We describe our rigorous translation approach, which involved a series of steps to preserve the original meaning of the P-TEM through careful team-based linguistic and cultural adaptation of the measure into Spanish. During this process, we also found additional opportunities to improve the understandability and content validity of the original English version of P-TEM. We then pilot tested the new Spanish P-TEM with 36 parents and administered the revised English P-TEM with 125 caregivers (ie, parents/legal guardians).In pilot testing, none of the Spanish-speaking parents reported difficulty understanding questions, though 6% (2/36) expressed difficulty with understanding the response scale, prompting a change to present clearer scale anchors. Mean scores on the Spanish P-TEM were 95.4 (SD, 9.6) for the total score. Mean scores on the revised English P-TEM were 88.6 (SD, 15.6; total).Using a team consensus translation approach is a comprehensive and collaborative approach that allows for translation of measures originally developed for English-speaking families to be translated in a way that is reliable, accurate, and culturally appropriate.

  View details for DOI 10.1542/hpeds.2022-007073

  View details for PubMedID 37334647