title: Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.
abstract: Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services.
  
  
  
  Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services.
  
  
  
  The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services.
  
  
  
  Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.
authors.affiliation: College of Nursing, University of Tennessee, 1200 Volunteer Blvd., Knoxville, TN, 37996, USA. llindley@utk.edu.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Lindley
authors.affiliation: College of Social Work, University of Tennessee, Knoxville, TN, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Held
authors.affiliation: College of Nursing, University of Tennessee, 1200 Volunteer Blvd., Knoxville, TN, 37996, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Henley
authors.affiliation: College of Nursing, University of Tennessee, 1200 Volunteer Blvd., Knoxville, TN, 37996, USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Miller
authors.affiliation: College of Nursing, University of Tennessee, 1200 Volunteer Blvd., Knoxville, TN, 37996, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Pedziwol
authors.affiliation: College of Nursing, University of Tennessee, 1200 Volunteer Blvd., Knoxville, TN, 37996, USA.
authors.forename: Laurie E
authors.initials: LE
authors.lastname: Rumley
mesh_terms: D003144:Communication Barriers; D017051:Hospice Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D007857:Leadership; D009726:Nurses; D015279:Organizational Culture; D061214:Patient Safety; D010371:Pediatric Nursing; D014175:Translating
keywords: Hospice environment; Language services; Nurse work environment; Pediatric hospice; Structural contingency theory