{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:28:55Z","timestamp":1788366535467,"version":"build-2803163510"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951525101442_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients with non-English language preference (NELP) face significant barriers to safe and effective communication in palliative and supportive care. These barriers compromise quality, delay care, and heighten the risk of unmet psychosocial needs, particularly when compounded by health literacy concerns and limited access to translated resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101442_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe two Spanish-speaking patients with advanced cancer whose inpatient and outpatient supportive care was complicated by language barriers, leading to communication gaps, including symptom misinterpretation and inadequate family discharge education. These factors contributed to significant distress and safety risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101442_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Interdisciplinary interventions, including professional interpreter use, bilingual supportive care psychology, teach-back education, medication relabeling in Spanish, and culturally tailored communication, helped restore trust, alleviate suffering, and align care with patient and family values. In one case, a lack of validated Spanish versions of the Edmonton Symptom Assessment System within the electronic medical record (EMR) hindered symptom self-reporting and safety. Following multiple requests, the EMR team initiated development of a Spanish-language template to facilitate future integration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101442_sec4d\">\n                    <jats:title>Significance of the results<\/jats:title>\n                    <jats:p>Structural gaps in language accessibility compound distress, reduce autonomy, and threaten safety. These cases underscore that interpreter services alone are insufficient. Integrating validated multilingual tools into EMRs, standardizing translated discharge instructions, and expanding access to in-person interpreters are critical steps toward equitable care. Institutionalizing linguistically responsive systems is essential for ensuring safety, equity, and dignity in palliative care for patients with NELP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951525101442","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T04:16:21Z","timestamp":1768796181000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["\u201cLanguage barriers and patient safety in supportive care: Two case reports bridging system-level gaps\u201d"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9000-0826","authenticated-orcid":false,"given":"Gladys Janice","family":"Jimenez-Torres","sequence":"first","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4308-0883","authenticated-orcid":false,"given":"Monica","family":"Agosta","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Garcia-Hocker","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahsan","family":"Azhar","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Carmack","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"S1478951525101442_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.13325"},{"key":"S1478951525101442_ref9","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2019-0055"},{"key":"S1478951525101442_ref2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003920"},{"key":"S1478951525101442_ref4","doi-asserted-by":"publisher","DOI":"10.1200\/OP.22.00040"},{"key":"S1478951525101442_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/22799036221146901"},{"key":"S1478951525101442_ref12","doi-asserted-by":"publisher","DOI":"10.1177\/0009922819900950"},{"key":"S1478951525101442_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17913"},{"key":"S1478951525101442_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/02692163231169318"},{"key":"S1478951525101442_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.10.011"},{"key":"S1478951525101442_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-021-06445-w"},{"key":"S1478951525101442_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.02.468"},{"key":"S1478951525101442_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.01.014"},{"key":"S1478951525101442_ref27","first-page":"531","article-title":"Addressing disparities in health outcomes for patients with advanced pancreatic cancer and limited English proficiency","volume":"20","author":"Williams","year":"2024","journal-title":"Asia-Pacific Journal of Clinical Oncology"},{"key":"S1478951525101442_ref19","doi-asserted-by":"publisher","DOI":"10.1177\/10436596241229485"},{"key":"S1478951525101442_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2015.03.012"},{"key":"S1478951525101442_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951524000166"},{"key":"S1478951525101442_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-017-9769-y"},{"key":"S1478951525101442_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07995-3"},{"key":"S1478951525101442_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.11.012"},{"key":"S1478951525101442_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318249c949"},{"key":"S1478951525101442_ref5","volume-title":"New Data on Detailed Languages Spoken at Home and the Ability to Speak English","year":"2025"},{"key":"S1478951525101442_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-022-01399-5"},{"key":"S1478951525101442_ref18","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0320"},{"key":"S1478951525101442_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s13187-020-01706-4"},{"key":"S1478951525101442_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.04.034"},{"key":"S1478951525101442_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2023.102436"},{"key":"S1478951525101442_ref25","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12030364"},{"key":"S1478951525101442_ref23","article-title":"The impact of limited English proficiency on oncological outcomes in the United States: a systematic review","volume":"31","author":"Smith","year":"2024","journal-title":"Journal of Evaluation in Clinical Practice"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951525101442","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T04:16:23Z","timestamp":1768796183000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951525101442\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":28,"alternative-id":["S1478951525101442"],"URL":"https:\/\/doi.org\/10.1017\/s1478951525101442","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e35"}}