{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:06:32Z","timestamp":1789376792724,"version":"build-2803163510"},"reference-count":49,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: To explore interpreter dependency in relation to rehabilitation outcomes and rehabilitation process measures for patients with acquired brain injury.\nDesign: Retrospective cohort study.\nSubjects: Data from 13,900 inpatients, with acquired brain injury as main diagnosis, included in a Swedish quality registry (2008\u20132020). Of these, 391 patients were interpreter-dependent whereas 13,509 were not.\nMethod: Outcomes were functional independence, health-related quality of life, self-perceived health, occurrence of complications, and length of stay. Process measures consisted of establishment of an individualized rehabilitation plan and collection of patient-reported experience measures.\nResults: On admission as well as discharge, interpreter dependency was related to lower scores regarding functional independence, health-related quality of life, and self-perceived health, while showing no association with the degree of improvement in these outcomes between the 2 time points. Interpreter-dependent patients were less likely to have had patient-reported experience measures administered. The results regarding functional independence and patient-reported experience measures persisted after adjusting for confounding variables. Length of stay, occurrence of complications, and establishment of an individualized rehabilitation plan were not related to interpreter dependency.\nConclusion: Disparities on admission and discharge were evident regarding functionality as well as health-related quality of life and self-perceived health. It is possible that acquired brain injury severity or disparities earlier in the care continuum may underlie the results.<\/jats:p>","DOI":"10.2340\/jrm.v58.45146","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T08:40:58Z","timestamp":1789375258000},"page":"jrm45146","source":"Crossref","is-referenced-by-count":0,"title":["Associations between interpreter dependency and rehabilitation outcomes and care processes following acquired brain injury: a Swedish registry-based cohort study"],"prefix":"10.2340","volume":"58","author":[{"given":"Ellen","family":"Grut","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Blom Johansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"L\u00f6fgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"168087","unstructured":"Statistics Sweden. Foreign-born in Sweden. Stockholm: Statistics Sweden; 2025 [updated 2025 Feb 21; cited 2025 Mar 09]. Available from: https:\/\/www.scb.se\/hitta-statistik\/sverige-i-siffror\/manniskorna-i-sverige\/utrikes-fodda-i-sverige\/"},{"key":"#cr-split#-168088.1","unstructured":"Health and Medical Services Act (SFS 2017:30) [Internet]. Stockholm: Ministry of Health and Social Affairs"},{"key":"#cr-split#-168088.2","unstructured":"2023 [cited 2023 Sep 25]. Available from: https:\/\/www.riksdagen.se\/sv\/dokument-och-lagar\/dokument\/svensk-forfattningssamling\/halso-och-sjukvardslag-201730_sfs-2017-30\/"},{"key":"168089","doi-asserted-by":"crossref","unstructured":"Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Implications of language barriers for healthcare: a systematic review. Oman Med J 2020; 35: e122.","DOI":"10.5001\/omj.2020.40"},{"key":"168090","doi-asserted-by":"crossref","unstructured":"Oca SR, Navas A, Leiman E, Buckland DM. Effect of language interpretation modality on throughput and mortality for critical care patients: a retrospective observational study. J Am Coll Emerg Physicians Open 2021; 2: e12477.","DOI":"10.1002\/emp2.12477"},{"key":"168091","doi-asserted-by":"crossref","unstructured":"Krupic F, Hellstr\u00f6m M, Biscevic M, Sadic S, Fatahi N. Difficulties in using interpreters in clinical encounters as experienced by immigrants living in Sweden. J Clin Nurs 2016; 25: 1721\u20131728.","DOI":"10.1111\/jocn.13226"},{"key":"168092","doi-asserted-by":"crossref","unstructured":"Bauer AM, Alegr\u00eda M. Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: a systematic review. Psychiatr Serv 2010; 61: 765\u2013773.","DOI":"10.1176\/ps.2010.61.8.765"},{"key":"168093","doi-asserted-by":"crossref","unstructured":"Hadziabdic E, Hjelm K. Register-based study concerning the problematic situation of using interpreting service in a region in Sweden. BMC Health Serv Res 2019; 19: 727.","DOI":"10.1186\/s12913-019-4619-7"},{"key":"168094","doi-asserted-by":"crossref","unstructured":"Samkange-Zeeb F, Samerski S, Doos L, Humphris R, Padilla B, Bradby H. \u201cIt\u2019s the first barrier: lack of common language a major obstacle when accessing\/providing healthcare services across Europe. Front Sociol 2020; 5: 557563.","DOI":"10.3389\/fsoc.2020.557563"},{"key":"168095","doi-asserted-by":"crossref","unstructured":"Lundin C, Hadziabdic E, Hjelm K. Language interpretation conditions and boundaries in multilingual and multicultural emergency healthcare. BMC Int Health Hum Rights 2018; 18(1): 23.","DOI":"10.1186\/s12914-018-0157-3"},{"key":"168096","doi-asserted-by":"crossref","unstructured":"Patriksson K, Wigert H, Berg M, Nilsson S. Health care professional\u2019s communication through an interpreter where language barriers exist in neonatal care: a national study. BMC Health Serv Res 2019; 19(1): 586.","DOI":"10.1186\/s12913-019-4428-z"},{"key":"168097","unstructured":"Papathanasiou I, Coppens P. Aphasia and related neurogenic communication disorders. Burlington, MA: Jones & Bartlett Learning; 2022."},{"key":"168098","unstructured":"World Health Organization (WHO). Rehabilitation in health systems: guide for action: World Health Organization (WHO); 2019 [updated 2019-06-25; cited 2023 September 19]. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789241515986"},{"key":"168099","doi-asserted-by":"crossref","unstructured":"Shiner CT, Bramah V, Wu J, Faux SG, Watanabe Y. Health care interpreter use in an inpatient rehabilitation setting: examining patterns of use and associated clinical outcomes. Disabil Rehabil 2023; 45: 2149\u20132159.","DOI":"10.1080\/09638288.2022.2086637"},{"key":"168100","doi-asserted-by":"crossref","unstructured":"Clark JR, Shlobin NA, Batra A, Liotta EM. The relationship between limited English proficiency and outcomes in stroke prevention, management, and rehabilitation: a systematic review. Front Neurol 2022; 13: 790553.","DOI":"10.3389\/fneur.2022.790553"},{"key":"168101","doi-asserted-by":"crossref","unstructured":"Kilkenny MF, Lannin NA, Anderson CS, Dewey HM, Kim J, Barclay-Moss K, et al. Quality of life is poorer for patients with stroke who require an interpreter: an observational Australian registry study. Stroke 2018; 49: 761\u2013764.","DOI":"10.1161\/STROKEAHA.117.019771"},{"key":"168102","doi-asserted-by":"crossref","unstructured":"Mellahn K, Kilkenny MF, Siyambalapitiya S, Lakhani A, Burns C, Purvis T, et al. Requiring an interpreter influences stroke care and outcomes for people with aphasia during inpatient rehabilitation. Stroke 2025; 56: 716\u2013724.","DOI":"10.1161\/STROKEAHA.124.047893"},{"key":"168103","doi-asserted-by":"crossref","unstructured":"Mellahn K, Kilkenny M, Siyambalapitiya S, Lakhani A, Purvis T, Reyneke M, et al. Comparing acute hospital outcomes for people with post-stroke aphasia who do and do not require an interpreter. Top Stroke Rehabil 2023: 1\u201310.","DOI":"10.1080\/10749357.2023.2295128"},{"key":"168104","doi-asserted-by":"crossref","unstructured":"Fluck D, Fry CH, Gulli G, Affley B, Robin J, Kakar P, et al. Adverse stroke outcomes amongst UK ethnic minorities: a multi-centre registry-based cohort study of acute stroke. Neurol Sci 2023; 44: 2071\u20132080.","DOI":"10.1007\/s10072-023-06640-z"},{"key":"168105","doi-asserted-by":"crossref","unstructured":"Lequerica A, Krch D. Issues of cultural diversity in acquired brain injury (ABI) rehabilitation. NeuroRehabilitation 2014; 34: 645\u2013653.","DOI":"10.3233\/NRE-141079"},{"key":"168106","doi-asserted-by":"crossref","unstructured":"El Alaoui-Faris M, Federico A, Grisold W. Neurology in migrants and refugees. Berlin: Springer; 2022.","DOI":"10.1007\/978-3-030-81058-0"},{"key":"168107","doi-asserted-by":"crossref","unstructured":"Lindmark A, Glader EL, Asplund K, Norrving B, Eriksson M. Socioeconomic disparities in stroke case fatality: observations from Riks-Stroke, the Swedish stroke register. Int J Stroke 2014; 9: 429\u2013436.","DOI":"10.1111\/ijs.12133"},{"key":"168108","doi-asserted-by":"crossref","unstructured":"Dysart-Gale D. Clinicians and medical interpreters: negotiating culturally appropriate care for patients with limited English ability. Fam Community Health 2007; 30: 237\u2013246.","DOI":"10.1097\/01.FCH.0000277766.62408.96"},{"key":"168109","doi-asserted-by":"crossref","unstructured":"Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res 2007; 42: 727\u2013754.","DOI":"10.1111\/j.1475-6773.2006.00629.x"},{"key":"168110","doi-asserted-by":"crossref","unstructured":"Heath M, Hvass AMF, Wejse CM. Interpreter services and effect on healthcare: a systematic review of the impact of different types of interpreters on patient outcome. J Migr Health 2023; 7: 100162.","DOI":"10.1016\/j.jmh.2023.100162"},{"key":"168111","doi-asserted-by":"crossref","unstructured":"Kwan M, Jeemi Z, Norman R, Dantas JAR. Professional interpreter services and the impact on hospital care outcomes: an integrative review of literature. Int J Environ Res Public Health 2023; 20(6): 5165.","DOI":"10.3390\/ijerph20065165"},{"key":"168112","doi-asserted-by":"crossref","unstructured":"Bischoff A, Denhaerynck K. What do language barriers cost? An exploratory study among asylum seekers in Switzerland. BMC Health Serv Res 2010; 10: 248.","DOI":"10.1186\/1472-6963-10-248"},{"key":"168113","unstructured":"Global, regional, and national burden of disorders affecting the nervous system, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23: 344\u2013381."},{"key":"#cr-split#-168114.1","unstructured":"Swedish Registry for Rehabilitation Medicine. Swedish Registry for Rehabilitation Medicine [Internet] 2023 [updated 2023 Sep 15"},{"key":"#cr-split#-168114.2","unstructured":"cited 2023 Sep 21]. Available from: https:\/\/svereh.registercentrum.se\/"},{"key":"168115","unstructured":"Swedish Agency for Health and Care Analysis. National quality registers coverage: description, calculation and assessment [Internet] 2014 [cited 2023 Sep 21]. Available from: https:\/\/www.vardanalys.se\/wp-content\/uploads\/2014\/12\/PM-2014-3-Nationella-kvalitetsregisters-t%C3%A4ckningsgrad.pdf"},{"key":"168116","unstructured":"Knowledge Management in Health and Medical Care. Swedish Registry for Rehabilitation Medicine [Internet] 2024 [cited 2025 Sep 10]. Available from: https:\/\/kunskapsstyrningvard.se\/kunskapsstyrningvard\/kvalitetsregister\/hittakvalitetsregister\/registerarkiv\/svensktregisterforrehabiliteringsmedicin.77618.html"},{"key":"#cr-split#-168117.1","unstructured":"Registercentrum V\u00e4stra G\u00f6taland. Registercentrum V\u00e4stra G\u00f6taland [Internet] 2023 [updated 2023 Sep 15"},{"key":"#cr-split#-168117.2","unstructured":"cited 2023]. Available from: https:\/\/registercentrum.se\/.32"},{"key":"168118","doi-asserted-by":"crossref","unstructured":"Chumney D, Nollinger K, Shesko K, Skop K, Spencer M, Newton RA. Ability of Functional Independence Measure to accurately predict functional outcome of stroke-specific population: systematic review. J Rehabil Res Dev 2010; 47: 17\u201329.","DOI":"10.1682\/JRRD.2009.08.0140"},{"key":"168119","doi-asserted-by":"crossref","unstructured":"Golicki D, Niewada M, Buczek J, Karli\u0144ska A, Kobayashi A, Janssen MF, et al. Validity of EQ-5D-5L in stroke. Qual Life Res 2015; 24: 845\u2013850.","DOI":"10.1007\/s11136-014-0834-1"},{"key":"168120","unstructured":"Swedish Registry for Rehabilitation Medicine (Svereh). Webrehab Sweden Annual Report 2009 [Internet]. Gothenburg; 2009 [cited 2023 Sep 26]. Available from: https:\/\/registercentrum.blob.core.windows.net\/svereh\/r\/Arsrapport-WebRehab-Sweden-2009-Byln3RPQZF.pdf"},{"key":"168121","unstructured":"Cohen J. Statistical power analysis for the behavioral -sciences. Hillsdale, NJ: Erlbaum Associates; 1988."},{"key":"168122","doi-asserted-by":"crossref","unstructured":"Rezania F, Neil CJA, Wijeratne T. Disparities in care and outcome of stroke patients from culturally and linguistically diverse communities in metropolitan Australia. J Clin Med 2021; 10(24): 5870.","DOI":"10.3390\/jcm10245870"},{"key":"168123","doi-asserted-by":"crossref","unstructured":"Glader EL, Jonsson B, Norrving B, Eriksson M. Socioeconomic factors\u2019 effect on return to work after first stroke. Acta Neurol Scand 2017; 135: 608\u2013613.","DOI":"10.1111\/ane.12639"},{"key":"168124","doi-asserted-by":"crossref","unstructured":"Le KDR, Le K, Shahzad A, Lee SJ. The role of language barriers on hospital outcomes in culturally and linguistically diverse patients following trauma admission. Trauma Care 2024; 4: 107\u2013119.","DOI":"10.3390\/traumacare4020010"},{"key":"168125","doi-asserted-by":"crossref","unstructured":"Muir KJ, Sliwinski K, Lasater KB. Reducing disparities in emergency department outcomes for individuals with limited English proficiency: the nurse work environment. Nurs Outlook 2025; 73: 102318.","DOI":"10.1016\/j.outlook.2024.102318"},{"key":"168126","doi-asserted-by":"crossref","unstructured":"Davies SE, Dodd KJ, Tu A, Zucchi E, Zen S, Hill KD. Does English proficiency impact on health outcomes for inpatients undergoing stroke rehabilitation? Disabil Rehabil 2016; 38: 1350\u20131358.","DOI":"10.3109\/09638288.2015.1092173"},{"key":"168127","doi-asserted-by":"crossref","unstructured":"Grandpierre V, Milloy V, Sikora L, Fitzpatrick E, Thomas R, Potter B. Barriers and facilitators to cultural competence in rehabilitation services: a scoping review. BMC Health Serv Res 2018; 18: 23.","DOI":"10.1186\/s12913-017-2811-1"},{"key":"168128","doi-asserted-by":"crossref","unstructured":"van Rosse F, de Bruijne M, Suurmond J, Essink-Bot ML, Wagner C. Language barriers and patient safety risks in hospital care: a mixed methods study. Int J Nurs Stud 2016; 54: 45\u201353.","DOI":"10.1016\/j.ijnurstu.2015.03.012"},{"key":"168129","doi-asserted-by":"crossref","unstructured":"Guttman OT, Lazzara EH, Keebler JR, Webster KLW, Gisick LM, Baker AL. Dissecting communication barriers in healthcare: a path to enhancing communication resiliency, reliability, and patient safety. J Patient Saf 2021; 17: e1465\u2013e1471.","DOI":"10.1097\/PTS.0000000000000541"},{"key":"168130","unstructured":"National Board of Health and Welfare. Poverty almost seven times more common among foreign-born [Internet]. Stockholm: National Board of Health and Welfare; 2022 [updated 2022 Oct 17; cited 2023 Sep 21]."},{"key":"168131","doi-asserted-by":"crossref","unstructured":"Fryer CE, Mackintosh SF, Stanley MJ, Crichton J. \u2018I understand all the major things\u2019: how older people with limited English proficiency decide their need for a professional interpreter during health care after stroke. Ethn Health 2013; 18: 610\u2013625.","DOI":"10.1080\/13557858.2013.828830"},{"key":"168132","doi-asserted-by":"crossref","unstructured":"Proceedings of the 6th National Patient Reported Outcome Measures (PROMs) Annual UK Research Virtual Conference, Bridgend, Wales 2022 : 14\u201315 June 2022, Virtual, Bridgend, Wales, UK. Qual Life Res 2023; 32(Suppl 1): 1\u201321.","DOI":"10.1007\/s11136-023-03353-w"}],"container-title":["Journal of Rehabilitation Medicine"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/45146\/55485","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/45146\/55486","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/45146\/55485","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T08:41:31Z","timestamp":1789375291000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/view\/45146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":49,"URL":"https:\/\/doi.org\/10.2340\/jrm.v58.45146","relation":{},"ISSN":["1651-2081"],"issn-type":[{"value":"1651-2081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]}}}