¿Habla Español?
Beth Ulrich, EdD, RN, CHE

¿Habla español? Do you speak Spanish? With over 85,000 ESRD patients of Hispanic origin (USRDS, 2004), knowing some basic Spanish is becoming almost as important as how to take a blood pressure.  
The Hispanic population in the United States is growing quickly. At the time of the 2000 census, there were just over 35 million Hispanics (12.6% of the total population) and by July, 2003, the number had grown to 39.9 million (U.S. Census Bureau, 2004). The Hispanic population growth is expected to continue, reaching over 47 million by 2010 and almost 60 million by 2020. About half of the population in the western hemisphere speaks Spanish and, in the U.S., it is the second most spoken language.
 
Why Learn Spanish?
Why learn at least some basic Spanish? The most obvious reason is for basic communication with our patients, particularly those for whom Spanish is their first and/or primary language.  Another is to help put patients, especially new patients, at ease. Beyond these reasons is recent research showing that culturally-appropriate health education improves clinical and behavioral patient outcomes (Pfizer Health Solutions, 2005). A program, known as Amigos en Salud (Friends in Health), implemented culturally appropriate care of Hispanic patients with diabetes by bilingual health care workers. The Hispanic population has more than twice the prevalence of diabetes as the non-Hispanic white population. With the care provided by Amigos en Salud, daily glucose monitoring increased significantly and mean HbA1c decreased significantly. With the prevalence of diabetes among Hispanic patients who also have ESRD (see Figure 1), this research is very applicable in our patient population.

Not All Hispanic People Are the Same
The 85,186 ESRD patients of Hispanic origin reported by the USRDS in 2004 (see Figure 2) are spread across the United States, however, as noted in Table 1, the mix of those Hispanic patients of Mexican origin and those who come from other Spanish-speaking countries vary by area of the country. It is particularly important, when trying to be culturally knowledgeable or to speak Spanish with a patient, to remember that not all of the Hispanic population comes from the same place. In each country and, indeed, sometimes within regions of the same country, there are cultural and language differences. The 2002 U.S. census update reported that 66.9% of Hispanics originated in Mexico,  14.3% in Central and South America, 8.6% in Puerto Rico, 3.7% in Cuba, and 6.5%  in other countries (U.S. Census Bureau, 2003). Just as we have different accents and different ways of saying the same things in various parts of the U.S., so too do people in Spanish-speaking countries.

A New Resource
So how do you start to learn Spanish and find patient resources for our Spanish-speaking patients and families? We are fortunate that a team of ANNA members and their associates have made speaking basic Spanish and finding resources for Spanish-speaking patients with ESRD and their families much easier for us all.
 
They have gathered a list of over 125 resources in Spanish and created an assessment form in Spanish and English. Both are presented in this issue of the Nephrology Nursing Journal and, in addition, will be available on both the ANNA and NNJ websites. We will be updating this material periodically and welcome your suggestions and additions.
 
The initiative and hard work of this group to develop these resources will benefit nephrology nurses, our patients, and our colleagues. Muchas gracias!

Beth Ulrich, EdD, RN, CHE
Editor
E-mail: BethUlrich@aol.com

References
Pfizer  Health Solutions (2005).  Amigos en Salud.  Accessed May 5, 2005 from http://www.pfizerhealthsolutions. com/p_amigos_frame.htm?showmenu=menu3

U.S. Census Bureau (2003). The Hispanic population in the United States: March  2002.  Accessed May 19,
2005 from http://www.census.gov/prod/2004pubs/
p20-545.pdf

U.S. Census Bureau (2004). Hispanic and Asian Americans increasing faster than overall population. Accessed May 19, 2005 from http://www.census.gov/ Press-Release/www/releases/archives/race/ 001839.html

USRDS (2004). USRDS 2004 annual report: Patient  characteristics. Accessed May 13, 2005 from http://www. usrds.org/2004/ref/C_tables_04.pdf