Research indicates that adequate preoperative PCA teaching leads to more effective pain control in trhe postoperative period(Knoerl, Paice, Faut-Callahan, & Shott, 199). However, if this teaching is not conducted in a manner the patient comprehends, the nurse becomes ethically, professionally, and legally liable for not acting in accordance with the Civil Rights Act of 1964 (Villarruel, Portillo, & Kane, 1999). Today's health care organizations provide care to Hispanic persons who comprise 35.3 million of the United States' current population (Population Data Series, 2000). Fifty-four percent of the Hispanic population in the United States speaks Spanish in their homes, and 8.3 million report difficulty speaking English (Villarruel, Portillo, & Kane, 1999(. Nurses often struggle to verbally communicate with this patient population causing an inability to provide culturally competent care. One specific instance of thie disparity, in quality care delivered to Spanish As Predominant Language (SAPL) patients, involves preoperative education of patient-controlled analgesia (PCA) therapy in the preoperative period. A review of the literature suggests that specific approaches can be used to enhance the effectiveness of PCA use by SAPL patients. Recommendations include developing Spanish language videotapes, Spanish language education booklets, and providing interpreters as needed in the preoperative education period. Further recommendations include the need to create a two-way dialogue form for use by English-speaking health care providers and SAPL patients.
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