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Nursing Research and Practice
Volume 2014 (2014), Article ID 702683, 13 pages
Research Article

Evaluating the Linguistic Appropriateness and Cultural Sensitivity of a Self-Report System for Spanish-Speaking Patients with Cancer

1University of South Florida, 4202 E Fowler Avenue, Tampa, FL 33620, USA
2University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA
3Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
4University of Central Florida, 4000 Central Florida Boulevard, Orlando, FL 32816, USA
5California Department of State Hospitals, P.O. Box 2297, Vacaville, CA 95696, USA

Received 18 January 2014; Revised 3 June 2014; Accepted 4 June 2014; Published 19 June 2014

Academic Editor: Patsy Yates

Copyright © 2014 Cindy Tofthagen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Spanish speakers in the United States encounter numerous communication barriers during cancer treatment. Communication-focused interventions may help Spanish speakers communicate better with healthcare providers and manage symptoms and quality of life issues (SQOL). For this study, we developed a Spanish version of the electronic self-report assessment for cancer (ESRA-C), a web-based program that helps people with cancer report, track, and manage cancer-related SQOL. Four methods were used to evaluate the Spanish version. Focus groups and cognitive interviews were conducted with 51 Spanish-speaking individuals to elicit feedback. Readability was assessed using the Fry readability formula. The cultural sensitivity assessment tool was applied by three bilingual, bicultural reviewers. Revisions were made to personalize the introduction using a patient story and photos and to simplify language. Focus group participants endorsed changes to the program in a second round of focus groups. Cultural sensitivity of the program was scored unacceptable () for audiovisual material and acceptable () for written material. Fry reading levels ranged from 4th to 10th grade. Findings from this study provide several next steps to refine ESRA-C for Spanish speakers with cancer.