Why do we not use trained interpreters for all patients with limited English proficiency? Is there a place for using family members? (original) (raw)
Related papers
Health & Social Care in The Community, 2017
Healthcare consultations with patients lacking English proficiency are challenging for all parties, even in Australian primary care where the engagement of interpreters is encouraged and fully subsidised. Our objective was to understand these challenges from the perspectives of interpreters, patients and general practitioners in order to improve the effectiveness of interpreted consultations. Our investigator team approached the interpreted consultation as an interprofessional collaboration.
Patient Education and Counseling, 2015
To explore differences in perspectives of general practitioners, Turkish-Dutch migrant patients and family interpreters on interpreters' role, power dynamics and trust in interpreted GP consultations. Methods: 54 semi-structured in-depth interviews were conducted with the three parties focusing on interpreter's role, power and trust in interpreters. Results: In line with family interpreters' perspective, patients expected the interpreters to advocate on their behalf and felt empowered when they did so. GPs, on the contrary, felt annoyed and disempowered when the family interpreters performed the advocacy role. Family interpreters were trusted by patients for their fidelity, that is, patients assumed that family interpreters would act in their best interest. GPs, on the contrary, mistrusted family interpreters when they perceived dishonesty or a lack of competence. Conclusion: Opposing views were found between GPs on the one hand and family interpreters and patients on the other hand on interpreter's role, power dynamics and the different dimensions of trust. These opposing perspectives might lead to miscommunication and conflicts between the three interlocutors. Practice implications: GPs should be educated to become aware of the difficulties of family interpreting, such as conflicting role expectations, and be trained to be able to call on professional interpreters when needed. 2015 Elsevier Ireland Ltd. All rights reserved.
Australian Journal of Primary Health, 2017
Family members continue to be used as interpreters in medical consultations despite the well-known risks. This paper examines participant perceptions of this practice in three New Zealand clinics chosen for their frequent use of interpreters and their skill in using them. It is based on a detailed study of 17 video-recorded interpreted consultations and 48 post-consultation interviews with participants (5 doctors, 16 patients and 12 interpreters, including 6 family members). All participants expressed satisfaction with the communication. Analysis of the interviews explored what participants liked or valued about family member interpreters (FMIs). Key themes were the FMIs’ personal relationship and knowledge, patient comfort, trust, cultural norms, time efficiency and continued help outside the consultation. General practitioners (GPs) expressed awareness of potential risks and how to manage them, in contrast to patients and FMIs. Although the use of professional interpreters needs t...
The Unmet Need for Interpreting Provision in UK Primary Care
PLOS ONE, 2011
Background: With increasing globalisation, the challenges of providing accessible and safe healthcare to all are great. Studies show that there are substantial numbers of people who are not fluent in English to a level where they can make best use of health services. We examined how health professionals manage language barriers in a consultation. Methods and Findings: This was a cross-sectional study in 41 UK general practices. Health professionals completed a proforma for a randomly allocated consultation session. Seventy-seven (63%) practitioners responded, from 41(59%) practices. From 1008 consultations, 555 involved patients who did not have English as a first language; 710 took place in English; 222 were in other languages, the practitioner either communicating with the patient in their own language/using an alternative language. Seven consultations were in a mixture of English/patient's own language. Patients' first languages numbered 37 (apart from English), in contrast to health practitioners, who declared at least a basic level of proficiency in 22 languages other than English. The practitioner's reported proficiency in the language used was at a basic level in 24 consultations, whereas in 21, they reported having no proficiency at all. In 57 consultations, a relative/friend interpreted and in 6, a bilingual member of staff/community worker was used. Only in 6 cases was a professional interpreter booked. The main limitation was that only one random session was selected and assessment of patient/professional fluency in English was subjective. Conclusions: It would appear that professional interpreters are under-used in relation to the need for them, with bilingual staff/family and friends being used commonly. In many cases where the patient spoke little/no English, the practitioner consulted in the patient's language but this approach was also used where reported practitioner proficiency was low. Further research in different setting is needed to substantiate these findings.
Ne diyor?” (What does she say?): Informal interpreting in general practice
Patient Education and Counseling, 2010
Objective: The aim of this study was to offer a comparative analysis of informal interpreters during medical consultations with both good and poor mutual understanding between general practitioners (GPs) and patients. Methods: Sixteen video-registered medical interviews of Turkish immigrant patients were analysed. Stretches of discourse of eight interviews with good mutual understanding between patient and doctor were compared to eight interviews with poor mutual understanding. The discourse analysis focused on:
Is it time to talk? Interpreter services use in general practice within Canterbury
Journal of primary health care, 2013
Effective communication is fundamental to successful health care service delivery, and has a positive impact on access, quality of care, health outcomes, and patient satisfaction. Although there are a growing number of New Zealanders who do not speak English proficiently, underutilisation of trained interpreter services appears to be common in primary health care settings. To describe the pattern of interpreter service need and utilisation by general practice services, and to identify key barriers and enabling factors to the use of trained interpreters. A mixed methods study was employed. Census and Partnership Health Canterbury Te Kei o Te Waka (PHC) databases were combined, and quantitative analysis used to derive interpreter service need and utilisation patterns. Transcripts of focus groups and interviews from general practitioners, practice nurses and practice administration staff within the PHC were analysed, using qualitative methods to identify barriers and enablers to interp...
Patient …, 2007
Objective: This paper explores physician perceptions of the ways professional and family interpreters affect their performance of doctorcommunication tasks described in the Calgary-Cambridge Framework. Methods: Physicians' (19) encounters with patients (24) accompanied by an interpreter were videotaped. Stimulated recall was used to elicit each of the participants' perceptions of the clinical encounter. We analyzed transcriptions of the physician interviews using Atlas-ti software. Results: Physicians perceived all communication tasks to be more difficult using an interpreter than when one was not needed. Physicians perceived family interpreters to be less skilled translators than professional interpreters. Physicians expected professional interpreters to serve as culture brokers at least some of the time. Although only some family interpreters were also caregivers, physicians assumed that all of them fulfilled caregiver roles. Conclusion: With professional interpreters, physicians follow communication rules they were taught. In contrast, physicians act as though these rules are not relevant with family interpreters who they treat as caregivers. Practice implications: Guidelines to working with an interpreter should include directives on working with both professional and family interpreters, describing the similarities and differences with each type, and modifying the clinical encounter process to correspond to those attributes. #
What do(n't) hospital patients like about using professional interpreting services
Language and Health, 2024
Interpreting services in healthcare facilities are essential for patients with limited proficiency in the societally dominant language to communicate effectively with healthcare professionals. Patients can report symptoms more easily and healthcare professionals can diagnose conditions and outline treatment options more readily. Aside from resolving the issue of linguistic discordance, it is possible that patients see the presence of the interpreter as achieving other things as well. A study of 464 overt responses from 1120 patients from 16 different language backgrounds in Melbourne shows that positive impressions (n=353) of interacting with an interpreter outnumber negative (n=111) ones. Over half of the positive feedback related to patients being able to fully understand and participate in medical consultations. Other positive outcomes included relieving family members of having to mediate, obviation of the risk associated with attempting to use English, and the belief that interpreters ensure information accuracy. Of those with negative experiences, 45 % cite waiting time and availability issues, 24 % a perceived lack of professionalism or linguistic ability. Feedback encompasses not only linguistic features and accuracy of the interpreter's output, but also what interpreters 'achieve' for them in the healthcare professional-patient interaction and beyond it, i.e. changes that are of a situational, intra-familial or socio-psychological nature.