Bilingual Health Communication: Distinctive Needs of Providers from Five Specialties (original) (raw)
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Patient Education and Counseling, 2010
OBJECTIVE: This study examines (a) providers' and interpreters' perception of their competition in controlling the content and process of provider-patient interactions, and (b) the challenges to providers' and interpreters' collaboration in bilingual health care.METHODS: I recruited 26 professional medical interpreters from 17 languages and 39 providers from 5 specialties to participate in in-depth interviews and focus groups. Grounded theory was used for data analysis to develop themes in areas where providers and interpreters compete and assert their expertise.RESULTS: Providers and interpreters experience conflicts over their expertise and authority due to their practice in (a) adopting different speech conventions, (b) controlling the other's narratives, and (c) overstepping expertise and role boundaries.CONCLUSION: A successful bilingual medical encounter is dependent on the interpreters' and providers' ability (a) to understand, communicate, and negotiate their and others' communicative strategies/goals and (b) be adaptive of and responsive to others' management of the communicative process.PRACTICE IMPLICATIONS: Authority in bilingual health care should not be established through pre-existing categories or expertise but negotiated and coordinated during the interactive process, which would allow individuals to be adaptive to the issues emerged in the communicative process.Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
TRANS. Revista de Traductología, 2021
Researchers have long been preoccupied with the issue of role in healthcare interpreting. However, most studies approach this construct in the course of medical consultations, leaving somewhat unattended other spaces and activities in which interpreters also participate. This paper aims to contribute to a better understanding of the healthcare interpreters’ role in these areas. Drawing on participant observation, I examined the roles played by five interpreters at a hospital in Madrid for five months in activities different to provider-patient interactions (e.g. waiting with patients). Seven key roles were identified outside medical consultations: intercultural and moral mediator, patient advocate, institutional navigator, healthcare ambassador, information miner and companion/conversation partner. A key finding is that most events in which interpreters participate occur outside medical consultations, which makes it essential to shift the attention to the roles played in these alter...
2010
BACKGROUND: The Hablamos Juntos-Together We Speak (HJ)-national demonstration project targeted the improvement of language access for Spanishspeaking Latinos in areas with rapidly growing Latino populations. The objective of HJ was to improve doctorpatient communication by increasing access to and quality of interpreter services for Spanish-speaking patients. OBJECTIVE: To investigate how access to interpreters for adult Spanish-speaking Latinos is associated with ratings of doctor/office staff communication and satisfaction with care. DESIGN: Cross-sectional cohort study. PATIENTS: A total of 1,590 Spanish-speaking Latino adults from eight sites across the United States who participated in the outpatient HJ evaluation. MEASUREMENTS: We analyzed two multi-item measures of doctor communication (4 items) and office staff helpfulness (2 items), and one global item of satisfaction with care by interpreter use. We performed regression analyses to control for patient sociodemographic characteristics, survey year, and clustering at the site of care. RESULTS: Ninety-five percent of participants were born outside the US, 81% were females, and survey response rates ranged from 45% to 85% across sites. In this cohort of Spanish-speaking patients, those who needed and always used interpreters reported better experiences with care than their counterparts who needed but had interpreters unavailable. Patients who always used an interpreter had better adjusted ratings of doctor communication [effect size (ES=0.51)], office staff helpfulness (ES=0.37), and satisfaction with care (ES=0.37) than patients who needed but did not always use an interpreter. Patients who needed and always used interpreters also reported better experiences with care in all three domains measured [doctor communication (ES= 0.30), office staff helpfulness (ES=0.21), and satisfaction with care (ES=0.23)] than patients who did not need interpreters. CONCLUSIONS: Among adult Spanish-speaking Latinos, interpreter use is independently associated with higher satisfaction with doctor communication, office staff helpfulness, and ambulatory care. Increased attention to the need for effective interpreter services is warranted in areas with rapidly growing Spanishspeaking populations.
Interpreters and patient-centered communication care
Journal of Interpretation, 2020
In the U.S., deaf individuals who use sign language have a legislated right to communication access in the healthcare system, which is often addressed through the provision of signed language interpreters. However, little is known about deaf patients’ perception of interpreter presence, its impact on their disclosure of medical information to physicians, and whether this perception affects their assessment of physicians’ patient-centered communication behaviors (PCC). A total of 811 deaf adults responded to questions on a bilingual ASL-English online survey about their experiences with interpreters and physicians. Logistic regression analysis was used to assess the relationship between deaf patients’ perception of interpreters’ presence with disclosure of medical information and deaf patients’ ratings of their physicians’ patient-centered communication behaviors. The majority of deaf respondents reported feeling that an interpreter’s presence does not interfere with disclosure of medical information to their provider; however, approximately 27% responded that an interpreter’s presence does interfere with their disclosure of medical information. After controlling for correlates of physicians’ patient-centered communication behaviors, the deaf respondents' negative perception of interpreters’ presence was associated with 1) low ratings of interpreters’ ability to understand their signed communication, and 2) low ratings of physicians’ patient-centered communication behaviors. Deaf patients’ perception of interpreters’ interference with disclosure of medical information to physicians has implications for trust relationships between the deaf patient and the interpreter, as well as between the deaf patient and physician. Understanding the importance of establishing trust in interpreter-mediated healthcare encounters may foster additional training of interpreters’ receptive skills and inform physician’s patient-centered care for deaf patients.
Interpreter services, language concordance, and health care quality
Journal of General Internal Medicine, 2005
BACKGROUND: Patients with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. Both interpreter-and languageconcordant clinicians may help overcome these problems but few studies have compared these approaches.
Social Science & Medicine, 2021
In today's multilingual and multicultural societies, healthcare interpreters are increasingly needed to mitigate communication barriers in language-discordant, intercultural medical consultations. To orient these interactions, existing guidelines, best practices and recommendations shed light on the behaviour and responsibilities of interpreters and healthcare providers involved. These documents, however, mainly treat both professionals as individuals that take care of separate, unrelated dimensions of consultations, thus failing to address how they can work collaboratively. This seems to be particularly relevant if we consider that prescriptive documents advocate for an invisible interpreter rather than an active participant, consequently ignoring the positive functions interpreters are playing when they step out of their prescribed roles. In this context, this paper sets out to explore potential collaboration between both professional groups to improve communication as a whole. Drawing on Goffman's production format (1981), we examined excerpts from real interpreter-mediated medical consultations that took place at a public hospital in Madrid (Spain) over a period of five months (February-June 2017). Data analysis reveals that interpreters enact an author role as main participants of consultations and serve several functions in medical encounters, consequently sharing some of the responsibilities which are conventionally seen as doctors'. This may reveal potential areas of interest for interprofessional collaboration. In addition to interpreting, participants performed other clinical functions, thus accounting for complementary functions of that performed by healthcare providers. Interpreters act as clinical and therapeutic allies, patient empowerers and metalinguistic negotiators. In light of our findings, the next step is to design a new model for the interpretermediated medical consultations that integrates both perspectives in a collaborative, non-excluding proposal.
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. #