Balancing truth-telling: relatives acting as translators for older adult cancer patients of Turkish or northwest African origin in Belgium

Abstract

The first generation of Turkish and Northwest African immigrants in Belgium are ageing and at risk for developing cancer. Relatives play an important role and provide both emotional and practical care, including mental support and acting as a contact person and/or a translator for improving access to healthcare, as most patients and their spouses have only a limited command of the language. Although access to professional interpreters has shown to be the best guarantee for qualitative healthcare, oncology health providers working with relatives as interpreters is much more common than professional interpreters. The aim of this study was to provide insight into the process wherein relatives balance truth-telling in translating for an older family member diagnosed with cancer. This was a qualitative research study, with elements of constructivist grounded theory. Twenty-eight loosely structured interviews were conducted. Most relatives consider it their responsibility to contribute to a positive attitude of the patient. Relatives decided to what extent they inform the patient, based on several motives and embedded in their assessment of the patient's emotional strength, understanding and need to be informed. What they decide influences the way they act as a translator and/or a contact person between the patient and health professional(s). Some considered it best to omit medical information while others considered it best to inform the patient fully. The results emphasise the importance for healthcare providers to take into account the complexity and unpredictable character of the process of balancing truth-telling when family members translate for their ill older relative.

Health care professional’s communication through an interpreter where language barriers exist in neonatal care: a national study

“…This can be an ethical dilemma, as there is no guarantee when a family member interprets that the health care professionals are safeguarding the patient’s rights. For example, there is often low transparency and the health care professional does not know what the family member is saying and whether their interpretation is a true interpretation [25].…”

Linguistic barriers in communication between oncologists and cancer patients with migration background in Germany: an explorative analysis based on the perspective of the oncologists from the mixed-methods study POM

“…Overall work with linguistically and culturally competent, trained and trusted translators, these professionals are not always available and are often not easy to organize [35,36], both for organizational and financial reasons [23,37]. Therefore, consultations with migrant patients in which the relatives act as translators are more common [23,37,38].…”

“…Therefore, consultations with migrant patients in which the relatives act as translators are more common [23,37,38]. However, this might result in uncomfortable situations for the physicians [29,35], who can feel violating the intimacy of the patients, as well as lacking trust in the accuracy of the translation [29,[35][36][37]39]. Hence, our results show how employees that could act as translators might result in an easier to manage and more trusted solution to overcome linguistic and cultural barriers during the consultation, without the development of mistrust between the physicians and the relatives, and therefore with a more positive experience regarding the perceived antagonistic behaviour from the relatives.…”

Twelve tips to teach culturally sensitive palliative care

“…In addition, communication with older patients can take the form of a 'triad' between physician, patient and a close relative. For older migrants, the relative often helps to resolve language problems (Van Eechoud et al 2017). This may result in a situation in which relatives play an important role in the decision-making process.…”