Bilingual Health Communication: Distinctive Needs of Providers from Five Specialties

Abstract

Understanding providers’ expectations and needs for medical interpreters can provide important insight into the dynamics and process of interpreter-mediated medical encounters. This is one of the first mixed-methods studies on the similarities and differences of providers’ views of interpreters across five specialties (i.e., obstetrics/gynecology, emergency medicine, oncology, mental health, and nursing). The two-stage studies include interview data with 39 providers and survey data with 293 providers. We used principal component analysis to identify three components in the survey data that represent providers’ views of interpreters: Patient Ally, Health Care Professionals, and Provider Proxy. We then used the interview data as exemplars to illuminate the quantitative findings. Patient Ally was the only component that reached significant differences between different specialties. Providers from different specialty areas differ significantly in their expectations on interpreters’ ability (a) to assist patients outside of medical encounters and (b) to advocate for the patient. In particular, nursing professionals place more importance on these two abilities than mental health providers and oncologists. Based on our findings, we proposed three research directions necessary to advance the field of bilingual health communication: to reevaluate and reconceptualize interpreters’ appropriate performances with special attention to the Patient Ally dimension, to examine the commonly held attitudes for all providers and the potential tensions within these attitudes, and to identify contextual factors that influence participants’ perceptions, evaluations, and choices of interpreters and their corresponding impacts.

Difficulties in using interpreters in clinical encounters as experienced by immigrants living in Sweden

“…Thus, the physician's awareness of when and how to use an interpreter is important (Hsieh et al . ). When there is no interpreter and a provider is forced to act as the interpreter in a consultation, this can have a negative impact on communication outcomes because the ability to balance the two roles at the same time has been shown to be challenging (MacFarlane et al .…”

Conceptualizing emotion in healthcare interpreting: A normative approach to interpreters’ emotion work

“…For example, when an interpreter believes that expressing empathy toward patients can facilitates QEC, we predict that they are likely to do so. However, because providers from different specialties may hold different expectations about the needed interpreter behaviors to achieve QEC, they may hold divergent evaluations about such practices [60,72].…”

“…Interpreters actively provide emotional support and minimize negative attitudes/emotions during medical encounters by noting the needs to bridge cultural differences, enhance provider-patient bonding, and ensure quality care [28,40,60,71]. A recent study found that nurses highly value interpreters' function as patient ally [72], which echoes with the general tasks of nurses in which they often help patients to voice their concerns, address their information needs, and provide emotional support [26,73].…”

Improving the effectiveness of interpreted consultations: Australian interpreter, general practitioner and patient perspectives

“…It might also be useful to address the roles of any bicultural support workers or family members present. Doctors, patients, bicultural support workers and/or family members may not understand that accurate interpreting does not require speech to be translated word for word (a misconception which has also been identified in other literature; Hadziabdic, Lundin, & Hjelm, ), and that a role as patient ally, advocate or support (including talking about health issues outside the consultation) may be viewed by trained interpreters as contravening professional ethics of impartiality, and undermining the doctor–patient relationship (Butow et al., ; Hsieh, Pitaloka, & Johnson, ). Doctors and patients may not be aware of ethical dilemmas for interpreters or of their emotional responses.…”