Lessons Learned

McCabe, Melvina; Morgan, Frank; Smith, Melissa; Yazzie, Ella; Spencer, Anthony; Curley, Helen; Begay, R. Cruz; Gohdes, Dorothy

doi:10.2337/diacare.26.6.1913

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…Untrained interpreters may have difficulty understanding and accurately interpreting key concepts related to diabetes and diabetes control [44], and studies have shown that unbeknownst to physicians, interpreters often actively influence the medical encounter [27,30,45-47]. Clinicians untrained in how to work with interpreters may not be aware of these shortcomings nor have skills to manage the specific communication difficulties that arise with untrained interpreters.…”

Section: Introductionmentioning

confidence: 99%

Interpreter-mediated diabetes consultations: a qualitative analysis of physician communication practices

et al. 2013

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BackgroundPatient-provider communication, in particular physicians’ ability to listen to their patients, and support them in making difficult lifestyle changes, is an essential component of effective diabetes care. Clinical communication around diabetes can be especially challenging when language barriers are present, and may contribute to poor diabetes management and outcomes. Clinicians need to be aware of and address potential communication difficulties associated with interpreter-mediated consultations. The purpose of our study was to explore how physicians communicate in interpreter-mediated consultations with diabetic patients, and how their communication behaviors may impact diabetes communication and care.MethodWe analyzed transcripts from 8 audio recorded, outpatient consultations at the Basel University Hospital general medicine outpatient clinic involving Turkish-speaking patients, German-speaking physicians, and Turkish-German interpreters (both community interpreters and family members).ResultsClinicians used closed questions when asking about symptoms and glucose control. When providing information and explanation, they spoke in long and complex speech turns. They often directed their speech to interpreters or became sidetracked by family members’ questions or requests for information. Patients’ participation in the consultation was minimal, and limited to brief answers to clinicians’ questions.ConclusionsClinicians need to be aware of common pitfalls that diminish patient-centeredness during interpreter-mediated consultations, and learn strategies to avoid them. Attention to established guidelines on triadic communication is recommended, as is hands-on training with interpreters.

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Section: Introductionmentioning

confidence: 99%

Interpreter-mediated diabetes consultations: a qualitative analysis of physician communication practices

et al. 2013

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“…Scaioli's work shows that meaning-based approaches to linguistic equivalence need to account for significant latitude being possible, even desirable, when specialised terminology in expert fields of other cultures (such as Western medicine) are not necessarily part of the target language and society. McCabe et al (2003) also conducted similar research on the Navajo language. However, they restricted their research to the medical term 'diabetes', which is translated to 'sugar illness' in the Navajo language.…”

Section: Lexical Challenges In Medical Interpretingmentioning

confidence: 99%

“…The health care context is particularly challenging because of the differences that typically exist in the language competency, linguistic practise, and socioeconomic status of service providers and the members of the public who use such services. However, there are few medical interpreting studies that address lexical challenges, apart from Scaioli (2000) and McCabe et al (2003). Lexical challenges are a major concern for legal interpreting (Morris, 1995;Hayes, 2009) and conference interpreting (Dam, 2000), but rarely appear in community interpreting studies.…”

Section: Introductionmentioning

confidence: 99%

Medical terminology rendition techniques employed by paraprofessional Chin-Hakha <> English interpreters

Ching

2017

Trans-Int

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This paper presents a study of the techniques employed by paraprofessional Chin-Hakha community interpreters when interpreting in a medical setting. Data was collected through a simulated dialogue in which participants were asked to interpret consecutively. Participants were then interviewed about their decision-making processes in formulating renditions of a number of medical terms. Lexical analysis found that Chin-Hakha interpreters produce interpretations of medical terminology according to certain observable patterned constructions. Overall, this study confirms the community interpreter's role as a 'negotiator' of language, where interpreters negotiate the intended meaning of specialised terminology by using their own 'storeroom' of linguistic skills and medical knowledge so as to be successful in rendering medical conversations.

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“…This situation creates many problems such as interpretation inaccuracies, non-neutrality and confidentiality problems, and burdens on informal interpreters (15,17,28). Untrained interpreters may have difficulty understanding and accurately interpreting key concepts related to diabetes and diabetes control (28,29). Previous studies found that approximately half of all conversations between foreign patients and hospital nurses resulted in misinterpretations that seriously compromised the physician's understanding of patient's symptoms or the credibility of the patient's concerns (14,30).…”

Section: Language Barriersmentioning

confidence: 99%

Factors complicating the diabetes management of visitors to Japan: advices from a Japanese National Center for overseas medical staff

Kishimoto

Noda

2016

J. Med. Invest.

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Linguistic, cultural, and geographical differences might challenge the management of diabetes patients travelling in a culturally and linguistically homogeneous country. This article presents an instructive case and identifies various factors that can help in effective diabetes management of such cases. A Russian female patient aged 23 came to Japan and visited our hospital for a second opinion regarding glycemic control. She was diagnosed with type 1 diabetes at age three and started insulin injections and diet therapy with carbohydrate counting methods. Her HbA1c level was 11.0% with multiple daily insulin injections. She showed neuropathy, nephropathy, and blindness due to her progressed retinopathy. Because of the language barrier, suggestions for lifestyle modification were not effectively conveyed to the patient. We analyzed possible barriers to effective diabetes management in such foreign patients. In addition to language barriers and difficulties in diet therapy, dissimilar diabetes treatment guidelines, inadequate healthcare insurance, and stress-inducing conditions can be barriers to effective diabetes management. Foreign diabetes patients might face several barriers in effective management while travelling in Japan. Use of medical interpreters, adequate medical insurance, and trained medical staff will help in overcoming these barriers.

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Lessons Learned

Cited by 7 publications

References 7 publications

Interpreter-mediated diabetes consultations: a qualitative analysis of physician communication practices

Interpreter-mediated diabetes consultations: a qualitative analysis of physician communication practices

Medical terminology rendition techniques employed by paraprofessional Chin-Hakha <> English interpreters

Factors complicating the diabetes management of visitors to Japan: advices from a Japanese National Center for overseas medical staff

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