The co-construction of empathic communication in interpreter-mediated medical consultations: A qualitative analysis of interaction

Abstract

Current interpreter training programs pay increasingly more attention to the intricacies of the clinical context, such as doctors and patients’ communicative goals. However, to date, the conduit model remains influential when it comes to interpreters dealing with other participants’ emotions and their own emotions in interpreter-mediated consultations (IMCs). Consequently, establishing a good doctor-patient relationship by means of empathic communication (EC) might be jeopardized in IMCs. During EC, patients express their emotional or illness experiences to which doctors convey their empathic understanding. This study aimed to assess how doctors, patients, and interpreters verbally co-construct EC and the interpreter’s effect on this process. We analyzed 7 authentic IMCs using the Empathic Communication Coding System, as previously adapted for IMCs. We identified empathic opportunities (EOs) and empathic responses (ERs) as expressed by patients/doctors, and as rendered by interpreters. Our results showed that EC is the result of an interactive and collaborative process among all participants in IMCs. That is, the interplay between participants’ communicative actions determines how patients’ expressed lived experiences are addressed in IMCs. Our findings suggest that interpreters hold a central position in this process as they initiated EC about the patient’s illness experience and exerted control over the ways in which statements were rendered (e.g., interpreters omitted and altered original statements). In addition, our results indicated that EC in IMCs might be compromised by doctors and interpreters’ communicative actions.

Teaching students to interpret (with) empathy during emotional interactions involving children

“…Although the original German term has since fallen out of use, "empathy," as a concept, continues to be studied from different perspectives and in different contexts. It has been explored in clinical psychology and in clinical encounters (Riess et al, 2012), both for its importance in patient-provider interactions (see Riess et al, 2012;Boissy et al, 2016) and in interpreter-mediated scenarios (Krystallidou et al, 2018;Theys et al, 2023;Theys et al, 2022;Theys et al, 2021;Theys et al, 2020;Merlini & Gatti, 2015). There are various definitions of empathy in the literature, all of which suggest some form of feeling for another's pain and suffering (see Decety & Ickes, 2009).…”

“…Unlike the Krystallidou et al (2018) study, which was based on simulated interactions, several other studies were conducted on empathy in interpreter-mediated interactions (see Theys et al, 2022;Theys et al, 2021;Theys et al, 2020). The most recent by Theys et al (2023) was a qualitative study on the interpreter's impact on the verbal co-construction of empathic communication in clinical consultations. They found that the different interlocutors (patient-provider-interpreter) co-construct empathic communication, with interpreters having both control and power over said co-construction (Theys et al, 2023).…”

“…The most recent by Theys et al (2023) was a qualitative study on the interpreter's impact on the verbal co-construction of empathic communication in clinical consultations. They found that the different interlocutors (patient-provider-interpreter) co-construct empathic communication, with interpreters having both control and power over said co-construction (Theys et al, 2023). Similar to the findings by Krystalliodu et al (2018), they also demonstrated that interpreters negatively impacted the patient-provider "mutual understanding of each other's perspectives" (p. 58).…”