What is needed in culturally competent healthcare systems? A qualitative exploration of culturally diverse patients and professional interpreters in an Australian healthcare setting

Abstract

Background Culturally competent health care service delivery can improve health outcomes, increasing the efficiency of clinical staff, and greater patient satisfaction. We aimed to explore the experience of patients with limited English proficiency and professional interpreters in an acute hospital setting. Methods In-depth interviews explored the experiences of four culturally and linguistically diverse communities with regards to their recent hospitalisation and access to interpreters. We also conducted focus group with professional interpreters working. Data were analysed using an inductive thematic approach with constant comparison. Results Individual interviews were conducted with 12 patients from Greek, Chinese, Dari and Vietnamese backgrounds. Focus groups were conducted with 11 professional interpreters. Key themes emerged highlighting challenges to the delivery of health care due distress and lack of advocacy in patients. Interpreters struggled due to a reliance on family to act as interpreters and hospital staff proficiency in working with them. Conclusions In an era of growing ethnic diversity this study confirms the complexity of providing a therapeutic relationships in contemporary health practice. This can be enhanced by training towards the effective use of professional interpreters in a hospital setting. Such efforts should be multidisciplinary and collective in order to ensure patients don’t fall through the gaps with regards to the provision of culturally competent care. Electronic supplementary material The online version of this article (10.1186/s12889-019-7378-9) contains supplementary material, which is available to authorized users.

Linguistic barriers and healthcare in China: Chaoshan vs. Mandarin

“…There are well-recognized breakers of language barriers to healthcare [ 1 , 2 ], such as professional interpreting service [ 27 – 29 ], language training of healthcare providers [ 30 ], or medical translation apps [ 31 , 32 ], which are nonetheless relevant mainly to LEP (Limited English Proficiency) in recent and remote immigrants in English-speaking resource-rich countries like the United States, Australia, and United Kingdom [ 29 , 31 – 33 ]. The recommended interventions are, therefore, far to be practical in dialectically diverse countries like India [ 9 ] or China.…”

“…The recommended interventions are, therefore, far to be practical in dialectically diverse countries like India [ 9 ] or China. For example, on-site professional interpreter service is recommended most for its overall effectiveness [ 24 , 28 ], but its cost [ 27 , 33 , 34 ] and in-house after-hours service could be significant concerns for Chinese hospitals because even public hospitals in China are only partially funded by the government [ 35 ].…”

Living with the Memories—Parents’ Experiences of Their Newborn Child Undergoing Heart Surgery Abroad: A Qualitative Study

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“…Both professional and family interpreters are used in health care encounters. Family interpreters are used when professional interpreters are inaccessible or unavailable (Jaeger et al, 2019; Kamimura et al, 2015; Smith, 2018; White et al, 2019). Evidence suggests that professional and family interpreters have different interpreting skills and may play different roles in the clinical environment (Hartford et al, 2019; Leanza et al, 2010).…”