Bilingual Communicators within the Health Care Setting

Abstract

The communication challenges posed by diversity in consumers and health workers prompted these researchers to seek information about how bilingual staff use their language skills in patient encounters. Content analysis, using the NUD•IST (Nonnumerical Unstructured Data Indexing, Searching, and Theory-Building) program, of the transcripts from 18 focus groups (n = 81) has resulted in new notions about bilingualism. Four types of bilingual workers were defined within the Bilingual Health Communication Model, based on level of fluency (no fluency to complex verbalizer) and the context of the interaction (social engagement to complex health information transference). These forms of communicators were found to be active and purposeful in language skill clusters, language exchange programs, and individual bilingual worker roles (direct caregiver, communication facilitator or consultant, and cultural advocate or broker). Implementing the systems and roles proposed might transform the communication or indeed miscommunication patterns that are widespread in our health care systems.

Bilingual health communicators:role delineation issues

“…Bilingual health professionals make a major contribution to enhancing communication within the health setting through their use of language in both social and more complex technical contexts (Johnson, Noble, Matthews & Aguilar 1999). However, it became apparent from this study that tension existed between the defined role of the interpreter and the use of languages other than English (LOTE) by health staff.…”

“…Tension between these workers, in relation to their roles in supporting communication for patients who speak a LOTE, was the impetus to undertake further examination of existing qualitative data. Several writers have identified that interpreters and other bilingual health staff can, and do, fulfil a range of roles from formal interpreters where the client is the health care provider, to roles where health care providers are direct carers, case managers, advocates, and consultants (Johnson et al 1999;Kaufert & Putsch 1997;Meleis 1992;Riddick 1999). The potential for confusion in these roles from the worker's and manager's perspective is evident (Johnson et al 1999).…”

“…The original coding of data described by Johnson et al (1999) was the basis for subsequent coding. Further codes and exemplars were added to highlight the similarities and differences in the roles and functions of interpreters and bilingual health staff using a number of key features.…”

“…Recent research by Johnson et al (1999) suggested that bilingual staff perceived difficulties with the nature of interpretation, but also misunderstood the process of interpreting. Bilingual staff often perceived themselves to be 'interpreting' although the situations they described did not support their claims to be interpreters, rather they were facilitating communication (Johnson et al1999).…”

“…The Bilingual Health Communication Model proposed by Johnson et al (1999) provided a conceptual framework for understanding how language and communication was negotiated when patients spoke a LOTE. This simple model proposed that there were two main components involved in the process: language proficiency and the context within which the language assistance is required.…”