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

Abstract

Healthcare consultations with patients lacking English proficiency are challenging for all parties, even in Australian primary care where the engagement of interpreters is encouraged and fully subsidised. Our objective was to understand these challenges from the perspectives of interpreters, patients and general practitioners in order to improve the effectiveness of interpreted consultations. Our investigator team approached the interpreted consultation as an interprofessional collaboration. A convenience sample of seven general practitioners, eight health interpreters and six representatives from culturally and linguistically diverse communities (representing the patient perspective) participated in three separate focus group discussions, lasting 60-90 min each, exploring participant experiences with healthcare consultations in which interpreters were present. Two semistructured interviews were undertaken subsequently with three additional community representatives purposively recruited to increase participant diversity. Data were collected in 2016 and analysed inductively using a method of constant comparison to identify, and reach consensus on, key emerging themes. All participant groups emphasised the importance of working with trained interpreters, rather than relying on family interpreters or a doctor's own second language skills. Although participants reported experiences of effective interpreted consultations, other reports suggested that some doctors are unaware of, or have difficulty following, accepted guidelines about speech, gaze and turn-taking. Challenges identified in relation to interpreted consultations fell into the five themes of contextual constraints, consultation complexity, communication difficulties, the interpreter role and collaboration. Some general practitioner participants appeared to be unsure and anxious about the etiquette of interpreted consultations, and there was some confusion between and within participant groups about interpreter roles and professional codes. A briefing session prior to the consultation, clarifying the roles of all parties, including any family or bicultural workers present, may help to establish respectful, flexible and effective interprofessional collaborations and to encourage participants to directly address any problems during the consultation.

Cross-Cultural Interpreting With Aboriginal and Torres Strait Islander Patients

“…These time constraints compromise quality in the sense that interpreters are not always able to provide verification of patient understanding. This finding is in consonance with Sturman et al (2018) who found that the placing of time constraints on interpreters was a systemic practice that resulted in interpreters, general practitioners, and patients all "feeling rushed in some consultations, which tended to reduce their effectiveness, particularly if the doctor appeared impatient to the others present" (p. 235). Thus, there is general agreement that more time needs to be allocated for interpreter-mediated consultations for them to be effective.…”

The professional interpreter’s effect on empathic communication in medical consultations: A qualitative analysis of interaction

“…cutting the interpreter short in order to introduce a new topic) and at times even responded to the EOs before these were translated. Doctors' own time constraints and at times their inability to allow for interpretation [40,41] resulted in EOs being left untranslated. This finding confirms that many doctors have not received any training on how to hold IMCs [42].…”

Challenges and chances by involving community interpreters in the regular health care of pregnant women and young mothers from third countries with language barriers. A qualitative study within the project RundUm – Transcultural network in the care of pregnancy and birth / Herausforderungen und Chancen bei der Hinzuziehung von Sprach- und Integrationsmittlerinnen in die Regelversorgung von Schwangeren und jungen Müttern aus Drittstaaten. Eine qualitative Erhebung im Rahmen des Projektes RundUm – Transkultu

“…Das beschriebene tiefe Vertrauen der Schwangeren und jungen Mütter in die Arbeit der Sprach-und Integrationsmittlerinnen und die dargestellten positiven Effekte der Begleitungen auf die geburtshilfliche Versorgung unterstreichen die bekannten wissenschaftlichen Erkenntnisse zum Nutzen der Hinzuziehung von Sprach-und Integrationsmittlerinnen (Borde, 2018;Brenne et al, 2013;Divi et al, 2007;RundUm. Ergebnisbroschüre, 2020) Interprofessionelle Trainings mit den professionellen Akteuren/innen des Gesundheits-und Sozialwesens dienen dazu, voneinander zu lernen und sind wertvoll für die Schaffung von gegenseitigem Verständnis und Respekt (Gün, 2018;Sturman et al, 2018). Relevante Ergebnisse, die durch zeitlich begrenzt geförderte Projekte wie RundUm generiert wurden, müssen als wissenschaftliche Fundierung Einfluss auf Anschlussfinanzierungen finden.…”