The Informed Consent: A Study of the Efficacy of Informed Consents and the Associated Role of Language Barriers

Clark, Shanetia P.; Mangram, Alicia; Ernest, Dunn; Lebron, Ricardo; Peralta, Lauren

doi:10.1016/j.jsurg.2010.09.009

Cited by 36 publications

(42 citation statements)

References 10 publications

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“…It is a dialogue during which information is exchanged between patients and health care providers, requiring at a minimum that both parties are competent and can communicate either directly or with the guidance of an interpreter [2,3]. It is the physician’s obligation to ensure that patients understand the purposes, procedures, alternatives, benefits, and risks of medical treatments to make informed decisions about their health care [4,5].…”

Section: Introductionmentioning

confidence: 99%

Preoperative consent for patients with limited English proficiency

Patel

Wakeam

Genoff

et al. 2016

Journal of Surgical Research

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Background Informed consent is important for limited English proficient (LEP) patients undergoing surgery, as many surgical procedures are complicated, making patient comprehension difficult even without language barriers. The study objectives were to (1) understand surgeons’ preoperative consenting process with LEP patients, (2) examine how surgeons self assess their non-English language proficiency levels using a standardized scale, and (3) identify the relationship between self assessed non-English language proficiency and surgeons’ self-reported use of interpreters during preoperative informed consent. Materials and methods A thirty-two item survey assessing surgeons’ reported preoperative informed consent process, with questions related to demographics, level of medical training, non-English language skills and their clinical use, language learning experiences, and hypothetical scenarios with LEP patients. Results Surgeons who were not fluent in non-English languages reported they often used those limited skills to obtain informed consent from their LEP patients. Many surgeons reported relying on bilingual hospital staff members, family members, and/or minors to serve as ad-hoc interpreters when obtaining informed consent. If a professional interpreter was not available in a timely manner, surgeons more frequently reported using ad-hoc interpreters or their own nonfluent language skills. Surgeons reported deferring to patient and family preferences when deciding whether to use professional interpreters and applied different thresholds for different clinical scenarios when deciding whether to use professional interpreters. Conclusions Surgeons reported relying on their own non-English language skills, bilingual staff, and family and friends of patients to obtain informed consent from LEP patients, suggesting that further understanding of barriers to professional interpreter use is needed.

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Section: Introductionmentioning

confidence: 99%

Preoperative consent for patients with limited English proficiency

Patel

Wakeam

Genoff

et al. 2016

Journal of Surgical Research

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show abstract

“…However, the unusual hours and time pressures of acute care medicine mean that we cannot assume translators will always be available. Moreover, patients who use translators are often less satisfied with their care, 3 may be less informed when providing consent, 4 and may demonstrate less outpatient compliance. 5 Therefore, it is important that front-line practitioners have basic language skills.…”

Section: In English/en Anglaismentioning

confidence: 99%

“…De fait, on s'attend beaucoup plus d'un médecin que le rôle restreint d'un expert des faits ou d'un technicien de pointe. En ce sens, on note qu'un bon nombre d'erreurs médicales évitables sont causées par des problèmes de communication [3][4][5][10][11][12][13][14][15] . Exprimé sous un autre angle, les standards attendus en termes d'habiletés de communication ne doivent en rien être moins élevés que nos standards en termes d'habiletés procédurales ou de savoir-faire 15 .…”

Section: En Allant De L'avant/moving Forward En Français/in Frenchunclassified

“…Exprimé sous un autre angle, les standards attendus en termes d'habiletés de communication ne doivent en rien être moins élevés que nos standards en termes d'habiletés procédurales ou de savoir-faire 15 . Les difficultés engendrées pas ces différences linguistiques patient-médecin [3][4][5] peuvent possiblement être atténuées en y mettant un accent M e d i c a l F r e n c h a n d M e d i c a l E n g l i s h / L a n g a g e m é d i c a l f r a n c o p h o n e e t a n g l o p h o n e 18 . La plupart des universités canadiennes offrent des cours de langue qui sont disponible pour les membres de la faculté de médecine.…”

Section: En Allant De L'avant/moving Forward En Français/in Frenchunclassified

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Medical French and Medical English: General Language Skills for a Bilingual Country/Langage médical francophone et anglophone: habiletés de communication médicales attendues dans un pays bilingue

Smith

LeBlanc²,

Cardinal³

et al. 2015

Can Journ Gen Int Med

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It has been argued that Canada contains two solitudes, based primarily upon its European founding languages: English and French.1,2 Bringing these solitudes closer requires effort and empathy. It also requires common words and phrases. This is the goal of this modest language primer for acute care practitioners. Many medical practitioners treat language-discordant patients and families (both within Canada and worldwide).Interpreters can be invaluable, and can avoid the loss of confidentiality that occurs if we rely upon family members. However, the unusual hours and time pressures of acute care medicine mean that we cannot assume translators will always be available. Moreover, patients who use translators are often less satisfied with their care, may be less informed when providing consent, and may demonstrate less outpatient compliance.Therefore, it is important that front-line practitioners have basic language skills. Empathy is integral to patient-focused care. Canadian and American data suggest that when we cannot communicate in a patient’s native language, we treat that patient differently.

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“…To make matters even worse, patients not speaking the same language as the doctors is suspected to be a major source of medical treatment errors [3]. It is also questionable if informed consent is achievable under such circumstances [1].…”

Section: Introductionmentioning

confidence: 99%

TIS – Talking in Symbols. Development of a Tool for Nonverbal Communication after Language Barriers in Pediatric Oncology

et al. 2020

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Language barriers have been reported to have a detrimental effect on various outcomes in paediatric care, such as therapy adherence, and may even cause medical treatment errors. To address this issue, we developed a set of 63 cards with which a wide range of specific messages can be conveyed nonverbally in a clinical context. The conceptualization of the tool involved multiple phases. In Study 1, we held a workshop with 11 children and adolescents between 8 and 19 years that had received treatment for oncological conditions to gain an understanding of the specific challenges. In Study 2, we presented a first prototype to 3 children and 14 adults; participants were asked to rate the cards on multiple dimensions. Based on information from the previous trials, we developed a second prototype and asked 10 children and 7 adults to rate the cards on multiple dimensions. In this multidisciplinary approach in addition to our experts of clinical psychology we involved patient advocators and graphic designers in the process to achieve high feasibility and comprehensibility; based on the workshop, expert consensus surveys, data gathered in evaluation, all prototypes and the final card set were developed in close collaboration. Participants had little difficulty interpreting the cards and rated the information content as adequate. Importantly, a majority of participants indicated that they would keep using the tool during their stay at the hospital. Overall, the evaluation implied high acceptance and usability. The final card set is a promising communication tool in clinical paediatric settings with various language barriers. Further research should address how patient outcomes are impacted by using the tool.

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The Informed Consent: A Study of the Efficacy of Informed Consents and the Associated Role of Language Barriers

Cited by 36 publications

References 10 publications

Preoperative consent for patients with limited English proficiency

Preoperative consent for patients with limited English proficiency

Medical French and Medical English: General Language Skills for a Bilingual Country/Langage médical francophone et anglophone: habiletés de communication médicales attendues dans un pays bilingue

TIS – Talking in Symbols. Development of a Tool for Nonverbal Communication after Language Barriers in Pediatric Oncology

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