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

Abstract

Objective: To investigate how empathic communication is expressed in interpreter-mediated consultations (IMCs) and the interpreter's effect on it. Methods:We coded 20 authentic video-recorded IMCs by using the Empathic Communication Coding System (ECCS). We compared patient-initiated empathic opportunities (EOs) and doctors' responses as expressed by patients and doctors and as rendered by interpreters. Results:We identified 44 EOs. In 2 of the 44 EOs there was a close match in the way the EOs were expressed by the patient in the first place and in the way they were rendered by the interpreter. Twenty-four of the 44 EOs that were passed on by the interpreter to the doctor and presented the doctor with an opportunity to respond, came with a shift in meaning and/or intensity. Twenty of the 44 EOs were not passed on by the interpreter to the doctor. Conclusion:In IMCs, EOs are subject to the interpreter's renditions and the doctor's actions during interaction.Practice implications: Doctors and interpreters require skills to detect patient cues, assess them correctly, render them completely and in an appropriate manner (interpreters) and display communicative behaviours that take into account the intricacies of interpretermediated clinical communication and facilitate each other's communicative goals.

Interpreters' experiences of participating in an introduction course in the healthcare sector. An ethnographic field observation study

“…Several studies have demonstrated that serious misunderstandings can lead to mistreatment, or threat of patient safety, when healthcare professionals are not collaborating with professional interpreters (Drewniak et al., 2017; Flores et al., 2003; Hadziabdic et al., 2014). Krystallidou et al have further demonstrated the importance of both health professionals and interpreters alike, acquire skills on how to collaborate and conduct empathic communication with patients (Krystallidou et al., 2019; Theys et al., 2020). This emphasizes the need for more courses in communication and in relational and cultural skills, aimed at both interpreters and healthcare professionals.…”

Study protocol of OncoTolk: an observational study on communication problems in language-mediated consultations with migrant oncology patients in Flanders (Belgium)

“…This prospective, mixed-methods observational study allows for a novel and fine-grained analysis of communication between oncologists/haematologists and patients from an under-represented group in the literature, namely migrant patients with language barriers in oncology settings. We combine qualitative methodologies, such as multimodal interaction analysis 35 36 and qualitative content analysis, 37 with analysis using the Empathic Communication Coding System (ECCS) [38][39][40] in which a priori categories that are typically associated with quantitative methods are used. The above combination allows for a comprehensive and fine-grained analysis of authentic, naturally occurring doctor-patient interactions that go beyond the mere identification and description.…”

“…The training will be provided by her supervisors (DK, PP), who have many years of experience in this research design. DK will train LV on the use of the ECCS as adapted for interpreter-mediated consultations 40 and on multimodal interaction analysis. 35 Eligibility criteria Inclusion criteria ► Turkish-speaking or Arabic-speaking migrant cancer patients ≥18 years and their family members who reside in Flanders, attend consultations in oncology settings, do not speak Dutch and, therefore, require language support.…”

“…third level of analysis: identification of inconsistencies in emotional talk (transcribed video-recorded consultations) Considering that cancer communication involves addressing patient emotion 1 53-55 and compromised emotional communication in language-mediated consultations might lead to suboptimal communication, 40 the Open access research team will identify different levels of emotional communication and will flag the language mediator's effect on the expression and management of emotions (by noticing shifts in the patients' emotion-laden statements and the doctors' levels of response to these). To this end, we will use the ECCS, 38 39 as adapted for languagemediated consultations, 40 56 in order to identify communication problems observed in the video recordings focusing on expression of, and response to, emotions.…”

Communication training is inadequate: the role of deception, non-verbal communication, and cultural proficiency

“…However, this has limited accessibility for those without previous understanding, and limited value for those who only memorize a few phrases. By contrast, the way an interpreter is utilized can increase both the empathy observed and the information exchanged in a medical encounter [66,67]. Perhaps the more fruitful path is instruction on how to work with interpreters to achieve these outcomes.…”