Working with the Hmong Population in a Genetics Setting: an Interpreter Perspective

Abstract

The aim of this pilot qualitative study was to describe the experiences and beliefs of medical interpreters when working with genetic counselors and other genetic providers caring for Hmong patients who are not native English speakers. Specific goals were to identify interpreters' thoughts and perceptions on (a) their roles during sessions, (b) unique challenges in a genetics session, (c) knowledge genetics providers need when working with Hmong patients and interpreters, and (d) supports and training needed to effectively interpret in a genetics setting. Hmong medical interpreters from Wisconsin and Minnesota were invited by email to participate in the study. Six were interviewed by telephone. Participants had worked with a variety of providers including geneticists, genetic counselors, primary care physicians, and oncologists. Factors identified by Hmong interpreters that made interpretation of content difficult in clinical genetics sessions included: time constraints, technical terms, and unique cultural perspectives of Hmong patients. While all respondents felt their primary role was to interpret session content as close to verbatim as possible, there was notable variation in the description of their interpretation style and other perceived roles in the genetic counseling session. Cultural issues genetics providers could consider when working with Hmong patients and different style issues when working with Hmong interpreters are discussed. Ideas for future studies and suggestions to improve communication with Hmong patients are explored.

Communication pitfalls in interpreted genetic counseling sessions

“…Another related limitation is that we did not interview our interpreters to understand their views concerning their role. Other genetic counseling interpreter studies among Hmong individuals have shown that interpreters can view their roles differently, such as a verbatim translator or as a cultural broker (Krieger, Agather, Douglass, Reiser, & Petty, ). The self‐perceived role of the interpreter could impact communication in a genetic counseling session.…”

Genetic Counselor and Healthcare Interpreter Perspectives on the Role of Interpreters in Cancer Genetic Counseling

“…Interpreters' survey responses indicated that most had no training in genetics, and that training on basic genetic concepts would enhance their ability to interpret effectively for genetic counseling. Similarly, a recent study on the perspectives of HIs serving Hmong patients in a genetics setting also identified the need for training in genetics and genetic concepts as a way to mitigate the difficulties associated with interpreting (Krieger et al, 2018).…”

“…Despite their critical role in language discordant encounters and cross-cultural patient-provider communication, the voice of HIs is surprisingly absent from the literature (Hudelson, 2005). There is little research in genetic counseling concerning the role of HIs, and it largely addresses interpretation as part of a broader account of genetic services for culturally diverse, LEP patient populations (Hunt & De Voogd, 2007;Krieger, Agather, Douglass, Reiser, & Petty, 2018;Saleh, Barlow-Stewart, Meiser, & Muchamore, 2009). This exploratory study examined the perspectives of both GCs and HIs on CGC sessions conducted with remote (telephone or video) interpreters.…”

Working with the Hmong Population in a Genetics Setting: Genetic Counselor Perspectives

“…Semi-structured interview questions for genetic counselors (Table 2) were developed using results from a previously unpublished pilot study done by Krieger, M. et al (2014) that interviewed Hmong medical interpreters about their experiences in medical genetics appointments. The questions were further developed and reviewed for appropriateness with help from a genetic counselor with greater than 30 years' experience, a medical geneticist, and two consultants from the Demographic questions were included in the interview.…”

“…They found that 70% of the study participants found the kit easy to understand, however the study only included Hmong individuals who could read and speak English. To try to quantify Hmong interpreter experiences in genetics appointments, an internal unpublished University of Wisconsin pilot study interviewed six Hmong interpreters regarding their experiences working with Hmong patients in genetic counseling sessions (Krieger et al 2014). The study found that most of the medical interpreters felt their training did not prepare them for genetics appointment.…”