Mary G Rhodes1, Kathlyn E Fletcher2, Francois Blumenfeld-Kouchner3, Elizabeth A Jacobs4. 1. Department of Medicine, Medical College of Wisconsin, Milwaukee, USA. Electronic address: mrhodes@mcw.edu. 2. Department of Medicine, Medical College of Wisconsin, Milwaukee, USA; Department of Medicine, Clement J. Zablocki VA Medical Center, Milwaukee, USA. Electronic address: kfletche@mcw.edu. 3. Department of Medicine, Medical College of Wisconsin, Milwaukee, USA; Department of Palliative Care, Aurora Medical Group, Grafton Medical Center, Grafton, USA(1). Electronic address: francois.blumenfeld-kouchner@aurora.org. 4. Departments of Internal Medicine and Population Health, The University of Texas at Austin Dell Medical School, Austin, USA; Maine Medical Center Research Institute, MaineHealth, Portland, ME, USA(1). Electronic address: EAJacobs1@mmc.org.
Abstract
OBJECTIVE: Professional medical interpreters facilitate patient understanding of illness, prognosis, and treatment options. Facilitating end of life discussions can be challenging. Our objective was to better understand the challenges professional medical interpreters face and how they affect the accuracy of provider-patient communication during discussions of end of life. METHODS: We conducted semi-structured interviews with professional Spanish medical interpreters. We asked about their experiences interpreting end of life discussions, including questions about values, professional and emotional challenges interpreting these conversations, and how those challenges might impact accuracy. We used a grounded theory, constant comparative method to analyze the data. Participants completed a short demographic questionnaire. RESULTS: Seventeen Spanish language interpreters participated. Participants described intensive attention to communication accuracy during end of life discussions, even when discussions caused emotional or professional distress. Professional strains such as rapid discussion tempo contributed to unintentional alterations in discussion content. Perceived non-empathic behaviors of providers contributed to rare, intentional alterations in discussion flow and content. CONCLUSION: We found that despite challenges, Spanish language interpreters focus intensively on accurate interpretation in discussions of end of life. PRACTICE IMPLICATIONS: Provider training on how to best work with interpreters in these important conversations could support accurate and empathetic interpretation.
OBJECTIVE: Professional medical interpreters facilitate patient understanding of illness, prognosis, and treatment options. Facilitating end of life discussions can be challenging. Our objective was to better understand the challenges professional medical interpreters face and how they affect the accuracy of provider-patient communication during discussions of end of life. METHODS: We conducted semi-structured interviews with professional Spanish medical interpreters. We asked about their experiences interpreting end of life discussions, including questions about values, professional and emotional challenges interpreting these conversations, and how those challenges might impact accuracy. We used a grounded theory, constant comparative method to analyze the data. Participants completed a short demographic questionnaire. RESULTS: Seventeen Spanish language interpreters participated. Participants described intensive attention to communication accuracy during end of life discussions, even when discussions caused emotional or professional distress. Professional strains such as rapid discussion tempo contributed to unintentional alterations in discussion content. Perceived non-empathic behaviors of providers contributed to rare, intentional alterations in discussion flow and content. CONCLUSION: We found that despite challenges, Spanish language interpreters focus intensively on accurate interpretation in discussions of end of life. PRACTICE IMPLICATIONS: Provider training on how to best work with interpreters in these important conversations could support accurate and empathetic interpretation.