Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2018

Open Access 01-12-2018 | Research

The experience of interpreter access and language discordant clinical encounters in Australian health care: a mixed methods exploration

Authors: Jennifer White, Trish Plompen, Christian Osadnik, Leanne Tao, Emily Micallef, Terry Haines

Published in: International Journal for Equity in Health | Issue 1/2018

Login to get access

Abstract

Background

Current evidence highlights that language discordant clinical encounters seriously compromise patient quality of care and health outcomes. We aimed to characterise patterns of interpreter service use in medical inpatient wards use and explore clinician experience of language discordance.

Methods

Participants included medical students, residents, attending physicians, nursing and allied health professionals working in General Internal Medicine wards across two tertiary referral hospitals servicing a large Australian health care area. This study involved a retrospective electronic medical record audit of interpreter use. Six focus groups were conducted with 32 participants. Data were analysed using an inductive thematic approach with constant comparison.

Results

Allied health professionals were identified as the largest users of interpreter services, followed by medical doctors. Distinct themes emerged regarding clinician experiences of language discordant encounters including: (1) Negotiating care when unable to get an accurate assessment; (2) Over servicing to fill in the gaps; (3) Using family members instead of professional interpreters: a vexed solution; (4) Disparities in care provision; and (5) Communication drought: broken by a flood.

Conclusions

Patients with low English proficiency are at risk of being less informed of care processes, and having a very large volume of information given in a shorter period of time when an interpreter is present. There is a need for systematic and transformative change that addresses utilisation of professional interpreters as well as embedded healthcare culture and practices leading to less interaction with patients with limited English proficiency and reliance on family members as informal interpreters.
Literature
1.
Booth H, Tickle L. The future aged: new projections of Australia's elderly population. Australas J Ageing. 2003;22:196–202.CrossRef
2.
Sears J, Khan K, Ardern CI, Tamim H. Potential for patient-physician language discordance in Ontario. BMC Health Serv Res. 2013;13:535.CrossRef
3.
Australian Bureau of Statistics. Census of population and housing; Australia revealed, 2017. Canberra: ACT; 2017.
4.
Office for National Statistics. Population by country of birth and nationality. London: Office for National Statistics; 2012.
5.
Ngo-Metzger Q, Sorkin D, Phillips R, Greenfield S, Massagli M, Clarridge B, Kaplan S. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. J Gen Intern Med. 2007;22:324–30.CrossRef
6.
Brodie K, Abel G, Burt J. Language spoken at home and the association between ethnicity and doctor–patient communication in primary care: analysis of survey data for south Asian and white British patients. BMJ Open. 2016;6:e010042.CrossRef
7.
Abdelrahim H, Elnashar M, Khidir A, Killawi A, Hammoud M, Al-Khal AL, Fetters MD. Patient perspectives on language discordance during healthcare visits: findings from the extremely high-density multicultural State of Qatar. J Health Commun. 2017;22:355–63.CrossRef
8.
Harrison M, Milbers K, Hudson M, Bansback N. Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments. BMJ open. 2017;7:e014719.PubMedPubMedCentral
9.
Divi C, Koss RG, Schmaltz SP, Loeb JM. Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health Care. 2007;19:60–7.CrossRef
10.
Weech-Maldonado R, Elliott MN, Morales LS, Spritzer K, Marshall GN, Hays RD. Health plan effects on patient assessments of Medicaid managed care among racial/ethnic minorities. J Gen Intern Med. 2004;19:136–45.CrossRef
11.
John-Baptiste A, Naglie G, Tomlinson G, Alibhai SM, Etchells E, Cheung A, Kapral M, Gold WL, Abrams H, Bacchus M. The effect of English language proficiency on length of stay and in-hospital mortality. J Gen Intern Med. 2004;19:221–8.CrossRef
12.
Ramirez D, Engel KG, Tang TS. Language interpreter utilization in the emergency department setting: a clinical review. J Health Care Poor Underserved. 2008;19:352–62.CrossRef
13.
Timmins CL. The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. J Midwifery Womens Health. 2002;47:80–96.CrossRef
14.
Woloshin S, Bickell NA, Schwartz LM, Gany F, Welch HG. Language barriers in medicine in the United States. J Am Med Assoc. 1995;273:724–8.CrossRef
15.
Olsson LE, Hansson E, Ekman I, Karlsson J. A cost-effectiveness study of a patient-centred integrated care pathway. J Adv Nurs. 2009;65:1626–35.CrossRef
16.
Hampers LC, Cha S, Gutglass DJ, Binns HJ, Krug SE. Language barriers and resource utilization in a pediatric emergency department. Pediatrics. 1999;103:1253–6.CrossRef
17.
Hlavac J, Beagley J, Zucchi E. Applications of policy and the advancement of patients’ health outcomes through interpreting services: data and viewpoints from a major public healthcare provider. Transl Interpreting. 2018;10:111–36.
18.
Brach C, Fraser I, Paez K. Crossing the language chasm. Health Aff. 2005;24:424–34.CrossRef
19.
Hacker K, Choi YS, Trebino L, Hicks L, Friedman E, Blanchfield B, Gazelle GS. Exploring the impact of language services on utilization and clinical outcomes for diabetics. PLoS One. 2012;7:e38507.CrossRef
20.
Phillips CB, Travaglia J. Low levels of uptake of free interpreters by Australian doctors in private practice: secondary analysis of national data. Aust Health Rev. 2011;35:475–9.PubMed
21.
Meuter RF, Gallois C, Segalowitz NS, Ryder AG, Hocking J. Overcoming language barriers in healthcare: a protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC Health Serv Res. 2015;15:371.CrossRef
22.
Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42:727–54.CrossRef
23.
Anderson LM, Scrimshaw SC, Fullilove MT, Fielding JE, Normand J. Services TFoCP: culturally competent healthcare systems: a systematic review. Am J Prev Med. 2003;24:68–79.CrossRef
24.
Narchal R. Migrant children are often their parents’ translators–and it can lead to ill health. Conversation. 2016;26.
25.
Moroe NF, de Andrade V. Hearing children of deaf parents: gender and birth order in the delegation of the interpreter role in culturally deaf families. Afr J Disabil. 2018;7:365.
26.
Hadjikakou K, Christodoulou D, Hadjidemetri E, Konidari M, Nicolaou N. The experiences of Cypriot hearing adults with deaf parents in family, school, and society. J Deaf Stud Deaf Educ. 2009;14:486–502.CrossRef
27.
Australian Demographic Statistics: Australian Bureau of Statistics (31010). Accessed 31 Jan 2017.
28.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
29.
Guba E, Lincoln Y. Do inquiry paradigms imply inquiry methodologies? In: Fetterman DM, (ed.) Qualitative approaches to evaluation in education: the silent scientific revolution. London: Praeger; 1988. p. 89–115.
30.
Morales LS, Cunningham WE, Brown JA, Liu H, Hays RD. Are Latinos less satisfied with communication by health care providers? J Gen Intern Med. 1999;14:409–17.CrossRef
31.
Schyve PM. Language differences as a barrier to quality and safety in health care: the joint commission perspective. J Gen Intern Med. 2007;22:360–1.CrossRef
32.
Parés-Avila JA, Sobralske MC, Katz JR. No comprendo: practice considerations when caring for Latinos with limited English proficiency in the United States health care system. Hispanic Health Care Int. 2011;9:159–67.CrossRef
33.
Ngo-Metzger Q, Sorkin DH, Phillips RS, Greenfield S, Massagli MP, Clarridge B, Kaplan SH. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. J Gen Intern Med. 2007;22:324–30.CrossRef
34.
Baker DW. Use and effectiveness of interpreters in an emergency department. J Am Med Asso. 1996;275:783.CrossRef
35.
Baker DW, Hayes R, Fortier JP. Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998:1461–70.CrossRef
36.
McGinnis JM, Stuckhardt L, Saunders R, Smith M. Best care at lower cost: the path to continuously learning health care in America: National Academies Press; 2013.
37.
Woloshin S, Schwartz LM, Katz SJ, Welch HG. Is language a barrier to the use of preventive services? J Gen Intern Med. 1997;12.CrossRef
Metadata
Title
The experience of interpreter access and language discordant clinical encounters in Australian health care: a mixed methods exploration
Authors
Jennifer White
Trish Plompen
Christian Osadnik
Leanne Tao
Emily Micallef
Terry Haines
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2018
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-018-0865-2

Other articles of this Issue 1/2018

International Journal for Equity in Health 1/2018 Go to the issue

Research

Equity of primary care service delivery for low income “sicker” adults across 10 OECD countries

Research

Accrediting private providers with National Health Insurance to better serve low-income populations in Kenya and Ghana: a qualitative study

Research

Impact of parental migration on psychosocial well-being of children left behind: a qualitative study in rural China

Research

Context matters for primary health care access: a multi-method comparative study of contextual influences on health service access arrangements across models of primary health care

Research

Contracting-out primary health care services in Tanzania towards UHC: how policy processes and context influence policy design and implementation

Research

How does membership in local savings groups influence the determinants of national health insurance demand? A cross-sectional study in Kisumu, Kenya