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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

‘It depends on the consultation’: revisiting use of family members as interpreters for general practice consultations – when and why?

Jo Hilder A B , Ben Gray A , Anthony Dowell A , Lindsay Macdonald A , Rachel Tester A and Maria Stubbe A
+ Author Affiliations
- Author Affiliations

A Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South, Wellington 6242, New Zealand.

B Corresponding author. Email: jo.hilder@otago.ac.nz

Australian Journal of Primary Health 23(3) 257-262 https://doi.org/10.1071/PY16053
Submitted: 14 June 2016  Accepted: 24 September 2016   Published: 11 November 2016

Abstract

Family members continue to be used as interpreters in medical consultations despite the well-known risks. This paper examines participant perceptions of this practice in three New Zealand clinics chosen for their frequent use of interpreters and their skill in using them. It is based on a detailed study of 17 video-recorded interpreted consultations and 48 post-consultation interviews with participants (5 doctors, 16 patients and 12 interpreters, including 6 family members). All participants expressed satisfaction with the communication. Analysis of the interviews explored what participants liked or valued about family member interpreters (FMIs). Key themes were the FMIs’ personal relationship and knowledge, patient comfort, trust, cultural norms, time efficiency and continued help outside the consultation. General practitioners (GPs) expressed awareness of potential risks and how to manage them, in contrast to patients and FMIs. Although the use of professional interpreters needs to be strongly promoted, a well-informed decision to use a family member is appropriate in some situations. GPs need to be well trained in how to assess and manage the risks. Rather than striving for ‘best practice’ (i.e. universal use of professional interpreters), it is better to aim for ‘good practice’ where a considered judgement is made about each situation on an individual basis.

Additional keywords: care of Limited English Proficiency Patients, communication barriers, interpreter services, translating.


References

Aranguri C, Davidson B, Ramirez R, Aranguri C, Davidson B, Ramirez R (2006) Patterns of communication through interpreters: a detailed sociolinguistic analysis. Journal of General Internal Medicine 21, 623–629.
Patterns of communication through interpreters: a detailed sociolinguistic analysis.Crossref | GoogleScholarGoogle Scholar |

Butow PN, Goldstein D, Bell ML, Sze M, Aldridge LJ, Abdo S, Tanious M, Dong S, Iedema R, Vardy J, Ashgari R, Hui R, Eisenbruch M (2011) Interpretation in consultations with immigrant patients with cancer: how accurate is it? Journal of Clinical Oncology 29, 2801–2807.
Interpretation in consultations with immigrant patients with cancer: how accurate is it?Crossref | GoogleScholarGoogle Scholar |

Edwards R, Temple B, Alexander C (2005) Users’ experiences of interpreters: the critical role of trust. Interpreting: International Journal of Research & Practice in Interpreting 7, 77–95.
Users’ experiences of interpreters: the critical role of trust.Crossref | GoogleScholarGoogle Scholar |

Fadiman A (1997) ‘The Spirit Catches You and You Fall Down: a Hmong Child, Her American Doctors, and the Collision of Two Cultures.’ (Farrar, Straus, and Giroux: New York)

Fryer CE, Mackintosh SF, Stanley MJ, Crichton J (2013) ‘I understand all the major things’: how older people with limited English proficiency decide their need for a professional interpreter during health care after stroke. Ethnicity & Health 18, 610–625.
‘I understand all the major things’: how older people with limited English proficiency decide their need for a professional interpreter during health care after stroke.Crossref | GoogleScholarGoogle Scholar |

Gray B, Hilder J, Donaldson H (2011) Why do we not use trained interpreters for all patients with limited English proficiency? Is there a place for using family members? Australian Journal of Primary Health 17, 240–249.
Why do we not use trained interpreters for all patients with limited English proficiency? Is there a place for using family members?Crossref | GoogleScholarGoogle Scholar |

Hadziabdic E, Albin B, Heikkilä K, Hjelm K (2014) Family members’ experiences of the use of interpreters in healthcare. Primary Health Care Research and Development 15, 156–169.
Family members’ experiences of the use of interpreters in healthcare.Crossref | GoogleScholarGoogle Scholar |

Jacobs EA, Diamond LC, Stevak L (2010) The importance of teaching clinicians when and how to work with interpreters. Patient Education and Counseling 78, 149–153.
The importance of teaching clinicians when and how to work with interpreters.Crossref | GoogleScholarGoogle Scholar |

Leanza Y, Boivin I, Rosenberg E (2013) The patient’s lifeworld: building meaningful clinical encounters between patients, physicians and interpreters. Communication & Medicine 10, 13–25.

Meeuwesen L, Twilt S, ten Thije JD, Harmsen H (2010) ‘Ne diyor?’ (What does she say?): informal interpreting in general practice. Patient Education and Counseling 81, 198–203.
‘Ne diyor?’ (What does she say?): informal interpreting in general practice.Crossref | GoogleScholarGoogle Scholar |

Meyer B, Pawlack B, Kliche O (2010) Family interpreters in hospitals: good reasons for bad practice? mediAzioni 10, 297–324.

Nisbett RE, Wilson TD (1977) The halo effect: evidence for unconscious alteration of judgments. Journal of Personality and Social Psychology 35, 250–256.
The halo effect: evidence for unconscious alteration of judgments.Crossref | GoogleScholarGoogle Scholar |

O’Reilly-de Brún M, MacFarlane A, de Brún T, Okonkwo E, Bonsenge Bokanga JS, Manuela De Almeida Silva M, Ogbebor F, Mierzejewska A, Nnadi L, van den Muijsenbergh M, van Weel-Baumgarten E, van Weel C (2015) Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project. BMJ Open 5, e007092
Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project.Crossref | GoogleScholarGoogle Scholar |

Phillips C (2010) Using interpreters – a guide for GPs. Australian Family Physician 39, 188–195.

Ramsey KW, Davis J, French G (2012) Perspectives of Chuukese patients and their health care providers on the use of different sources of interpreters. Hawai’i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health 71, 249–252.

Seers K, Cook L, Abel G, Schluter P, Bridgford P (2013) Is it time to talk? Interpreter services use in general practice within Canterbury. Journal of Primary Health Care 5, 129–137.

Seidelman RD, Bachner YG (2010) That I won’t translate! Experiences of a family medical interpreter in a multicultural environment. Mount Sinai Journal of Medicine 77, 389–393.
That I won’t translate! Experiences of a family medical interpreter in a multicultural environment.Crossref | GoogleScholarGoogle Scholar |

Zendedel R, Schouten BC, van Weert JC, van den Putte B (2016) Informal interpreting in general practice: comparing the perspectives of general practitioners, migrant patients and family interpreters. Patient Education and Counseling 99, 981–987.
Informal interpreting in general practice: comparing the perspectives of general practitioners, migrant patients and family interpreters.Crossref | GoogleScholarGoogle Scholar |