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Patterns of communication through interpreters: a detailed sociolinguistic analysis
Cesar Aranguri1, Brad Davidson, Robert Ramirez
1King Drew Medical Center, Los Angeles, CA 90059, USA. caranguri@doctor.com
Journal of General Internal Medicine
|July 1, 2006
Summary
Using interpreters in clinical settings reduces communication quality and rapport. Training for physicians and interpreters is crucial to minimize information loss and improve patient-centered care.
Area of Science:
- Medical Communication
- Sociolinguistics
- Health Disparities
Background:
- Physician-patient communication challenges are well-documented when interpreters are present.
- Limited research exists on the actual dynamics of communication through interpreters in clinical encounters.
Purpose of the Study:
- To record and analyze physician-interpreter-patient interactions.
- To understand the communication process and identify areas for improvement.
Main Methods:
- Recruited primary care physicians serving high-volume Hispanic practices.
- Recorded and transcribed naturally occurring clinical interactions involving dyslipidemic Hispanic patients (monolingual Spanish or bilingual).
- Conducted post-visit interviews with patients and physicians; analyzed transcripts using sociolinguistic and discourse analytic techniques.
Main Results:
- Interpreters significantly reduced and altered the speech of both patients and physicians, impacting content, meaning, and affect.
- Clinical visits with interpreters lacked rapport-building 'small talk,' hindering comprehensive history taking and emotional engagement.
- Semantic information and linguistic nuances were lost during interpretation.
Conclusions:
- The presence of an interpreter complicates effective physician-patient communication.
- Training for physicians and interpreters is essential to mitigate conversational loss and enhance information and relational exchange.
- Improving communication strategies can lead to better health outcomes for patients with limited English proficiency.
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