Healthcare interpreters and difficult conversations: a survey
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Updated: Oct 26, 2025

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Published on: August 9, 2024
Helen James1, Gregory Brian Crawford2,3
1Central Adelaide Local Health Network, Adelaide, South Australia, Australia helenjames797@gmail.com.
Objectives:
The aims of this survey of healthcare interpreters were to assess the impacts of difficult conversations such as discussions involving explanation of a serious diagnosis, goals-of-care or death or dying and to discover interpreters' opinions on ways to improve these conversations.
Methods:
A purpose derived survey incorporating the Professional Quality of Life measure 5 was distributed to all healthcare interpreters in an Australian state. Outcome measures were to quantify levels of compassion satisfaction (CS), burn-out and secondary traumatic stress (STS), as well as to determine how well interpreters believed difficult conversations were being conducted and suggestions for improvement.
Results:
There were 94 respondents all scoring moderate (34.1%) or high (65.9%) on the CS score. No respondents scored high on burn-out or STS scales. Significant subgroup analysis was those aged 18-30 with higher burn-out scores. The two most common concerns raised were (1) not knowing the content prior to a discussion and (2) feeling guilty about delivering bad news. The two most frequent suggestions for improvement were (1) prebriefing with medical teams prior and (2) allowing opportunity to explain cultural concerns.
Conclusions:
Interpreters surveyed were not experiencing burn-out or STS and had moderate or high CS scores. Recommendations are: further training and evidence-based guidelines for medical staff and healthcare interpreters in the facilitation of difficult conversations; prebriefing and debriefing for interpreters; further research to delineate the characteristics that predispose to compassion fatigue.
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