Interpreters as epistemic brokers in cross-cultural primary care consultations in Ireland: A discourse analysis

The Russian invasion of Ukraine in February 2022 resulted in the displacement of millions of people of varying ages and diverse health needs, with almost 120,000 granted Temporary Protection in Ireland. In Ireland, there were a number of healthcare adaptations, including the employment of multilingual Ukrainian Beneficiaries of Temporary Protection (BoTP) as interpreters in general practitioner (GP) clinics. There is a lack of research examining interpreting in primary care, even though primary care is the first point of contact for most patients and language remains a critical social determinant of health for migrants.

This is a participatory health research study co-designed with community partners. Purposeful sampling was used to recruit patients (n = 21), interpreters (n = 4) and GPs (n = 3) in primary care clinics established for BoTP coming from Ukraine. We conducted discourse analysis of 21 audio-recorded interpreter-facilitated consultations and completed follow-up interviews with the GPs and interpreters about their perceptions of the interpreted consultations.

The interpreter's role is multifaceted, encompassing various responsibilities within the interpreted consultation. Each interpreter has developed strategies to ensure accuracy, including engaging in epistemic brokering to ascertain the best language to use; conveying cultural equivalency; attending to sight translation; and interpreting paralinguistic features.

Although rooted in the Irish context, these findings contribute to the growing evidence base on interpreting in practice, extending prior research by offering detailed insights into how untrained but experienced healthcare interpreters shape communication, cultural understanding, and clinical interactions in primary care. They also offer clear, practical learning that can strengthen training and professional development for clinicians and interpreters both in Ireland and internationally.