Advertisement

Interpreting in the Emergency Department: How Context Matters for Practice

  • Antoon Cox
  • Raquel Lázaro Gutiérrez
Chapter
Part of the Palgrave Studies in Translating and Interpreting book series (PTTI)

Abstract

The literature on medical interpreting shows that lack of a common language between a patient and a doctor is a major cause of health disparities in healthcare in multilingual environment. This problem is exacerbated around the world by the fact that emergency departments are becoming increasingly diverse and cater for multicultural as well as multilingual societies. Language barriers pose frequent problems between patients and caregivers, and this contribution stems from a project that is seeking to identify ways of dealing more effectively with multilingualism on in hospitals. As 80% of the diagnosis depends on oral communication, medical mishaps in emergency departments often result from vulnerable communication processes, due to language barriers; this area of research is under-represented in the growing focus on medical interpreting. Furthermore, considering that the conditions for communication in emergency departments are very different from primary care settings, this contribution presents the results of a research conducted to better understand interpreting needs in this context. This chapter hence reports on practices, emerging needs, and varying degrees of concerted, institutional responses in two specific local contexts (in which the research was carried out) that may be representative of endemic situations.

Keywords

Language Barrier Professional Interpreter Medical Interpreter Cultural Broker Foreign Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Bickley, Lynn S. 2013. Bates’ guide to physical examination and history taking. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.Google Scholar
  2. Boivin, Isabelle, Yvan Leanza, and Ellen Rosenberg. 2013. Conceptions des rôles des interprètes professionnels et familiaux dans les entretiens médicaux et postures par rapport au monde vécu. Alterstice – Revue Internationale de la Recherche Interculturelle 2(2): 35–46.Google Scholar
  3. Bonacruz Kazzi, G., and Carolyn Cooper. 2003. Barriers to the use of interpreters in emergency room paediatric consultations. Journal of Paediatrics and Child Health 39(4): 259–263.Google Scholar
  4. Bowen, Sarah. 2001. Language barriers in access to health care. Ottawa: Health Canada.Google Scholar
  5. Burley, Duncan. 2011. Better communication in the emergency department. Emerg Nurse 19(2): 32–6.Google Scholar
  6. Cerf, D. 2012. Le bon usage du service des urgences. Unpublished paper. Séminaires des Services d’Urgences IRIS. Brussels: IRIS Public Hospital Network.Google Scholar
  7. Chisholm, Carey D., Amanda M. Dornfeld, David R. Nelson, and William H. Cordell. 2001. Work interrupted: A comparison of workplace interruptions in emergency departments and primary care offices. Annals of Emergency Medicine 38(2): 146–151.CrossRefGoogle Scholar
  8. Clark, Margaret M. 1983. Cultural context of medical practice. Western Journal of Medicine 139(6): 806.Google Scholar
  9. Cossey, K., and R. Jeanmonod. 2012. Impact of language discordance on doorto-room time and patient satisfaction in triage. Annals of Emergency Medicine 60(4): S113–S114.Google Scholar
  10. Cox, Antoon. 2015. Do You Get the Message? Defining the Interpreter’s Role in Medical Interpreting. MonTI, Monographs in Translation and Interpreting Special Issue - Interpreting.Google Scholar
  11. Cox, Antoo and Nicolas Dauby. 2014. The challenge of obtaining informed consent in a highly multilingual hospital emergency department. In (Re) considerando ética e ideología en situaciones de conflicto = (Re) visisiting ethics and ideology in situations of conflict, ed. Carmen Valero Garcés, 114–19. Alcalá de Henares: Universidad de Alcalá, Servicio de Publicaciones.Google Scholar
  12. Cox, Antoon, Koen Kerremans, and Rita Temmerman. 2013. Niche Sourcing and Transexplanations for the Enhancement of Doctor-Patient Comprehension in Multilingual Hospital Settings. Proceedings of the Workshop on Optimizing Understanding in Multilingual Hospital Encounters. 33–36. Paris: Université Paris.Google Scholar
  13. Deboosere, Patrick, Thierry Eggerickx, Etienne Van Hecke, and Benjamins Wayens. 2009. De Brusselse Bevolking: Een Demografische Doorlichting. Brussels Studies, 1–17. Available at: http://www.brusselsstudies.be/medias/publications/NL_71_SGB3.pdf. Accessed 19 Oct 2015.
  14. Debosscher, T. 2012. “Infogids Voor Hulpverleners En Begeleiders van Mensen Zonder Wettig Verblijf.” Kruispunt Migratie-Integratie vzw.Google Scholar
  15. Diamond, Lisa C., and Elizabeth A. Jacobs. 2010. Let’s not contribute to disparities: The best methods for teaching clinicians How to overcome language barriers to health care. Journal of General Internal Medicine 25(2): 189–193.CrossRefGoogle Scholar
  16. Divi, Chandrika, Richard G. Koss, Stephen P. Schmaltz, and Jerod M. Loeb. 2007. Language proficiency and adverse events in US hospitals: A pilot study. International Journal for Quality in Health Care 19(2): 60–67.CrossRefGoogle Scholar
  17. Eisenberg, Eric M., Alexandra G. Murphy, Kathleen Sutcliffe, Robert Wears, Stephen Schenkel, Shawna Perry, and Mary Vanderhoef. 2005. Communication in emergency medicine: Implications for patient safety. Communication Monographs 72(4): 390–413.CrossRefGoogle Scholar
  18. Elderkin-Thompson, Virginia, Roxane Cohen Silver, and Howard Waitzkin. 2001. When nurses double as interpreters: A study of Spanish-speaking patients in a US primary care setting. Social Science & Medicine 52(9): 1343–1358.CrossRefGoogle Scholar
  19. Engel, Kirsten G., Barbara A. Buckley, Danielle M. McCarthy, Victoria E. Forth, and James G. Adams. 2010. Communication amidst chaos: Challenges to patient communication in the emergency. JCOM 17 (10). http://www.abim.org.www.turner-white.com/pdf/jcom_oct10_emergency.pdf. Accessed 19 Oct 2015.
  20. Fagan, Mark J., Joseph A. Diaz, Steven E. Reinert, Christopher N. Sciamanna, and Dylan M. Fagan. 2003. Impact of interpretation method on clinic visit length. Journal of General Internal Medicine 18(8): 634–638.CrossRefGoogle Scholar
  21. Fedasil. 2011. Fedasil: Centrum van Brussel (Klein Kasteeltje) Beschrijving. http://fedasil.be/nl/center/749/description. Accessed 19 Oct 2015.
  22. Flores, Glenn, Jennifer Rabke-Verani, Whitney Pine, and Ashu Sabharwal. 2002. The importance of cultural and linguistic issues in the emergency care of children. Pediatric Emergency Care 18(4): 271–284.CrossRefGoogle Scholar
  23. Flores, Glenn, M. Barton Laws, Sandra J. Mayo, Barry Zuckerman, Milagros Abreu, Leonardo Medina, and Eric J. Hardt. 2003. Errors in medical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics 111(1): 6–14.CrossRefGoogle Scholar
  24. Flores, Glenn, M. Abreu, C.P. Barone, R. Bachur, and H. Lin. 2012. Errors of medical interpretation and their potential clinical consequences: A comparison of professional versus ad hoc versus no interpreters. Annals of Emergency Medicine 60(5): 545–553.CrossRefGoogle Scholar
  25. Gheorghiu, Iliescu. 2001. Introducción a la Interpretación. la Modalidad Consecutiva, Textos Docentes/Universidad de Alicante Series. Alicante: Universidad de Alicante.Google Scholar
  26. Goldman, Ran D., Parsa Amin, and Alison Macpherson. 2006. Language and length of stay in the pediatric emergency department. Pediatric Emergency Care 22(9): 640–643.CrossRefGoogle Scholar
  27. Gumperz, John J. 1982. Discourse strategies. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  28. Hampers, Louis C., Susie Cha, David J. Gutglass, Helen J. Binns, and Steven E. Krug. 1999. Language barriers and resource utilization in a pediatric emergency department. Pediatrics 103(6): 1253–1256.CrossRefGoogle Scholar
  29. Helander, Bernhard. 1991. Words, worlds, and wishes: The aesthetics of Somali kinship. Cultural Anthropology 6: 113–120.CrossRefGoogle Scholar
  30. Hymes, Dell H. 1974. Foundations in sociolinguistics; An ethnographic approach. Philadelphia: University of Pennsylvania Press.Google Scholar
  31. Karliner, Leah S., Eliseo J. Párez-Stable, and Ginny Gildengorin. 2004. The language divide the language divide. The importance of training in the use of interpreters for outpatient practice. Journal of General Internal Medicine 19(2): 175–183.CrossRefGoogle Scholar
  32. Karliner, Leah S., Elizabeth A. Jacobs, Alice Hm Chen, and Sunita Mutha. 2007. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research 42(2): 727–754.CrossRefGoogle Scholar
  33. Karliner, Leah S., Andrew Auerbach, Anna Nápoles, Dean Schillinger, Dana Nickleach, and Eliseo J. Pérez-Stable. 2012. Language barriers and understanding of hospital discharge instructions. Medical Care 50(4): 283–289.CrossRefGoogle Scholar
  34. Knopp, Robert, Steve Rosenzweig, Edward Bernstein, and Vicken Totten. 1996. Physician-patient communication in the emergency department, part 1. Academic Emergency Medicine 3(11): 1065–1076.CrossRefGoogle Scholar
  35. Lázaro Gutiérrez, Raquel. 2014. Use and abuse of an interpreter. In (Re) considerando ética e ideología en situaciones de conflicto = (Re) visisiting ethics and ideology in situations of conflict, ed. Carmen Valero Garcés, 214–221. Alcalá de Henares: Universidad de Alcalá, Servicio de Publicaciones.Google Scholar
  36. Leanza, Yvan, Alessandra Miklavcic, Isabelle Boivin, and Ellen Rosenberg. 2014. Working with interpreters. In: Cultural consultation, ed. Laurence J. Kirmayer, Jaswant Guzder, and Cécile Rousseau, 89–114. New York: Springer. http://link.springer.com/chapter/10.1007/978-1-4614-7615-3_5. Accessed 19 Oct 2015.Google Scholar
  37. Mahmoud, I., X.-Y. Hou, K. Chu, and M. Clark. 2013. Language affects length of stay in emergency departments in Queensland public hospitals. World Journal of Emergency Medicine 4(1): 5–9.CrossRefGoogle Scholar
  38. Meyer, Bernd, Birte Pawlack, and Kliche Ortun. 2010. Family interpreters in hospitals: Good reasons for bad practice? Mediazioni (10). http://mediazioni.sitlec.unibo.it. Accessed 19 Oct 2015.
  39. O’Leary, Sonja C. Burbano, Steven Federico, and Louis C. Hampers. 2003. The truth about language barriers: One residency program’s experience. Pediatrics 111(5): e569–e573.CrossRefGoogle Scholar
  40. Phelan, Mary. 2001. The interpreter’s resource. Frankfurt Lodge: Multilingual Matters.Google Scholar
  41. Ramirez, Dorian, Kirsten G. Engel, and Tricia S. Tang. 2008. Language interpreter utilization in the emergency department setting: A clinical review. Journal of Health Care for the Poor and Underserved 19(2): 352–362.CrossRefGoogle Scholar
  42. Rosenberg, Ellen, Robbyn Seller, and Yvan Leanza. 2008. Through interpreters’ eyes: Comparing roles of professional and family interpreters. Patient Education and Counseling 70(1): 87–93.CrossRefGoogle Scholar
  43. Scheeres, Hermine, Diana Slade, Marie Manidis, Jeannette McGregor, and Christian M. Matthiessen. 2008. Communicating in hospital emergency departments. Prospect Journal 23(2): 13–22.Google Scholar
  44. Schillinger, Dean, and Alice H. Chen. 2004. Literacy and language disentangling measures of access, utilization, and quality. Journal of General Internal Medicine 19(3): 288–290.CrossRefGoogle Scholar
  45. Slade, Diana, Hermine Scheeres, Marie Manidis, Rick Iedema, Roger Dunston, Jane Stein-Parbury, Christian Matthiessen, Maria Herke, and Jeannette McGregor. 2008. Emergency communication: The discursive challenges facing emergency clinicians and patients in hospital emergency departments. Discourse & Communication 2(3): 271–298.CrossRefGoogle Scholar
  46. Valero-Garcés, Carmen. 2006. Formas de mediación intercultural e interpretación en los servicios públicos. Conceptos, datos, situaciones y práctica. Granada: Comares.Google Scholar
  47. Vandermotten, Christian, Pierre Marissal and Gilles Van Hamme. 2011. Dynamique Des Quartiers En Difficulté Dans Les Régions Urbaines Belges. PPS Social Integration, Anti-Poverty Policy, Social Economy and Federal Urban Policy. http://mi-is.be/sites/default/files/doc/atlasfr_0.pdf. Accessed 19 Oct 2015.
  48. Wadensjö, Cecilia. 1998. Interpreting as interaction. London: Longman.Google Scholar
  49. Wallbrecht, Joshua, Linda Hodes-Villamar, Steven J. Weiss, and Amy A. Ernst. 2014. No difference in emergency department length of stay for patients with limited proficiency in English. Southern Medical Journal 107(1): 1–5.CrossRefGoogle Scholar
  50. Watt, Ian S. 2008. Consultation, medical history and record taking. In Clinical examination, 4th ed, ed. O. Epstein, G.D. Perkin, J. Cookson, I.S. Watt, R. Rakhit, A. Robins, and G.A.W. Hornet, 1–19. London: Mosby Elsevier.Google Scholar
  51. Waxman Matthew A., M. Andrew Levitt. 2000. Are diagnostic testing and admission rates higher in non–english-speaking versus english-speaking patients in the emergency department? Annals of Emergency Medicine 36(5) 456–61.Google Scholar
  52. Zun, Leslie S., Tania Sadoun, and LaVonne Downey. 2006. English-language competency of self-declared English-speaking Hispanic patients using written tests of health literacy. Journal of the National Medical Association 98(6): 912.Google Scholar

Copyright information

© The Author(s) 2016

Authors and Affiliations

  • Antoon Cox
    • 1
    • 2
  • Raquel Lázaro Gutiérrez
    • 3
  1. 1.Department of Applied LinguisticsVrije Universiteit Brussel (VUB)BrusselsBelgium
  2. 2.The Centre for Language, Discourse and Communication, Division of Medical EducationKing’s College London (KCL)St. Thomas’ St, London SE1 9RTUK
  3. 3.Filología ModernaUniversidad de AlcaláMadridSpain

Personalised recommendations