Linguistically diverse ad hoc mediated ED consultations (2): Communication patterns and medical consequences of interpreters’ “inaccuracies”: Contribution to The interpreter’s role in healthcare conversations: A multimodal analysis of a multimodal reality, organized by Van Vaerenbergh Leona [et al.]

Yvan Leanza, Ellen Rosenberg, Audrey Marcoux, Paulina Gonzalez Orea, Anne-Sophie Thommeret-Carrière, Antoon Cox, Philippe Humblé, Luc Huygens

Onderzoeksoutput: Meeting abstract (Book)

Samenvatting

Background [This paper is the second part of the presentation of the results of the research Doctor patient communication via an ad hoc interpreter in the Emergency Department: what is lost in translation?] Emergency medicine is a predominantly oral activity in which medical errors often result from poor communication. Due to the increasing diversity of patients in Emergency Departments (ED), especially in the light of the current refugee influx into Europe, emergency physicians have to take history from patients with whom they do not share a language. Sometimes, these patients bring along companions with some (often-limited) knowledge of the hospital’s language to support the communication process. While these companions are often helpful, they may add additional sources of uncertainties to the communication process and hence of potential miscommunication. So far, the literature on language barriers in the ED has mainly focussed on health outcomes in the presence of language barriers, and the impact of interventions such as interpreting on these outcomes.
This study aims to contribute to insights on the process of communication, by dissecting different levels of miscommunication and describing how they are interrelated.
Methods We audio-recorded linguistically 16 multi party consultations in an ED and collected the corresponding contextual information via ethnographic participant observation (including note taking and after action interviews with clinicians). The consultations were transcribed, translated, and multimodally analysed from a medical, interactional sociolinguistic and communication pattern perspective. This paper presents both the communication pattern and medical analysis. Analyses of patterns consist of determining which underlying
voice is expressed in the consultations’ dialogues, or, in other words according to Habermas and Mishler theories, how the voice of the Lifeworld (VoL) and the voice of Medicine (VoM) interact. Each utterance was coded as the VoM or the VoL separately by at two coders, who then compared their work in order to reach consensus on the divergently coded utterances. The medical impact of interpreters’ mistranslations was assessed in a two-time procedure. First, the interpreters’ utterances were coded as accurate or not. Inaccuracies were evaluated (omission, addition …). Second, the clinical impact of inaccuracies was determined (0 insignificant to 2 high). The coders were two practicing physicians with experience in communication research. Both procedures have proved to be efficient in previous works.
Findings Analysis are still undergoing at the time to submit this abstract. Concerning communication patterns, a preliminary result is the absence of a structured communication in such ED consultations. Contrary to previous work where the VoL was shown to be blocked, ignored or taken into account in a meaning building process, ad hoc mediated consultations appear mainly oriented toward the VoM and very unstructured. In most consultations, the interpreter answered the doctor’s questions without checking with the patient. The clinical
impact of possibly incorrect answers is great. Interpreters rarely translated doctor explanations or expressions of empathy to patients thus preventing the known benefits of a strong doctor-patient relationship.
Discussion From his analysis of the same data, Cox proposes a dynamic taxonomy that allows researchers to track communication problems within a linguistically complex multi-party ED consultation. Based on our own analysis, we will discuss and possibly enhance this taxonomy. Knowing in detail why and how miscommunication arises can help to produce tailor-made guidelines for clinical skills training on linguistically diverse doctor-patient consultations and other interventions.
Originele taal-2English
TitelIPRA Book of Abstracts
Subtitel15th International Pragmatics Conference, Belfast, 16-21 July 2017
Pagina's379-380
StatusPublished - 2017
Evenement15th International Pragmatics Conference: Pragmatics in the real world - Waterfront Centre Belfast, Belfast, United Kingdom
Duur: 16 jul 201721 jul 2017
https://www.ulster.ac.uk/ipra

Conference

Conference15th International Pragmatics Conference
Land/RegioUnited Kingdom
StadBelfast
Periode16/07/1721/07/17
Internet adres

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