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Using a Translator in Integrated Care Settings

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Enhancing Behavioral Health in Latino Populations

Abstract

Failure to address limited English proficiency (LEP) is one of the main reasons leading to health disparities among Latinos. Translators in the clinical setting facilitate communication between providers and patients with LEP. In this chapter we talk about the effect of choosing to utilize a translator or not and its relationship to the quality of communication, patient/physician satisfaction, and health-related outcomes.

We describe the different types of interpreters available and compare the advantages and disadvantages of each type, patient and physician preferences, and the quality of interpretation they provide. Our hope is to provide a framework from which the provider will be able to decide the form of interpretation most appropriate for each particular circumstance.

We also explore specific themes on using a translator for mental health encounters. We will provide some information relevant to everyday interpreter use and tips to make more effective use of interpreters in integrated care settings.

We then comment on different policies and systems approaches that have been tried in order to improve communication with Hispanic patients and improve interpreter utilization. Finally, we share some insights found in the literature from the translators themselves about improving communication with Latino LEP patients.

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References

  • Aranguri, C., Davidson, B., & Ramirez, R. (2006). Patterns of communication through interpreters: A detailed sociolinguistic analysis. Journal of General Internal Medicine, 21(6), 623–629.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baker, D. W., Baker, D. W., Parker, R. M., Williams, M. V., Coates, W. C., & Pitkin, K. (1996). Use and effectiveness of interpreters in an emergency department. JAMA, 275(10), 783–788.

    Article  PubMed  Google Scholar 

  • Barkin, S., Balkrishnan, R., Manuel, J., & Hall, M. A. (2003). Effect of language immersion on communication with Latino patients. North Carolina Medical Journal, 64(6), 258–262.

    PubMed  Google Scholar 

  • Bauer, A. M., & Alegria, M. (2010). Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: A systematic review. Psychiatric Services, 61(8), 765–773.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bischoff, A., Bovier, P. A., Rrustemi, I., Gariazzo, F., Eytan, A., & Loutan, L. (2003). Language barriers between nurses and asylum seekers: Their impact on symptom reporting and referral. Social Science & Medicine, 57(3), 503–512.

    Article  Google Scholar 

  • Burbano O’Leary, S. C., Federico, S., & Hampers, L. C. (2003). The truth about language barriers: One residency program’s experience. Pediatrics, 111(5 Pt 1), e569–e573.

    Article  PubMed  Google Scholar 

  • Casas, R., Guzmán-Vélez, E., Cardona-Rodriguez, J., Rodriguez, N., Quiñones, G., Izaguirre, B., et al. (2012). Interpreter-mediated neuropsychological testing of monolingual Spanish speakers. The Clinical Neuropsychologist, 26(1), 88–101.

    Article  PubMed  Google Scholar 

  • Costantino, G., Malgady, R. G., & Primavera, L. H. (2009). Congruence between culturally competent treatment and cultural needs of older Latinos. Journal of Consulting and Clinical Psychology, 77(5), 941–949.

    Article  PubMed  Google Scholar 

  • Cunningham, H., Cushman, L. F., Akuete-Penn, C., & Meyer, D. D. (2008). Satisfaction with telephonic interpreters in pediatric care. Journal of the National Medical Association, 100(4), 429–434.

    Article  PubMed  Google Scholar 

  • Derose, K. P., & Baker, D. W. (2000). Limited English proficiency and Latinos’ use of physician services. Medical Care Research and Review, 57(1), 76–91.

    Article  PubMed  Google Scholar 

  • Diamond, L. C., Tuot, D. S., & Karliner, L. S. (2012). The use of Spanish language skills by physicians and nurses: Policy implications for teaching and testing. Journal of General Internal Medicine, 27(1), 117–123.

    Article  PubMed  Google Scholar 

  • Drennan, G., & Swartz, L. (2002). The paradoxical use of interpreting in psychiatry. Social Science & Medicine, 54(12), 1853–1866.

    Article  Google Scholar 

  • Eamranond, P. P., Davis, R. B., Phillips, R. S., & Wee, C. C. (2009). Patient-physician language concordance and lifestyle counseling among Spanish-speaking patients. Journal of Immigrant and Minority Health, 11(6), 494–498.

    Article  PubMed  Google Scholar 

  • Escott, S., Lucas, B., & Pearson, D. (2009). Lost in translation: Using bilingual simulated patients to improve consulting across language barriers. Education for Primary Care, 20(2), 93–98.

    Article  PubMed  Google Scholar 

  • Eytan, A., Bischoff, A., Rrustemi, I., Durieux, S., Loutan, L., Gilbert, M., et al. (2002). Screening of mental disorders in asylum-seekers from Kosovo. The Australian and New Zealand Journal of Psychiatry, 36(4), 499–503.

    Article  PubMed  Google Scholar 

  • Fagan, M. J., Diaz, J. A., Reinert, S. E., Sciamanna, C. N., & Fagan, D. M. (2003). Impact of interpretation method on clinic visit length. Journal of General Internal Medicine, 18(8), 634–638.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fernandez, A., Schillinger, D., Grumbach, K., Rosenthal, A., Stewart, A. L., Wang, F., et al. (2004). Physician language ability and cultural competence. An exploratory study of communication with Spanish-speaking patients. Journal of General Internal Medicine, 19(2), 167–174.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fernandez, Y., Garcia, E., Franks, P., Jerant, A., Bell, R. A., & Kravitz, R. L. (2011). Depression treatment preferences of Hispanic individuals: Exploring the influence of ethnicity, language, and explanatory models. Journal of the American Board of Family Medicine, 24(1), 39–50.

    Article  Google Scholar 

  • Gany, F., Leng, J., Shapiro, E., Abramson, D., Motola, I., Shield, D. C., et al. (2007a). Patient satisfaction with different interpreting methods: A randomized controlled trial. Journal of General Internal Medicine, 22(Suppl 2), 312–318.

    Google Scholar 

  • Gany, F., Kapelusznik, L., Prakash, K., Gonzalez, J., Orta, L. Y., Tseng, C. H., et al. (2007b). The impact of medical interpretation method on time and errors. Journal of General Internal Medicine, 22(Suppl 2), 319–323.

    Google Scholar 

  • Gany, F., Leng, J. C., Winston, G., Tseng, C. H., Qin, A., & Changrani, J. (2011). Diabetes care and language discordance among Chinese and Latino primary care patients. Ethnicity & Disease, 21(4), 473–479.

    Google Scholar 

  • Gonzalez, R., Vasquez, V., & Mikkelson, H. (1991). Prerequisites for court interpreting. Durham, NC: Carolina Academic Press.

    Google Scholar 

  • Gray, B., Hilder, J., & Donaldson, H. (2011). Why do we not use trained interpreters for all patients with limited English proficiency? Is there a place for using family members? Australian Journal of Primary Health, 17(3), 240–249.

    Article  PubMed  Google Scholar 

  • Gray, B., Hilder, J., & Stubbe, M. (2012). How to use interpreters in general practice: The development of a New Zealand toolkit. Journal of Primary Health Care, 4(1), 52–61. A1-8.

    PubMed  Google Scholar 

  • Greenhalgh, T., Robb, N., & Scambler, G. (2006). Communicative and strategic action in interpreted consultations in primary health care: A Habermasian perspective. Social Science & Medicine, 63(5), 1170–1187.

    Article  Google Scholar 

  • Haffner, L. (1992). Translation is not enough. Interpreting in a medical setting. The Western Journal of Medicine, 157(3), 255–259.

    PubMed  PubMed Central  Google Scholar 

  • Hewitt, W. E., & Lee, R. J. (1996). Behind the language barrier, or “You say you were eating an orange?”. State Court Journal, 20(1), 23–31.

    Google Scholar 

  • Hornberger, J. C., Gibson, C. D., Jr., Wood, W., Dequeldre, C., Corso, I., Palla, B., et al. (1996). Eliminating language barriers for non-English speaking patients. Medical Care, 34(8), 845–856.

    Article  PubMed  Google Scholar 

  • Hudelson, P. (2005). Improving patient-provider communication: Insights from interpreters. Family Practice, 22(3), 311–316.

    Article  PubMed  Google Scholar 

  • Juckett, G., & Unger, K. (2014). Appropriate use of medical interpreters. American Family Physician, 90(7), 476–480.

    PubMed  Google Scholar 

  • Karliner, L. S., Perez-Stable, E. J., & Gildengorin, G. (2004). The language divide. The importance of training in the use of interpreters for outpatient practice. Journal of General Internal Medicine, 19(2), 175–183.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kline, F., Acosta, F. X., Austin, W., & Johnson, R. G., Jr. (1980). The misunderstood Spanish-speaking patient. The American Journal of Psychiatry, 137(12), 1530–1533.

    Article  PubMed  Google Scholar 

  • Kuo, D., & Fagan, M. J. (1999). Satisfaction with methods of Spanish interpretation in an ambulatory care clinic. Journal of General Internal Medicine, 14(9), 547–550.

    Article  PubMed  PubMed Central  Google Scholar 

  • Laws, M. B., Heckscher, R., Mayo, S. J., Li, W., & Wilson, I. B. (2004). A new method for evaluating the quality of medical interpretation. Medical Care, 42(1), 71–80.

    Article  PubMed  Google Scholar 

  • Leyva, M., Sharif, I., & Ozuah, P. O. (2005). Health literacy among Spanish-speaking Latino parents with limited English proficiency. Ambulatory Pediatrics, 5(1), 56–59.

    Article  PubMed  Google Scholar 

  • Lion, K. C., Thompson, D. A., Cowden, J. D., Michel, E., Rafton, S. A., Hamdy, R. F., et al. (2012). Impact of language proficiency testing on provider use of Spanish for clinical care. Pediatrics, 130(1), e80–e87.

    Article  PubMed  Google Scholar 

  • Locatis, C., Williamson, D., Gould-Kabler, C., Zone-Smith, L., Detzler, I., Roberson, J., et al. (2010). Comparing in-person, video, and telephonic medical interpretation. Journal of General Internal Medicine, 25(4), 345–350.

    Article  PubMed  PubMed Central  Google Scholar 

  • Marcos, L. R., Uruyo, L., Kesselman, M., & Alpert, M. (1973a). The language barrier in evaluating Spanish-American patients. Archives of General Psychiatry, 29(5), 655–659.

    Google Scholar 

  • Marcos, L. R., Alpert, M., Urcuyo, L., & Kesselman, M. (1973b). The effect of interview language on the evaluation of psychopathology in Spanish-American schizophrenic patients. The American Journal of Psychiatry, 130(5), 549–553.

    Google Scholar 

  • Mazor, S. S., Hampers, L. C., Chande, V. T., & Krug, S. E. (2002). Teaching Spanish to pediatric emergency physicians: Effects on patient satisfaction. Archives of Pediatrics & Adolescent Medicine, 156(7), 693–695.

    Article  Google Scholar 

  • Morales, L. S., Cunningham, W. E., Brown, J. A., Liu, H., & Hays, R. D. (1999). Are Latinos less satisfied with communication by health care providers? Journal of General Internal Medicine, 14(7), 409–417.

    Article  PubMed  PubMed Central  Google Scholar 

  • Napoles, A. M., Santoyo-Olsson, J., Karliner, L. S., O’Brien, H., Gregorich, S. E., & Pérez-Stable, E. J. (2010). Clinician ratings of interpreter mediated visits in underserved primary care settings with ad hoc, in-person professional, and video conferencing modes. Journal of Health Care for the Poor and Underserved, 21(1), 301–317.

    Article  PubMed  PubMed Central  Google Scholar 

  • Norris, W. M., Wenrich, M. D., Nielsen, E. L., Treece, P. D., Jackson, J. C., & Curtis, J. R. (2005). Communication about end-of-life care between language-discordant patients and clinicians: Insights from medical interpreters. Journal of Palliative Medicine, 8(5), 1016–1024.

    Article  PubMed  Google Scholar 

  • O’Neil, J. D., Koolage, W. W., & Kaufert, J. M. (1988). Health communication problems in Canadian Inuit communities. Arctic Medical Research, 47(Suppl 1), 374–378.

    PubMed  Google Scholar 

  • Price, J. (1975). Foreign language interpreting in psychiatric practice. The Australian and New Zealand Journal of Psychiatry, 9(4), 263–267.

    Article  PubMed  Google Scholar 

  • Rivadeneyra, R., Elderkin-Thompson, V., Silver, R. C., & Waitzkin, H. (2000). Patient centeredness in medical encounters requiring an interpreter. The American Journal of Medicine, 108(6), 470–474.

    Article  PubMed  Google Scholar 

  • Roat, C., & CAFP. (2005). Addressing language access issues in your practice: A toolkit for physicians and their staff members

    Google Scholar 

  • Schenker, Y., Wang, F., Selig, S. J., Ng, R., & Fernandez, A. (2007). The impact of language barriers on documentation of informed consent at a hospital with on-site interpreter services. Journal of General Internal Medicine, 22(Suppl 2), 294–299.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sleath, B. L., & Williams, J. W., Jr. (2004). Hispanic ethnicity, language, and depression: Physician-patient communication and patient use of alternative treatments. International Journal of Psychiatry in Medicine, 34(3), 235–246.

    Article  PubMed  Google Scholar 

  • Stolk, Y., Ziguras, S., Saunders, T., Garlick, R., Stuart, G., & Coffey, G. (1998). Lowering the language barrier in an acute psychiatric setting. The Australian and New Zealand Journal of Psychiatry, 32(3), 434–440.

    Article  PubMed  Google Scholar 

  • Valdini, A., Early, S., Augart, C., Cleghorn, G. D., & Miles, H. C. (2009). Spanish language immersion and reinforcement during residency: A model for rapid acquisition of competency. Teaching and Learning in Medicine, 21(3), 261–266.

    Article  PubMed  Google Scholar 

  • VanderWielen, L. M., Enurah, A. S., Rho, H. Y., Nagarkatti-Gude, D. R., Michelsen-King, P., Crossman, S. H., et al. (2014). Medical interpreters: Improvements to address access, equity, and quality of care for limited-eEnglish-proficient patients. Academic Medicine, 89(10), 1324–1327.

    Article  PubMed  Google Scholar 

  • Vasquez, C., & Javier, R. A. (1991). The problem with interpreters: Communicating with Spanish-speaking patients. Hospital & Community Psychiatry, 42(2), 163–165.

    Google Scholar 

  • Vega, W. A., Rodriguez, M. A., & Ang, A. (2010). Addressing stigma of depression in Latino primary care patients. General Hospital Psychiatry, 32(2), 182–191.

    Article  PubMed  Google Scholar 

  • Villalobos, B., Bridges, A. J., Anastasia, E. A., Ojeda, C. A., Rodriguez, J. H., Gomez D. (2015). Effects of language concordance and interpreter use on therapeutic alliance in Spanish-speaking integrated behavioral health care patients, University of Arkansas.

    Google Scholar 

  • Welty, E., Yeager, V. A., Ouimet, C., & Menachemi, N. (2012). Patient satisfaction among Spanish-speaking patients in a public health setting. Journal for Healthcare Quality, 34(5), 31–38.

    Article  PubMed  Google Scholar 

  • Yawman, D., McIntosh, S., Fernandez, D., Auinger, P., Allan, M., & Weitzman, M. (2006). The use of Spanish by medical students and residents at one university hospital. Academic Medicine, 81(5), 468–473.

    Article  PubMed  Google Scholar 

  • Zun, L. S., Sadoun, T., & Downey, L. (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), 912–917.

    PubMed  PubMed Central  Google Scholar 

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Ribas-Roca, J., Eamranond, P. (2016). Using a Translator in Integrated Care Settings. In: Benuto, L., O'Donohue, W. (eds) Enhancing Behavioral Health in Latino Populations. Springer, Cham. https://doi.org/10.1007/978-3-319-42533-7_7

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