LAUSR

CONTEXT Research has shown that utilizing medical interpreters in language discordant patient-provider encounters improves outcomes. There is limited research evaluating the views of medical interpreters on best interpreter practices when they are utilized to break bad news or participate in end of life conversations. OBJECTIVES To (1) develop insights from medical interpreters about their role when interpreting discussions regarding end of life issues, (2) identify practices interpreters perceive as helping to improve or hinder patient-provider communication, and (3) obtain suggestions on how to improve communication during end of life conversations with Spanish and Chinese speaking patients. METHODS Semi-structured interviews were conducted with Spanish or Chinese medical interpreters. Participants were recruited until thematic saturation was reached. Twelve interviews were conducted, audio tape-recorded, transcribed, and analyzed using standard qualitative methods. RESULTS Six major themes were identified: (1) medical interpreters' perceived comfort level during end of life interpretation, (2) perception of interpreter role, (3) communication practices perceived as barriers to effective communication, (4) communication practices felt to facilitate effective communication, (5) concrete recommendations how to best utilize medical interpreters, and (6) training received/perceived training needs. CONCLUSION Medical interpreters provide literal interpretation of the spoken word. Due to cultural nuances in Chinese and Spanish speaking patients/family members during end of life conversations, medical interpreters can translate the meaning of the message within a specific cultural context. Conducting pre-meetings and debriefings after the encounter are potentially important strategies to maximize communication during end of life conversations.