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Patient Educ Couns. 2016 Apr;99(4):542-548. doi: 10.1016/j.pec.2015.10.032. Epub 2015 Dec 8.

The challenge of tetradic relationships in medically interpreted pediatric primary care visits: A descriptive study of communication practices.

Author information

1
College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street SN511, MSC 160, Charleston, SC 29425-1600, USA; Ralph H. Johnson Veterans Affairs (VA) Medical Center, 109 Bee Street, Charleston, SC 29401, USA. Electronic address: popec@musc.edu.
2
Bilingo LLC, Goose Creek, SC. Electronic address: eskobarm@gmail.com.
3
Department of English, University of North Carolina at Charlotte, 9201 University City Boulevard, Fretwell 255A, Charlotte, NC 28223, USA. Electronic address: bdavis@uncc.edu.
4
Department of Pediatrics, Medical University of South Carolina College of Medicine, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA. Electronic address: robertsj@musc.edu.
5
Department of Pediatrics, Medical University of South Carolina College of Medicine, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA. Electronic address: obriene@musc.edu.
6
Department of Pediatrics, Medical University of South Carolina College of Medicine, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA. Electronic address: HintonE@musc.edu.
7
General & Community Pediatrics, Oklahoma University Health Sciences Center, 1200 Children's Avenue, Suite 12400, Oklahoma City, OK 73104-4637, USA. Electronic address: paul-darden@ouhsc.edu.

Abstract

OBJECTIVE:

To examine spoken interactions between pediatricians and community-based interpreters speaking with adolescents and parents with Limited English proficiency (LEP) in primary care to identify the challenges of interpreting in a four-person or tetradic visit, its sources of co-constructed errors, and specific practices for educational intervention.

METHODS:

As part of a larger study of vaccine decision-making at six clinical sites in two states, this descriptive study used discourse analysis to examine 20 routine primary care visits in a Latino Clinic in interactions between adolescents, parents, community-based interpreters, and pediatricians. Specific patterns of communication practices were identified that contributed to inaccuracies in medical interpretation

RESULTS:

Practices needing improvement were tallied for simple frequencies and included: omissions; false fluency; substitutions; editorializing; added clarification, information, or questions; medical terminology; extra explanation to mother; and, cultural additions. Of these speaking practices, omissions were the most common (123 out of 292 total) and the most affected by pediatricians.

CONCLUSION:

The dynamics of both pediatricians and interpreters contributed to identification of areas for improvement, with more adolescent participation in bilingual than monolingual visits.

PRACTICE IMPLICATIONS:

These observations provide opportunities for mapping a communication skills training intervention based on observations for future testing of an evidence-based curriculum.

KEYWORDS:

Adolescent; Communication barriers; Healthcare disparities; Hispanic Americans; Linguistics; Primary care

PMID:
26796067
DOI:
10.1016/j.pec.2015.10.032
[Indexed for MEDLINE]

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