Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency? A Systematic Review of the Literature

Cook County Hospital, Chicago, Illinois, United States
Health Services Research (Impact Factor: 2.78). 05/2007; 42(2):727-54. DOI: 10.1111/j.1475-6773.2006.00629.x
Source: PubMed


To determine if professional medical interpreters have a positive impact on clinical care for limited English proficiency (LEP) patients.
A systematic literature search, limited to the English language, in PubMed and PsycINFO for publications between 1966 and September 2005, and a search of the Cochrane Library.
Any peer-reviewed article which compared at least two language groups, and contained data about professional medical interpreters and addressed communication (errors and comprehension), utilization, clinical outcomes, or satisfaction were included. Of 3,698 references, 28 were found by multiple reviewers to meet inclusion criteria and, of these, 21 assessed professional interpreters separately from ad hoc interpreters. Data were abstracted from each article by two reviewers. Data were collected on the study design, size, comparison groups, analytic technique, interpreter training, and method of determining the participants' need for an interpreter. Each study was evaluated for the effect of interpreter use on four clinical topics that were most likely to either impact or reflect disparities in health and health care.
In all four areas examined, use of professional interpreters is associated with improved clinical care more than is use of ad hoc interpreters, and professional interpreters appear to raise the quality of clinical care for LEP patients to approach or equal that for patients without language barriers.
Published studies report positive benefits of professional interpreters on communication (errors and comprehension), utilization, clinical outcomes and satisfaction with care.

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Available from: Elizabeth A Jacobs
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    • "Due to worldwide migration the language barrier between migrant patients and healthcare providers has become a daily constraint in medical practice [1]. Professional interpreters are provided in some countries to bridge the language gap between patients and healthcare providers [2]. In Dutch general practice the language barrier is often tackled with the help of family interpreters [3]. "
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    ABSTRACT: Objective: To explore differences in perspectives of general practitioners, Turkish-Dutch migrant patients and family interpreters on interpreters' role, power dynamics and trust in interpreted GP consultations. Methods: 54 semi-structured in-depth interviews were conducted with the three parties focusing on interpreter's role, power and trust in interpreters. Results: In line with family interpreters' perspective, patients expected the interpreters to advocate on their behalf and felt empowered when they did so. GPs, on the contrary, felt annoyed and disempowered when the family interpreters performed the advocacy role. Family interpreters were trusted by patients for their fidelity, that is, patients assumed that family interpreters would act in their best interest. GPs, on the contrary, mistrusted family interpreters when they perceived dishonesty or a lack of competence. Conclusion: Opposing views were found between GPs on the one hand and family interpreters and patients on the other hand on interpreter's role, power dynamics and the different dimensions of trust. These opposing perspectives might lead to miscommunication and conflicts between the three interlocutors. Practice implications: GPs should be educated to become aware of the difficulties of family interpreting, such as conflicting role expectations, and be trained to be able to call on professional interpreters when needed.
    Full-text · Article · Dec 2015 · Patient Education and Counseling
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    • "There are many studies that have examined whether interpreters improve the experience of health care for those with limited English proficiency (LEP). A systematic literature review by Karliner et al. (2007) "

    Full-text · Article · Nov 2015 · Diversity and Equality in Health and Care
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    • "Language barriers lead to poor comprehension of medical treatments [9] [10]. When professional medical interpreters or truly bilingual physicians facilitate communication , LEP patients are more likely to understand their diagnosis and treatment plan and receive care comparable with that of their English-speaking counterparts [9] [11] [12]. "
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    ABSTRACT: Background: Informed consent is important for limited English proficient (LEP) patients undergoing surgery, as many surgical procedures are complicated, making patient comprehension difficult even without language barriers. The study objectives were to (1) understand surgeons' preoperative consenting process with LEP patients, (2) examine how surgeons self assess their non-English language proficiency levels using a standardized scale, and (3) identify the relationship between self assessed non-English language proficiency and surgeons' self-reported use of interpreters during preoperative informed consent. Materials and methods: A thirty-two item survey assessing surgeons' reported preoperative informed consent process, with questions related to demographics, level of medical training, non-English language skills and their clinical use, language learning experiences, and hypothetical scenarios with LEP patients. Results: Surgeons who were not fluent in non-English languages reported they often used those limited skills to obtain informed consent from their LEP patients. Many surgeons reported relying on bilingual hospital staff members, family members, and/or minors to serve as ad-hoc interpreters when obtaining informed consent. If a professional interpreter was not available in a timely manner, surgeons more frequently reported using ad-hoc interpreters or their own nonfluent language skills. Surgeons reported deferring to patient and family preferences when deciding whether to use professional interpreters and applied different thresholds for different clinical scenarios when deciding whether to use professional interpreters. Conclusions: Surgeons reported relying on their own non-English language skills, bilingual staff, and family and friends of patients to obtain informed consent from LEP patients, suggesting that further understanding of barriers to professional interpreter use is needed.
    Full-text · Article · Oct 2015 · Journal of Surgical Research
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