Barriers to professional interpretation led LEP patients to delay care or proceed without assistance, limiting communication
Source
Brooks (2016). Patient Perspectives on the Need for and Barriers to Professional Medical Interpretation. Rhode Island Medical Journal.
Description #
Patients reported that barriers to professional interpretation led them to delay care or proceed through encounters without assistance, after which they were limited in their ability to ask questions, describe symptoms, or understand instructions — a self-reinforcing access barrier in which absent interpretation degrades the encounter the patient does receive.
"I asked for an interpreter and the interpreter never showed up. So [the doctor] asked me if it was ok like that and you know, you think you can defend yourself. But that's the mistake, to agree knowing that you're not going to understand 100%, that you're going to be limited in the questions you can ask…You end up lost." (Brooks, 2016, p. 31)
"Many participants reported that barriers to professional interpretation lead them to delay care or brave medical encounters without assistance." (Brooks, 2016, p. 31)
Methods Context #
What? #ⓘ
The observable: patient-reported care-seeking behavior (delaying or foregoing care; proceeding without an interpreter) and consequent constraints on communication within the encounter.
"In these scenarios, they are limited in their ability to ask questions, adequately describe their symptoms or understand providers' instructions." (Brooks, 2016, p. 31)
How? #ⓘ
Four semi-structured Spanish-language focus groups analyzed via immersion/crystallization thematic coding; topics included barriers to care and interpretation and experiences using ad hoc versus professional interpreters.
"Topics included demographics, recent encounters with health providers, barriers to care and interpretation, experiences using ad hoc versus professional interpreters…" (Brooks, 2016, p. 30)
Who? #ⓘ
22 LEP Spanish-speaking adults from Providence County, Rhode Island, recruited from community organizations, churches, businesses, and clinics; all with limited English proficiency and recent medical encounters.
"Individuals aged 18 or older were considered eligible provided they spoke little to no English (per patient report) and had at least 2 medical encounters in the last 6 months." (Brooks, 2016, p. 30)
Other Notes #
The authors link this pattern to downstream effects in their discussion — "recurrent medical visits, poor treatment adherence, and additional costs to the patient and health system" (p. 32).