The content of talk about health conditions and medications during appointments involving interpreters.

Abstract

INTRODUCTION: Interpreters often join immigrants and physicians to permit communication. OBJECTIVE: To describe the content of talk about health problems and medications during clinical encounters involving interpreters [professionals (PI) or family members (FI)]. METHODS: We analysed one regularly scheduled encounter for each of 16 adult patients with his family physician and their usual interpreter (10 with a PI and 6 with a FI). A different PI, not involved in the consultations, translated the non-English or French parts. We coded all utterances about each medical problem and each medication using six health problem and 16 medication topics from MEDICODE, a validated coding scheme. RESULTS: Physicians and patients addressed an average of 3.6 problems and 3 medications per encounter. No psychosocial problems were discussed in encounters involving FIs. On average, three topics were discussed per problem. In order of frequency, they were follow-up, explanations of the condition, non-drug management, consequences, self-management and emotions about the problem. Encounters involving PIs were more likely than encounters with FIs to include discussions of emotions about the problem (42% versus 4%, P = 0.001) and indications for follow-up (88% versus 28%, P < 0.001). An average of 6.5 topics was discussed per medication. Commonest topics discussed were medication class, how the drug was being used, achieved effect and expected effect. CONCLUSIONS: One can address multiple problems and share vital information even in the presence of a language barrier. When FIs are interpreting, physicians would do well to make a particular effort to bring the patient's psychological and emotional issues into the interaction.