Working with interpreters in health care: a systematic review and meta-ethnography of qualitative studies.

Abstract

OBJECTIVE: To identify relational issues involved in working with interpreters in healthcare settings and to make recommendations for future research. METHODS: A systematic literature search in French and English was conducted. The matrix method and a meta-ethnographic analysis were used to organize and synthesize the data. RESULTS: Three themes emerged. Interpreters'roles: Interpreters fill a wide variety of roles. Based on Habermas's concepts, these roles vary between agent of the Lifeworld and agent of the System. This diversity and oscillation are sources of both tension and relational opportunities. DIFFICULTIES: The difficulties encountered by practitioners, interpreters and patients are related to issues of trust, control and power. There is a clear need for balance between the three, and institutional recognition of interpreters' roles is crucial. COMMUNICATION CHARACTERISTICS: Non-literal translation appears to be a prerequisite for effective and accurate communication. CONCLUSION: The recognition of community interpreting as a profession would appear to be the next step. Without this recognition, it is unlikely that communication difficulties will be resolved. PRACTICE IMPLICATIONS: The healthcare (and scientific) community must pay more attention to the complex nature of interpreted interactions. Researchers need to investigate how relational issues in interpreted interactions affect patient care and health.