临终问题讨论的阐释：一项全国医疗口译员调查的结果。
Interpretation for discussions about end-of-life issues: results from a National Survey of Health Care Interpreters.
机构信息
Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pennsylvania 15213, USA.
出版信息
J Palliat Med. 2012 Sep;15(9):1019-26. doi: 10.1089/jpm.2012.0032. Epub 2012 Jul 12.
BACKGROUND
Communication about end-of-life issues is difficult across language barriers. Little is known about the experience of health care interpreters in these discussions.
OBJECTIVES
Objectives of this study were to: 1) assess the experiences of healthcare interpreters when interpreting discussions about end-of-life issues; 2) identify interpreter characteristics and experiences that may be associated with improved satisfaction and comfort with interpreting these discussions; and 3) describe interpreter training needs.
METHODS
The study utilized an electronically administered survey distributed nationally to health care interpreters in the United States. One hundred and forty-two health care interpreters participated. Measurements included general experiences, attitudes, and perceived training needs when interpreting discussions about end-of-life issues.
RESULTS
Most respondents had received a certificate in interpretation (71%, 101/142), completed more than 40 hours of training (89%, 127/142), and had more than 5 years of interpreting experience (65%, 93/142). Overall, 85% (121/142) of respondents had interpreted discussions about end-of-life issues and most interpreted multiple discussions per week. Of those interpreters who had experience with these discussions, the majority (85%, 103/121) reported feeling comfortable, but only half (48%, 58/121) reported that these discussions usually went well. Interpreters who felt clear about their role were more likely than interpreters who did not feel clear about their role to think that discussions went well (51% [57/112] versus 11% [1/9], p=0.02) and to feel comfortable interpreting (88% [98/112] versus 56% [5/9], p=0.01). Eighty percent (97/121) of respondents with experience in end-of-life discussions were personally interested in more specific training for these discussions. Attitudes and perceived training needs did not differ by interpreter demographics or qualifications.
CONCLUSIONS
The majority of interpreters have experience with end-of-life discussions but, independent of interpreter training and experience, only half report that these discussions usually go well. Interpreters want and may benefit from targeted educational interventions that could improve the quality of care for vulnerable patients and families in these difficult situations. Health systems and interpreter certification programs should incorporate specific training on how to interpret discussion about end-of-life issues.
背景
语言障碍使得临终问题的交流变得困难。对于医疗口译员在这些讨论中的经历，人们知之甚少。
目的
本研究的目的是：1）评估医疗口译员在口译临终问题讨论时的经历；2）确定可能与提高对这些讨论的口译满意度和舒适度相关的口译员特征和经验；3）描述口译员培训需求。
方法
本研究采用电子问卷调查的方式，在全美范围内向医疗口译员发放问卷。共有 142 名医疗口译员参与了研究。测量包括在口译临终问题讨论时的一般经历、态度和感知到的培训需求。
结果
大多数受访者持有口译证书（71%，101/142），完成了超过 40 小时的培训（89%，127/142），并具有超过 5 年的口译经验（65%，93/142）。总体而言，85%（121/142）的受访者曾口译过临终问题讨论，大多数受访者每周口译多次讨论。在有过这些讨论经验的口译员中，大多数（85%，103/121）表示感到舒适，但只有一半（48%，58/121）表示这些讨论通常进行得很顺利。感到角色明确的口译员比角色不明确的口译员更有可能认为讨论进行得很顺利（51%[57/112]与 11%[1/9]，p=0.02），并且更愿意进行口译（88%[98/112]与 56%[5/9]，p=0.01）。80%（97/121）有过临终讨论经验的受访者对这些讨论的特定培训感兴趣。态度和感知到的培训需求与口译员的人口统计学特征或资质无关。
结论
大多数口译员都有过临终讨论的经验，但无论口译员的培训和经验如何，只有一半的人表示这些讨论通常进行得很顺利。口译员希望并且可能受益于有针对性的教育干预，这可以改善这些困难情况下弱势患者和家庭的护理质量。卫生系统和口译认证项目应纳入关于如何口译临终问题讨论的具体培训。
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