Estrada Robin Dawson, Reynolds Jennifer F, Hilfinger Messias DeAnne K
Assistant Professor, College of Nursing, University of South Carolina, 1601 Greene St., Columbia, SC 29208.
Associate Professor, Department of Anthropology, University of South Carolina, Columbia, SC.
Res Nurs Health. 2015 Aug;38(4):278-88. doi: 10.1002/nur.21660. Epub 2015 Apr 24.
Language asymmetry between patients with limited English proficiency and health care providers increases the complexity of patient-provider communication. In this research, we used conversation analysis to examine the content and processes of five triadic clinical communication encounters between Spanish-speaking adult patients, English-speaking nurse practitioners, and clinic-based interpreters. Data collection included audio-recordings of the triadic clinical encounters and self-administered post-encounter surveys of the nurse practitioners and interpreters. Our findings revealed communication trouble spots that, when directly addressed by the interactants, facilitated processes of negotiating relationships, and coming to a mutual understanding. Exemplars labeled Making Assumptions; Colloquialisms as Signaling Potential for Trouble; Repairing a Mis-Statement; and Turn-Taking, Silences, and Laughter illustrated how the parties identified and navigated such trouble spots. The final exemplar, Attaining Intersubjectivity, represented a successful multi-lingual triadic communication. While the role of the interpreter often is seen as a conduit of information from one language to another, in practice they also enacted roles of communication collaborators and coconstructors. Future interdisciplinary research can include closer examination of occurrences of communication trouble spots and further exploration of how interpretermediated communication is conceptualized and problematized in diverse clinical settings, to promote language interpretation policies and practices that contribute to reducing health disparities among limited-English-proficient populations.
英语水平有限的患者与医疗服务提供者之间的语言不对称增加了医患沟通的复杂性。在本研究中，我们运用会话分析来审视讲西班牙语的成年患者、讲英语的执业护士和驻诊口译员之间五次三方临床沟通会面的内容及过程。数据收集包括三方临床会面的录音以及执业护士和口译员在会面结束后自行填写的调查问卷。我们的研究结果揭示了沟通中的问题点，当互动者直接处理这些问题点时，有助于协商关系并达成相互理解的过程。标记为“做出假设”“俗语暗示潜在问题”“纠正错误陈述”以及“话轮转换、沉默与笑声”的示例说明了各方如何识别和应对这些问题点。最后的示例“达成主体间性”代表了一次成功的多语言三方沟通。虽然口译员的角色通常被视为从一种语言到另一种语言的信息传递渠道，但在实际中，他们还扮演了沟通协作者和共同构建者的角色。未来的跨学科研究可以更深入地考察沟通问题点的出现情况，并进一步探索在不同临床环境中如何理解和处理口译介导的沟通问题，以推动有助于减少英语水平有限人群健康差距的语言口译政策和实践。
