“这关乎生死之别”：专业医学口译员对自身在为英语水平有限的患者提供安全护理中所扮演角色的看法。
"It's the difference between life and death": The views of professional medical interpreters on their role in the delivery of safe care to patients with limited English proficiency.
作者信息
Wu Margaret Siyu, Rawal Shail
机构信息
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of General Internal Medicine, University Health Network, Toronto, Ontario, Canada.
出版信息
PLoS One. 2017 Oct 5;12(10):e0185659. doi: 10.1371/journal.pone.0185659. eCollection 2017.
BACKGROUND
Patients with limited English proficiency (LEP) experience poorer quality care and more adverse events in hospital. Consequently, there is interest in understanding the role of professional medical interpreters in efforts to improve patient safety.
OBJECTIVE
To describe the views of professional medical interpreters on their role in the delivery of safe patient care.
DESIGN
Qualitative analysis of in-depth semi-structured interviews.
PARTICIPANTS
15 professional medical interpreters affiliated with the Healthcare Interpretation Network in Toronto, Canada.
APPROACH
Participants' views on their role in patient safety were analyzed and organized into themes.
KEY RESULTS
Professional medical interpreters described being uniquely situated to identify and prevent adverse events involving patients with LEP by: 1) facilitating communication and enhancing patients' comprehension, 2) giving voice to patients, and 3) speaking up about safety concerns. Participants described a tension between 'speaking up' and interpreters' ethical imperative to remain impartial. Interpreters also highlighted several challenges, including 4) medical hierarchy and healthcare providers' limited knowledge of the role of interpreters. These challenges introduced safety issues if providers asked interpreters to act outside of their scope of practice.
CONCLUSIONS
Our study found that professional medical interpreters view their work as integral to the delivery of safe care to patients with LEP. In order to effectively engage in patient safety efforts together, interpreters and providers require a mutual understanding of their roles. Team hierarchy and limited provider knowledge of the role of interpreters can introduce safety concerns. In addition, interpreters describe a tension between "speaking up" about patient safety and the need for interpreters to remain impartial when facilitating communication. Healthcare institutions, providers, and interpreters must engage in discussion on how to best to "speak up" and integrate interpreters into safety efforts. Importantly, the benefits of partnering with interpreters can only be realized when providers consistently use their services.
背景
英语水平有限（LEP）的患者在医院接受的护理质量较差，且遭遇更多不良事件。因此，人们对于了解专业医学口译员在改善患者安全方面的作用很感兴趣。
目的
描述专业医学口译员对其在提供安全患者护理中所起作用的看法。
设计
对深入的半结构化访谈进行定性分析。
参与者
15名隶属于加拿大多伦多医疗口译网络的专业医学口译员。
方法
分析参与者对其在患者安全中作用的看法，并将其组织成主题。
主要结果
专业医学口译员表示，他们处于独特地位，可通过以下方式识别和预防涉及LEP患者的不良事件：1）促进沟通并增强患者的理解能力，2）为患者发声，3）说出安全问题。参与者描述了“说出问题”与口译员保持公正的道德要求之间的矛盾。口译员还强调了几个挑战，包括4）医疗等级制度以及医疗服务提供者对译员作用的了解有限。如果医疗服务提供者要求口译员超出其执业范围行事，这些挑战就会引发安全问题。
结论
我们的研究发现，专业医学口译员认为他们的工作对于为LEP患者提供安全护理至关重要。为了共同有效地参与患者安全工作，口译员和医疗服务提供者需要相互理解各自的角色。团队等级制度以及医疗服务提供者对译员作用的了解有限可能会引发安全问题。此外，口译员描述了在“说出”患者安全问题与在促进沟通时保持公正的必要性之间的矛盾。医疗机构、医疗服务提供者和口译员必须就如何最好地“说出问题”以及将口译员纳入安全工作进行讨论。重要的是，只有当医疗服务提供者持续使用口译服务时，与口译员合作的益处才能实现。
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