Chuukese Patients, Dual Role Interpreters, and Confidentiality: Exploring Clinic Interpretation Services for Reproductive Health Patients.

This exploratory study analyzes limited English proficient (LEP) Chuukese patients' perspectives on dual-role interpreters in Guam and Chuuk. Methods included ethnographic observations of encounters with health care workers (HCWs) and 225 female Chuukese patients seeking reproductive healthcare in community health clinics: 126 women in Guam and 99 women in Chuuk. Ethnographic observations were supplemented by semi-structured interviews with 26 HCWs, and life history interviews with 15 Chuukese transnational migrant women. Notes from interview transcripts and observations were analyzed using critical interpretive and grounded theory. Findings demonstrated that Chuukese LEP patients need and at times want interpreters in order to understand their healthcare visits. In the absence of professional interpreters, ad-hoc interpreters (family interpreters and employees of the clinic) are an important resource. However, social and cultural concerns with community confidentiality influenced patient trust of staff interpreters. This lack of trust can limit access to health care overall, as some patients may avoid seeking care to prevent their confidential health information being disclosed. These complexities in interpretation must be considered in order for clinics to provide optimal care for the communities they serve.