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迈向协作型口译介导的医患沟通结构:医疗口译员与医护提供者的功能互补。

Towards a collaborative structure of interpreter-mediated medical consultations: Complementing functions between healthcare interpreters and providers.

机构信息

University of Alcalá, Colegio Trinitarios - UAH, Calle de La Trinidad, 1, 28801, Alcalá de Henares, Madrid, Spain.

Shepherds House, Guys Campus, King's College London School of Medical Education, St Thomas St, London, SE1 9RT, UK.

出版信息

Soc Sci Med. 2021 Jan;269:113529. doi: 10.1016/j.socscimed.2020.113529. Epub 2020 Nov 17.

Abstract

In today's multilingual and multicultural societies, healthcare interpreters are increasingly needed to mitigate communication barriers in language-discordant, intercultural medical consultations. To orient these interactions, existing guidelines, best practices and recommendations shed light on the behaviour and responsibilities of interpreters and healthcare providers involved. These documents, however, mainly treat both professionals as individuals that take care of separate, unrelated dimensions of consultations, thus failing to address how they can work collaboratively. This seems to be particularly relevant if we consider that prescriptive documents advocate for an invisible interpreter rather than an active participant, consequently ignoring the positive functions interpreters are playing when they step out of their prescribed roles. In this context, this paper sets out to explore potential collaboration between both professional groups to improve communication as a whole. Drawing on Goffman's production format (1981), we examined excerpts from real interpreter-mediated medical consultations that took place at a public hospital in Madrid (Spain) over a period of five months (February-June 2017). Data analysis reveals that interpreters enact an author role as main participants of consultations and serve several functions in medical encounters, consequently sharing some of the responsibilities which are conventionally seen as doctors'. This may reveal potential areas of interest for interprofessional collaboration. In addition to interpreting, participants performed other clinical functions, thus accounting for complementary functions of that performed by healthcare providers. Interpreters act as clinical and therapeutic allies, patient empowerers and metalinguistic negotiators. In light of our findings, the next step is to design a new model for the interpreter-mediated medical consultations that integrates both perspectives in a collaborative, non-excluding proposal.

摘要

在当今的多语言和多元文化社会中,医疗口译员越来越需要弥合语言交流障碍,促进跨文化医学咨询。为了指导这些交流,现有的指南、最佳实践和建议阐明了参与的口译员和医疗保健提供者的行为和责任。然而,这些文件主要将这两种专业人员视为单独的个体,处理咨询的不同、不相关的方面,从而未能解决他们如何能够进行协作。如果我们考虑到规定性文件主张使用隐形口译员而不是积极的参与者,从而忽略了口译员在超越规定角色时所发挥的积极作用,那么这一点似乎尤为重要。在这种情况下,本文旨在探讨这两个专业群体之间的潜在合作,以改善整体沟通。本研究借鉴戈夫曼的生产格式(1981),分析了在马德里(西班牙)一家公立医院进行的为期五个月(2017 年 2 月至 6 月)的真实口译介导的医学咨询摘录。数据分析表明,口译员作为咨询的主要参与者扮演着作者的角色,并在医疗遭遇中发挥了多种功能,从而分担了一些传统上被视为医生的责任。这可能揭示了跨专业合作的潜在领域。除了解译,参与者还执行其他临床功能,从而弥补了医疗保健提供者的职能。口译员是临床和治疗盟友、患者赋权者和元语言谈判者。鉴于我们的发现,下一步是设计一种新的口译介导的医学咨询模式,将这两个视角整合到一个协作、不排斥的方案中。

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