Department of Women and Children's Health, Faculty of Life Sciences & Medicine, King's College London, 10th Floor, North Wing St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Chelsea and Westminster NHS Foundation Trust, Clinical Research Facility, St Stephen's Centre, 252 Fulham Road, London, SW109NA, UK.
Int J Equity Health. 2021 Oct 24;20(1):233. doi: 10.1186/s12939-021-01570-8.
Black and minority ethnic women and those with social risk factors such as deprivation, refugee and asylum seeker status, homelessness, mental health issues and domestic violence are at a disproportionate risk of poor birth outcomes. Language barriers further exacerbate this risk, with women struggling to access, engage with maternity services and communicate concerns to healthcare professionals. To address the language barrier, many UK maternity services offer telephone interpreter services. This study explores whether or not women with social risk factors find these interpreter services acceptable, accessible and safe, and to suggest solutions to address challenges.
Realist methodology was used to refine previously constructed programme theories about how women with language barriers access and experience interpreter services during their maternity care. Twenty-one longitudinal interviews were undertaken during pregnancy and the postnatal period with eight non-English speaking women and their family members. Interviews were analysed using thematic framework analysis to confirm, refute or refine the programme theories and identify specific contexts, mechanisms and outcomes relating to interpreter services.
Women with language barriers described difficulties accessing maternity services, a lack of choice of interpreter, suspicion around the level of confidentiality interpreter services provide, and questioned how well professional interpreters were able to interpret what they were trying to relay to the healthcare professional during appointments. This resulted in many women preferring to use a known and trusted family member or friend to interpret for them where possible. Their insights provide detailed insight into how poor-quality interpreter services impact on their ability to disclose risk factors and communicate concerns effectively with their healthcare providers. A refined programme theory puts forward mechanisms to improve their experiences and safety such as regulated, high-quality interpreter services throughout their maternity care, in which women have choice, trust and confidence.
The findings of this study contribute to concerns highlighted in previous literature around interpreter services in the wider healthcare arena, particularly around the lack of regulation and access to high-quality interpretation. This is thought to have a significant effect on pregnant women who are living socially complex lives as they are not able to communicate their concerns and access support. This not only impacts on their safety and pregnancy outcomes, but also their wider holistic needs. The refined program theory developed in this study offers insights into the mechanisms of equitable access to appropriate interpreter services for pregnant women with language barriers.
黑人和少数族裔女性以及那些处于社会风险因素中的人，如贫困、难民和寻求庇护者身份、无家可归、心理健康问题和家庭暴力，她们的不良生育结果的风险不成比例地高。语言障碍进一步加剧了这种风险，女性在获取、参与产妇服务和与医疗保健专业人员沟通方面都存在困难。为了解决语言障碍问题，许多英国产妇服务机构提供电话口译服务。本研究探讨了处于社会风险因素中的女性是否认为这些口译服务是可以接受、可及和安全的，并提出了解决挑战的方法。
使用现实主义方法来完善先前构建的关于语言障碍女性在产妇护理期间如何获取和体验口译服务的方案理论。在怀孕和产后期间，对 8 名非英语母语的女性及其家属进行了 21 次纵向访谈。使用主题框架分析对访谈进行分析，以确认、反驳或完善方案理论，并确定与口译服务相关的具体背景、机制和结果。
语言障碍女性描述了在获取产妇服务方面的困难、对口译人员选择的缺乏、对口译人员提供的保密性程度的怀疑，以及质疑专业口译人员在预约期间能够将她们试图传达给医疗保健专业人员的内容翻译得有多好。这导致许多女性尽可能地选择使用熟悉和信任的家庭成员或朋友来为她们翻译。她们的见解详细说明了低质量口译服务如何影响她们向医疗保健提供者披露风险因素和有效沟通的能力。一个经过改进的方案理论提出了改善她们体验和安全的机制，例如在整个产妇护理过程中提供有监管的、高质量的口译服务，让女性拥有选择、信任和信心。
本研究的结果有助于解决之前文献中强调的口译服务在更广泛的医疗保健领域中的问题，特别是缺乏监管和获得高质量口译的问题。这被认为对生活在社会复杂环境中的孕妇有重大影响，因为她们无法表达自己的担忧并获得支持。这不仅影响到她们的安全和妊娠结果，也影响到她们更广泛的整体需求。本研究中开发的改进方案理论提供了有关为有语言障碍的孕妇提供公平获取适当口译服务的机制的见解。
