School of Nursing, University of Shizuoka, Shizuoka, Japan.
College of Nursing and Nutrition, Shukutoku University, Chiba, Japan.
Patient Educ Couns. 2024 Jun;123:108233. doi: 10.1016/j.pec.2024.108233. Epub 2024 Mar 1.
We aimed to evaluate a proposed conceptual framework for quality assessment of medical interpretation using actual data from clinical settings.
A mixed methods approach was used. Routine outpatient encounters involving Portuguese-speaking Brazilian patients, Japanese physicians, and hospital-provided and ad hoc interpreters were digitally recorded and transcribed. A questionnaire survey examining participants' satisfaction was conducted; 111 and 13 encounters by hospital-provided and ad hoc interpreters, respectively, were recorded. Segments of consecutively interpreted utterances were coded as "altered," whereby the interpreter changed the meaning of the source utterance, or "unaltered (accurate)." Frequency and type of alteration were analyzed. The effect of positive interpretation alterations on physician-patient interactions was qualitatively described.
Interpretation accuracy was significantly higher for hospital-provided interpreters, but was not associated with overall patient satisfaction. Overall physician satisfaction was associated with accurate interpretation, clinically negative altered interpretations, and positive voluntary interventions (p < 0.05). Positive alterations promoted patient, physician, and interpreter interactions, which helped to achieve clinical outcomes.
A new conceptual framework for quality assessment of medical interpretation was developed for clinical settings. Healthcare provider satisfaction can provide a measure of interpretation alterations.
Healthcare providers can effectively use the conceptual framework to improve medical interpretation and collaboration with healthcare interpreters.
我们旨在使用临床环境中的实际数据评估一种用于医疗口译质量评估的概念框架。
采用混合方法。记录并转录了涉及讲葡萄牙语的巴西患者、日本医生以及医院提供的和临时口译员的常规门诊就诊情况。进行了一项调查参与者满意度的问卷调查；分别记录了由医院提供的和临时口译员提供的 111 次和 13 次口译。将口译员改变源语意思的连续口译话语片段编码为“改变”，或者“未改变（准确）”。分析了改变的频率和类型。定性描述了积极的口译改变对医患互动的影响。
医院提供的口译员的口译准确性明显更高，但与总体患者满意度无关。总体医生满意度与准确口译、临床负面的口译改变以及积极的自愿干预有关（p<0.05）。积极的改变促进了患者、医生和口译员之间的互动，有助于实现临床结果。
为临床环境开发了一种新的医疗口译质量评估概念框架。医疗服务提供者的满意度可以提供口译改变的衡量标准。
医疗服务提供者可以有效地使用该概念框架来改善医疗口译和与医疗口译员的合作。
