MacLellan Jennifer, McNiven Abigail, Kenyon Sara
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Int J Nurs Stud Adv. 2023 Nov 4;6:100162. doi: 10.1016/j.ijnsa.2023.100162. eCollection 2024 Jun.
Language, communication and understanding of information are central to safe, ethical and efficient maternity care. The National Health Service (NHS) commissioning board, NHS England, describes how healthcare providers should obtain language support through professionally trained interpreters. Providers of interpreters are commissioned to deliver remote/face to face interpretation across the NHS. Services can be booked in advance or calls can be made in real time. However, women report infrequent use of professionally trained interpreters during their maternity care, often relying on friends and family as interpreters which can compromise confidentiality, disclosure and accuracy.
To determine the demand for, and provision of, professionally trained interpreters in practice, we sent a Freedom of Information (FOI) request to 119 NHS Trusts delivering maternity services in England in November 2022. For the financial years 2020/2021 and 2021/2022, we asked how many women in the maternity service were identified as needing an interpreter, the number and mode of interpreter sessions, and the annual spend on interpreting services. Data were analysed using descriptive statistics.
One hundred maternity Trusts responded by 21st April 2023 (response rate 100/119-84 %). Of these, 56 (56 %) recorded a woman's need for an interpreter. Nineteen Trusts relied on documentation in paper notes and 37 Trusts recorded the information on a digital system. From the 37 Trusts where this information could be digitally retrieved, women requiring interpreter support reflected between 1 and 25 % of the annual birth rate of the Trust (average 9 %) and received an average of three interpreter sessions across their pregnancy, birth and postnatal journey. Telephone was the dominant mode used for interpreting sessions, though 11 Trusts favoured face to face interpreting. Financial spend on interpreting services varied across Trusts; some funded their own in-house interpreting services, or worked with local community groups in addition to their contracted interpreting provider.
Information obtained from this FOI request suggests that documentation of a woman's interpreting need is not complete or consistent across NHS maternity services. As a result, it is not clear how many women require an interpreter, the mode of provision or how frequently it is provided, and the cost involved. However, the limited information available suggests a failure to provide interpreter support to women at each scheduled care encounter. This raises questions about, the risk of women not understanding the care being offered, and the increased risk of uninformed, unconsented care as women traverse pregnancy and birth.
There appears to be failure to provide interpreter support to women at each scheduled maternity care encounter increasing the risk of uninformed, unconsented care.
语言、沟通和信息理解对于安全、合乎伦理且高效的孕产妇护理至关重要。英国国民医疗服务体系(NHS)委托委员会,即英国国家医疗服务体系(NHS England),阐述了医疗服务提供者应如何通过专业培训的口译员获得语言支持。口译服务提供商受委托在整个NHS范围内提供远程/面对面口译服务。服务可以提前预订,也可以实时拨打。然而,女性报告称在其孕产妇护理期间很少使用专业培训的口译员,她们通常依赖朋友和家人作为口译员,这可能会损害保密性、信息披露和准确性。
为了确定实际中对专业培训的口译员的需求及提供情况,我们于2022年11月向在英格兰提供孕产妇服务的119个NHS信托机构发送了信息公开请求(FOI)。对于2020/2021和2021/2022财政年度,我们询问了孕产妇服务中有多少女性被确定需要口译员、口译场次的数量和方式以及口译服务的年度支出。使用描述性统计方法对数据进行分析。
截至2023年4月21日,100个孕产妇信托机构做出了回应(回应率为100/119 - 84%)。其中,56个(56%)记录了女性对口译员的需求。19个信托机构依赖纸质记录,37个信托机构在数字系统上记录信息。在可以从数字上检索到这些信息的37个信托机构中,需要口译员支持的女性占信托机构年度出生率的1%至25%(平均9%),并且在整个孕期、分娩期和产后过程中平均接受三次口译服务。电话是口译服务使用的主要方式,不过有11个信托机构倾向于面对面口译。各信托机构在口译服务上的财政支出各不相同;一些机构资助自己的内部口译服务,或者除了与签约的口译服务提供商合作外,还与当地社区团体合作。
从这项信息公开请求中获得的信息表明,NHS孕产妇服务中关于女性对口译需求的记录并不完整或一致。因此,不清楚有多少女性需要口译员、提供方式或提供频率以及所涉及的成本。然而,现有的有限信息表明,未能在每次预定的护理接触中为女性提供口译员支持。这引发了关于女性不理解所提供护理的风险,以及女性在经历怀孕和分娩过程中接受未经告知、未经同意的护理的风险增加的问题。
在每次预定的孕产妇护理接触中似乎都未能为女性提供口译员支持,这增加了接受未经告知、未经同意的护理的风险。