Howard Joycelyn, Torke Alexia M, Hickman Susan E, Sachs Greg, Sotto-Santiago Sylk, Slaven James E, Robinson Denise
Indiana University Health (J.H.), Indiana, USA.
Indiana University Center for Aging Research (A.M.T.), Regenstrief Institute, Inc., Indiana University Health, Indianapolis, Indiana, USA.
J Pain Symptom Manage. 2025 Sep;70(3):221-229. doi: 10.1016/j.jpainsymman.2025.02.468. Epub 2025 Mar 7.
Medical interpreters play a critical role in communicating with patients and families with non-English language preference (NELP), previously referred to as limited English proficiency , near the end-of-life (EOL) but often receive minimal education about providing this type of care.
To understand interpreter experiences with providing services for patients near the end of life and needs for professional support and training in EOL care.
A 60 question survey, was distributed to 1,660 medical interpreters at two hospitals and one interpreter service company. The survey included questions about participant characteristics, examined interpreter experiences, self-efficacy responding to EOL symptoms and EOL concerns, comfort levels, educational needs, racial discrimination, and barriers to effective interpretation for patients who are near EOL.
Medical interpreters (n = 162) generally report high self-efficacy in interpreting conversations about EOL care but have lower scores regarding the communication and decision-making subscale compared to symptom management subscale (Diff = 0.90 (95% CI 0.48-1.32), P < 0.0001). Many (70.4%) of the interpreters indicated that they never or seldom meet with the patient's medical providers prior to a goals of care meeting and only 52.2% report they are usually or always treated as part of the medical team. Interpreters often received little warning about conversation topics prior to interpreting. Qualitative comments revealed experiences of high emotional distress during and after these conversations. Approximately three quarters of the interpreters indicated they would be interested in receiving education regarding EOL topics. Increased experience as an interpreter was associated with a lower fear of death (r = -0.204, P = 0.0092 and witnessed discrimination (r= 0.179, P = 0.0236).
Although self-efficacy for interpreting EOL conversations is generally high, interpreters desire education about EOL care. Interventions are also needed to address the high emotional toll of interpreting EOL conversations. Education and training about EOL care may help them to not only convey information accurately but also cope with emotional nuances characteristic of these significant conversations, ultimately elevating the quality of care for patients and family members in vulnerable and important moments.
在临终阶段，医学口译员在与偏好非英语（NELP，以前称为英语水平有限）的患者及其家属沟通中发挥着关键作用，但他们在提供此类护理方面接受的教育往往很少。
了解口译员为临终患者提供服务的经历以及在临终关怀方面对专业支持和培训的需求。
向两家医院和一家口译服务公司的1660名医学口译员发放了一份包含60个问题的调查问卷。该调查包括有关参与者特征的问题，考察了口译员的经历、对临终症状和临终问题做出回应的自我效能感、舒适度、教育需求、种族歧视以及为临终患者进行有效口译的障碍。
医学口译员（n = 162）总体上报告在口译有关临终关怀的对话方面自我效能感较高，但与症状管理子量表相比，在沟通和决策子量表上的得分较低（差异=0.90（95%CI 0.48 - 1.32），P < 0.0001）。许多（70.4%）口译员表示，在护理目标会议之前，他们从未或很少与患者的医疗服务提供者会面，只有52.2%的人报告他们通常或总是被视为医疗团队的一部分。口译员在口译之前通常很少收到关于对话主题的预警。定性评论揭示了在这些对话期间及之后高度情绪困扰的经历。大约四分之三的口译员表示他们有兴趣接受有关临终主题的教育。口译经验的增加与较低的死亡恐惧（r = -0.20, P = 0.0092）和目睹的歧视（r = 0.179, P = 0.0236）相关。
虽然口译临终对话的自我效能感总体较高，但口译员希望接受临终关怀方面的教育。还需要采取干预措施来应对口译临终对话带来的高昂情绪代价。关于临终关怀的教育和培训可能有助于他们不仅准确传达信息，还能应对这些重要对话中特有的情绪细微差别，最终在脆弱而重要的时刻提高患者及其家属的护理质量。
