What Are the Techniques for Skilled Interviewing of a Patient With a Language Barrier?

Be careful when relying on children to interpret for their parents.
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That first interview when patients enter a health care facility is vital. It sets the tone for the entire treatment plan for the patient and gives doctors and nurses the basis for making a good diagnosis. It’s the beginning of a relationship based on trust, too. But if you can’t even understand whether the patient has a raging headache or a nasty ringing in her ears, you’re going to have a tough time getting any history or account of other symptoms out of her.

Check Your Judgments

As an interviewer, there will be times when your own prejudices and preconceived notions get in the way of a professional interview. For example, you may not even realize that you automatically think people with poor hygiene don’t care about their health, when in fact, poverty or cultural teachings may be the reason for the lack of personal care based on American standards. One technique is to take a step back, pause and reflect on your own feelings and reactions to gauge whether they are appropriate or if they’re getting in the way of a thorough interview. When detecting cultural differences, look for compromise and maintain a respectful attitude toward the patient’s choices as long as they aren’t completely harmful.

Modify Your Communication

In many cases, pictures can prove helpful when language barriers continue to crop up in interviewing patients with limited English skills. Use large charts and ask patients to point to the areas that hurt. Assess the patient’s reading level because she might read better English than she speaks and can adequately fill out a questionnaire that’s geared toward getting you the responses you need. Smile, nod and use body language to encourage patients to continue when they have difficulties expressing their symptoms or answering your questions. Create bilingual questionnaires and printed charts in the languages most commonly seen at your facility.

Bring in the Team

You may end up doing more harm than good if you rely solely on your own limited language skills – if they are in fact limited. Instead of guessing at certain responses or relying exclusively on the daughter of a patient to interpret her mother’s symptoms, bring in another staff member who is more knowledgeable about the culture of the person you’re interviewing and who may possess better language skills – or find a telephone interpreter to verify your interpretations. As more and more patients present with language barriers, it’s important for health care facilities to train staff to work together to provide the most accurate care possible.

Use an Interpreter

When your patient doesn’t speak a word of English, you may have to rely on an interpreter. This presents additional challenges, though. For one thing, the patient gives up her confidentiality by having a stranger present. At the same time, it can be touch and go using a friend or family member because they may interpret things the way they want you to hear them and not give you the exact responses the patient expressed. They might condense a lengthy response, leading to missed details that could really help with a proper diagnosis. The best way to deal with interpreters is to keep questions short and to the point. Sit facing the patient and speak directly to her. Finally, whenever possible, use a trained interpreter accustomed to working in health care environments.

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