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Tweets by genesdev. Current Issue September 1, , 33 Participants included link workers and carers may be limited, and privacy and confidenti- employed by primary care trusts, a National Health ality may be compromised Gerrish Additionally, Service NHS community Trust interpreting service practitioners may not have received training in using and freelance interpreters employed via a community- interpreters, with the result that interpreters are not based interpreting service.
The size of the groups varied important role that primary care nurses are to play in according to the different interpreting services, with each respect of chronic disease management, public health, group comprising between three and six participants. If nurses are to provide an ences of interpreting, their involvement with primary equitable service to minority ethnic communities, they care nurses, factors influencing the quality of interpret- will need to bridge language barriers. To date, there is a ing, training and the future development of interpreting paucity of research examining how primary care nurses services.
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Individual semi-structured interviews were communicate with patients who are not fluent in Eng- undertaken with managers responsible for the different lish. Whereas district nurses have been shown to make interpreter services. The interviews followed a similar minimal use of interpreting services Gerrish , agenda to the focus group discussions with interpreters, little is known about how other primary care nurses but also explored organisational issues.
Five focus groups were undertaken with members The present study seeks to address this deficit by of the community language groups identified above. The aim of the study was to explore the utilisation of Each focus group involved between seven and 13 par- interpreting services by primary care nurses from the ticipants.
The focus group discussions were conducted perspectives of the nurses, interpreters and minority in two languages, i. English and the appropriate com- ethnic communities. There was an overall from which they were drawn, it was anticipated that lack of awareness of interpreting services, and although participants could provide a perspective on the use of keen to utilise interpreters, the participants did not interpreters by various primary care nurses.
Participation was voluntary, and the partic- how to ask for somebody to translate for them. Somali ipants were assured of anonymity and confidentiality.
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Whereas where there had been no one available to interpret. Fre- the whole focus group discussion was tape-recorded, quently, the community participant was left unaware of only the English was transcribed. On other the discussion was subsequently listened to by an occasions, either the community member or the nurse independent interpreter who checked for accuracy of took the initiative to establish communication: translation alongside the transcript.
No interpreter accompanied [the] nurse on home visits. I Data analysis drew upon the principles of framework know nothing about English. Following familiari- simple words, and I let [the community worker] look at the notes sation with the content of the transcripts, a thematic and she translates them. Chinese woman coding schedule was developed with reference to the It was often left to community members to overcome topics discussed during the interviews.
The transcripts language barriers: were subsequently coded and the issues raised by each of the three sets of focus groups i.
I just put and community groups were mapped. Why [do] they do this? They should get someone who understands. I waited until my Results husband could phone the nurse, so he acted as interpreter. Arab woman Minority ethnic community perspectives The consequences of poor communication were Community groups agreed that communication between keenly felt by community participants.
One Chinese members of minority ethnic communities who had lim- man was concerned that he could be seriously ill, but ited proficiency in English and healthcare professionals because of poor communication, would not be aware of was fraught with difficulty because of inadequate inter- his condition. Contact between community partici- could die but not have [an] illness. Con- primary care nurses. She may just talk to us using hands. Somali woman primary care unless they had a serious problem. The next appointment may be one week later.
Bengali woman first visits undertaken by district nurses, had a degree of urgency that meant that they could not be delayed until an interpreter was available: Nursing perspectives I think the reason Health Visitors use interpreters more is All nursing groups were concerned about the conse- because they have the time to make arrangements. Nevertheless, the extent to me. Or you might visit someone nication varied considerably both across and within daily. Some participants felt under pressure by their then their services were utilised. In other situations, managers to take account of the cost of using interpret- heavy reliance was placed on family members.
What are we supposed to do? Practice nurse Despite these difficulties, there were clear indica- tions of when an interpreter would be used: Some used children only in exceptional circumstances: I prefer to use an interpreter for an initial first contact visit I think the principle of using children is really bad. For less formal visits, a arrange something else. Midwife However, such concerns were frequently not reflected Sensitive topics such as contraception or incontinence in the accounts of their experiences of caring for patients were also considered inappropriate to discuss through who did not speak English.
In many instances, patients family interpreters. Midwife available to a broad range of primary care professionals, it was not clear why so few nurses had taken up this Whereas it was recognised that family interpreters opportunity. Link workers of information, many nurses seemed resigned to com- were particularly valued because of their wider role: promising care in this way.
Many nurses lacked aware- part of a team. Specialist nurse were unsure how to access different types of service. When we arrived, she launched into Bengali, and the continuity both in terms of the patients visited and the mother just went paler and paler. This was detri- thing not right here.
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And she was telling this woman that the house was relationship between interpreter, patient and nurse, very smelly and this was making the baby ill. Interpreter perspectives Interpreters voiced concern about the general lack of The different interpreter groups held various roles in respect and recognition that they felt was shown by respect of interpretation, information giving and support nurses towards them. They perceived themselves to to patients. The freelance interpreters from the community- occupy a professional role in which issues of confiden- based interpreting service saw their role solely in terms tiality and respect for patients featured prominently: of language translation in situations where the health Confidentiality is very important.
By contrast, the link workers perceived that Arabic-speaking interpreter, they wanted somebody who interpretation was one aspect of a much broader role in spoke Arabic, but who was from a different country because which they also provided information to patients, acted then no one could go back to the community and tell others as a cultural broker and patient advocate. The interpret- their business. Trust interpreter as a cultural broker, but this did not include advocacy: Interpreters perceived that there was a lack of My role is to liaise between the patient and the professional knowledge of community languages among health providing a confidential and professional service.
A Brief History
Trust interpreter ledge of interpreting services. Whereas specialist nurses Additionally, nurses were often unaware of how to and some health visitors used link workers, other nurses use an interpreter effectively: made little demand on their services. Trust-based inter- preters and those working freelance served a range of I was called in because a patient forgot her appointments.
One sentences and allowing me to explain to the patient before possible reason was the perceived cost: asking the next question.
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Link workers and trust-based interpreters par- me? Many inter- only come when that person can speak some English and is preters had acquired such knowledge through experi- able to ask for an interpreter. Link worker ence or private study. The freelance interpreters had participated in a training day which covered principles Interpreters raised concerns regarding their working of interpreting, but there was nothing specific relating relationships with primary care nurses.
Apart from link to healthcare.
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Discussion As a result, the skills of interpreters were not necessarily The findings from the present study confirm those of used most effectively. Interpreters generally regarded other UK studies examining interpreting provision in their training to have been inadequate. Whereas inter- The fact that nurses tended to draw more highlighted. Community participants were often reluc- upon interpreters when dealing with complex or sensi- tant to initiate contact with health professionals because tive health issues highlighted the need for interpreters of language barriers.
Where consultations did occur, to be properly prepared for this aspect of their role. The quality of care was further compromised Many primary care nurses appeared complacent and through a lack of privacy and the negative impact on accepting of the status quo.