From the Guidelines
The most appropriate action is to arrange for a professional medical interpreter who speaks Nepali to ensure the patient understands her medical care and can provide informed consent. This approach is supported by the American Society of Clinical Oncology consensus guideline, which strongly recommends using a medical interpreter rather than a family interpreter when there are barriers to communication 1. Using a family member as an interpreter can compromise patient autonomy, confidentiality, and the accuracy of medical information. A professional interpreter ensures the patient can directly participate in her own care decisions and fully understand the preoperative assessment and upcoming procedure.
The Association of Anaesthetists of Great Britain and Ireland also emphasizes the importance of using an interpreter for patients who do not speak English, rather than relying on family members or friends to translate 1. This guideline highlights the need for accurate and unbiased communication to ensure informed consent. By using a professional medical interpreter, the patient's right to informed consent is respected, and her privacy regarding sensitive medical information is maintained.
Key considerations for ensuring the patient's understanding include:
- Using plain language to explain medical information
- Focusing on the most important points and checking frequently for understanding
- Providing written information in the patient's preferred language, if possible
- Ensuring the interpreter is available to facilitate communication throughout the patient's care.
By prioritizing the patient's understanding and using a professional medical interpreter, the healthcare team can ensure the patient receives high-quality care and can make informed decisions about her treatment.
From the Research
Ensuring Understanding of Medical Care for Nepali-Speaking Patients
To ensure a Nepali-speaking patient undergoing laparoscopic cholecystectomy understands her medical care despite a language barrier, several strategies can be employed:
- Utilize professional interpreters: As highlighted in 2, the complementary use of professional interpreters alongside family members can help safeguard patient autonomy and respect ethno-cultural values.
- Preoperative care and assessment: Nurses play a crucial role in the preoperative assessment, identifying patient vulnerabilities, and managing expectations 3. This assessment can be an opportunity to address language barriers and arrange for interpretation services.
- Clear communication: High-quality doctor-patient communication is essential, especially in linguistically and culturally diverse societies 2. Nurses and healthcare professionals should strive to provide clear and accurate information, using interpreters when necessary.
- Patient-centered care: Approaches like shared decision making and motivational interviewing can help achieve patient-centered care 4. These methods can be adapted to accommodate language barriers, ensuring that patients are involved in decision-making processes.
- Addressing challenges in medical interpreting: Recognizing the challenges faced by medical interpreters, such as deviations from medical interpreting standards 5, can help healthcare professionals better support interpreters and ensure effective communication.
Implementing Language Support
Healthcare professionals can take the following steps to implement language support for Nepali-speaking patients:
- Arrange for professional interpreters to be present during preoperative assessments, consultations, and surgical procedures.
- Use remote interpretation services, such as telephone or video interpretation, when in-person interpreters are not available.
- Provide patient information and educational materials in the patient's preferred language, whenever possible.
- Encourage patients to ask questions and seek clarification, using interpreters to facilitate communication.