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 for the laparoscopic cholecystectomy. 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 professional interpreter ensures the patient's autonomy, confidentiality, and accuracy of medical information, and is often required by healthcare facilities to meet legal and ethical standards for providing care to patients with limited English proficiency.
Additionally, the Association of Anaesthetists of Great Britain and Ireland guidelines emphasize the importance of providing sufficient time for the consent process and using interpreters or translators for patients who do not speak English 1. The guidelines also highlight the need to provide written information in languages commonly read by local patients and to make translators or readers available for those patients unable to read the written information.
Key considerations for ensuring the patient's understanding of her medical care include:
- Using a professional medical interpreter to communicate medical information and obtain informed consent
- Providing written information in the patient's preferred language
- Allowing sufficient time for the consent process
- Ensuring the patient understands the surgical procedure, its risks, benefits, and alternatives
- Explaining the importance of completing preoperative tests and procedures.
By taking these steps, the patient's rights and needs can be respected, and her safety and well-being can be ensured throughout the medical care process.
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 due to a language barrier, several strategies can be employed:
- Use of medical interpreters: Although medical interpreters are guided by a clear set of medical interpreting standards, research has shown that patient and provider expectations, requests, and a desire to protect patient-provider relationships can lead to deviations from these standards 2.
- Patient-centered care approaches: Shared decision making and motivational interviewing can provide practical methods to accomplish patient-centered care, especially in situations where medical evidence supports specific behavior changes and the most appropriate action is dependent on the patient's preferences 3.
- Nursing role in preoperative assessment: The nurse's role in the preoperative assessment is critical in identifying patient vulnerabilities, facilitating multidimensional communication, managing patients' expectations, and compensating for gaps in care 4.
- Interventions to improve patient comprehension: Interactive interventions, particularly with test/feedback or teach-back components, appear to be superior in improving patient comprehension in informed consent 5.
- Effective communication in the preoperative setting: Healthcare providers should allocate sufficient time to interact with patients and families, and engage in nonmedical talk to establish trust and rapport, as families spend a significant amount of time in the preoperative area with limited interaction with healthcare providers 6.
Key Considerations
- Language barriers can significantly impact patient understanding and care
- Medical interpreters play a crucial role in facilitating communication, but their effectiveness can be influenced by various factors
- Patient-centered care approaches and nursing interventions can help improve patient comprehension and care
- Effective communication in the preoperative setting is essential to establish trust and rapport with patients and families.