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 for patients with language barriers 1. Additionally, the Association of Anaesthetists of Great Britain and Ireland guidelines emphasize the importance of using an interpreter for patients who do not speak English, rather than relying on family members or friends to translate, to ensure the accuracy of the information provided and reduce coercive influence 1.
Using a professional medical interpreter is crucial in this scenario, as it allows the patient to directly participate in her own care decisions and fully understand the preoperative assessment and upcoming laparoscopic cholecystectomy procedure. This approach respects the patient's right to informed consent, maintains her privacy regarding sensitive medical information, and complies with healthcare standards for patients with limited English proficiency. The interpreter can help explain the need for pending preoperative tests and ensure the patient's questions and concerns are properly addressed, which is particularly important given the patient's upcoming surgical procedure, as complete understanding is essential for proper preparation and optimal outcomes.
Key considerations in ensuring the patient's understanding include:
- Using plain language to explain medical information
- Focusing on the most important points and checking frequently for understanding
- Using visual aids, such as pictographs, to help explain complex information
- Providing written information in the patient's preferred language, if possible
- Ensuring the patient has sufficient time to ask questions and express concerns before the procedure.
By taking these steps, healthcare providers can help ensure that the patient receives high-quality care and can make informed decisions about her medical treatment, which is essential for improving morbidity, mortality, and quality of life outcomes.
From the Research
Ensuring Patient Understanding
To ensure a Nepali-speaking patient undergoing laparoscopic cholecystectomy understands her medical care due to a language barrier, several strategies can be employed:
- Utilize medical interpreters to facilitate communication between the patient and healthcare providers, as highlighted in the study 2.
- Provide patient information and preoperative care in a language the patient can understand, which can be achieved through preoperative outpatient appointments led by nurse specialists or advanced nurse practitioners 3.
- Employ shared decision making and motivational interviewing techniques to achieve patient-centered care, as described in the study 4.
- Conduct a thorough preoperative assessment to identify patient vulnerabilities and manage expectations, as emphasized in the study 5.
Improving Patient Comprehension
Interventions to improve patient comprehension in informed consent for medical and surgical procedures can be effective in addressing language barriers:
- Written, audiovisual, and multicomponent interventions can improve patient comprehension, although interactive digital interventions and verbal discussions with test/feedback or teach-back components appear to be more effective 6.
- Healthcare providers should consider the patient's education level, health literacy, and race/ethnicity when developing interventions to improve patient comprehension, as noted in the study 6.