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 upcoming 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 can directly communicate her medical history, understand the preoperative requirements, and provide informed consent for the surgical procedure. This approach respects the patient's right to make her own healthcare decisions and ensures she fully comprehends the surgical procedure, risks, benefits, and alternatives.
The use of professional interpreters is also emphasized in the Association of Anaesthetists of Great Britain and Ireland guidelines, which state that consent must take place with the use of an interpreter, and must not rely on family members or friends to translate, ensuring the accuracy of the information provided and reducing any coercive influence 1. Additionally, the guidelines recommend that written information should be available in languages commonly read by local patients, and translators or readers must be available for those patients unable to read the written information provided.
Key considerations for ensuring the patient's understanding include:
- Using a professional medical interpreter to facilitate communication
- Providing written information in the patient's preferred language
- Ensuring the patient has sufficient time to understand the information and ask questions
- Focusing on the most important points and using plain language to facilitate understanding, as recommended by the American Society of Clinical Oncology consensus guideline 1
- Considering the patient's individual needs and preferences when providing information, as emphasized in the Association of Anaesthetists of Great Britain and Ireland guidelines 1.
By taking these steps, healthcare providers can ensure that the patient receives high-quality, patient-centered care that respects her autonomy and promotes her understanding of her medical care.
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.