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 can directly communicate her medical history, understand the preoperative requirements, and provide informed consent for the upcoming surgery. 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 Association of Anaesthetists of Great Britain and Ireland also emphasizes the importance of using an interpreter for patients who do not speak English, stating that consent must take place with the use of an interpreter and must not rely on family members or friends to translate 1. This guideline highlights the need for accurate and unbiased communication to ensure the patient's autonomy and informed decision-making.
Key considerations for ensuring effective communication with the patient include:
- Using a professional medical interpreter who speaks Nepali
- Providing written information in languages commonly read by local patients
- Making translators or readers available for patients who are unable to read the written information
- Ensuring the patient understands the nature of the procedure, significant foreseeable risks, and alternatives
- Respecting the patient's right to make her own healthcare decisions and providing opportunities for her to ask questions and seek clarification.
By prioritizing the use of a professional medical interpreter and following these guidelines, healthcare providers can ensure that the patient receives high-quality, patient-centered care that respects her autonomy and promotes optimal 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.