From the Guidelines
When working with an interpreter, it's better to say "tell me about the pain" rather than "tell us about the pain". Using "me" maintains a direct doctor-patient relationship and avoids creating confusion about who is asking the question. The interpreter serves as a language conduit, not as another party in the clinical conversation. This approach helps preserve the therapeutic alliance between you and your patient. When the interpreter translates your question, they will naturally convert it to the appropriate form in the target language. Using "tell me" also reinforces that you, as the healthcare provider, are the one gathering information and making clinical decisions, while the interpreter is facilitating communication rather than participating as a separate entity in the medical encounter. According to the American Society of Clinical Oncology consensus guideline 1, effective communication is crucial, especially when there are barriers to communication, and using a medical interpreter is recommended for families who do not share a common language with the clinician.
Some key points to consider when communicating with patients through an interpreter include:
- Focusing on the most important points and using plain language 1
- Checking frequently for understanding 1
- Using visual aids when available to help with health numeracy 1
- Conducting an initial comprehensive pain assessment that includes an in-depth interview to explore the multidimensional nature of the pain 1
By saying "tell me about the pain", you are following the guideline's recommendation to communicate effectively and maintain a direct relationship with your patient, which is essential for providing high-quality care and improving patient outcomes.
From the Research
Language in Pain Assessment
- The use of language can be a significant influencing factor in the effective management of pain, with terms such as pain, discomfort, and comfort used interchangeably 2.
- When assessing pain, healthcare professionals should consider the patient's personal experience and use language that helps to understand their pain experience.
Addressing the Patient
- There is no specific guidance in the provided studies on whether to say "tell me" or "tell us" about the pain when an interpreter is present.
- However, the focus should be on using clear and simple language to communicate with the patient and ensure that their pain experience is understood 2.
Effective Pain Management
- Effective pain management involves a comprehensive approach that includes evidence-based nonpharmacologic options, such as cognitive behavioral therapy, exercise, and mindfulness-based interventions 3, 4, 5.
- A multimodal treatment approach that combines different therapies can be beneficial for patients with chronic pain 6.