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Not Just “Getting by”: Factors Influencing Providers’ Choice of Interpreters

  • Original Research
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

Background

Providers consistently underutilize professional interpreters in healthcare settings even when they perceive benefits to using professional interpreters and when professional interpreters are readily available. Little is known about providers’ decision-making processes that shape their use of interpreters.

Objective

To understand the variety of considerations and parameters that influence providers’ decisions regarding interpreters.

Design

A qualitative, semi-structured interview guide was used to explore providers’ decision making about interpreter use. The author conducted 8 specialty-specific focus groups and 14 individual interviews, each lasting 60–90 minutes.

Participants

Thirty-nine healthcare professionals were recruited from five specialties (i.e., nursing, mental health, emergency medicine, oncology, and obstetrics-gynecology) in a large academic medical center characterized as having “excellent” interpreter services.

Approach

Audio-recorded interviews and focus groups were transcribed and analyzed using grounded theory to develop a theoretical framework for providers’ decision-making processes.

Key Results

Four factors influence providers’ choice of interpreters: (a) time constraints, (b) alliances of care, (c) therapeutic objectives, and (d) organizational-level considerations. The findings highlight (a) providers’ calculated use of interpreters and interpreting modalities, (b) the complexity of the functions and impacts of time in providers’ decision-making process, and (c) the importance of organizational structures and support for appropriate and effective interpreter utilization.

Conclusions

Providers actively engage in calculated use of professional interpreters, employing specific factors in their decision-making processes. Providers’ understanding of time is complex and multidimensional, including concerns about disruptions to their schedules, overburdening others’ workloads, and clinical urgency of patient condition, among others. When providers make specific choices due to time pressure, they are influenced by interpersonal, organizational, therapeutic, and ethical considerations. Organizational resources and guidelines need to be consistent with institutional policies and professional norms; otherwise, providers risk making flawed assessments about the effective and appropriate use of interpreters in bilingual health care.

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Contributors

The author gratefully acknowledges her research team members: Haiying Kong, MA, and Hyejung Ju, Ph.D., for their passion and hard work for data collection and analysis and Michelle Farabough, MA, for her preliminary data analysis as a graduate course project. Finally, I thank Dr. Eric Kramer for his continuous feedback throughout all phases of the research project.

Funders

The author gratefully acknowledges the support of Grant #1R03MH76205-01-A1 (Title: Providers’ Views of the Roles of Medical Interpreters) funded by National Institutes of Health/National Institute of Mental Health (NIMH).

Prior Presentations

2012 National Communication Association Convention, November 18, 2012.

Conflicts of Interest

The author declares that she does not have any conflicts of interest.

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Authors and Affiliations

  1. Department of Communication, University of Oklahoma, 610 Elm Ave #101, Norman, OK, 73019, USA

    Elaine Hsieh Ph.D

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  1. Elaine Hsieh Ph.D
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Correspondence to Elaine Hsieh Ph.D.

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Hsieh, E. Not Just “Getting by”: Factors Influencing Providers’ Choice of Interpreters. J GEN INTERN MED 30, 75–82 (2015). https://doi.org/10.1007/s11606-014-3066-8

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