"Interpreters don't tell you everything": experiences with medical interpretation among Latino cancer patients and caregivers with limited English proficiency

Abstract

Purpose: Language is an underrecognized social driver of health that disproportionately affects Hispanic/Latino (H/L) patients and can negatively impact comprehension and engagement with medical care. Professional interpretation services can help overcome language barriers in the clinic or hospital setting; however, interpreters are not universally available and, even when they are, the quality of communication can be limited. In this secondary analysis of a qualitative study which examined the barriers and facilitators H/L patients and their caregivers experience when navigating rectal cancer care, we sought to explore how Spanish-speaking rectal cancer patients and their caregivers communicated with oncology providers and the ways in which professional interpretation may have facilitated or detracted from their care experiences.

Methods: We conducted a community-partnered qualitative study to explore H/L patients with rectal cancer and their caregivers' experiences with medical interpretation during their oncologic care. We developed an interview guide based on the Ecological Model of Health Behavior and iteratively refined it with input from our Community Advisory Board. Data analysis utilized grounded theory and reflexive thematic analysis to identify core themes.

Results: Over a 6-month period, we conducted 21 semi-structured interviews. Three major themes related to language arose from our review of coded transcripts: (1) interpreters' use of medical jargon; (2) dialect discordance between patient and hospital interpreter; and (3) lack of trust in the interpretation process.

Conclusion: Our sample of H/L rectal cancer patients and their caregivers reported barriers due to overuse of medical jargon and dialectic differences, both of which eroded trust in the interpretation process. Beyond simply hiring more interpreters, hospitals would benefit from re-envisioning the patient-interpreter relationship as a means of improving communication and fostering trust in the healthcare system.

Keywords: Colorectal cancer; Community engaged; Health disparities; Hispanic/Latino; Language barriers.