Auswahl der wissenschaftlichen Literatur zum Thema „Hospital interpreting“

This paper presents the findings of cross-sectional national surveys on how Swiss hospitals address the problem of language barriers in health care and how they respond to the high number of allophone patients (i.e. patients who do not speak the local language). Half of the 244 hospital services responding to the questionnaire estimated the proportion of allophone patients to the total number of patients at 1–5%. Only 14% ‘often’ use paid interpreters, 79% rely mostly on relatives, 75% primarily on health staff, and 43% ‘often’ on non-health staff. Only 11% of the hospital services studied have a budget for interpreters, and 17% have access to an interpreter service. Forty-eight percent express the need to have access to interpreter services. The communication management of hospitals dealing with patients speaking one of the most frequent foreign languages is described; these languages are Italian, Spanish, Portuguese, South-Slavic, Albanian, Russian, Kurdish, Turkish, Arabic and Tamil. The discussion addresses quality of care issues for allophone patients, the risk of poor health care outcomes in the absence of interpreters and the potential benefits of using qualified interpreters.

The provision of professional interpreting services in the hospital setting decreases communication errors of clinical significance and improves clinical outcomes. A retrospective audit was conducted at a tertiary referral adult hospital in Brisbane, Australia. Of 20 563 admissions of patients presenting to the hospital emergency department (ED) and admitted to a ward during 2013-2014, 582 (2.8%) were identified as requiring interpreting services. In all, 19.8% of admissions were provided professional interpreting services in the ED, and 26.1% were provided on the ward. Patients were more likely to receive interpreting services in the ED if they were younger, spoke an Asian language, or used sign language. On the wards, using sign language was associated with 3 times odds of being provided an interpreter compared with other languages spoken. Characteristics of patients including their age and type of language spoken influence the clinician’s decision to engage a professional interpreter in both the ED and inpatient ward.

Beyond a potential role in infection surveillance, computers offer epidemiologists several important and unique potentials. Epidemiologists deal with complex interrelationships when interpreting or contributing information in the biomedical literature. Annals of Internal Medicine recently published a series dealing with the general problem of information management. The commentary that follows examines one area in which computers can be applied to our advantage-electronic exchange of information-and presents a practical example of using database searches.

Thesis (PhD)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: It is more than 18 years since South Africa became a democratic country. However, many South Africans are still discriminated against when accessing state services, such as healthcare services (Drennan, 1999). The problem is that healthcare practitioners, in the higher positions of the healthcare system, are commonly made up of professionals who speak only one or at most two of South Africa’s official languages (Swartz, 1998). Due to the lack of funding ad hoc arrangements are made for interpreter-services (Drennan, 1999). Anyone available that can speak even a fragment of the patient’s language, such as nurses, household aides and security guards are called to act as interpreters (Drennan, 1999; Smith, 2011). In many clinical settings, although not ideal, it is possible to treat patients even if there are minimal shared communicative resources (Anthonissen & Meyer, 2008). However, in psychiatric care, language is the primary diagnostic tool, and is one of the central instruments through which patients voice their symptoms (Westermeyer & Janca, 1997). In the Western Cape (one of the nine provinces in South Africa), clinicians working in psychiatric care are mainly fluent in English and Afrikaans. Many Black isiXhosa-speaking patients are not proficient in these languages. The aim of this dissertation is to gain a better understanding of the language barriers facing isiXhosa-speaking patients by focusing on natural conversations, which take place during psychiatric interviews within a particular psychiatric institution in the Western Cape. I made video-recordings of interpreter-mediated psychiatric interviews (n=13) as well as psychiatric interviews (n=12) conducted without the use of an interpreter. In addition, I had discussions (i.e. through semi-structured interviews) with registrars, interpreters and patients to understand their views about issues related to language barriers and interpreting practices. I used an ethnographic approach and the method of Conversation Analysis to understand the study findings. The findings, derived from the psychiatric interviews that were not interpreter-mediated, suggest that the Limited English Proficient (LEP) patients had great difficulty communicating with the registrars. The findings (emerging from the interpreter-mediated encounters and semi-structured interviews), strongly suggest that the haphazard use of hospital employees, who are not trained and employed to act as interpreters, have a significant impact on the goals of the psychiatric interview. In some instances, the use of ad hoc interpreters positively contributed to the successful achievement of the goals of the psychiatric interview. In most instances, the use of ad hoc interpreters inhibited the successful achievement of the goals of the psychiatric interview. One of the most significant findings was that interpreters’ interpretations of patients’ words at times suggest that patients appear to be more psychiatrically ill (increasing the risk for over-diagnosis) than it appears when looking at patients’ original responses. In essence, the lack of language services is unjust towards patients, clinicians, hospital staff acting as ad hoc interpreters, and LEP patients caught in a system, which construct them as voiceless, dependent, powerless, healthcare users.
AFRIKAANSE OPSOMMING: Suid-Afrika is vir die afgelope 18 jaar `n demokratiese land, maar ongeag die afskaffing van apartheid word daar steeds teen baie Suid-Afrikaners gediskrimineer. Dit is veral die geval wanneer Suid-Afrikaners gebruik maak van gesondheidsdienste (Drennan, 1999). Baie gesondheidspraktisyne of dokters is alleenlik vaardig in een of op die meeste twee offisiële Suid-Afrikaanse tale (Swartz, 1998). Ongelukkig weens `n gebrek aan fondse, is die meeste hospitale nie instaat om amptelike tolke in diens te neem nie. Gevolglik word ad hoc reëlings getref wanneer pasiënte tolkdienste benodig. Gewoonlik word enige iemand, insluitende verpleegsters, skoonmakers en sekuriteitswagte, wat selfs net tot `n sekere mate die pasiënt se taal kan praat, gebruik as tolke (Drennan, 1999; Smith, 2011). Die gebrek aan tolkdienste is veral problematies wanneer dit kom by psigiatriese dienste. Dit is omdat in psigiatrie word taal en kommunikasie as primêre diagnostiese instrument gebruik, en pasiënte gebruik hoofsaaklik taal om hul simptome en ervaringe met die dokter mee te deel (Westermeyer & Janca, 1997). In die Wes-Kaap (een van Suid-Afrika se nege provinsies) is die meeste dokters wat in psigiatriese instansies werk hoofsaaklik Engels en / of Afrikaans-sprekend. Baie Swart isiXhosa-sprekende pasiënte, wat gebruik maak van psigiatriese staatsdienste, is egter nie vlot in Afrikaans en Engels nie. Die doel van my proefskrif is om hierdie probleem, wat baie siXhosa-sprekende pasiënte in die gesig staar, beter te verstaan. Ek het besluit om dit te doen deur te fokus op `n spesifieke aspek – natuurlike gesprekke tussen dokters en isiXhosa-sprekende pasiënte. Dokters en pasiënte kommunikeer onder andere gedurende psigiatriese onderhoude, en ek het besluit om video opnames van psigiatriese onderhoude te maak. Ek het die video opnames in `n spesifieke hospitaal in die Wes-Kaap gemaak. Die video opnames het ingesluit psigiatriese onderhoude (n=12) waarin die dokter en pasiënt in Engels kommunikeer, sowel as onderhoude (n=13) waarin die dokter en pasiënt deur middel van (d.m.v) `n ad hoc tolk kommunikeer. Ek het ook gesprekke gevoer (deur middel van semi-gestruktureerde onderhoude) met pasiënte, dokters, en ad hoc tolke om hulle insigte en opinies rakende die bogenoemde taalkwessies beter te verstaan. Verder het ek `n ethnografiese benadering en gespreksanaliese gebruik om die data te benader en verstaan. Die bevindinge wat voortgevloei het uit die psigiatriese onderhoude (beide waarin daar nie `n tolk gebruik was nie, sowel as die waarin daar `n tolk gebruik was) suggereer dat die gebrek aan tolkdienste dikwels die doel van psigiatriese onderhoud ondermyn. Dit komvoor dat in die psigiatriese onderhoude, waarin daar nie tolk gebruik was nie, die pasiënte dit baie moeilik gevind het om met die dokters in Engels te kommunkeer. Dit is waarskynlik omdat hulle nie oor die nodige taalvaardighede beskik om hulleself ten volle in Engels uit te druk nie. Dit kom wel voor dat in sommige gevalle gedurende die psigiatriese onderhoude, waarin die dokters en pasiënte d.m.v.`n tolk gekommunikeer het, het die gebruik van `n tolk `n positiewe impak gehad. Die probleem is egter dat in baie gevalle het dit geblyk het die gebruik van tolke `n ongewenste impak gehad. Een van die belangrikste voorbeelde hiervan is dat die tolke se weergawes van die pasiënte se woorde, dit dikwels laat voorkom asof pasiënte nie juis veel insig in hulle psigiatriese versteurings gehad het nie. Wanneer daar egter gekyk word na die pasiënte se oorspronklike weergawes is dit duidelik dat sommige pasiënte wel insig gehad het. Die bevindinge suggereer hoofsaaklik dat die gebrek aan offisieel en opgeleide tolkdienste onregverdig is teenoor die pasiënte, ad hoc tolke, en die dokters. Dit dra ook by tot `n gesondsheids-sisteem waarin isiXhosa-sprekende pasiënt uitgebeeld word as afhanklik, tot `n groot mate magteloos en sonder `n sê.

There are few museums in the western half of the United States that provide an opportunity to educate the public about the history of mental health care. Recently, a mental health museum and archive of artifacts, photographs, and documents was established on the grounds of Patton State Hospital in Highland, California. The purpose of this paper is to reflect on the establishment of this museum and archive and to provide an account of the 125 year history of Patton State Hospital. Understanding the history of Patton provides an opportunity to understand the history of mental health care in the United States from the late 19th century to the present. The establishment of this museum and archive became a joint initiative between Patton and California State University, San Bernardino’s History Department in January 2014. The museum and archive are meant to provide an educational venue that will increase awareness of the plight of the mentally ill, decrease stigmatization of those afflicted with mental illness, and further efforts to improve the care of patients through preservation and display of the artifacts, photographs, and documents related to Patton’s history. The goal of this paper is to assist future public historians with the design and establishment of a museum and/or archive, be it related to mental health history or to projects with other themes, and to provide information to other mental health facilities that wish to establish their own museums.

The utilization of interpreters in medical interviews has increasingly become a focus of research, both globally and in South Africa. Effective communication lies at the core of the delivery of a patient-focussed approach to health care and this has been a factor in the drive to improve service delivery, especially from a communication perspective. A number of studies in health care have focussed on the medical interaction between health professionals and their patients. In this study, the aim was to describe and analyse interpreted diagnostic consultations, specifically focussing on the interactions between the health professional, trained interpreter and caregiver. The research was conducted at a tertiary level children's hospital in Cape Town. A qualitative research design was employed in this study. The participants were three health professionals [medical doctors], and a trained interpreter, all employed at a tertiary level children's hospital in the Western Cape, and three caregivers of the children attending the outpatients department. Video recordings of initial assessment consultations were made and thereafter each participant in the consultation, was interviewed. Detailed analysis of the consultations was done using the methods of conversational analysis. Thematic analysis of the post-consultation interviews was done and the findings triangulated with the themes emerging out of the conversational analysis. The findings resulting from the conversational analysis, suggest that interactions taking place in this study could be described as institutional interactions. This was suggested on the basis of the patterns of interactional behaviour, which emerged in the communications of the participants, the interactional strategies used and the interpreter models employed. The need for training for health professionals in interactional strategies also became apparent and highlighted aspects, which may be included in future training of health professionals, which may serve to advance the quality of communication in medical interactions.

This thesis sets out to investigate the field of public service interpreting in southern Spain, with a particular emphasis on the position of volunteer interpreters working at two different healthcare institutions. It looks at the power relationships that develop between agents that hold different degrees of control and autonomy, especially in a context where individuals hold different forms and volume of capital in each encounter. Drawing on Bourdieu’s Theory of Practice, the study offers an in-depth examination of a group of volunteer interpreters as legitimate agents of the wider field of public service interpreting and the sub-field of healthcare interpreting, while looking at their impact on the structures and ethics of the larger field. This is the first project to employ Bourdieu’s theory in a sustained case study of a healthcare context where volunteer interpreters operate as legitimised institutional agents. One of the peculiarities of the two settings under examination is that volunteer interpreters seem to have acquired a high degree of institutionalisation, which provides them with a large volume of symbolic capital and allows them to take part in the field as legitimate members of the healthcare team, often occupying similar positions to those adopted by doctors at the top end of the field hierarchy. The study adopts an ethnographic approach based on a triangulation of data: participant observation of volunteer interpreters, audio-recorded interpreter-mediated interaction and focus-group interviews with volunteer interpreters. The primary data that informs the thesis consists of four focus groups carried out with volunteer interpreters in two different Spanish hospitals. The additional use of participant observations and audio-recordings make it possible to examine not only interpreters’ perceptions but also actual behaviour in authentic encounters, and to compare interpreters’ perception of their positioning with the actual positions they often occupy in the field.

Background: Adolescents are more likely to be dissatisfied with perinatal care than adults. Adolescents’ perspectives of their perinatal care experiences have been explored; however, there are few studies exploring adolescent-friendly inpatient care from nurses’ perspectives. Purpose: To explore adolescent-friendly care from the perspective of hospital-based adolescent-friendly perinatal nurses. Research Questions: (1) How and why do perinatal nurses in inpatient settings adapt their practice when caring for adolescents? (2) What are the individual nursing behaviours and organizational characteristics of adolescent-friendly care in inpatient perinatal settings, from the perspective of perinatal nurses? Methods: I report the qualitative component of a mixed methods study. Open-ended interviews were conducted with twenty-seven purposively-sampled expert nurses. Data were analyzed using Interpretive Description. Findings: Nurses described being mother-friendly to adolescents by being nonjudgmental, forming connections, individualizing care, and employing behavioural strategies that facilitate relationship-building. Implications: These findings will inform the development of interventions to facilitate connections between nurses and adolescent mothers.

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an interpretive description approach was used to determine 52 physicians' utilization of food safety accompanied by Slotnick four-stage theory of physician’s learning as the study’s theoretical foundation. The study found that Harlem Hospital medicine and ICU physicians were more knowledgeable in FBI than other hospital physicians, and even though physicians’ definitions of FBI were different, all physicians' answers corresponded with the behaviors of clean, separate cook and chill. The research concludes Harlem Hospital physicians know how to diagnose and treat patients with FBI, and physicians acquired their knowledge of food safety through multiple resources. The study also found the physicians do not always include food safety in comprehensive patient care. However, all physicians agreed patients should be educated in food safety to prevent its reoccurrence. When physicians provide education at the bedside, this may help increase patient awareness in food safety, reducing hospital readmission rates, leading to a positive social change.

This chapter is aimed at junior hospital pharmacists and steps outside the normal format of complementing the British National Formulary. It introduces a number of interesting clinical topics that will be introduced as the pharmacist’s training progresses. Subject topics include therapy-related topics encountered in intensive care units, supporting patients with alcohol dependence, interpreting blood gases, and other interesting specialist topics.

This article discusses the printed works produced by Samuel Pepys during his lifetime, along with significant references to him in print by his contemporaries. Pepys’s own print contributions ranged from news reports on Charles II’s Restoration to self-vindicating naval Memoires (1690). Having been the subject of a libel during the Popish Plot in 1679, Pepys was himself criticized for authoring libels as a result of his pamphlet campaign to reform Christ’s Hospital (1698–1699). Pepys’s strategic uses of publication media mean that following his career is a way to investigate the boundaries between print and manuscript publication in the late seventeenth century and examine the association of these media with concepts of private and public. Pepys’s uses of print also provide an important context for interpreting his intentions concerning the preservation and circulation of his diary of the 1660s, which was to remain unprinted until the nineteenth century.

A leader in community interpreting, Australia provides professional interpreting services within its public health system. Healthcare interpreters face various challenges for a variety of reasons, including cultural differences. Existing research on healthcare interpreting focuses on differences between a mainstream culture of healthcare professionals and ethnically diverse cultures of migrant patients. Interpreters are widely regarded as bicultural professionals able to provide cultural information on behalf of patients as necessary or whenever healthcare professionals ask for it. However, research on healthcare interpreting in a globalized era should consider the changing nature of culture. The question of whether the interpreter should be a cultural broker remains controversial. Based on an ethnographic study of healthcare interpreters at a public hospital in Australia, this chapter aims to survey how multiple perspectives on cultural evolution affect healthcare interpreting.

Sentient computing can provide ambient intelligence environments with devices capable of inferring and interpreting context, while ambient displays allow for natural and subtle interactions with such environment. In this paper we propose to combine sentient devices and ambient displays to augment everyday objects. These sentient displays are aware of their surroundings while providing continuous information in a peripheral, subtle, and expressive manner. To seamlessly convey information to multiple sentient displays in the environment, we also propose an approach based on abstract interfaces which use contextual information to decide which display to use and how the information in the display changes in response to the environment. Our approach is illustrated through a hospital monitoring application. We present the design of two sentient displays that provide awareness of patient’s urine outputs to hospital workers, and how contextual information is used to integrate the functionality of both displays.

An important part of nursing decision-making, in both hospital and community settings, is interpreting the results of physiological measurements. These may be used to assist in making a diagnosis, monitoring the effects of treatments, or assessing changes to a person’s health condition. Physiological values are always interpreted within the context of what is known about the person and their health state, and can guide nursing practices and interventions. This chapter describes widely used physiological measurements, together with reference range values which may be useful to the general nurse.

While regulatory, management, and statistics concepts are commonly considered pertinent primarily for examinations, the mastery of this skillset allows for effective leadership in an intensive care unit. In the modern multidisciplinary model of critical care, an intensivist needs to be comfortable interpreting quality metrics as well as medical literature. Additionally, an understanding of the regulatory role of government and how such policies affect the care of patients is directly pertinent to interactions with hospital administrators and peers of other specialties. This chapter provides a general overview of these concepts for the examination, but the reader is encouraged to read more into the background of these topics in order to gain a practical mastery of these concepts for practice.

This chapter seeks a deeper understanding of stakeholder dynamics as a critical social component influencing IT strategy alignment. Perez-Batres et al. (2012) recognized the paucity of research on alignment dynamics, mainly stakeholder dynamics. Stakeholder theory, primarily Mitchell et al. (1997) identification model, is used to determine stakeholders' saliency throughout an ICT strategic project in a Saudi public hospital. However, stakeholder theory is static and does not help in tracing how saliency is gained and lost through time, and hence interpreting the influence on the alignment process. Therefore, this research utilizes the appreciative systems concepts of Geoffrey Vickers as dynamizing instrument to understand saliency dynamics and their influence. Results show that stakeholder dynamics resides in the nature of the relationship they pursue with each other.