Dissertationen zum Thema „Hospital interpreting“

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.

A Contextualist Approach to Telehealth Innovations By Sunyoung Cho Abstract Healthcare is considered one of the most important social issues in the U.S. as well as in other societies with ever-increasing costs of medical service provision. The information-intensive nature of the healthcare industry and the perception of information technology (IT) as a way to ease up healthcare costs and improve quality have lead to increased use of and experiments with IT-based innovations. These activities present interesting research opportunities for IS researchers and they have led to an increasing body of knowledge on healthcare information systems. This research aims at contributing to this line of research by adopting a contextualist approach to examine the adoption, use, and further diffusion of telehealth innovations. A contextualist approach provides a particularly interesting and relevant perspective to study adoption and diffusion processes of healthcare innovations. The adopted contextualist approach is process-oriented, it applies multiple levels of analysis, and it accommodates different theoretical lenses to make sense of the two telehealth innovations under investigation. A key assumption is that innovations should be understood as ongoing processes of change, not just technologies, or isolated change events with clear boundaries. Healthcare innovations have in this view much broader connotations, including development of IT-based applications, their adoption and diffusion over time, and the interactions between many stakeholders and organizations that shape the innovation in a specific context. The contextualist approach suggested by Pettigrew is adopted as an overarching framework for multiple studies based on empirical investigation of two telehealth innovations; the main focus is on a telestroke innovation in the U.S. while a radiology innovation in Sweden serves as a complementary case. Each study is documented as an independent research publication with its own theoretical perspective and contributions. The overall contextualist approach and the related findings are then summarized across the individual studies. Telehealth innovations are particularly interesting examples of healthcare information systems. They leverage contemporary network infrastructures and interaction devices to allow provision of healthcare services, clinical information, and education over distance, thereby reducing the costs and improving the availability of medical services. The two telehealth innovations are investigated through in-depth case studies. This theses summary presents the theoretical background for the studies; it motivates and details how the qualitative case studies based on critical realist assumptions were designed and conducted; it outlines the resulting research publications; and it discusses the contributions of investigating telehealth innovations from a contextualist approach.

Mental health care in South Africa has long been governed by inequalities (Foster & Swartz, 1997). During apartheid, those who did not speak English and Afrikaans could not access mental health services in the same way as those who did (Foster & Swartz, 1997). One main reason for this is the majority of mental health practitioners could not, and were not required to speak languages other than English and Afrikaans (Swartz, 1991). The South African mental health literature suggests that language and communication must be prioritised if there is to be an improvement in mental health care services for those individuals who do not speak English and Afrikaans (Bantjes, 1999; Drennan & Swartz, 1999; Swartz & Drennan, 2000; Swartz & MacGregor, 2002). Drawing on Prasad's (2002) interpretation of Gadamer's critical hermeneutic theory and utilising thematic networks analysis (Attride-Stirling, 2001), this study investigated the process of translated clinical assessment interviews within a psychiatric hospital in the Eastern Cape Province within South Africa. Results of the study revealed that contextual factors, issues concerning linguistic and cultural heritage, clinicians' role expectations regarding translators' role performance, as well as relational dynamics regarding individual levels of control and influence within the translation triad, all impacted on the effectiveness of communication, translation and service provision. These fmdings are supported by literature on the theory and practice of translation that identifies these issues as prominent (Robinson, 2003). Specific recommendations regarding the formalisation of translation practices within the hospital setting, as well as the familiari~ation of clinical practitioners and psychiatric nurses with the intricacies of translation processes are offered.

Viele der Geflüchteten und Asylsuchenden in Deutschland sprechen nur wenig oder kein Deutsch. Hinreichende Gesundheitsversorgung ist daher oft nur mithilfe von Sprachmittlung möglich. Die vorliegende Arbeit untersucht, wie ein Sprachmittlungsdienst im Gesundheitsbereich in Berlin aussehen kann und soll, damit die Regelversorgung für nicht deutschsprachige Menschen gewährleistet und Integration gefördert wird. Im theoretischen Teil wird der Forschungsstand zum Thema Sprachmittlung im Gesundheitsbereich sowie die aktuelle Situation in Deutschland und insbesondere in Berlin dargestellt. Im empirischen Teil werden die Bedarfe, der Status quo und bisherige Erfahrungen anhand des Sprachmittlungsangebotes durch SprInt Berlin, einer schriftlichen Umfrage unter Fachkräften (n = 66), welche mit Sprachmittler*innen arbeiten, sowie Interviews mit Sprachmittler*innen (n = 11) ermittelt. Die Ergebnisse zeigen den Bedarf an Sprachmittlung im Berliner Gesundheitsbereich. Um diesen zu decken, muss Sprachmittlung größtenteils aus öffentlichen Mitteln finanziert und transparent organisiert werden. Das Sprachangebot und die Anzahl der Sprachmittler*innen müssen vergrößert werden. Telefon- und Videodolmetschen sollte für einfach strukturierte Gespräche und Notfallsituationen vermehrt zum Einsatz kommen. Die Qualität muss durch einheitliche Qualifizierung und Weiterbildung der Sprachmittler*innen gewährleistet werden. Sprachliche, interkulturelle, berufsbezogene, translatorische und soziale Kompetenzen sind für die Sprachmittler*innen unerlässlich. Die Arbeit verdeutlicht, dass Gesundheit ein wichtiger Faktor für Integrationsprozesse ist und professionelle Sprachmittlung an der Entwicklung einer pluralistischen, gleichberechtigten Gesellschaft mitwirkt.:1 Einleitung 1 I. Theoretische Grundlagen: Sprachmittlung im Gesundheitsbereich 3 2 Forschungsstand: Dolmetschen im Gesundheitsbereich 3 2.1 Besonderheiten des Dolmetschens im Gesundheitsbereich 5 2.1.1 Wo und was wird gedolmetscht? Einsatzorte, Themengebiete und Gesprächstypen 5 2.1.2 Wie wird gedolmetscht? Kompetenzen für das Dolmetschen im Gesundheitsbereich 7 2.1.3 Die Rolle der Sprachmittler*innen 10 2.2 Wer dolmetscht? Nicht ausgebildete, geschulte und ausgebildete Sprachmittler*innen 13 2.2.1 Nicht ausgebildete Sprachmittler*innen 13 2.2.2 Geschultes medizinisches Personal und ausgebildete Sprachmittler*innen 16 2.3 Wege zum Beruf Sprachmittler*in 18 2.4 Telefonisches und videobasiertes Dolmetschen 21 2.5 Was dolmetscht? Alternativen zur Sprachmittlung durch eine Person 25 3 Sprachmittlung im Gesundheitsbereich in Deutschland 26 3.1 Menschen mit Migrationshintergrund in Deutschland 26 3.2 Migration und Gesundheit 28 3.2.1 Daten zum Gesundheitszustand von Menschen mit Migrationshintergrund 30 3.2.2 Daten zum Gesundheitsverhalten von Menschen mit Migrationshintergrund 31 3.2.3 Hintergründe und Einflussfaktoren 32 3.2.4 Migration, Gesundheit und Sprachmittlung 33 3.3 Das Recht auf Sprachmittlung 36 3.4 Finanzierung von Sprachmittlung 39 4 Sprachmittlung im Gesundheitsbereich in Berlin 42 4.1 Menschen mit Migrationshintergrund in Berlin 42 4.2 Gesundheitsversorgung in Berlin 44 4.3 Finanzierung von Sprachmittlung im Gesundheitsbereich in Berlin 45 4.4 Geschulte und ausgebildete Sprachmittler*innen in Berlin 46 5 Zwischenfazit: Warum sollten Sprachmittler*innen im Gesundheitsbereich eingesetzt werden? 49 II. Empirische Untersuchung: Sprachmittlung im Gesundheitsbereich am Beispiel SprInt Berlin 51 6 SprInt Berlin als Akteur für Sprachmittlung im Gesundheitsbereich 52 7 Quantitative Umfrage unter Fachkräften in der Gesundheitsversorgung 54 7.1 Methoden: Planung und Anwendung 54 7.2 Analyse und Auswertung 56 7.2.1 Rücklauf und Studienpopulation 56 7.2.2 Klient*innenfrequenz 58 7.2.3 Verständigung mit nicht deutschsprachigen Klient*innen 59 7.2.4 Termine mit Sprachmittlung 61 7.2.5 Wer benötigt Sprachmittlung? Personengruppen, Herkunftsländer und Sprachen 63 7.2.6 Bedeutung der gleichen Herkunft von Sprachmittler*in und Klient*in 65 7.2.7 Wer übernimmt die Sprachmittlung? 68 7.2.8 Erfahrungen mit Sprachmittler*innen 70 7.2.9 Was tun Sie, wenn kein*e Sprachmittler*in zur Verfügung steht? 74 7.2.10 Hinzuziehung von Sprachmittler*innen 76 7.2.11 Maßnahmen zur Verbesserung der Kommunikation mit nicht deutschsprachigen Klient*innen 76 7.2.12 Kompetenzen von Sprachmittler*innen 78 7.2.13 Kompetenzen der SprInt-Mittler*innen 79 7.2.14 Aufgaben der Sprachmittler*innen 80 7.2.15 Nutzen von Sprachmittlung 82 7.2.16 Telefonische Sprachmittlung 83 7.2.17 Videobasierte Sprachmittlung 86 7.2.18 Argumente für und gegen telefonische und videobasierte Sprachmittlung 87 7.2.19 Finanzierung von Sprachmittlung 88 7.2.20 Vermittlung der Einsätze und Verfügungszeiten 89 7.2.21 Weitere Serviceleistungen, Kritik und Verbesserungsvorschläge 90 7.3 Zusammenfassung und Beurteilung der Umfrageergebnisse 94 8 Leitfadengestützte Interviews mit SprInt-Mittler*innen 96 8.1 Methoden: Planung und Anwendung 96 8.2 Analyse und Auswertung 98 8.2.1 Studienpopulation 98 8.2.2 Einsätze: Anzahl, Einsatzorte und Themen 100 8.2.3 Klient*innen: Personengruppen und Herkunftsländer 102 8.2.4 Kompetenzen von Sprachmittler*innen 105 8.2.5 Aufgaben und Rolle von Sprachmittler*innen 110 8.2.6 Erfahrungen im Kontakt mit Fachkräften 112 8.2.7 Erfahrungen im Kontakt mit Klient*innen 113 8.2.8 Missverständnisse aufgrund kultureller Hintergründe 115 8.2.9 Psychische Belastung und Supervision zur Bewältigung 116 8.2.10 Telefonische und videobasierte Sprachmittlung 118 8.2.11 Die SprInt-Qualifizierung, Aufqualifizierung und Weiterbildungen 119 8.2.12 Der Weg zum Beruf Sprachmittler*in 121 8.2.13 Erfahrungen mit nicht ausgebildeten Sprachmittler*innen 123 8.2.14 Die Zusammenarbeit mit der Vermittlungszentrale 123 8.3 Zusammenfassung und Beurteilung der Auswertung der Interviews 124 9 Diskussion der Ergebnisse: Theoretische Grundlagen, Perspektive der Fachkräfte und der Sprachmittler*innen im Vergleich 127 10 Reflexion und Ausblick 133

South African public hospitals face communication barriers between medical staff (more specifically doctors) and patients as a result of cultural and linguistic diversity. Consequently, medical staff and patients experience frustrations, errors in diagnosis have been recorded and multiple tests need to be run to determine patients’ conditions, all these at the expense of patients. The services of ad hoc untrained interpreters such as relatives (including children), other medical staff (including fellow doctors, nurses, cleaners and porters), and other patients are used to bridge communication barriers, since there is no statutory interpreting service. However, the use of ad hoc untrained interpreters has been shown to lead to more complications, including breach of patient confidentiality, distortion and/or omission of information, and patients turning to sangomas (traditional witchdoctors), only to return to the hospital when their conditions have worsened. In the first part of this study, conducted at the Department of Radiation Oncology, Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, semi-structured interviews were conducted with patients and medical staff members in order to obtain a clear picture of their linguistic profiles. Thereafter, in order to determine whether ad hoc interpreters such as nurses interpret better than trained interpreters, the interpreting performance of a professionally trained interpreter is contrasted with that of an ad hoc nurse interpreter, both interpreting in an oncology setting; and a thorough analysis of both performances is provided through the use of Conversation Analysis (CA). The present research report is therefore a first attempt to determine possible solutions to miscommunication in the South African health care setting in general and an oncology setting in particular, from the perspective of Interpreting Studies.

碩士
國立臺灣大學
翻譯碩士學位學程
106
Globalization has greatly impacted Taiwan’s medical system with the increase in immigrants and medical tourists contributing to the rise in cross-language communication in hospitals. Without the establishment of proper measures to facilitate cross-language communication, language barriers can lead to inaccurate diagnosis and unsatisfactory medical experiences for both patients and physicians as shown by previous research. Being aware of the potential problems, Taiwan’s government and private organizations have taken measures to overcome the barriers. However, little research has been conducted to explore the current situation of cross-language communication, demand for professional interpreting services, and expectations of professional interpreting services in Taiwan’s hospitals. Without understanding these issues, it is difficult to create an interpreting system that suits the needs of Taiwan’s medical system. With this in mind, this research aims to explore the current situation in Taiwan’s hospitals and physicians’ demand for professional interpreting services by conducting in-depth interviews with 21 physicians working at medical centers in Northern Taiwan. The results show that physicians do not engage in cross-language communication very often. When they do, they communicate with patients or patients’ proxies in English or with the help of ad hoc interpreters. Physicians also apply various strategies, including gesturing and drawing. While some physicians regard professional interpreting service systems as nice to have, most physicians find the current situation acceptable and do not consider professional interpreting services in hospitals necessary. Overall, judging from the participants’ responses, the demand for professional interpreting services may be lower than expected in Taiwan’s hospitals.

The purpose of this study was to explore the knowledge and attitudes of hospital postpartum and public health nurses towards postpartum depression (PPD) using interpretive description. Postpartum depression is the leading complication after childbirth and impacts negatively on the health of the mother and her child. The nurses in this study participated in focus groups and/or participant observation. The five patterns that describe participants experiences related to PPD were: “Nurses understand PPD in different ways”, “Nurses recognize that women need support”, “Nurses reported that teaching about PPD makes a difference”, “Strong relationships with a primary care provider is essential in the post partum period”, and “a key role of the nurse is to listen”. The nurses in this study revealed a rich understanding of PPD leading to recommendations for practice by hospital and public health nurses related to PPD contributing to better care for women experiencing PPD.