1887
Volume 19, Issue 2
  • ISSN 1384-6647
  • E-ISSN: 1569-982X
USD
Buy:$35.00 + Taxes

Abstract

This study of social representations about interpreted medical consultations examines the discourse of French language focus groups (FGs), conducted in Quebec, with 22 third year medical students (4 FGs), 29 family medicine residents (4 FGs) and 47 experienced family physicians (5 FGs). The audio-recorded FGs were transcribed. Each discussed two video vignettes of interpreted consultations. Statistical textual analysis showed that the students’ discourse patterns differed by FG. Residents prioritized access to the patient’s culture via the interpreter, though recognizing the need to respect the patient-physician relationship. Senior physicians organized their discourse differently for each vignette, associating it with a ‘standard’ response: for them, the two main issues were the quest for information, which we relate to the medical socialization process; and the interpreter’s stances, in terms of how s/he is perceived by physicians and the role(s) s/he is seen to play in the consultation. Physicians tend to represent the interpreter as a controllable ‘object’, not a full-fledged healthcare professional.

Loading

Article metrics loading...

/content/journals/10.1075/intp.19.2.04lea
2017-12-04
2019-10-20
Loading full text...

Full text loading...

References

  1. Angelelli, C. V.
    (2004) Medical interpreting and cross-cultural communication. Cambridge: Cambridge University Press. doi: 10.1017/CBO9780511486616
    https://doi.org/10.1017/CBO9780511486616 [Google Scholar]
  2. Bauer, A. M. & Alegria, M.
    (2010) Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: A systematic review. Psychiatric Services61 (8), 765–773. doi: 10.1176/ps.2010.61.8.765
    https://doi.org/10.1176/ps.2010.61.8.765 [Google Scholar]
  3. Beagan, B. L.
    (2000) Neutralizing differences: Producing neutral doctors for (almost) neutral patients. Social Science & Medicine51 (8), 1253–1265. doi: 10.1016/S0277‑9536(00)00043‑5
    https://doi.org/10.1016/S0277-9536(00)00043-5 [Google Scholar]
  4. Beagan, B. L. & Kumas-Tan, Z.
    (2009) Approaches to diversity in family medicine: “I have always tried to be colour blind”. Canadian Family Physician55 (8), e21–e28.
    [Google Scholar]
  5. Beaud, J.-P.
    (2009) L'échantillonnage. In B. Gauthier (Ed.), Recherche sociale. De la problématique à la collecte des données. Québec: Presses de l'Université du Québec, 251–283.
    [Google Scholar]
  6. Betancourt, J. R. , Green, A. R. , Carrillo, J. E. & Ananeh-Firempong, O.
    (2003) Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports118 (4), 293–302. doi: 10.1016/S0033‑3549(04)50253‑4
    https://doi.org/10.1016/S0033-3549(04)50253-4 [Google Scholar]
  7. Bezuidenhout, L. & Borry, P.
    (2009) Examining the role of informal interpretation in medical interviews. Journal of Medical Ethics35 (3), 159–162. doi: 10.1136/jme.2008.026286
    https://doi.org/10.1136/jme.2008.026286 [Google Scholar]
  8. Bjorn, G. J.
    (2005) Ethics and interpreting in psychotherapy with refugee children and families. Nordic Journal of Psychiatry59 (6), 516–521. doi: 10.1080/08039480500360740
    https://doi.org/10.1080/08039480500360740 [Google Scholar]
  9. Bot, H.
    (2003) The myth of the uninvolved interpreter interpreting in mental health and the development of a three-person psychology. In L. Brunette , G. Bastin , I. Hemlin & H. Clarke (Eds.), The Critical Link 3. Amsterdam: John Benjamins, 27–35. doi: 10.1075/btl.46.07bot
    https://doi.org/10.1075/btl.46.07bot [Google Scholar]
  10. Brady, D. W. , Corbie-Smith, G. & Branch, W. T.
    (2002) What's important to you?: The use of narratives to promote self-reflection and to understand the experiences of medical residents. Annals of Internal Medicine137 (3), 220–223. doi: 10.7326/0003‑4819‑137‑3‑200208060‑00025
    https://doi.org/10.7326/0003-4819-137-3-200208060-00025 [Google Scholar]
  11. Brisset, C. , Leanza, Y. & Laforest, K.
    (2013) Working with interpreters in health care. A systematic review and a meta-ethnography of qualitative studies. Patient Education and Counseling91, 131–140. doi: 10.1016/j.pec.2012.11.008
    https://doi.org/10.1016/j.pec.2012.11.008 [Google Scholar]
  12. Brisset, C. , Leanza, Y. , Rosenberg, E. , Vissandjée, B. , Kirmayer, L. , Muckle, G. , Xenocostas, S. & Laforce, H.
    (2014) Language barriers in mental health care: A survey of primary care practitioners. Journal of Immigrant and Minority Health16, 1238–1246. doi: 10.1007/s10903‑013‑9971‑9
    https://doi.org/10.1007/s10903-013-9971-9 [Google Scholar]
  13. Burbano O'Leary, S. C. , Federico, S. & Hampers, L. C.
    (2003) The truth about language barriers: one residency program's experience. Pediatrics111 (5 Pt 1), e569–e573. doi: 10.1542/peds.111.5.e569
    https://doi.org/10.1542/peds.111.5.e569 [Google Scholar]
  14. Caillaud, S. & Kalampalikis, N.
    (2013) Focus groups and ecological practices: A psychosocial approach. Qualitative Research in Psychology10 (4), 382–401. doi: 10.1080/14780887.2012.674176
    https://doi.org/10.1080/14780887.2012.674176 [Google Scholar]
  15. Chapman, E. , Kaatz, A. & Carnes, M.
    (2013) Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities. Journal of General and Internal Medicine28 (11), 1504–1510. doi: 10.1007/s11606‑013‑2441‑1
    https://doi.org/10.1007/s11606-013-2441-1 [Google Scholar]
  16. Cole, M.
    (1996) Cultural psychology: A once and future discipline. Cambridge, MA: Belknap Press of Harvard University Press.
    [Google Scholar]
  17. Cox, A.
    (2015) Do you get the message? Defining the interpreter’s role in medical interpreting in Belgium. Monographs in Translation and Interpreting, Special Issue2, 161–184.
    [Google Scholar]
  18. Drennan, G.
    (1999) Psychiatry, post-Apartheid integration and the neglected role of language in South African institutional contexts. Transcultural Psychiatry36 (1), 5–22. doi: 10.1177/136346159903600101
    https://doi.org/10.1177/136346159903600101 [Google Scholar]
  19. Greenhalgh, T. , Robb, N. & Scambler, G.
    (2006) Communicative and strategic action in interpreted consultations in primary health care: A Habermasian perspective. Social Science and Medicine63 (5), 1170–1187. doi: 10.1016/j.socscimed.2006.03.033
    https://doi.org/10.1016/j.socscimed.2006.03.033 [Google Scholar]
  20. Grize, J.-B.
    (1993) Logique naturelle et représentations sociales. Papers on Social Representations2, 151–159.
    [Google Scholar]
  21. Hadziabdic, E. , Heikkila, K. , Albin, B. & Hjelm, K.
    (2009) Migrants' perceptions of using interpreters in health care. International Nursing Review56 (4), 461–469. doi: 10.1111/j.1466‑7657.2009.00738.x
    https://doi.org/10.1111/j.1466-7657.2009.00738.x [Google Scholar]
  22. Hatton, D. C. & Webb, T.
    (1993) Information transmission in bilingual, bicultural contexts: a field study of community health nurses and interpreters. Journal of Community Health Nursing10 (3), 137–147. doi: 10.1207/s15327655jchn1003_2
    https://doi.org/10.1207/s15327655jchn1003_2 [Google Scholar]
  23. Hilfinger Messias, D. K. , McDowell, L. & Estrada, R. D.
    (2009) Language interpreting as social justice work: Perspectives of formal and informal healthcare interpreters. Advances in Nursing Science32 (2), 128–143. doi: 10.1097/ANS.0b013e3181a3af97
    https://doi.org/10.1097/ANS.0b013e3181a3af97 [Google Scholar]
  24. Hsieh, E.
    (2006) Conflicts in how interpreters manage their roles in provider-patient interactions. Social Science and Medicine62, 721–730. doi: 10.1016/j.socscimed.2005.06.029
    https://doi.org/10.1016/j.socscimed.2005.06.029 [Google Scholar]
  25. (2007) Interpreters as co-diagnosticians: overlapping roles and services between providers and interpreters. Social Science and Medicine64, 924–937. doi: 10.1016/j.socscimed.2006.10.015
    https://doi.org/10.1016/j.socscimed.2006.10.015 [Google Scholar]
  26. (2008) "I am not a robot!" Interpreters' views of their roles in health care settings. Qualitative Health Research18, 1367–1383. doi: 10.1177/1049732308323840
    https://doi.org/10.1177/1049732308323840 [Google Scholar]
  27. (2010) Provider-interpreter collaboration in bilingual health care: Competitions of control over interpreter-mediated interactions. Patient Education and Counseling78, 154–159. doi: 10.1016/j.pec.2009.02.017
    https://doi.org/10.1016/j.pec.2009.02.017 [Google Scholar]
  28. Hsieh, E. & Kramer, E.
    (2012) Medical interpreters as tools: Dangers and challenges in the utilitarian approach to interpreters’ roles and functions. Patient Education and Counseling89, 158–162. doi: 10.1016/j.pec.2012.07.001
    https://doi.org/10.1016/j.pec.2012.07.001 [Google Scholar]
  29. Hsieh, E. & Terui, S.
    (2015) Inherent tensions and challenges of oncologist–patient communication: Implications for interpreter training in health-care settings. Journal of Applied Communication Research43 (2), 141–162. doi: 10.1080/00909882.2015.1019542
    https://doi.org/10.1080/00909882.2015.1019542 [Google Scholar]
  30. Hudon, R.
    (2009) Le pouvoir médical au Québec. Tensions autour du statut professionnel des médecins. Recherches sociographiques50 (2), 245–253. doi: 10.7202/037956ar
    https://doi.org/10.7202/037956ar [Google Scholar]
  31. Hudon, R. , Martin, É. & Perreault, M.
    (2009) Le pouvoir médical et le défi de la collaboration interprofessionnelle. Trois cas de figure. Recherches sociographiques50 (2), 321–344. doi: 10.7202/038042ar
    https://doi.org/10.7202/038042ar [Google Scholar]
  32. Hudon, R. , Mathieu, R. & Martin, É.
    (2009) Pouvoir médical et interventions législatives au Québec, 2001–2008. Recherches sociographiques50 (2), 255–281. doi: 10.7202/037957ar
    https://doi.org/10.7202/037957ar [Google Scholar]
  33. Immigration et Communautés culturelles Québec
    (2011) Portraits régionaux 2000–2009: Caractéristiques des immigrants établis au Québec et dans les régions en 2011.Québec: Gouvernement du Québec.
    [Google Scholar]
  34. Jefferson, G.
    (1984) Transcription Notation. In J. Atkinson & J. Heritage (Eds.), Structures of social action: Studies in conversation analysis. Cambridge/New York/Paris: Cambridge University Press; Editions de la Maison des Sciences de l’homme, 346–369.
    [Google Scholar]
  35. Jodelet, D.
    (1991) Les représentations sociales (2nd ed.). Paris: Presse Universitaires de France.
    [Google Scholar]
  36. Kai, J. , Bridgewater, R. & Spencer, J.
    (2001) "'Just think of TB and Asians', that's all I ever hear": medical learners' views about training to work in an ethnically diverse society. Medical Education35 (3), 250–256. doi: 10.1046/j.1365‑2923.2001.00871.x
    https://doi.org/10.1046/j.1365-2923.2001.00871.x [Google Scholar]
  37. Kalet, A. L. , Mukherjee, D. , Felix, K. , Steinberg, S. E. , Nachbar, M. , Lee, A. , Changrani, J. & Gany, F.
    (2005) Can a web-based curriculum improve students' knowledge of, and attitudes about, the interpreted medical interview?Journal of General Internal Medicine20 (10), 929–934. doi: 10.1111/j.1525‑1497.2005.0193.x
    https://doi.org/10.1111/j.1525-1497.2005.0193.x [Google Scholar]
  38. Karliner, L. S. , Jacobs, E. A. , Chen, A. H. & Mutha, S.
    (2007) Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Service Research42 (2), 727–754. doi: 10.1111/j.1475‑6773.2006.00629.x
    https://doi.org/10.1111/j.1475-6773.2006.00629.x [Google Scholar]
  39. Kaufert, J. M. & Koolage, W. W.
    (1984) Role conflict among 'culture brokers': The experience of native Canadian medical interpreters. Social Science and Medicine18 (3), 283–286. doi: 10.1016/0277‑9536(84)90092‑3
    https://doi.org/10.1016/0277-9536(84)90092-3 [Google Scholar]
  40. Lafon, P.
    (1980) Sur la variabilité de la fréquence des formes dans un corpus. Mots1 (1), 127–165. doi: 10.3406/mots.1980.1008
    https://doi.org/10.3406/mots.1980.1008 [Google Scholar]
  41. Leanza, Y.
    (2005) Roles of community interpreters in pediatrics as seen by interpreters, physicians and researchers. Interpreting7 (2), 167–192. doi: 10.1075/intp.7.2.03lea
    https://doi.org/10.1075/intp.7.2.03lea [Google Scholar]
  42. (2008) Community interpreter's power. The hazards of a disturbing attribute. Curare31 (2+3), 211–220.
    [Google Scholar]
  43. (2011) Exercer la pédiatrie en contexte multiculturel: Une approche complémentariste du rapport institutionnalisé à l’Autre. Genève: Georg Éditeur.
    [Google Scholar]
  44. Leanza, Y. , Boivin, I. , Moro, M. R. , Rousseau, C. , Brisset, C. , Rosenberg, E. & Hassan, G.
    (2015) Integration of interpreters in mental health interventions with children and adolescents: The need for a framework. Transcultural Psychiatry52 (3), 353–375. doi: 10.1177/1363461514558137
    https://doi.org/10.1177/1363461514558137 [Google Scholar]
  45. Leanza, Y. , Boivin, I. & Rosenberg, E.
    (2010) Interruptions and resistance: A comparison of medical consultations with family and trained interpreters. Social Science and Medicine70 (12), 1888–1895. doi: 10.1016/j.socscimed.2010.02.036
    https://doi.org/10.1016/j.socscimed.2010.02.036 [Google Scholar]
  46. (2013) Patients' Lifeworld: Building meaningful clinical encounters between patients, physicians and interpreters. Communication and Medicine10 (1), 81–93.
    [Google Scholar]
  47. Leanza, Y. , Rizkallah, É. & Michaud Labonté, T.
    (2014) Intégrer un interprète dans les consultations de médecine familiale : une analyse de discours assistée par ordinateur. Monografías de Çédille, 4, 9–30.
    [Google Scholar]
  48. Lebart, L.
    (1989) Stratégies du traitement des données d'enquètes. La revue de Modulad3, 21–29.
    [Google Scholar]
  49. Lebart, L. , Salem, A. & Berry, L.
    (1998) Exploring textual data. Dordrecht ; Boston: Springer. doi: 10.1007/978‑94‑017‑1525‑6
    https://doi.org/10.1007/978-94-017-1525-6 [Google Scholar]
  50. Lie, D. , Bereknyei, S. , Kalet, A. & Braddock, C.
    , 3rd (2009) Learning outcomes of a web module for teaching interpreter interaction skills to pre-clerkship students. Family Medicine41 (4), 234–235.
    [Google Scholar]
  51. Lie, D. , Bereknyei, S. & Vega, C. P.
    (2010) Longitudinal development of medical students' communication skills in interpreted encounters. Education for Health23 (3), 466.
    [Google Scholar]
  52. Maingueneau, D. & Angermüller, J.
    (2007) Discourse analysis in France: A conversation. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research8 (2). Retrieved fromwww.qualitative-research.net/index.php/fqs/article/view/254
    [Google Scholar]
  53. Marcus, E. R.
    (2003) Medical student dreams about medical school: The unconscious developmental process of becoming a physician. International Journal of Psychoanalysis84 (Pt 2), 367–386. doi: 10.1516/PFUF‑D9NF‑NKHU‑9QTH
    https://doi.org/10.1516/PFUF-D9NF-NKHU-9QTH [Google Scholar]
  54. Martinez, W.
    (2003) Contribution à une méthodologie de l'analyse des cooccurrences lexicales multiples dans les corpus textuels.Paris: Paris III – Sorbonne nouvelle.
    [Google Scholar]
  55. McEvoy, M. , Santos, M. T. , Marzan, M. , Green, E. H. & Milan, F. B.
    (2009) Teaching medical students how to use interpreters: a three year experience. Medical Education Online14, 12. doi: 10.3402/meo.v14i.4507
    https://doi.org/10.3402/meo.v14i.4507 [Google Scholar]
  56. National Physician Survey
    (2010) 2010 National Physician Survey. RetrievedFebruary1st 2013, fromnationalphysiciansurvey.ca/surveys/2010-survey/
  57. Papic, O. , Malak, Z. & Rosenberg, E.
    (2012) Survey of family physicians' perspectives on management of immigrant patients: Attitudes, barriers, strategies, and training needs. Patient Education and Counselling86 (2), 205–209. doi: 10.1016/j.pec.2011.05.015
    https://doi.org/10.1016/j.pec.2011.05.015 [Google Scholar]
  58. Pöchhacker, F.
    (1999) "Getting organized": The evolution of community interpreting. Interpreting4 (1), 125–140. doi: 10.1075/intp.4.2.06poc
    https://doi.org/10.1075/intp.4.2.06poc [Google Scholar]
  59. (2008) Interpreting as mediation. In C. Valero Garcés & A. Martin (Eds.), Crossing borders in community interpreting: Definitions and dilemmas. Amsterdam: John Benjamins, 9–26. doi: 10.1075/btl.76.02poc
    https://doi.org/10.1075/btl.76.02poc [Google Scholar]
  60. Pottie, K. , Ng, E. , Spitzer, D. , Mohammed, A. & Glazier, R.
    (2008) Language proficiency, gender and self-reported health: An analysis of the first two waves of the longitudinal survey of immigrants to Canada. Canadian Journal of Public Health99 (6), 505–510.
    [Google Scholar]
  61. Rastier, F.
    (2001) Arts et sciences du texte. Paris: Presses universitaires de France.
    [Google Scholar]
  62. Ratinaud, P. & Marchand, P.
    (2015) Des mondes lexicaux aux représentations sociales. Une première approche des thématiques dans les débats à l’assemblée nationale (1998-2014). Mots2, 57–77. doi: 10.4000/mots.22006
    https://doi.org/10.4000/mots.22006 [Google Scholar]
  63. Reinert, M.
    (1993) Les ‘mondes lexicaux’ et leur ‘logique' à travers l’analyse statistique d'un corpus de récits de cauchemars. Langage et société66 (1), 5–39. doi: 10.3406/lsoc.1993.2632
    https://doi.org/10.3406/lsoc.1993.2632 [Google Scholar]
  64. Rosenberg, E. , Leanza, Y. & Seller, R.
    (2007) Doctor-patient communication in primary care with an interpreter: Physician perceptions of professional and family interpreters. Patient Education and Counseling67 (3), 286–292. doi: 10.1016/j.pec.2007.03.011
    https://doi.org/10.1016/j.pec.2007.03.011 [Google Scholar]
  65. Rouanet, H. , Bernard, J.-M. & Lecoutre, B.
    (1986) Nonprobabilistic statistical inference: A set-theoretic approach. The American Statistician40 (1), 60–65.
    [Google Scholar]
  66. Rouanet, H. & Bert, M.-C.
    (1998) Introduction to combinatorial inference. In H. Rouanet , J.-M. Bernard , M.-C. Bert , B. Lecoutre , M.-P. Lecoutre & B. Le Roux (Eds.), New ways in statistical methodology: From significance tests to Bayesian inference. Bern; New York: Peter Lang, 97–122.
    [Google Scholar]
  67. Ryan, G. & Bernard, R.
    (2000) Data management and analysis methods. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (2nd ed.). Thousand Oaks: Sage, 769–802.
    [Google Scholar]
  68. Ministère de la Santé et des Services sociaux du Québec
    (2011) Info-Méd. Bulletin d'information concernant la répartition des médecins selon le sexe et l'âge, au Québec. Québec: Ministère de la Santé et des Services sociaux.
    [Google Scholar]
  69. Sleed, M. , Durrheim, K. , Kriel, A. , Solomon, V. & Baxter, V.
    (2002) The effectiveness of the vignette methodology: A comparison of written and video vignettes in eliciting responses about date rape. South African Journal of Psychology32 (3), 21–28. doi: 10.1177/008124630203200304
    https://doi.org/10.1177/008124630203200304 [Google Scholar]
  70. Street, R. L.
    (2002) Gender differences in health care provider-patient communication: Are they due to style, stereotypes, or accommodation?Patient Education and Counseling48 (3), 201–206. doi: 10.1016/S0738‑3991(02)00171‑4
    https://doi.org/10.1016/S0738-3991(02)00171-4 [Google Scholar]
  71. Sullivan, M.
    (2003) The new subjective medicine: Taking the patient's point of view on health care and health. Social Science and Medicine56 (7), 1595–1604. doi: 10.1016/S0277‑9536(02)00159‑4
    https://doi.org/10.1016/S0277-9536(02)00159-4 [Google Scholar]
  72. ten Have, P.
    (2001) Sequential structure and categorical implications in doctor-patient interaction: Ethnomethodology and history. Paper presented at theStructure and emergence of professionalized "Praxis". Retrieved fromwww2.fmg.uva.nl/emca/paul.htm.
    [Google Scholar]
  73. Verrept, H.
    (2008) Intercultural mediation – an answer to health disparities?In C. Valero Garcés & A. Martin (Eds.), Crossing borders in community interpreting: Definitions and dilemmas. Amsterdam: John Benjamins, 187–201. doi: 10.1075/btl.76.10ver
    https://doi.org/10.1075/btl.76.10ver [Google Scholar]
  74. Wagner, W. , Duveen, G. , Farr, R. , Jovchelovitch, S. , Lorenzi-Cioldi, F. & Marková, I.
    (1999) Theory and method of social representations. Asian Journal of Social Psychology2, 95–125. doi: 10.1111/1467‑839X.00028
    https://doi.org/10.1111/1467-839X.00028 [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.1075/intp.19.2.04lea
Loading
/content/journals/10.1075/intp.19.2.04lea
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was successful
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error