TY - ABST

T1 - Challenged understanding in consultations with language barriers

AU - Hansen, Cæcilie

AU - Davidsen, Annette Sofie

AU - Lindell, Johanna Falby

AU - Fosgerau, Christina Fogtmann

AU - Michaëlis, Camilla

AU - Krasnik, Allan

AU - Lutterodt, Melissa C.

PY - 2022

Y1 - 2022

N2 - BackgroundSince 2018, patients with who have lived in Denmark for more than three years and in need for interpreter assistance have had to pay for interpreter service when using health care. A decrease has been found in the use of interpreter services following the introduction of the user fee. This study investigates which strategies and resources the participants, GPs and patients, use to overcome language barriers in the consultations in the absence of a professional interpreter.MethodThe study is based on 11 video-recorded consultations without a professional interpreter present in general practice in two out of five regions in Denmark. Using conversation analysis, we investigated how GPs and patients worked to establish intersubjective understanding in consultations.ResultsThe study showed that the language barrier caused great challenges for establishing an understanding in these consultations. The GP had to prompt the patient in several ways to present their concern. When the patient did present their concern, the “problem presentations” resembled fragmented symptom descriptions, were long and repetitive while at the same time limited in the dimensions they included. Gesture was used by patients as a linguistic resource but could only signify vague bodily placements or bodily phenomena.Thus, both participants seemed to work hard to understand each other and express themselves, yet fell short of establishing sufficient mutual understanding about what the patient tried to present and what the GP tried to ask and inform about.ConclusionThe absence of a professional interpreter in consultations with language barriers affects the establishment of intersubjective understanding between GP and patient and how far the patient’s problem can be explored. This hampers the quality of treatment and the process of shared decision making with the patient and the patient-centredness of the consultation.

AB - BackgroundSince 2018, patients with who have lived in Denmark for more than three years and in need for interpreter assistance have had to pay for interpreter service when using health care. A decrease has been found in the use of interpreter services following the introduction of the user fee. This study investigates which strategies and resources the participants, GPs and patients, use to overcome language barriers in the consultations in the absence of a professional interpreter.MethodThe study is based on 11 video-recorded consultations without a professional interpreter present in general practice in two out of five regions in Denmark. Using conversation analysis, we investigated how GPs and patients worked to establish intersubjective understanding in consultations.ResultsThe study showed that the language barrier caused great challenges for establishing an understanding in these consultations. The GP had to prompt the patient in several ways to present their concern. When the patient did present their concern, the “problem presentations” resembled fragmented symptom descriptions, were long and repetitive while at the same time limited in the dimensions they included. Gesture was used by patients as a linguistic resource but could only signify vague bodily placements or bodily phenomena.Thus, both participants seemed to work hard to understand each other and express themselves, yet fell short of establishing sufficient mutual understanding about what the patient tried to present and what the GP tried to ask and inform about.ConclusionThe absence of a professional interpreter in consultations with language barriers affects the establishment of intersubjective understanding between GP and patient and how far the patient’s problem can be explored. This hampers the quality of treatment and the process of shared decision making with the patient and the patient-centredness of the consultation.

M3 - Conference abstract for conference

ER -