Nabi Fatahi Fil.Mag, Med Lic. Med.dr

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1 Nabi Fatahi Fil.Mag, Med Lic. Med.dr GOTHEBURG UNIVERSITY The Sahlgrenska Academy at Gothenburg University Department of Radiology and Department of Primary Health Care Gothenburg Sweden. Telefon e-post.

2 Experiences of communication with non-swedish speaking patients in radiological examinations as seen by radiographers NABI FATAHI 1,2, SOVEIG LUNDGREN 3 BENGT MATTSSON 2, MIKAEL HELLSTRÖM 1 1. Department of Radiology, Sahlgrenska University Hospital, The Sahlgrenska Academy at Gothenburg University, 2 Department of Primary Health Care, The Sahlgrenska Academy at Gothenburg University 3 Department of Caring Sciences, The Sahlgrenska Academy at Gothenburg University, Sweden

3 Aim The aim of this study was to explore radiographers experiences of examining patients who do not speak Swedish. Which are the obstacles and how could barriers be overcome?

4 Materials and Method Three focus group interviews with experienced radiographers were carried out. 11 radiographers, nine women and two men, participated in the group interviews. The interviews started with an open question: Could you comment on making radiological examinations on patients who do not understand Swedish? A content analysis was used for analysis and interpretation of the data. The interviews were complemented by a five-month period of registration of patient and interpreters backgrounds data at all departments of radiology at the Sahlgrenska University Hospital in Gothenburg.

5 Result The analysis of the interviews resulted in four main categories: Modes, needs, quality and improvements of interpreting

6 Categories, subcategories and theme Subcategories Categories Theme Professional interpreter Friend or relative as interpreter Modes of interpreting Personnel as interpreter Without interpreter Absolute necessary Fairly necessary Needs of interpreting The interpreting setting Not necessary - a variety of sceneries Interpreter s quality Time aspects Cultural aspects Quality of interpreting Specific interpreter training Scheduling of interpreter Improvement of interpreter Employment of interpreters Education of radiographers

7 Modes of interpreting Relative or friend as interpreter (adult) 43 (33%) Relative or friend as interpreter (child) 8 (6%) Professional interpreter 33 (25%) Bilingual staffs as interpreter 14 (11%) Contact without interpreter 33 (25%) Friends and relatives, especially children, as interpreters were not considered ideal. Using bilingual personnel as interpreter is a possibility, but often hampers workflow and is stressful for the staff Total interactions (n=131)

8 Needs of interpreting Absolute necessary Fairly necessary Not necessary The need for interpreter in radiological examinations is strongly associated with the type of the examination. For interventional procedures and examinations with contrast medium professional interpreter is warranted. Nabi Fatahi 2008

9 Quality of interpreting Interpreter s quality Time aspects Cultural aspects The encounter between personnel and patient in the radiology department is different from other clinical encounters. It may be very short, but nevertheless stressful for the patient, because of anxiety and fear for the examination itself and its result. At the same time the radiographer has to focus on the technical performance and quality of the examination. The quality of the communication is therefore very important, and poor language communication, shortage of time and more cultural diversity adds to these difficulties.

10 Improvement of interpreter Specific interpreter training Scheduling of interpreter Employment of interpreters Education of radiographers The participating radiographers suggested improved education of the interpreters, especially about cultural diversities, medical terminology and methodology in radiology. Early identification of the need of interpreter, preferably stated on the radiology request form, and sufficient on-site time for the interpreters for the radiological examinations was asked for. Employment by the health care system of professional interpreters in the most frequent foreign languages seems warranted. Finally, inter-cultural communication skills and foreign cultural issues should be emphasized in radiographers and other health care educational programmes

11 Conclusion The necessity for interpreter is strongly influenced by the type and complexity of the radiological examination. who acts as interpreter has a strong influence on the quality of communication. Professional interpreters are preferred before relatives or employees as interpreters. Time constraints and cultural diversities between interpreter and patients were important factors that hampered communication outcome. Specific interpreter education in medical terminology and radiology procedure performance was asked for, as well as the need for the interpreter to remain at the department throughout the whole radiological procedure. Permanent employment of professional interpreters, rather than part-time consulting interpreter service, was suggested as a way to improve the outcome of the communication. Nabi Fatahi 2008

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