Loss of patient centeredness in interpreter-mediated primary care visits.

To explore consequences of interpreter mediation of visit communication on patient centered dialogue and patient satisfaction with interpreter listening. Fifty-five professionally interpreted primary care visits were coded using the Roter Interaction Analysis System (RIAS). Two corresponding quantitative measures of patient-centered dialogue were calculated as ratios of psycho-emotional to biomedical statements based on (1) patient and clinician expressed codes and (2) interpreter conveyed codes. Multilevel models examined consequences of interpreter mediation on patient-centered dialogue and patient ratings of interpreter listening. Study participants included 27 Cantonese, 17 Mandarin and 11 Spanish-speaking primary care patients and 31 of their clinicians. Overall, clinicians expressed 2.26 times more statements and patients expressed 1.74 times more statements than interpreters conveyed. Interpreters conveyed significantly less patient-centered dialogue than expressed by patients and clinicians. All differences were evident within each study language. Interpreter conveyed patient centered dialogue positively predicted patient ratings of interpreter listening (B = 0.817; p < .007). The level of interpreter-conveyed patient-centered dialogue was both substantially lower than that expressed by patients and clinicians and a positive predictor of patient satisfaction with interpreter listening. Fuller interpretation of patient-centered dialogue may enhance patient experience with interpreters and thereby increase care quality.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest Debra Roter is the author and holds the copyright for the Roter Interaction Analysis System (RIAS). She is also the owner of RIAS Prime, LLC, a company that provides consulting services related to the RIAS and its applications. It is possible that the company may benefit indirectly from dissemination of the current research. The co-authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.