Healthcare Professionals’ Perspectives

Abstract

This chapter introduces the narratives of eight healthcare professionals that detail their experiences with video remote interpreting (VRI) and in-person interpreting, as well as their experiences with treating deaf and hard of hearing patients and limited English proficiency patients. This chapter also explores their interpreting preferences for critical and non-critical care and their suggestions for improving VRI services and patient–provider communication. Similar to the deaf and hard of hearing patient perspective, healthcare professionals prefer in-person interpreters for critical care, but they do not have a strong interpreting preference for non-critical care. Furthermore, most healthcare professionals lack knowledge of Deaf culture, but recoginize the importance of establishing patient–provider communication.

To protect the anonymity of the healthcare professionals featured in this chapter, their names were coded with fictitious initials.

Appendix: Comparison Between Limited English Proficiency Patients and Deaf and Hard of Hearing Patients

Both limited English proficiency (LEP) and deaf and hard of hearing (D/HH) populations experience communication barriers due to a lack of qualified interpreters, providers’ limited knowledge of cultural competency and their legal obligations, and limited literacy skills (Brooks et al., 2016; Chen et al., 2007; Harmer, 1999; Meador & Zazove, 2005). Meanwhile, healthcare providers often depend on ad hoc interpreters for LEP patients and D/HH patients, including the parents or children of LEP patients and D/HH patients (Harmer, 1999).

Even when interpreting services are available, LEP patients may turn them down due to time constraints or mistrust. Additionally, LEP patients may feel frustration and embarrassment at their limited language skills and attempt to express themselves in imperfect English in order to avoid depending on others’ help. Sometimes, LEP patients may pretend that they understand the information (Brooks et al., 2016).

Meanwhile, D/HH patients experience similar frustration and pretend to understand the information given by providers. LEP and D/HH patients experience similar barriers to healthcare access, although LEP patients are better able to access healthcare communication with their family members in their native languages compared to D/HH patients with hearing family members (Harmer, 1999). This is because LEP patients have family members who are fluent in their native languages, compared to 90% of D/HH patients whose parents are hearing and often not fluent in sign languages. Hence, D/HH patients may have limited communication access at home (Mitchell & Karchmer, 2004).

Previous research examined the language skills of LEP and D/HH patients and found that both groups had significant difficulty understanding medical vocabulary. Moreover, D/HH patients expressed that their healthcare providers understood them less often than LEP patients. Yet, D/HH patients were less likely to re-explain themselves (McEwen & Anton-Culver, 1988).

According to the interviews with the eight healthcare professionals (BE, EP, GJ, GO, MN, KS, TY, and WD), there were similarities in patient–provider communication and financial concerns. Even though in-person interpreting is generally helpful for LEP patients and D/HH patients, there was no difference between the two groups in this regard because both experienced language challenges and required time for communication access. Meanwhile, the necessity of paying for in-person interpreting services had a negative impact on both populations (Yabe, 2019).

Finally, there were different challenges when working with LEP and D/HH patients. For example, for LEP patients, it was less challenging to use VRI because they could hear when they would lie down or move round. However, for D/HH patients, it was more challenging to use VRI because they were unable to see the interpreter in such instances. Therefore, the decision to use different interpreting modalities is driven by logistics and the type of language accommodations that each of these populations requires (Yabe, 2019).