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Health and death literacy and cultural diversity: insights from hospital-employed interpreters
  1. Barbara Hayes1,2,
  2. Anne Marie Fabri1,
  3. Maria Coperchini3,
  4. Rafatullah Parkar4 and
  5. Zoe Austin-Crowe5
  1. 1 Advance Care Planning Program, Northern Health, Bundoora, Victoria, Australia
  2. 2 Palliative & Supportive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  3. 3 Palliative Care Department, Western Health, Footscray, Victoria, Australia
  4. 4 Aged Care Program, Monash Health, Melbourne, Australia
  5. 5 Continuing Care, Department of Health and Human Services, Melbourne, Victoria, Australia
  1. Correspondence to Dr Barbara Hayes, Advance Care Planning Program, Northern Health Bundoora Extended Care Centre, 1231 Plenty Road, Bundoora, Victoria 3083, Australia; barbara.hayes{at}


Objectives 001225The aim of this qualitative study is to better understand, through the experiences and insights of hospital interpreters, how people from culturally and linguistic diverse (CALD) communities might respond to advance care planning (ACP) and end-of-life discussions.

Methods Hospital interpreters from five Melbourne metropolitan health services were recruited for in-depth semi-structured interviews that explored the question, ‘What can be learnt from hospital interpreters about cultural issues related to ACP and end-of-life decision-making?’ Thirty-nine interpreters, representing 22 language groups, were interviewed. Analysis of the transcribed interviews used qualitative description.

Results Thematic analysis identified three major themes: (1) moral difference; (2) health and death literacy; and (3) diversity within culture.

Conclusion A value-based approach to ACP is recommended as a way to capture the person’s individual values and beliefs. Health and death literacy have been identified as areas that may be over-estimated; areas that can be addressed and improved, if recognised. Health and death literacy is a particular area that needs to be assessed and addressed as a pre-requisite to ACP discussions.

  • end of life

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  • Contributors BH and AMF: conceptualised and designed the study. BH: conducted all interviews and data coding. AMF: contributed to data coding. All authors: contributed to interpretation of interview data, and drafting and revising the article.

  • Funding The study was supported by project funding from the Department of Healthand Human Services Victoria

  • Competing interests None declared.

  • Ethics approval Human Research Ethics Committees of: Northern Health; Western Health; Melbourne Health; Monash Health; and Alfred Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement De-identified interview data is held by Dr Barbara Hayes and Anne Marie Fabri and is not accessible by researchers who have not been part of this study.