Article Text
Abstract
Background Personalised communication is essential in effective palliative care (Silva, Genoff, Zaballa. J Pain Symptom Manage. 2016;51(3):569–80; Jaitly, Bronnert. BMJ Support Palliat Care. 2023;13:A52). However, language barriers coupled with diversity in cultural and faith backgrounds can make personalising information, dialogue and care planning complex. The lack of teaching around this subject in UK medical schools compounds the problem. The 2021 UK census shows that 8.9% of the population does not identify English as their primary language, making it a pressing concern for healthcare providers.
Aims This project aims to co-develop, pilot and evaluate learning resources for working with interpreters during end-of-life consultations. We report here on developing this work.
Methods Facilitated workshops drew on the experiences from a diverse range of stakeholders, who had delivered and/or received care, where the primary language was not shared. Discussion centred on real-life scenarios in advanced illness and end of life care involving complex discussions with interpreters.
Results The workshops highlighted that culture, as well as language, both played a significant role in communicating with non-English speaking patients. In an ideal situation, family and friends should not be expected to interpret consultations, especially in the emotional context of end-of-life discussions. The complexity of reality makes this challenging. Attendees felt that the interpreter briefing and debriefing was vital, and that nuanced education is needed. Healthcare workers lack the confidence to use interpreters, and some do not know how to access them. Telephone interpretation is easy to access, but can be the hardest to do well. Attendees greatly valued hearing about other people’s experiences as a way of learning.
Conclusion The study underscores the need for culturally safe education to improve communication through interpreters during end-of-life consultations. The next step is to develop and pilot the learning packages targeting medical students, internal medical trainees, and palliative care nurses.