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Healthcare interpreters and difficult conversations: a survey
  1. Helen James1 and
  2. Gregory Brian Crawford2,3
  1. 1 Central Adelaide Local Health Network, Adelaide, South Australia, Australia
  2. 2 Palliative Care, Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
  3. 3 Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
  1. Correspondence to Dr Helen James, Pelaco Building, Richmond, Victoria, Australia; helenjames797{at}


Objectives The aims of this survey of healthcare interpreters were to assess the impacts of difficult conversations such as discussions involving explanation of a serious diagnosis, goals-of-care or death or dying and to discover interpreters’ opinions on ways to improve these conversations.

Methods A purpose derived survey incorporating the Professional Quality of Life measure 5 was distributed to all healthcare interpreters in an Australian state. Outcome measures were to quantify levels of compassion satisfaction (CS), burn-out and secondary traumatic stress (STS), as well as to determine how well interpreters believed difficult conversations were being conducted and suggestions for improvement.

Results There were 94 respondents all scoring moderate (34.1%) or high (65.9%) on the CS score. No respondents scored high on burn-out or STS scales. Significant subgroup analysis was those aged 18–30 with higher burn-out scores. The two most common concerns raised were (1) not knowing the content prior to a discussion and (2) feeling guilty about delivering bad news. The two most frequent suggestions for improvement were (1) prebriefing with medical teams prior and (2) allowing opportunity to explain cultural concerns.

Conclusions Interpreters surveyed were not experiencing burn-out or STS and had moderate or high CS scores. Recommendations are: further training and evidence-based guidelines for medical staff and healthcare interpreters in the facilitation of difficult conversations; prebriefing and debriefing for interpreters; further research to delineate the characteristics that predispose to compassion fatigue.

  • communication
  • cultural issues
  • education and training
  • end of life care

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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  • Contributors HJ and GBC conceived of the study idea and overall design. HJ developed the survey with input from GBC, HJ organised the distribution of the survey and collection of results. HJ took the lead in writing the manuscript with input and feedback from GBC. All authors provided critical feedback to help shape the research and manuscript. HJ is responsible for the overall content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.