Guidelines for health staff

Brief communication guidelines

GETTING SERIOUS ABOUT COMMUNICATION IN INDIGENOUS HEALTH CARE

ATTENTION: All Health Staff

Do you need an interpreter?

Are you fluent in the patient's main language (i.e. the language they speak at home, with family and friends) ?

Do you have an in-depth understanding of the patient's culture?

NO?? Then you need an interpreter to ensure effective communication.

Call the Aboriginal Interpreter Service on 89998353 to request an interpreter any time of day or night including weekends and public holidays.

RDH staff : page 737 to request an Aboriginal interpreter during business hours and 98353 AHrs weekends & public holidays.

NB: Interpreters are available to all DHACS staff through the Aboriginal Interpreter Service on a fee for service basis through specific funding. Ward and Divisional budgets are not affected.

When you work with an interpreter:

Arrange a pre-interview..

A brief meeting between the health professional and the interpreter before talking with the patient is very important to:

  • explain what you want to achieve
  • check the interpreter's understanding of the key concepts and issues you will be talking about with the patient / family
  • discuss the best way to explain concepts and terms that are difficult to translate
  • find out if there are any cultural issues you should know about for this interaction

A 'pre-interview' discussion between the patient/family and the interpreter is also important to:

  • find out what the patient /family wants to achieve in the encounter
  • to inform patients unused to interpreters about the role of the interpreter, particularly the issues of confidentiality and impartiality

Practice good communication strategies (in all interactions with Indigenous patients):

  • talk to the patient, not the interpreter, and encourage the patient to talk directly to you (arrange seating to facilitate this)
  • do not speak too quickly (or too slowly)
  • keep your sentences short: one idea or question at a time
  • pause frequently : allow sufficient time for the interpreter to think about the best translation
  • fully explain terms and processes in plain English - don't oversimplify or use 'broken' English: detailed explanations are important if the patient / family are to make genuinely informed choices about their health care (with the assistance of an interpreter this can be achieved much more effectively)
  • repeat the same information in different ways
  • use pictures and diagrams wherever possible to illustrate your explanation.
  • think carefully about how your own communication style and content are influenced by your culture - are they appropriate / meaningful to the interpreter and patient?
  • avoid metaphors which are culturally specific e.g. clock and calendar references to time, quantification in terms of percentages, grams or litres e.t.c cannot be translated into languages which use different measures of time and quantity
  • encourage the interpreter to interrupt when clarification or repetition of information is needed
  • avoid questions that require a yes/no response - the patient may give the response she/he thinks you want to hear because this is appropriate in some cultures
  • provide opportunities for the patient / family to use their preferred communication style e.g. ask them to tell their story rather than using question and answer routines which can be uncomfortable/ unfamiliar / ineffective

WAIT: pause times are very different across cultures; some people might need a few minutes before they are ready to respond to a request or question or to continue a story.. just be patient - this takes practice

Check frequently to check the message has been understood - both ways:

  • never assume communication has been effective - CHECK
  • asking 'do you understand?' is not a valid way to assess comprehension
  • ask the patient to tell you what they think you have said in their own words
  • summarise what you think the patient has said and check if your understanding is accurate (with the assistance of the interpreter)

Post Interview: after the session, discuss with the interpreter any communication problems either of you experienced or observed during the interaction with the patient.