Item Details

The comparison of shared decision making in monolingual and bilingual health encounters

Issue: Vol 15 No. 2 (2018) Special Issue: Interpreter-Mediated Healthcare Encounters

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.38674

Abstract:

In the United States, Hispanics with limited English
proficiency (LEP) experience disproportionate disparities
in health services, a phenomenon that relates to
communication and decision making. After a quality
improvement review identified a disparity in obstetric
services for Hispanic women with LEP, a pilot study
discussed here explored how LEP and the presence
of a medical interpreter affected shared decision
making in comparisons of monolingual (English) and
bilingual (English-Spanish) encounters with the same
physician. A series of 16 prenatal encounters between
physicians, patients, and medical interpreters were
recorded. First, medical visits were recorded with eight
Spanish-speaking mothers using a hospital interpreter
to speak with their physician. The same physician was
then recorded discussing a similar prenatal agenda
with a primary language English-speaking patient.
Discourse analysis was used to categorize discursive
practices in social interaction. Both encounters were
rated using the OPTION shared decision-making
scale. Results portray how shared decision making
shifts in second-language situations and the associated
practices that distinguish monolingual and
bilingual encounters. Examples of discursive practices
suggest strategies that may mark ethnolinguistic identity
and membership categorization indirectly during
health encounters.

Author: Charlene Pope, Jason Roberson

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