Item Details

Third party insurance?: Interactional role alignment in family member mediated primary care consultations

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

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.38675

Abstract:

This paper deals with general practice consultations
where there is a third party present, as a companion,
to support the patient and act as a mediator between
doctor and patient. Our study contrasts with most,
but by no means all, of the studies on interpreting,
which (1) focus on a transmission of information
model in professional interpreting, (2) do not address
monolingual mediated consultations where the third
person is a carer and/or (3) do not address issues of
trust and feelings which can characterise consultations
mediated by family members.
The data for this paper is drawn from a Londonbased
project: Patients with Limited English and
Doctors in General Practice: Educational Issues
(PLEDGE). Using Goffman’s participant framework
and aspects of narrative performance, we propose a
cline of mediation, which can be mapped onto the
structure of the clinical consultation – as evidenced
through two case studies. The analysis indicates
that consultations with companions that act as lay
interpreters have more in common with monolingual
triadic consultations than with professionally
interpreted consultations. The shifts in role-relationships
and alignments between the three participants
subvert their official position to produce a remarkable
intimacy and collaboration, while often subduing
but sometimes amplifying the patient’s voice. There
are implications of our findings both for family
carers as mediators and for primary care health
providers.

Author: Celia Roberts, Srikant Sarangi

View Full Text

References :

Angelelli, C. (2005) Medical Interpreting and Cross-Cultural Communication. Cambridge: Cambridge University Press.
https://doi.org/10.1017/CBO9780511486616

 

Bamberg, M. and Georgakopoulou, A. (2008) Small stories as a new perspective in narrative and identity analysis. Text & Talk 28 (3): 377-396.
https://doi.org/10.1515/TEXT.2008.018

 

Baraldi, C. and Gavioli, L. 2012 (eds) Coordinating Participation in Dialogue Interpreting. Amsterdam: John Benjamins.
https://doi.org/10.1075/btl.102

 

Beisecker, A. 1989 The influence of a companion on the doctor-elderly patient interaction. Health and Communication 1 (1): 55-70.
https://doi.org/10.1207/s15327027hc0101_7

 

Bolden, G. B. (2000) Toward understanding practices of medical interpreting: Interpreters’ involvement in history taking. Discourse Studies 2 (4): 387-419.
https://doi.org/10.1177/1461445600002004001

 

Cohen, S., Moran-Ellis, J. and Smaje, C. (1999) Children as informal interpreters in GP consultations: pragmatics and ideology. Sociology of Health & Illness 21 (2): 163-186.
https://doi.org/10.1111/1467-9566.00148

 

Cordella, M. (2011) A triangle that may work well: Looking through the angles of a three-way exchange in cancer medical encounters. Discourse and Communication 5 (4): 337-353.
https://doi.org/10.1177/1750481311418100

 

Corsellis, A. (2008) Public Service Interpreting: The First Steps. London: Palgrave Macmillan.
https://doi.org/10.1057/9780230581951

 

Coupland, N. and Coupland, J. (2000) Relational frames and pronominal address reference: The discourse of geriatric medical triads. In S. Sarangi and M. Coulthard (eds) Discourse and Social Life, 207-229. Harlow, UK: Pearson Education.

 

Davidson, B. (2000) The interpreter as institutional gatekeeper: The socio-linguistic role of interpreters in Spanish-English medical discourse. Journal of Sociolinguistics 4 (3): 379-405.
https://doi.org/10.1111/1467-9481.00121

 

Davidson, B. (2002) A model for the construction of conversational common ground in interpreted discourse. Journal of Pragmatics 34 (9): 1273-1300. DELETE
https://doi.org/10.1016/S0378-2166(02)00025-5

 

Ebden, P., Carey, O.J., Bhatt, A. and Harrison, B. 1988 The bilingual consultation. Lancet (8581): 347.
https://doi.org/10.1016/S0140-6736(88)91133-6

 

Goffman, E. (1974) Frame Analysis: An Essay on the Organisation of Experience. New York: Harper & Row.

 

Goffman, E. (1981) Forms of Talk. Oxford: Blackwell.

 

Goffman, E. (1983) The interaction order. American Sociological Review 48 (1): 1-17.
https://doi.org/10.2307/2095141

 

Greenhalgh, T., Robb, N. and Scambler, G. (2006) Communicative and strategic action in interpreted consultations in primary healthcare: A Habermassian perspective. Social Science & Medicine 63 (5): 1170-1187.
https://doi.org/10.1016/j.socscimed.2006.03.033

 

Haffner, L. (1992) Translation is not enough: Interpreting in a medical setting. Western Journal of Medicine 157 (3): 255-259.

 

Hale, S. (2004) The Discourse of Course Interpreting: Discourse Practices of the Law, the Witness and the Interpreter. Amsterdam: John Benjamins.
https://doi.org/10.1075/btl.52

 

Labov, W. and Waletzky, J. (1967) Narrative analysis: Oral versions of personal experience. In J. Helms (ed.) Essays on the Verbal and Visual Arts, 12-44. Seattle: University of Washington Press.

 

Li, S. (2015) Nine types of turn-taking in interpreter-mediated GP consultations. Applied Linguistics Review 6 (1): 73-96.
https://doi.org/10.1515/applirev-2015-0004

 

Li, S., Gerwing, J., Krystallidou, D., Rowlands, A., Cox, A. and Pype, P. (2017) Interaction - A missing piece of the jigsaw in interpreter-mediated medical consultation models. Patient Education and Counseling 100 (9): 1769-1771.
https://doi.org/10.1016/j.pec.2017.04.021

 

Meyer, B. (2012). Ad hoc interpreting for partially language-proficient patients: Participation in multilingual constellations. In C. Baraldi and L. Gavioli (eds) Coordinating Participation in Dialogue Interpreting, 99-113. Amsterdam: John Benjamins.
https://doi.org/10.1075/btl.102.05mey

 

Mishler, E. G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.

 

Pöchhacker, F. (2004) Introducing Interpreting Studies. London: Routledge.
https://doi.org/10.4324/9780203504802

 

Psathas, G. (1995) ‘Talk and social structure’ and ‘studies of work’. Human Studies 18 (2-3): 139-155.
https://doi.org/10.1007/BF01323207

 

Putsch, R. W. III (1985) Cross-cultural communication: The special case of interpreters in health care. Journal of the American Medical Association 254 (23): 3344-3348.
https://doi.org/10.1001/jama.1985.03360230076027

 

Raymond, C. W. (2014a) Conveying information in the interpreter-mediated medical visit: The case of epistemic brokering. Patient Education and Counseling 97 (1): 38-46.
https://doi.org/10.1016/j.pec.2014.05.020

 

Raymond, C. W. (2014b) Epistemic brokering in the interpreter-mediated medical visit: Negotiating ‘patient’s side’ and ‘doctor’s side’ knowledge. Research on Language and Social Interaction 47 (4): 426-446.
https://doi.org/10.1080/08351813.2015.958281

 

Robb, N. and Greenhalgh, T. (2006) ‘You have to cover up the words of the doctor’: The mediation of trust in interpreted consultations in primary healthcare. Journal of Healthcare Organisation and Management 20 (5): 434-455.
https://doi.org/10.1108/14777260610701803

 

Roberts, C. and Moss, R. (2005) Explanations, explanations, explanations: How do patients with limited English construct narrative accounts in multi-lingual, multi-ethnic settings and how can GPs interpret them? Family Practice 22 (4): 412-418.
https://doi.org/10.1093/fampra/cmi037

 

Roberts, C., Sarangi, S. and Moss, R. (2004) ‘Presentation of self and symptom in primary care consultations involving patients from non-English speaking backgrounds. Communication & Medicine 1 (2): 159-169.
https://doi.org/10.1515/come.2004.1.2.159

 

Roy, C. B. (1999) Interpreting as a Discourse Process. New York: Oxford University Press.

 

Sarangi, S. (2012) The intercultural complex in healthcare encounters: A discourse analytical perspective. In N. G. Patil and C. L. K. Lam (eds) Making Sense in Communication, 13 -24. Hong Kong: IMHSE Publication.

 

Schouten, B. and Meeuwesen, L. (2006) Cultural differences in medical communication: A review of the literature. Patient Education & Counselling 64 (1-3): 21-34.
https://doi.org/10.1016/j.pec.2005.11.014

 

Silverman, D. (1987) Communication and Medical Practice: Social Relations in the Clinic. London: Sage.

 

Singy, P. and Guex, P. (2005) The interpreter’s role with immigrant patients: Contrasted points of view. Communication & Medicine 2 (1): 45-51.
https://doi.org/10.1515/come.2005.2.1.45

 

Stokes, R. and Hewitt, J. P. (1976) Aligning actions. American Sociological Review 41 (5): 838-849.
https://doi.org/10.2307/2094730

 

Swinglehurst, D., Roberts, C., Li, S., Weber, O. and Singy, P. (2014) Beyond the ‘dyad’: A qualitative re-evaluation of the changing clinical consultation. BMJ Open 4 (9): e006017. https://doi.org/10.1136/bmjopen-2014-006017
https://doi.org/10.1136/bmjopen-2014-006017

 

Tannen, D. and Wallat, C. (1983) Doctor/mother/child communication: Linguistic analysis of a paediatric interaction. In S. Fisher and A. D. Todd (eds) The Social Organisation of Doctor-Patient Communication, 203-219. Washington, DC: Center for Applied Linguistics.

 

Tsai, M. (2007) Who gets to talk?: An interactive framework evaluating companion effects in geriatric triads. Communication & Medicine 4 (1): 37-49.
https://doi.org/10.1515/CAM.2007.005

 

Vertovec, S. (2007) Super-diversity and its implications. Ethnic and Racial Studies 30 (6): 1024-1054.
https://doi.org/10.1080/01419870701599465

 

Vertovec, S. (2010) Towards post-multilingualism? Changing communities, conditions and contexts of diversity. International Science Journal 199: 83-95.
https://doi.org/10.1111/j.1468-2451.2010.01749.x

 

Vickers, C. Goble, R and Deckert, S. (2015) Third party interaction in the medical context: Code-switching and control. Journal of Pragmatics 84: 154-171.
https://doi.org/10.1016/j.pragma.2015.05.009

 

Wadensjö, C. (1998) Interpreting as Interaction. Harlow, UK: Addison Wesley Longman.