Special articlePatient centeredness in medical encounters requiring an interpreter☆
Section snippets
Methods
Patients aged 18 to 64 years who were attending a university-affiliated multi-ethnic primary care clinic for the first time were approached and asked for permission to videotape their medical encounters. The clinic serves a low socioeconomic area with many immigrants from Mexico and Central America. Two groups of patients who saw English-speaking physicians were compared: 19 Spanish-speaking patients were matched to 19 English-speaking patients, based on sex and lack of accompanying family
Results
The demographic characteristics of the English- and Spanish-speaking groups were similar, except for years of schooling (Table 1). All physicians (except one from the Middle East) were born in the United States; four were Asian and three were non-Latino white. The patients were assigned to physicians arbitrarily as they appeared in the clinic, so physicians cared for Spanish-speakers and English-speakers by chance.
English- and Spanish-speaking patients differed significantly for five of the six
Discussion
Primary care patients who spoke through an interpreter made markedly fewer comments of all types during medical encounters than did patients who spoke directly with their physicians. Due to the time consumed by the interpretation process, patients may have had fewer opportunities to raise concerns or to explain their symptoms. Because most affective communication is communicated through nonverbal channels, such as voice tone or eye contact (26), Spanish-speaking patients in cross-language
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Supported by the National Institute of Mental Health (1 RO1 MH 47536) and the Regents of the University of California.