Experiences of interpreters in supporting the transition from oncology to palliative care: A qualitative study

Emma Kirby, Alex Broom, Phillip Good, Vanessa Bowden, Zarnie Lwin

Medical consultations focused on managing the transition to palliative care are interpersonally challenging and require high levels of communicative competence. In the context of non-English speaking patients, communication challenges are further complicated due to the requirement of interpreting; a process with the potential to add intense layers of complexity in the clinical encounter, such as misunderstanding, misrepresentation and power imbalances. The aim of the study was to explore the experiences and perspectives of professional interpreters in supporting the transition of culturally and linguistically diverse patients to specialist palliative care. Qualitative, semistructured interviews with 20 professional interpreters working in oncology and palliative care settings in two metropolitan hospitals in Queensland, Australia. Four key themes emerged from the thematic analysis: the challenges of translating the meaning of "palliative care"; managing interpreting in the presence of family care-givers; communicating and expressing sensitivity while remaining professional and interpreters' own emotional burden of difficult clinic encounters between doctor and patient negotiations. The results suggest that interpreters face a range of often concealed interpersonal and interprofessional challenges and recognition of such dynamics will help provide necessary support for these key stakeholders in the transition to palliative care. Enriched understanding of interpreters' experiences has clinical implications on improving how health professionals interact and work with interpreters in this sensitive setting.