Professional Interpreter Use When a Child is Dying: A Survey of Pediatric Critical Care Clinicians.

Abstract

Objective: Approximately 67.8 million people in the United States population speak a language other than English (LOE). Within the health care setting, professional interpreters are critical to providing quality patient care. How pediatric clinicians engage with interpreters is understudied. Our goal was to explore pediatric intensive care unit (PICU)-clinician practices related to interpreter services at time of withdrawal of life-sustaining medical treatment in patients who speak an LOE.

Methods: A 44-question web-based survey was distributed via 2 pediatric critical care listservs. Demographics of respondents, types of interpreters available, how interpreters are used, and clinician perception of interpreter services were collected. Comparisons were made using the paired t test.

Results: About 176 clinicians completed the survey. Significant differences were seen between in-person and remote interpreters regarding the percentage of clinicians who brief interpreters prior to engaging with the patient/family (84% vs 42%; P < .0001) and confidence in (1) interpretation of their words (72% vs 41%; P < .0001), (2) the communication of the general context of the conversation (89% vs 53%; P < .0001), and (3) in interpreters using their cultural understanding to aid the conversion (79% vs 41%; P < .0001).

Conclusions: PICU-clinician engagement and confidence in interpreters was significantly higher for in-person than remote interpreting modalities. We have identified multiple opportunities for improvement in communication between LOE families and clinicians including interpreter briefing, expansion of in-person interpreter availability, and expansion of education on partnering with professional medical interpreters.