Evaluation of the Use of Interpreters in Medical and Psychosocial Health Care of Refugees in a Reception and Registration Centre of the German Federal State of Baden-Wuerttemberg

Abstract

In the medical and psychosocial health care of refugees the use of interpreters is of fundamental importance. The involvement of interpreters changes the dyadic practitioner-patient system to a triad requiring different behavior guidelines. The aim of the present study was to evaluate the involvement of interpreters in the medical and psychosocial outpatient clinic in a registration centre for refugees in the state of Baden-Württemberg. For a general overview of the use of interpreters in different types of consultation hours and a comparison of the local practice with guidelines from the literature, a systematic survey was conducted in N=75 treatment cases with N=19 practitioners, N=27 interpreters and N=75 patients using an observation sheet. Among the factors studied were sitting positions in the triad, the manner of translation by interpreters, eye contact and orientation of speech of practitioners and patients towards each other during the phases of linguistic production, the interaction with family members and the occurrence of briefings or meetings after the consultation. Results show that the observed interpreters were almost exclusively non-professionals without qualification for this profession. Interpreters translated according to the so-called black box model or predominantly self-initiated as co-therapists and usually did not act as references of cultural aspects. Furthermore it could be observed that practitioners oriented the communication - eye contact and direct speech - primarily towards interpreters, not to patients. In addition, there was no briefing between the therapist and the interpreter or meeting after the consultation in any of the consultation hours surveyed. The practice of involving interpreters differs from guidelines of research literature. The present study uncovers these discrepancies and thus has implications for the work of practitioners and interpreters in refugee care.