‘Don’t blame the middle man’: an exploratory qualitative study to explore the experiences of translators breaking bad news | Zendy

Joanna Prentice | Zendy; Annmarie Nelson | Zendy; Jessica Baillie | Zendy; Hannah Osborn | Zendy; Simon Noble | Zendy

Open Access

‘Don’t blame the middle man’: an exploratory qualitative study to explore the experiences of translators breaking bad news

Author(s) -

Joanna Prentice,

Annmarie Nelson,

Jessica Baillie,

Hannah Osborn,

Simon Noble

Publication year - 2014

Publication title -

journal of the royal society of medicine

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.38

H-Index - 81

eISSN - 1758-1095

pISSN - 0141-0768

DOI - 10.1177/0141076814527275

Subject(s) - thematic analysis , feeling , blame , qualitative research , debriefing , focus group , health care , distress , medicine , exploratory research , psychology , surprise , anger , confidentiality , nursing , medical education , social psychology , psychotherapist , sociology , social science , anthropology , economics , economic growth , law , political science

Background: Healthcare professionals find breaking bad news difficult and upsetting. Increasing cultural diversity has led to a greater number of patients whose first language differs to that of the healthcare provider, with more patients requiring a translator to facilitate communication. Hospitals often ask non-clinical translators to facilitate breaking bad news. We sought to explore the experiences of translators within a specialist oncology centre.Methods: Following ethical and governance approvals, semi-structured interviews were undertaken with five translators recruited from the specialist oncology centre. Interviews were audiotaped and transcribed verbatim. The data were analysed thematically, with major themes and subthemes identified.Setting: Outpatient setting of a regional cancer centre.Participants: Translators serving a regional cancer centre.Main outcome measures: Qualitative data identified through thematic analysis.Results: Major themes included the significant emotional impact of translating distressing information, the challenges of accurately conveying information in a culturally congruent format and the need for formal briefing, debriefing and support. Subthemes included feeling guilty for divulging distressing news, being the focus of patients’ distress or anger, and feeling in conflict with the patient or family and issues surrounding confidentiality. Translators also felt a strong sense of advocacy for the patients and found encounters with death and dying emotionally challenging.Conclusions: The increasing use of translators in the care of patients with advanced cancer is increasingly resulting in lay people being subject to similar emotional pressures faced by clinical staff, yet without the necessary formal training or support mechanisms that are recommended for clinicians. This exploratory study highlights the training and support needs of non-clinical staff as identifying a unique set of communication challenges faced by translators.

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