“Sometimes the Interpreters Don't Tell You Everything”: Experiences with Medical Interpretation among Latino Cancer Patients and Caregivers with Limited English Proficiency

Introduction: Language concordance is critical for effective communication between patient and provider. Compared to the percentage of primary Spanish speakers in California, there is a lack of Spanish-speaking providers in healthcare, especially in oncology. In-house hospital interpreters help overcome basic language barriers; however, even with the adoption of these services, gaps in comprehension remain. This study aimed to explore language barriers Hispanic/Latino (H/L) patients and their caregivers face when navigating rectal cancer care.

Methods: We conducted a community-partnered qualitative study involving H/L individuals with a past or current rectal cancer diagnosis who reside in the Bay Area or San Joaquin Valley. Caregivers were also invited to participate. We developed an interview guide based on the Ecological Model of Health Behavior and iteratively refined it with input from our Community Advisory Board. Interviews lasted 45-60 minutes in English or Spanish. Data analysis utilized grounded theory and reflexive thematic analysis to identify core themes.

Results: Over a 6-month period, twenty-one interviews were conducted. Three major themes arose from our review of coded transcripts: (1) interpreters’ use of medical jargon; (2) Spanish dialect discordance between patient and hospital interpreter; and (3) lack of trust in the interpretation process.

Conclusion: Our sample of H/L rectal cancer patients and their caregivers reported barriers due to overuse of medical jargon and dialectic differences, both of which eroded trust in the interpretation process. Beyond simply hiring more interpreters, hospitals would benefit from re-envisioning the patient-interpreter relationship as a means of improving communication and fostering trust in the healthcare system.