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Institute of Mental Health (NIMH) 1¥HiffJ.i:~ # 1R03MH76205-01-~Al (~ f$: Providers' Views of tlw Roles of Medical Interpreters) o ::zls:)CfF# ;ffi:llt~lM1 NIH/NIMH!¥J*M!;fJ o. ::zls:::)($:)t:8f*4'lt/ ~~T~it OW;Jn:fl§~ 1¥1 :f!HH~ )(" ffiT :1f if;§:* :1m ifl. ii~f'i'i%-: Dr. Elaine Hsieh, Department of

Communication, University of Oklahoma, 610 Elm Ave. # 101,,

Norman, OK, 73019. Fax·405-325-7625. ·E-mail: ehsieh@ou. edu. ' -~ '

_· ... ,

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287

Patient Autonomy and Patient Empowerment in

Interpreter-Mediated Medical Encounters

Abstract: Medical inteq)reters ·often: face interactional dilemmas as they

mediate, negotiate, and reconcile· provider-patient differences. In this paper, we

will examine (a) how interpreters' linderstanding of patient autonomy shapes their

choices ·of · coinmunicatiVe· strategies and (b) providers' and interpreters'

understanding of patient empowerment. We also will explore how differences in

providers' and patients' understanding create tensions and challenges in their

collaboration. Out data includes participant observation, in-depth interviews, and

focus groups.

Extending from past literature that recognizes interpreters' active involvement in

medical encounters, we will further 'explore how the interpreters' strategies improve

or hinder patients'· autonomous decisionS in theil: illness events. We will investigate

how interpreters' specific strategies (i.e., making inexplicit information explicit and

providing ·means of self-efficacy) influence patient autonomy and patient

empowerment. Our findings will demonstrate that interpreters' active involvement is

essential in creating the hecessary conditions (e.g., health literacy) that enable

patients to make autonomous decisions. Their interventions not only facilitate the

immediate provider-patient interactions but can also have long-lasting impacts on

providers' and patients' communicative competence. We will conclude the manuscript

by identifying specific principles that should guide interpreters' communicative

practices in health care settings.

Key worm: medical interpreting; provider-patient communication; communication;

autonomy; empowerment

[ fttf fBi 1l' l i.ftHit ~ (Elaine HSIEH) , Associate Professor, Department of

Communication, University of Oklahoma. Research Interests: Medical Interpreting

and Health Communication.

Eric KRAMER, Professor, Department of Communication, University of

Okld10tria. Research Interests: Intercultural Communication and Comparative

Civilization.

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