Through interpreters' eyes: comparing roles of professional and family interpreters.

Objective: We describe and compare the perceptions of professional and family member interpreters concerning their roles and tasks as interpreters in primary care clinical encounters.

Methods: Encounters between physicians (19) and patients (24) accompanied by a professional (6) or a family (9) interpreter were videotaped. Stimulated recall was used to elicit interpreters' perceptions of their role in the clinical encounter. We analyzed transcriptions of the interpreter interviews using Atlas-ti software.

Results: The roles professional interpreters identified were: information transfer; creating a safe environment for the patient; mediation between cultures; maintaining professional boundaries. Family interpreters perceived their roles (facilitating understanding; ensuring diagnosis and treatment; interacting with the health care system) as part of their responsibilities as a family member.

Conclusion: Professional interpreters act mainly to ensure information transfer. Family interpreters act mainly as a third participant often speaking as themselves rather than rendering the words of doctor and patient into the other's language.

Practice Implications: To obtain the maximum benefit from a professional interpreter the physician must invite the interpreter to act as an advocate for the patient and a culture broker. Physicians should always use a professional interpreter to ensure accurate information transfer. A family member should often be included in encounters to serve as a valuable patient advocate.