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Perspectives of Chuukese Patients and Their Health Care Providers On the Use of Different Interpretation Methods

Friday, October 19, 2012
Room R06-R09 (Morial Convention Center)
Kara Wong Ramsey, MD, James Davis, PhD and Gina French, MD, Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI


Most national studies on culturally and linguistically appropriate medical services have examined primarily Spanish speaking patients. Few have looked at languages where the availability of bilingual staff or professional interpreters is more limited, such as Micronesian languages. Immigrants from Chuuk, a Pacific Island nation in Micronesia, are a growing population of limited-English speakers in Hawai‘i. The purpose of this study was to examine the perspectives of Chuukese patients and their physicians in Honolulu, Hawai‘i on different interpretation services. 


An anonymous multiple choice survey was distributed to Chuukese people in the local community through partnership with a Chuukese community group and to physicians via email to examine the following interpretation methods: Family member or friend, Telephone interpreter, or professional in-person interpreter. Statistical significance of cross-tabulated responses were analyzed using Fisher’s exact test. 


114 surveys from health care providers and 95 surveys from the Chuukese community were analyzed after exclusion criteria. Using a family member or friend was the method most frequently used by physicians (89%) and Chuukese people (65%). Telephone interpretation was used the least by physicians (7%) and Chuukese people (2%) and both rated it poorly in terms of comfort and ease of use. Physicians rated professional in-person interpretation as the best method (76%) while Chuukese people rated using a family member or friend as the best method (55%), especially among those who reported a lower English proficiency (p=0.04) and who lived in Hawai‘i for fewer years (p=0.003). 


The preference of Chuukese patients for using a family member or friend as interpreter differs from national standards which promote the use of a professional interpreter. This highlights how culturally sensitive health care should be targeted towards the preferences of the individual cultural group or patient. Future studies are needed to help understand the discrepancy between Chuukese and their physicians in preference for professional in-person interpretation versus interpretation by a family member or friend. Given the preference of both physicians and Chuukese people for in-person interpreters over telephone interpreters, there is a need for increased training and hiring of professional in-person interpreters.