From “stuck” to satisfied: Aboriginal people’s experience of culturally safe care with interpreters in a Northern Territory hospital

Vicki Kerrigan, Stuart Yiwarr McGrath, Sandawana William Majoni, Michelle Walker, Mandy Ahmat, Bilawara Lee, Alan Cass, Marita Hefler, Anna Ralph

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)
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Abstract

Background
Globally, interpreters are underused by health providers in hospitals, despite 40 years of evidence documenting benefits to both patients and providers. At Royal Darwin Hospital, in Australia’s Northern Territory, 60-90% of patients are Aboriginal, and 60% speak an Aboriginal language, but only approximately 17% access an interpreter. Recognising this system failure, the NT Aboriginal Interpreter Service and Royal Darwin Hospital piloted a new model with interpreters embedded in a renal team during medical ward rounds for 4 weeks in 2019.

Methods
This research was embedded in a larger Participatory Action Research study examining cultural safety and communication at Royal Darwin Hospital. Six Aboriginal language speaking patients (five Yolŋu and one Tiwi), three non-Indigenous doctors and five Aboriginal interpreter staff were purposefully sampled. Data sources included participant interviews conducted in either the patient’s language or English, researcher field notes from shadowing doctors, doctors’ reflective journals, interpreter job logs and patient language lists. Inductive narrative analysis, guided by critical theory and Aboriginal knowledges, was conducted.

Results
The hospital experience of Yolŋu and Tiwi participants was transformed through consistent access to interpreters who enabled patients to express their clinical and non-clinical needs. Aboriginal language-speaking patients experienced a transformation to culturally safe care. After initially reporting feeling “stuck” and disempowered when forced to communicate in English, participants reported feeling satisfied with their care and empowered by consistent access to the trusted interpreters, who shared their culture and worldviews. Interpreters also enabled providers to listen to concerns and priorities expressed by patients, which resulted in holistic care to address social determinants of health. This improved patient trajectories and reduced self-discharge rates.

Conclusions
A culturally unsafe system which restricted people’s ability to receive equitable healthcare in their first language was overturned by embedding interpreters in a renal medical team. This research is the first to demonstrate the importance of consistent interpreter use for providing culturally safe care for Aboriginal patients in Australia.
Original languageEnglish
Article number548
Pages (from-to)1-13
Number of pages13
JournalBMC Health Services Research
Volume21
Issue number1
DOIs
Publication statusPublished - 4 Jun 2021

Bibliographical note

Funding Information:
The authors would like to thank: TEHS, the RDH Division of Medicine, RDH renal department staff, Dr. Maddison Hall, Curtis Roman from the NT AIS and NT AIS staff. We also thank Menzies School of Health Research project officer Vincent Mithen for contributing to data cleaning.

Funding Information:
Vicki Kerrigan is supported by an Australian Government Research Training Program Scholarship and Improving Health Outcomes in the Tropical North: A multidisciplinary collaboration (HOT NORTH)’, (NHMRC GNT1131932). Stuart Yiwarr McGrath was supported by HOT NORTH Indigenous Development and Training Award (NHMRC GNT 113193). Anna P Ralph is supported by an NHMRC fellowship 1142011. A funding contribution to undertake data collection was provided by the Menzies School of Health Research Grants Scheme. The NT AIS provided interpreters and the trainer in kind.

Publisher Copyright:
© 2021, The Author(s).

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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