Using interpreters in diagnostic research and practice: Pilot results and recommendations

Objective: This pilot study examined the impact and role of interpreters in videotaped and some live diagnostic interviews of Hispanic outpatients in an urban psychiatric service. Method: The study, conducted from June 2002 to February 2004, included 98 bilingual or Spanish-speaking monolingual adult Hispanic outpatients who participated in live or videotaped diagnostic interviews with English-speaking, non-Hispanic (N = 33) or Hispanic (N = 16) clinicians. Interpreters provided assistance to patients and to non-Hispanic clinicians in 71 cases. After completing live interviews or watching videotaped interviews with interpreter assistance, clinicians independently filled out questionnaires asking for diagnoses and other information (questions about the clinical encounter and rating of symptom severity). Results: Clinicians reported high confidence in their assessments because interpreters provided unbiased, accurate information. Without interpreters, clinicians reported that patient diagnoses and functioning would have been assessed as less severe or the same. Interpreters helped patients with limited English navigate mostly videotaped interviews and respond to clinician queries. Interpreters brokered cultural expressions and colloquialism, distinguished easily misunderstood words and concepts, and were challenged by patients with cognitive deficits and thought disorders. Conclusions: Findings point to functions, process, and logistics of interpretation, including reaching for linguistic and conceptual fidelity and acting as unobtrusive, disciplined participants to maintain diagnostic accuracy. Recommendations for assuring useful research-quality data are applicable to diagnostic practice.