Language and informed consent in childhood cancer

描述（由申请人提供）： 沟通是医疗保健的基础。然而，据最近估计，美国有超过3100万人无法与他们的医疗保健提供者用同一种语言进行交流。招聘口译员，以促进临床医生和患者之间的沟通压力随之而来，一个因素，引入医疗保健沟通等问题，如口译不准确，角色冲突，和其他复杂的语言解释。 这项为期两年的研究调查了癌症临床试验知情同意背景下的语言解释，有效的沟通对于信息的最佳披露和理解以及患者及其家属的决策能力至关重要。它的重点是知情同意讨论，涉及新诊断患有白血病的儿童的父母。本研究的目的是：1。研究口译员在癌症临床试验的知情同意讨论中的作用，以及他们的行为如何塑造同意过程; 2。评估翻译行为对父母理解知情同意的影响; 3.将上述发现与关键利益相关者在知情同意书解释方面的关切和需求的第一手数据联系起来。该研究计划通过对知情同意讨论录音样本的英语和西班牙语部分进行结构化的逐句分析来实现前两个目标。将使用结构化问卷来实现第三个目标。这些将被管理到口译员，父母和临床医生谁曾参加过癌症临床试验的多语言知情同意讨论的样本。 关于癌症试验知情同意中使用口译服务的研究很少，尽管很明显，在没有合格的语言翻译的情况下获得的知情同意不太可能是真正知情的。拟议的研究将确定可能需要改进的语言解释方面，或者可以作为在儿科环境内外的癌症试验知情同意讨论中增强沟通和理解的模型。

DESCRIPTION (provided by applicant): Communication is the fabric of medical care. Nevertheless, it has recently been estimated that more than 31 million people in the United States are unable to communicate in the same language as their health care providers. Pressure to recruit interpreters in order to facilitate communication between clinicians and patients has followed, a factor that introduces into health care communication such issues as interpreter inaccuracy, role conflict, and other complexities of language interpretation. This two-year study investigates language interpretation in the context of informed consent for cancer clinical trials, where effective communication is vital to the optimal disclosure and understanding of information, and the decision-making competency of patients and their families. It focuses on informed consent discussions involving parents with children who were newly diagnosed with leukemia. The study's objectives are to: 1. Examine how interpreters function during informed consent discussions for cancer clinical trials, and how their behaviors shape the consent process; 2. Assess the impact of interpreter behaviors on parental understanding of informed consent; and, 3. Tie the above findings to first-hand data on the concerns and needs of key stakeholders in interpreted informed consent. The study plans to meet the first two objectives through a structured, sentence-by-sentence analysis of the English and Spanish portions of a sample of audiotaped informed consent discussions. Structured questionnaires will be used to meet the third objective. These will be administered to a sample of interpreters, parents, and clinicians who have previously participated in multilingual informed consent discussions for cancer clinical trials. Little research exists on the use of interpreter services in informed consent for cancer trials, even though it is clear that informed consent obtained without competent language interpretation is unlikely to be truly informed. The proposed study will identify aspects of language interpretation that may require improvement, or that may serve as a model for enhanced communication and understanding in informed consent discussions for cancer trials, both within and beyond the pediatric setting.