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一體兩面:臺灣通譯的角色及其在醫病溝通的能動性

Two Sides of One Coin: Roles of Taiwan's Interpreters and Their Agency in Doctor-Patient Communication

摘要


全球化時代,跨境遷徙的移民愈來愈多,族群、文化和語言的多樣性使得醫病溝通出現新的挑戰,為此,各國發展通譯制度,以因應移民健康照顧的需求。臺灣自2006年開始培訓東南亞籍通譯,主要任務為推動新移民生育健康管理計畫。雖然國外已累積大量通譯研究,臺灣仍缺乏通譯的質性研究。本文透過機構的脈絡分析、參與觀察與深度訪談,探討我國通譯角色的兩面性及其在醫病溝通的能動性,以發掘通譯在新移民健康照顧的潛力。一方面,通譯很容易與新移民建立信任關係,將新移民對公衛和醫療體系的陌生、恐懼轉變為自願地使用;假手通譯,政府得以順利向新移民推展生育健康管理政策,規訓新移民。另一方面,雖然通譯的身分是志工,且處於醫療體系最底層,但是通譯正在形成新的位置─醫病互動的第三個對話者。目前,通譯僅在門診進行少量的醫病溝通,通譯對新移民遭遇不適當的照顧相當敏感,遇到這種狀況,她們往往以新移民權益捍衛者的角色出現。不僅協助新移民進行醫病溝通、設法延長溝通時間,並幫助新移民詢問醫生問題,充分告知新移民同意書的內容,使新移民維護其醫療自主權。比起夫家,通譯的參與更能提供新移民發聲,建立有效且彼此信任的醫病溝通。政府應重視通譯在醫病溝通和跨文化照顧的潛力,讓通譯成為新移民健康照顧的伙伴。

關鍵字

通譯 新移民健康 醫病溝通 文化

並列摘要


In the era of globalization, with the increase of cross-border migration, ethnic and linguistic diversity makes health communication and doctor-patient communication a new challenge. On this point, many countries develop interpreter services to cope with the need of immigrant healthcare. Since 2006, the authorities in Taiwan have trained interpreters from South-Asia countries to serve the management of foreign brides' reproductive health. Although many studies of interpreters have accumulated abroad, interpreters are still lack of qualitative research in Taiwan. Based on a context analysis of institutions, participant observation and in-depth interviews, this paper explores the two-sided roles of interpreters in Taiwan and their agency in doctor-patient communication, so as to uncover their potentiality for immigrant healthcare. On the one hand, interpreters' leading role in disciplining new immigrants can be found in the primary health care department, as they easily build up trust with immigrants, and facilitate the Bureau of Health Promotion's policy on the management of immigrants' reproductive health. On the other hand, they act as a patient-rightadvocate role when immigrants are confronted unsuitable healthcare and unequal doctor-patient relationships. Though neglected due to their volunteer status, interpreters are undertaking a bit of doctor-patient communication and de facto forming a new medical position in the health care system, a third interlocutor in the interaction. Substantively, they are sensitive to the communication problems that immigrants encounter. Under the circumstance of time limits, they prolong the time used to communicate with doctors. Interpreters insist they fully inform immigrants about consent forms on the scene, so that immigrants can make decisions on their own. They also enable doctors and patients to communicate with trust. By so doing, they improve medical autonomy for immigrants, and increase the quality of immigrant healthcare. The authorities should pay attention to interpreters' potential for doctor-patient communication and cross-cultural health care, let interpreters be a partner of immigrant healthcare.

被引用紀錄


王誱竩、林君黛(2019)。協助一位思覺失調症新移民女性跨文化適應之護理經驗弘光學報(84),21-33。https://doi.org/10.6615%2fHAR.201909_(84).0002

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