• Meaghann S Weaver, Alicia Roeth, Hema Navaneethan, Valerie K Shostrom, and Melissa Contreras-Nourse.
• Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, NE, USA.
• J Palliat Care. 2020 Jun 11: 825859720933112.

BackgroundMedical interpreters are critical mediators in communication with pediatric subjects and families to include participation in difficult conversations.ObjectiveThe objective of this pilot study was to provide suggestions from medical interpreters to palliative care teams as to how to effectively incorporate medical interpreters into end-of-life conversations.Subjects And MethodParticipants included pediatric hospital-based medical interpreters who had interpreted for at least 1 end-of-life conversation in the pediatric hospital setting. A total of 11 surveys were completed by medical interpreters. The study consisted of a written 12-item survey with a follow-up focus group to further explore survey themes.ResultsThe translation of cultural contexts, awareness of the mixed messages the family received from health care teams, and the emotional intensity of the interactions were depicted as the most challenging aspects of the medical interpreter's role. Despite these challenges, 9 interpreters reported they would willingly be assigned for interpreting "bad news" conversations if given the opportunity (82%). Medical interpreters recognized their relationship with the family and their helping role for the family as meaningful aspects of interpreting even in difficult conversations. Medical interpreters shared 7 thematic suggestions for improved communication in language-discordant visits: content review, message clarity, advocacy role, cultural understanding, communication dynamics, professionalism, and emotional support.ConclusionsAs experts in cultural dynamics and message transmission, the insights of medical interpreters can improve communication with families.

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