Abstract
Background: In serious illness and end-of-life care, effective communication is critical to honoring patients’ values and goals. For patients with refugee backgrounds, healthcare encounters may also evoke distress or (re)traumatization due to past experiences of displacement, persecution, or medical mistrust. Interpreters are essential in facilitating understanding and emotional safety. Yet, their role often extends beyond that of neutral language conduits, they act as cultural brokers, bridging cultural and religious divides, buffering emotions, and fostering trust between refugees and the healthcare team.
Objective: To explore how medical interpreters experience their role as cultural brokers in serious illness conversations.
Methods: A 126-minute focus group with eight medical interpreters was analyzed using a community-engaged approach. Refugee partners co-developed prompts, participated in theme identification, and collaborated in coding to ensure cultural accuracy. Thematic analysis guided interpretation, emphasizing shared meaning-making between academic and community partners.
Results: Results revealed five themes: (1) interpreters need for pre-briefs, role clarity, and emotional regulation during the delivery of bad news; (2) cultural brokering in both routine and serious care; (3) clinician behaviors that erode trust; (4) structural and logistical barriers; and (5) quiet undermining of patient credibility. Interpreters described navigating ethical boundaries while engaging in cultural brokerage, often softening idioms, reframing sensitive language, and advocating for patients’ right to ask questions.
Implication for Nursing Practice: Nurses play a critical role in fostering equitable communication for patients with refugee backgrounds by recognizing interpreters as integral members of the care team rather than neutral intermediaries. By engaging interpreters as cultural partners, nurses can strengthen trust, reduce miscommunication, and promote culturally responsive, patient-centered care.
Conclusion: Interpreters in serious illness and end-of-life care are more than linguistic conduits. They function as critical members of the team, cultural brokers who bridge understanding, restore trust, and humanize communication at life’s most vulnerable moments. Recognizing and integrating their cultural expertise is vital to advancing equity and ensuring that every patient’s values and voice are honored in serious illness care.
Notes
References:
Bigger, S. E., Obregon, D., Keinath, C., & Doyon, K. (2024). Language Justice as Health Equity in Palliative Care: A Scoping Review. Journal of Pain and Symptom Management.
Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide.
Hancox, J. A., McKiernan, C. F., Martin, A. L., Tomas, J., & MacArtney, J. I. (2023). The emotional effects on professional interpreters of interpreting palliative care conversations for adult patients: A rapid review. Palliative medicine, 37(7), 931-946.
Slusarz, C. (2023). The roles and experiences of medical interpreters in palliative care: A narrative review. Palliative & supportive care, 1-8.
Wallerstein, N., Duran, B., Oetzel, J. G., & Minkler, M. (Eds.). (2017). Community-based participatory research for health: Advancing social and health equity. John Wiley & Sons.
Willey, S., Desmyth, K., & Truong, M. (2022). Racism, healthcare access and health equity for people seeking asylum. Nursing Inquiry, 29(1), e12440.
Sigma Membership
Gamma Rho
Lead Author Affiliation
Boise State University, Boise, Idaho, USA
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
DEI/BIPOC, Health Equity or Social Determinants of Health, Hospice Care, Palliative Care, End-of-Life, Terminal Care, Medical Interpreters, Professional Role
Recommended Citation
Doyon, Katherine; Abdulkadir, Sadia; Darney, Sarah; Smart, Sunny; Ornelas, Hannya; Mwamba, Alice; and Oluwatoba-Adeyemi, Adebusola, "More Than a Voice: Interpreters as Cultural Brokers in Serious Illness Conversations" (2026). International Nursing Research Congress (INRC). 88.
https://www.sigmarepository.org/inrc/2026/presentations_2026/88
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-29
More Than a Voice: Interpreters as Cultural Brokers in Serious Illness Conversations
Toronto, Ontario, Canada
Background: In serious illness and end-of-life care, effective communication is critical to honoring patients’ values and goals. For patients with refugee backgrounds, healthcare encounters may also evoke distress or (re)traumatization due to past experiences of displacement, persecution, or medical mistrust. Interpreters are essential in facilitating understanding and emotional safety. Yet, their role often extends beyond that of neutral language conduits, they act as cultural brokers, bridging cultural and religious divides, buffering emotions, and fostering trust between refugees and the healthcare team.
Objective: To explore how medical interpreters experience their role as cultural brokers in serious illness conversations.
Methods: A 126-minute focus group with eight medical interpreters was analyzed using a community-engaged approach. Refugee partners co-developed prompts, participated in theme identification, and collaborated in coding to ensure cultural accuracy. Thematic analysis guided interpretation, emphasizing shared meaning-making between academic and community partners.
Results: Results revealed five themes: (1) interpreters need for pre-briefs, role clarity, and emotional regulation during the delivery of bad news; (2) cultural brokering in both routine and serious care; (3) clinician behaviors that erode trust; (4) structural and logistical barriers; and (5) quiet undermining of patient credibility. Interpreters described navigating ethical boundaries while engaging in cultural brokerage, often softening idioms, reframing sensitive language, and advocating for patients’ right to ask questions.
Implication for Nursing Practice: Nurses play a critical role in fostering equitable communication for patients with refugee backgrounds by recognizing interpreters as integral members of the care team rather than neutral intermediaries. By engaging interpreters as cultural partners, nurses can strengthen trust, reduce miscommunication, and promote culturally responsive, patient-centered care.
Conclusion: Interpreters in serious illness and end-of-life care are more than linguistic conduits. They function as critical members of the team, cultural brokers who bridge understanding, restore trust, and humanize communication at life’s most vulnerable moments. Recognizing and integrating their cultural expertise is vital to advancing equity and ensuring that every patient’s values and voice are honored in serious illness care.
Description
This study explored how medical interpreters act as cultural brokers in serious illness care for refugees. A focus group of interpreters revealed five themes: need for pre-briefs and role clarity, cultural brokering across encounters, clinician behaviors that erode trust, structural barriers, and bias undermining patient credibility. Findings highlight interpreters as essential care team members who bridge culture, restore trust, and promote equitable, patient-centered communication.