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研究生: 周彥甫
Chou, Yen-Fu
論文名稱: 由醫師觀點探討臺灣醫療通譯現況
Medical Interpreting in Taiwan: Physicians’ Perspective
指導教授: 陳子瑋
Chen, Tze-Wei
學位類別: 碩士
Master
系所名稱: 翻譯研究所
Graduate Institute of Translation and Interpretation
論文出版年: 2019
畢業學年度: 107
語文別: 英文
論文頁數: 141
中文關鍵詞: 醫療通譯混合型研究新移民醫療照護醫病溝通品質
英文關鍵詞: medical interpreting, mixed-methods research, health care of the new immigrants, quality of doctor-patient communication
DOI URL: http://doi.org/10.6345/THE.NTNU.GTI.004.2019.A07
論文種類: 學術論文
相關次數: 點閱:268下載:37
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  • 醫師在臨床工作中,面對語言能力有限的外籍病人時,必須思考如何解決和病人之間的語言溝通障礙。在相關文獻中,醫療通譯是一個相當重要的研究主題,但對台灣醫療情境中之語言障礙和醫療通譯的研究則相對缺乏。本文採用混合型研究方法,透過問卷調查和訪談,探討台灣醫師在面對中文能力有限之外籍病人時,如何解決與病人之間的語言溝通障礙,同時也試圖了解台灣醫師認為醫療通譯員需具備哪些特質。
      研究結果發現,醫師在面對中文能力有限之外籍病人時,傾向先用英文溝通,而不是先尋求通譯服務協助。醫師之所以選擇先用英文,可能是基於普遍存在於醫師間的共同信念,即英語可用來作為與外籍病人溝通的通用語言,但其實這不見得適用於所有醫療情境。此外,研究結果也指出,醫師之所以選擇不使用通譯服務協助醫病溝通,可能是基於一個對通譯員的錯誤刻板印象,即醫療場域中的通譯員都是仲介,再加上醫師普遍對仲介無法信任,以至於他們也無法相信醫療場域中的通譯服務品質,進而降低通譯服務的使用頻率。問卷結果的量化分析顯示,通譯協助無法顯著提升醫病溝通品質,進一步透過訪談結果的分析,試圖解釋這個令人意外的結果,可發現醫師因不懂外語,無法判斷通譯品質好壞,這時如果又看到通譯員以不專業、不可靠的方式提供通譯協助時,就有可能對通譯品質產生懷疑,因而導致醫病溝通品質無法有效提升。根據此發現,本研究得以強調,專業醫療通譯服務的發展在台灣確實有其重要性。
      基於上述研究結果,本研究對專業醫療通譯服務在台灣的未來發展以及新移民醫療照護均有重要啟發。

    Physicians have to address the language barrier when meeting foreign patients with limited language proficiency, and there is a great abundance of literature on strategies for bridging language and cultural gaps between physicians and patients. Among the strategies, medical interpreting is a principal research topic. There is little research, however, on the language barrier and medical interpreting in Taiwan’s healthcare settings.
      Using the mixed methods design—that is, a questionnaire survey complemented by follow-up interviews, the researcher attempted to explore how Taiwan’s physicians addressed the language barrier in the context of meeting a foreign patient with limited Mandarin proficiency. Their attitudes toward the characteristics of the medical interpreter were examined as well. The findings suggested that the participants appeared to try speaking English first, instead of using the interpreting service, in the context of communicating with foreign patients with limited Mandarin proficiency. Although the physicians appeared to share a common belief that English can serve as a lingua franca in communication with foreign patients, such an idea may not necessarily work in all clinical contexts. Besides, the results also indicated that the participants were likely to refrain from employing the interpreting assistance because of their common presupposition about the medical interpreter that the interpreter in the medical context is always the agent. Such presupposition, as well as the physicians’ mistrust toward the agent, might inevitably lead to their mistrust toward the medical interpreter and consequently decrease the utilization of the interpreting service.
      Another remarkable finding was that there was no significant positive effect of the interpreting assistance on the quality of doctor-patient communication according to the quantitative data. Using the qualitative data collected by the interview, the researcher argued that the physicians were likely to develop doubt about the quality of interpretation when seeing the interpreting service being conducted by an unprofessional, unreliable way by the interpreter. As a result, concern about the poor quality of communication would possibly emerge based on the suspicious interpretation, leading to unsatisfying quality of care. From this critical finding, the study highlighted the value of developing professional medical interpreting service.
      To conclude, this study had important implications for the development of professional medical interpreting and the new immigrants’ health care as well in Taiwan.

    誌謝 i ABSTRACT ii 摘要 iii CONTENTS iv LIST OF FIGURES viii LIST OF TABLES ix Chapter 1 Introduction 1 1.1 Background and Motivation 1 1.2 Research Purpose 4 1.3 Thesis Structure 5 Chapter 2 Literature Review 7 2.1 The Language Barrier in Medical Settings 7 2.1.1 Effects of the Language Barrier on Health Care 7 2.1.2 Strategies for Addressing the Language Barrier in Medical Settings 11 2.2 Medical Interpreting 13 2.2.1 Doctor-Patient Communication in the Doctor-Patient Relationship 13 2.2.2 Role of Interpreter in the Medical Context 15 2.2.3 Categories of Medical Interpreting 16 2.3 Language Barriers and Medical Interpreting in Taiwan’s Health Care System 19 Chapter 3 Research Methods 22 3.1 Research Design 22 3.2 Research Participants 24 3.2.1 Questionnaire Survey Participants 24 3.2.2 Follow-up Interview Participants 25 3.3 Research Instruments 27 3.3.1 Questionnaire 27 3.3.1.1 Design 27 3.3.1.2 Revision 31 3.3.1.3 The Online Instrument 32 3.3.1.4 Pilot Testing 32 3.3.2 Follow-up Interviews 35 3.3.3 Validity and Reliability 36 3.3.3.1 Validity and Reliability of the Quantitative Data 36 3.3.3.2 Validity of the Overall Mixed Methods Study 40 3.4 Data Collection 41 3.4.1 Questionnaire Data Collection 41 3.4.2 Follow-up Interview Data Collection 42 3.5 Data Analyses 42 3.5.1 Questionnaire Data Analyses 42 3.5.2 Follow-up Interview Data Analyses 43 Chapter 4 Results of the Questionnaire Survey 45 4.1 Participants Background Information 45 4.1.1 The Six Demographic Variables 45 4.1.1.1 Gender, Age, and Length of Time Practicing Medicine 45 4.1.1.2 Clinical Specialty 48 4.1.1.3 Type of Medical Institution and Geographic Location 50 4.1.2 Other Background Information 52 4.2 Strategies for Addressing the Language Barrier 53 4.2.1 Influence of Interpretation Assistance on the Quality of Doctor–Patient Communication 56 4.2.2 Effect of Native Language of Patients on Physicians’ Utilization of Interpretation Assistance 57 4.2.3 Influence of Participant Demographic Variables on Utilization of Interpretation Assistance 59 4.2.4 Physicians’ Experience of Working with Interpreters 63 4.3 Physicians’ Attitudes about Medical Interpreter Characteristics 65 4.3.1 Descriptive Statistics about the Three Dimensions 65 4.3.2 Effect of Demographic Variables on Physicians’ Attitudes about the Importance of Medical Interpreter Characteristics 70 Chapter 5 Discussion and Results of the Interviews 72 5.1 Strategies for Addressing the Language Barrier 72 5.2 Factors Affecting Physicians’ Decision About or Not to Employ Interpretation Assistance 80 5.3 Physicians’ Utilization of Interpretation Assistance versus Quality of Doctor-Patient Communication 89 5.4 Important Characteristics of Medical Interpreters 94 5.5 Conclusions 98 5.6 Research Limitations 101 5.7 Recommendations for Future Research 103 REFERENCE 105 APPENDICES 117 Appendix A Modifications of the original questionnaire in Campbell et al. (2007) for the scale of the quality of doctor-patient communication 117 Appendix B Expert feedback chart 118 Appendix C Pilot opinion chart 121 Appendix D Formalized questionnaire 122 Appendix E Interview outline 140

    Adler, H. M. (2002). The sociophysiology of caring in the doctor-patient relationship. Journal of General Internal Medicine, 17(11), 883-890.

    Agger-Gupta, N. (2001). From ‘Making Do’to Established Service, the Development of Health Care Interpreter Services in Canada and the United States of America: A Grounded Theory Study of Health Organization Change and the Growth of a New Profession. Fielding Graduate University, 227.

    Angelelli, C. V. (2004). Revisiting the interpreter's role: A study of conference, court, and medical interpreters in Canada, Mexico, and the United States. Amsterdam: John Benjamins Publishing.

    Angelelli, C. V. (2006). Validating professional standards and codes: Challenges and opportunities. Interpreting, 8(2), 175-193.

    Angelelli, C. V. (2008). Medical interpreting and cross-cultural communication. Cambridge: Cambridge University Press.

    Avery, M. P. B. (2001). The role of the health care interpreter: An evolving dialogue. National Council on Interpreting in Health Care.

    Baker, D. W., Hayes, R., & Fortier, J. P. (1998). Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Medical Care, 1461-1470.

    Baker, D. W., Parker, R. M., Williams, M. V., Coates, W. C., & Pitkin, K. (1996). Use and effectiveness of interpreters in an emergency department. JAMA, 275(10), 783-788.

    Baxter, M., & Bucci, W. (1981). Studies in linguistic ambiguity and insecurity. Urban Health, 10(5), 36-40.

    Bischoff, A., Bovier, P. A., Isah, R., Françoise, G., Ariel, E., & Louis, L. (2003). Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral. Social Science & Medicine, 57(3), 503-512.

    Bogdan, R., & Biklen, S. (2007). Qualitative research for education: An introduction to theory and practice. Needham Heights, MA: Allyn and Bacon.

    Brach, C., Fraser, I., & Paez, K. (2005). Crossing the language chasm. Health Affairs, 24(2), 424-434.

    Brisset, C., Leanza, Y., Rosenberg, E., Vissandjée, B., Kirmayer, L. J., Muckle, G., ... & Laforce, H. (2014). Language barriers in mental health care: A survey of primary care practitioners. Journal of Immigrant and Minority Health, 16(6), 1238-1246.

    Buchwald, D., Caralis, P.V., Gany, F., Hardt, E. J., Muecke, M. A., & Putsch III, R. W. (1993). The medical interview across cultures. Patient Care, 27(7), 141-152.

    Butow, P. N., Sze, M., Dugal-Beri, P., Mikhail, M., Eisenbruch, M., Jefford, M., ... & Psycho-Oncology Co-operative Research Group. (2011). From inside the bubble: migrants’ perceptions of communication with the cancer team. Supportive Care in Cancer, 19(2), 281-290.

    California Standards for Healthcare Interpreters. (2002). California standards for healthcare interpreters: Ethical principles, protocols, and guidance on roles & intervention. Retrieved October 26, 2018, from http://www.chiaonline.org/resources/Pictures/CHIA_standards_manual_%20March%202017.pdf

    Cambridge, J. (1999). Information loss in bilingual medical interviews through an untrained interpreter. The Translator, 5(2), 201-219.

    Campbell, C., Lockyer, J., Laidlaw, T., & MacLeod, H. (2007). Assessment of a matched‐pair instrument to examine doctor-patient communication skills in practising doctors. Medical Education, 41(2), 123-129.

    Carrasquillo, O., Orav, E. J., Brennan, T. A., & Burstin, H. R. (1999). Impact of language barriers on patient satisfaction in an emergency department. Journal of General Internal Medicine, 14(2), 82-87.

    Chan, Y. F., Alagappan, K., Rella, J., Bentley, S., Soto-Greene, M., & Martin, M. (2010). Interpreter services in emergency medicine. The Journal of Emergency Medicine, 38(2), 133-139.

    Chang, T. C. (2009). The knowledge and construction of diverse cultural care: The perception, communication and disparity between Vietnam’s mothers and nurses during children’s hospitalization (Unpublished master’s thesis). Kaohsiung Medical University, Taiwan.

    Chen, A. W., Kazanjian, A., & Wong, H. (2009). Why do Chinese Canadians not consult mental health services: health status, language or culture?. Transcultural Psychiatry, 46(4), 623-641.

    Chen, H. Y. (2013). The doctor-patient interaction in cross-cultural medical care: Views from clinical physicians (Unpublished master’s thesis). National Chi Nan University, Nantou, Taiwan.

    Chen, T. Y. (2002). The adjustability of international marriage in Peng-Hu County: Comparison with Indonesian and Vietnamese brides (Unpublished master’s thesis). National Taiwan Normal University, Taipei, Taiwan.

    Chong, H. H., & Liu, H. Y. (2012). Known is unknown: Language and social work with immigrants. Soochow Journal of Social Work, 23, 121-144.

    Crane, J. A. (1997). Patient comprehension of doctor-patient communication on discharge from the emergency department. Journal of Emergency Medicine, 15(1), 1-7.

    Creswell, J. W., & Clark, V. L. P. (2017). Designing and conducting mixed methods research. Thousand Oaks: Sage publications.

    David, R. A., & Rhee, M. (1998). The impact of language as a barrier to effective health care in an underserved urban Hispanic community. Mount Sinai Journal of Medicine, 65, 393-397.

    Davidson, B. (2000). The interpreter as institutional gatekeeper: The social-linguistic role of interpreters in Spanish-English medical discourse. Journal of Sociolinguistics, 4(3), 379-405.

    Dysart-Gale, D. (2005). Communication models, professionalization, and the work of medical interpreters. Health Communication, 17(1), 91-103.

    Dysart-Gale, D. (2007). Clinicians and medical interpreters: negotiating culturally appropriate care for patients with limited English ability. Family & Community Health, 30(3), 237-246.

    Dillman, D. A., Smyth, J. D., & Christian, L. M. (2014). Internet, phone, mail, and mixed‐method surveys: the tailored design method. Boston, MA: John Wiley.

    Dörnyei, Z. (2007). Research methods in applied linguistics: Quantitative, qualitative, and mixed methodologies. Oxford: Oxford University Press.

    Downing, B., & Roat, C. (2002). Models for the provision of language access in health care settings. California: National Council on Interpreting in Health Care and Hablamos Juntos.

    Edlow, J. A. (1996). Foreign tongues. Annals of Emergency Medicine, 28(4), 453-455.

    Engel, G. L. (1978). The biopsychosocial model and the education of health professionals. Annals of the New York Academy of Sciences, 310(1), 169-181.

    Erzinger, S. (1991). Communication between Spanish-speaking patients and their doctors in medical encounters. Culture, Medicine and Psychiatry, 15(1), 91-110.

    Eytan, A., Bischoff, A., & Loutan, L. (1999). Use of interpreters in Switzerland's psychiatric services. The Journal of Nervous and Mental Disease, 187(3), 190-192.

    Fan, M. Y. (2011). Healthcare interpreting in Taiwan: A case study of healthcare interpreters in public health centers in New Taipei City (Unpublished master’s thesis). National Taiwan Normal University, Taipei, Taiwan.

    Ferguson, W. J., & Candib, L. M. (2002). Culture, language, and the doctor-patient relationship. FMCH Publications and Presentations, 61.

    Fiscella, K., Franks, P., Doescher, M. P., & Saver, B. G. (2002). Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Medical Care, 40(1), 52-59.

    Flores, G. (2000). Culture and the patient-physician relationship: achieving cultural competency in health care. The Journal of Pediatrics, 136(1), 14-23.

    Flores, G. (2005). The impact of medical interpreter services on the quality of health care: A systematic review. Medical Care Research & Review, 62(3), 255-299.

    Flores, G. (2006). Language barriers to health care in the United States. New England Journal of Medicine, 355(3), 229-231.

    Flores, G., & Vega, L. R. (1998). Barriers to health care access for Latino children: a review. FAMILY MEDICINE-KANSAS CITY-, 30, 196-205.

    Fox, S. A., & Stein, J. A. (1991). The effect of physician-patient communication on mammography utilization by different ethnic groups. Medical Care, 29(11), 1065-1682.

    Freeman, G. K., Rai, H., Walker, J. J., Howie, J. G., Heaney, D. J., & Maxwell, M. (2002). Non-English speakers consulting with the GP in their own language: a cross-sectional survey. British Journal of General Practice, 52(474), 36-38.

    Gandhi, T. K., Burstin, H. R., Cook, E. F., Puopolo, A. L., Haas, J. S., Brennan, T. A., & Bates, D. W. (2000). Drug complications in outpatients. Journal of General Internal Medicine, 15(3), 149-154.

    Grasska, M. A., & McFarland, T. (1982). Problems and Solutions. The American Journal of Nursing, 82(9), 1376-1379.

    Guba, E. G., & Lincoln, Y. S. (2005). Paradigmatic Controversies, Contradictions, and Emerging Differences. In Denzin, N. K., & Lincoln, Y. S. (Eds.), The Sage handbook of qualitative research (3rd ed., pp. 191-216). Thousand Oaks: Sage publications.

    Haffner, L. (1992). Translation is not enough. Interpreting in a medical setting. Western Journal of Medicine, 157(3), 255.

    Hale, S. (2007). Community interpreting. Berlin: Springer.

    Hampers, L. C., Cha, S., Gutglass, D. J., Binns, H. J., & Krug, S. E. (1999). Language barriers and resource utilization in a pediatric emergency department. Pediatrics, 103(6), 1253-1256.

    Hornberger, J., Itakura, H., & Wilson, S. R. (1997). Bridging language and cultural barriers between physicians and patients. Public Health Reports, 112(5), 410.

    Hsieh, E. (2006). Understanding medical interpreters: Reconceptualizing bilingual health communication. Health Communication, 20(2), 177-186.

    Hsieh, E. (2010). Provider-interpreter collaboration in bilingual health care: competitions of control over interpreter-mediated interactions. Patient Education and Counseling, 78(2), 154-159.

    Hsieh, E., Pitaloka, D., & Johnson, A. J. (2013). Bilingual health communication: distinctive needs of providers from five specialties. Health Communication, 28(6), 557-567.

    Hu, D. J., & Covell, R. M. (1986). Health care usage by Hispanic outpatients as a function of primary language. Western Journal of Medicine, 144(4), 490.

    Huang, J. N., & Kuo, S. T. (2012). Counselor and interpreter collaboration in counseling service. Taiwan Counseling Quarterly, 4(2), 12-21

    International Organization for Migration (2002). International Dialogue on Migration. International Organization for Migration Policy and Research Programme. Retrieved October 26, 2018, from http://publications.iom.int/system/files/pdf/idm_1_en.pdf

    Jacobs, E. A., Agger-Gupta, N., Chen, A. H., Piotrowski, A., & Hardt, E. J. (2003). Language barriers in health care settings: an annotated bibliography of the research literature. Woodland Hills, CA: The California Endowment, 1-80.

    Kale, E., & Syed, H. R. (2010). Language barriers and the use of interpreters in the public health services. A questionnaire-based survey. Patient Education and Counseling, 81(2), 187-191.

    Karliner, L.S., Pérez-Stable, E.J., & Gildengorin, G. (2004). The language divide. The importance of training in the use of interpreters for outpatient practice. Journal of General Internal Medicine, 19(2), 175-183.

    Karliner, L.S., Jacobs, E.A., Chen, A.H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research, 42(2), 727-754.

    Kaufert, J. M., & Koolage, W. W. (1984). Role conflict among ‘culture brokers’: The experience of native Canadian medical interpreters. Social Science & Medicine, 18(3), 283-286.

    Kirkman-Liff, B., & Mondragón, D. (1991). Language of interview: relevance for research of southwest Hispanics. American Journal of Public Health, 81(11), 1399-1404.

    Kirmayer, L. J., Weinfeld, M., Burgos, G., du Fort, G. G., Lasry, J. C., & Young, A. (2007). Use of health care services for psychological distress by immigrants in an urban multicultural milieu. The Canadian Journal of Psychiatry, 52(5), 295-304.

    Kuo, D., & Fagan, M.J. (1999). Satisfaction with methods of Spanish interpretation in an ambulatory care clinic. Journal of General Internal Medicine, 14(9), 547-550.

    Kurtz, S.M., Draper, J., & Silverman, J. (2016). Skills for communicating with patients. Boca Raton, FL: CRC Press.

    Lee, L. J., Batal, H. A., Maselli, J. H., & Kutner, J. S. (2002). Effect of Spanish interpretation method on patient satisfaction in an urban walk‐in clinic. Journal of General Internal Medicine, 17(8), 641-646.

    Leman, P., & Williams, D. J. (1999). Questionnaire survey of interpreter use in accident and emergency departments in the UK. Emergency Medicine Journal, 16(4), 271-274.

    Liao, W. Y. (2011). A study of primary care physicians on cross-cultural health care competence and its correlated factors (Unpublished master’s thesis). National Defense Medical Center, Taipei, Taiwan.

    London, F. (2000). Patient education depends on correct interpretation. RN, 63(6), 9-9.

    Manson, A. (1988). Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Medical Care, 1119-1128.

    Marcos, L. R., Urcuyo, L., Kesselman, M., & Alpert, M. (1973). The language barrier in evaluating Spanish-American patients. Archives of General Psychiatry, 29(5), 655-659.

    Marshall, M. N. (1996). Sampling for qualitative research. Family practice, 13(6), 522-526.

    Metzger, M. (1999). Sign language interpreting: Deconstructing the myth of neutrality. Washington, DC: Gallaudet University Press.

    Ministry of Labor, Republic of China. (2018). Retrieved October 26, 2018, from http://www.mol.gov.tw/

    Nápoles, A. M., Santoyo-Olsson, J., Karliner, L. S., O’Brien, H., Gregorich, S. E., & Pérez-Stable, E. J. (2010). Clinician ratings of interpreter mediated visits in underserved primary care settings with ad hoc, in-person professional, and video conferencing modes. Journal of Health Care for the Poor and Underserved, 21(1), 301-317.

    National Immigration Agency, Republic of China. (2018). Retrieved October 26, 2018, from https://www.immigration.gov.tw/mp.asp?mp=1

    Ngo-Metzger, Q., Massagli, M. P., Clarridge, B. R., Manocchia, M., Davis, R. B., Iezzoni, L. I., & Phillips, R. S. (2003). Linguistic and cultural barriers to care. Journal of General Internal Medicine, 18(1), 44-52.

    Office of Minority Health. (2016). National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. Retrieved October 26, 2018, from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53

    Oxford Advanced Learner’s Dictionary. (2018). Retrieved October 26, 2018, from https://www.oxfordlearnersdictionaries.com/definition/english/barrier?q=barrier

    Papic, O., Malak, Z., & Rosenberg, E. (2012). Survey of family physicians’ perspectives on management of immigrant patients: attitudes, barriers, strategies, and training needs. Patient Education and Counseling, 86(2), 205-209.

    Parsons, J. A., Baker, N. A., Smith-Gorvie, T., & Hudak, P. L. (2014). To ‘Get by’or ‘get help’? A qualitative study of physicians’ challenges and dilemmas when patients have limited English proficiency. BMJ open, 4(6), e004613.

    Patton, M. Q. (2001). Evaluation, knowledge management, best practices, and high quality lessons learned. American Journal of Evaluation, 22(3), 329-336.

    Pérez -Stable, E. (1987). Issues in Latino health care. Western Journal of Medicine, 146(2), 213.

    Pérez-Stable, E. J., & Nápoles-Springer, A. (2000). Interpreters and communication in the clinical encounter. The American Journal of Medicine, 108(6), 509-510.

    Pérez-Stable, E. J., Nápoles-Springer, A., & Miramontes, J. M. (1997). The effect of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Medical Care, 35(12), 1212-1219.

    Phelan, M., & Parkman, S. (1995). How to work with an interpreter. British Medical Journal, 311(7004), 555.

    Pöchhacker, F. (2016). Introducing interpreting studies. New York: Routledge.

    Pöchhacker, F., & Kadric, M. (1999). The hospital cleaner as healthcare interpreter: A case study. The Translator, 5(2), 161-178.

    Ramirez, D., Engel, K. G., & Tang, T. S. (2008). Language interpreter utilization in the emergency department setting: a clinical review. Journal of Health Care for the Poor and Underserved, 19(2), 352-362.

    Reddy, M. (1979). The conduit metaphor. Metaphor and Thought, 2, 285-324.

    Reschovsky, J., & Boukus, E. R. (2010). Modest and uneven: physician efforts to reduce racial and ethnic disparities. Washington, DC: Center for Studying Health System Change.

    Rivero-Kempf, R. (1999). AT&T language line: educating transcultural nurses on federal mandates and interpreter use. Journal of Transcultural Nursing, 10, 159-160.

    Roat, C. E. (1999). Bridging the gap: A basic training for medical interpreter. Seattle, WA: The Cross Cultural Health Care Program.

    Rosenberg, E., Leanza, Y., & Seller, R. (2007). Doctor-patient communication in primary care with an interpreter: physician perceptions of professional and family interpreters. Patient Education and Counseling, 67(3), 286-292.

    Rosenberg, E. E., Lussier, M. T., & Beaudoin, C. (1997). Lessons for clinicians from physician-patient communication literature. Archives of Family Medicine, 6(3), 279.

    Roy, C. B. (1993). The problem with definitions, descriptions, and the role metaphors of interpreters. Journal of Interpretation, 6(1), 127-154.

    Sadavoy, J., Meier, R., & Ong, A. Y. M. (2004). Barriers to access to mental health services for ethnic seniors: The Toronto study. The Canadian Journal of Psychiatry, 49(3), 192-199.

    Seidman, I. (2006). Interviewing as qualitative research: A guide for researchers in education and social sciences. New York: Teachers College Press.

    Shih, C. L., (2018). A probe into the language service of online machine translation for Southeast Asian immigrants. Compilation and Translation Review, 11(2), 31-60.

    Simons, G. F. (2017). Ethnologue: Languages of the world. SIL International.

    Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal treatment: confronting racial and ethnic disparities in healthcare.

    Snowden, L. R., & Yamada, A. M. (2005). Cultural differences in access to care. Annual Review of Clinical Psychology, 1, 143-166.

    Sun, L. J., Chen, C. M., Lee, P. H., & Huang, L. H. (2006). Factors Related to the Public Health Nurses Implementation of Family Planning for Foreign Spouses in Miaoli County. Hungkuang Academic Review, 49, 91-100.

    Taiwan Medical Association. (2017). Retrieved October 26, 2018, from http://www.tma.tw/stats/files/2017/2017%E5%B9%B4%E7%B5%B1%E8%A8%88%E5%9C%96-%E6%9C%83%E5%93%A1%E6%95%B8(%E5%8F%B0%E7%81%A3%E5%9C%B0%E5%9C%96).pdf

    Tang, S. Y. S. (1999). Interpreter services in health care: Policy recommendations for health care agencies. Journal of Nursing Administration, 29(6), 23–29.

    Teunissen, E., Gravenhorst, K., Dowrick, C., van Weel-Baumgarten, E., Van den Driessen Mareeuw, F., de Brún, T., ... & O’Reilly-de Brún, M. (2017). Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study. International Journal for Equity in Health, 16(1), 32.

    Thompson, W. L., Thompson, T. L., & House, R. M. (1990). Taking care of culturally different and non-English speaking patients. The International Journal of Psychiatry in Medicine, 20(3), 235-245.

    United Nations Department of Economics and Social Affairs. (2017). Trends in international migration, 2017. Retrieved October 26, 2018, from http://www.un.org/en/development/desa/population/migration/publications/migrationreport/docs/MigrationReport2017_Highlights.pdf

    United States Department of State. (1996). Title VI of the Civil Rights Act of 1964. Retrieved October 26, 2018, from https://www.justice.gov/crt/fcs/TitleVI

    Vasquez, C., & Javier, R. A. (1991). The problem with interpreters: communicating with Spanish-speaking patients. Psychiatric Services, 42(2), 163-165.

    Wadensjö, C. (1992). Interpreting as interaction: On dialogue-interpreting in immigration hearings and medical encounters (Unpublished doctoral dissertation). Linköpings universitet, Linköping.

    Wadensjö, C. (1999). Interpreting as interaction. New York: Routledge.

    Wang, Y. M., Han, C. H., & Huang, M. C. (2007). The interpreter: crossing communication barriers between healthcare providers and international patients. The Journal of Nursing, 54(4), 73-77.

    Waxman, M. A., & Levitt, M. A. (2000). Are diagnostic testing and admission rates higher in non-English-speaking versus English-speaking patients in the emergency department?. Annals of Emergency Medicine, 36(5), 456-461.

    Weinick, R. M., & Krauss, N. A. (2000). Racial/ethnic differences in children's access to care. American Journal of Public Health, 90(11), 1771.

    Woloshin, S., Bickell, N. A., Schwartz, L. M., Gany, F., & Welch, H. G. (1995). Language barriers in medicine in the United States. JAMA, 273(9), 724-728.

    Woloshin, S., Schwartz, L. M., Katz, S. J., & Welch, H. G. (1997). Is language a barrier to the use of preventive services?. Journal of General Internal Medicine, 12(8), 472-477.

    Wu, M. L. (2010). Thesis writing and quantitative research. Taipei, Taiwan: Wu-Nan Book Inc.

    Yang, Y. M. & Wang, H. H. (2003). The Health Concerns of Interracial Marriage Among Indonesian Women in Taiwan. The Journal of Nursing Research, 11(3), 167-176.

    Yen, C. C. (2002). A study on the process of adaptation among foreign brides from Southeast Asia: Interpreting the phenomenon of their lived experiences (Unpublished master’s thesis). National Chiayi University, Taiwan.

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