Personne : Leanza, Yvan
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Leanza
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Yvan
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Université Laval. École de psychologie
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ncf10881325
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Publication Restreint Language barriers in mental health care : a survey of primary care practitioners(Springer Nature, 2013-12-29) Brisset, Camille; Leanza, Yvan; Rosenberg, Ellen; Muckle, Gina; Vissandjée, Bilkis; Kirmayer, Laurence J.; Xenocostas, Spyridoula; Laforce, HuguesMany migrants do not speak the official language of their host country. This linguistic gap has been found to be an important contributor to disparities in access to services and health outcomes. This study examined primary care mental health practitioners’ experiences with linguistic diversity. 113 practitioners in Montreal completed a self-report survey assessing their experiences working with allophones. About 40 % of practitioners frequently encountered difficulties working in mental health with allophone clients. Few resources were available, and calling on an interpreter was the most common practice. Interpreters were expected to play many roles, which went beyond basic language translation. There is a clear need for training of practitioners on how to work with different types of interpreters. Training should highlight the benefits and limitations of the different roles that interpreters can play in health care delivery and the differences in communication dynamics with each role.Publication Restreint Roles of community interpreters in pediatrics as seen by interpreters, physicians and researchers(John Benjamins Publishing Co, 2005-01-01) Leanza, YvanThis paper is an attempt at defining more clearly the various roles of community interpreters and the processes implicitly connected with each of them. While the role of the interpreter is a subject that has been widely discussed in the social science literature, it is less present in the biomedical one, which tends to emphasize the importance of interpreting in overcoming language barriers, rather than as a means of building bridges between patients and physicians. Hence, studies looking at interpreted medical interactions suggest that the presence of an interpreter is more beneficial to the healthcare providers than to the patient. This statement is illustrated by the results of a recent study in a pediatric outpatient clinic in Switzerland. It is suggested that, in the consultations, interpreters act mainly as linguistic agents and health system agents and rarely as community agents. This is consistent with the pediatricians’ view of the interpreter as mainly a translating machine. A new typology of the varying roles of the interpreter is proposed, outlining the relation to cultural differences maintained therein. Some recommendations for the training of interpreters and healthcare providers are suggested.Publication Restreint Doctor–patient communication in primary care with an interpreter : physician perceptions of professional and family interpreters(Elsevier, 2007-04-19) Rosenberg, Ellen; Leanza, Yvan; Seller, RobbynObjective This paper explores physician perceptions of the ways professional and family interpreters affect their performance of doctor-communication tasks described in the Calgary-Cambridge Framework. Methods Physicians’ (19) encounters with patients (24) accompanied by an interpreter were videotaped. Stimulated recall was used to elicit each of the participants’ perceptions of the clinical encounter. We analyzed transcriptions of the physician interviews using Atlas-ti software. Results Physicians perceived all communication tasks to be more difficult using an interpreter than when one was not needed. Physicians perceived family interpreters to be less skilled translators than professional interpreters. Physicians expected professional interpreters to serve as culture brokers at least some of the time. Although only some family interpreters were also caregivers, physicians assumed that all of them fulfilled caregiver roles. Conclusion With professional interpreters, physicians follow communication rules they were taught. In contrast, physicians act as though these rules are not relevant with family interpreters who they treat as caregivers. Practice implications Guidelines to working with an interpreter should include directives on working with both professional and family interpreters, describing the similarities and differences with each type, and modifying the clinical encounter process to correspond to those attributes.Publication Restreint Working with interpreters in health care : a systematic review and meta-ethnography of qualitative studies(Elsevier, 2012-12-13) Laforest, Karine; Brisset, Camille; Leanza, YvanObjective : To identify relational issues involved in working with interpreters in healthcare settings and to make recommendations for future research. Methods : A systematic literature search in French and English was conducted. The matrix method and a meta-ethnographic analysis were used to organize and synthesize the data. Results : Three themes emerged. Interpreters’ roles: Interpreters fill a wide variety of roles. Based on Habermas's concepts, these roles vary between agent of the Lifeworld and agent of the System. This diversity and oscillation are sources of both tension and relational opportunities. Difficulties: The difficulties encountered by practitioners, interpreters and patients are related to issues of trust, control and power. There is a clear need for balance between the three, and institutional recognition of interpreters’ roles is crucial. Communication characteristics: Non-literal translation appears to be a prerequisite for effective and accurate communication. Conclusion : The recognition of community interpreting as a profession would appear to be the next step. Without this recognition, it is unlikely that communication difficulties will be resolved.Publication Restreint Integration of interpreters in mental health interventions with children and adolescents : the need for a framework(Sage Publications, 2014-12-11) Boivin, Isabelle; Brisset, Camille; Moro, Marie Rose; Leanza, Yvan; Rousseau, Cécile; Rosenberg, Ellen; Hassan, GhaydaFew empirical studies have detailed the specificities of working with interpreters in mental healthcare for children. The integration of interpreters in clinical teams in child mental healthcare was explored in two clinics, in Montreal and Paris. Four focus groups were conducted with interpreters and clinicians. Participants described the development of the working alliance between interpreters and clinicians, the delineation of interpreters’ roles, and the effects of translation on the people in the interaction. Integrating interpreters in a clinical team is a slow process in which clinicians and interpreters need to reflect upon a common framework. An effective framework favours trust, mutual understanding, and valorization of the contribution of each to the therapeutic task. The interpreter’s presence and activities seem to have some therapeutic value.Publication Restreint Interprétation et interprétariat : chassé-croisé en thérapies analytiques plurilingues(Filigrane, 2012-01-23) Boivin, Isabelle; Brisset, Camille; Leanza, YvanCet article porte sur l’interprétation, processus au coeur de l’activité aussi bien de l’interprète communautaire que du thérapeute d’approche analytique. Chacun agit selon une démarche particulière, sur une base de référents théoriques et techniques propres à sa profession ou à sa fonction ; et tous deux reçoivent un ensemble d’informations qu’ils doivent comprendre, transformer et transmettre à nouveau. Cependant, ni l’un ni l’autre ne se positionne comme simple passeur d’information, mais bien comme interlocuteur à part entière dans un dialogue à trois, participant à la construction d’une intercompréhension. Les auteurs passent en revue des notions clés de la thérapie analytique, comme la neutralité, le transfert et le contre-transfert, qui doivent être repensées dans le cas où un interprète communautaire est nécessaire pour établir le dialogue. Il apparaît qu’interprète et thérapeute doivent se questionner sur la place à accorder à la neutralité et à leur propre subjectivité dans la communication, en fonction des objectifs thérapeutiques.Publication Accès libre Intégrer un interprète dans les consultations de médecine familiale : une analyse de discours assistée par ordinateur(Universidad de La Laguna, 2014-09-01) Michaud Labonté, Thomas; Leanza, Yvan; Rizkallah, ÉliasPublication Accès libre Pédiatres, parents migrants et interprètes communautaires : un dialogue de sourds ?(Université de Lausanne, 2004-01-01) Leanza, YvanPublication Restreint The patient’s lifeworld : building meaningful clinical encounters between patients, physicians and interpreters(Equinox Publishing Ltd., 2014-02-16) Boivin, Isabelle; Leanza, Yvan; Rosenberg, EllenIn this paper, our objectives are first to explore the different ways physicians and interpreters interact with patients’ Lifeworld, and second, to describe and compare communication patterns in consultations with professional and those with family interpreters. We conducted analyses of transcriptions of 16 fam-ily practice consultations in Montreal in the pres-ence of interpreters. Patterns of communication are delineated, grounded in Habermas’ Communicative Action Theory and Mishler’s operational concepts of Voice of Medicine and Voice of Lifeworld. Four com-munication patterns emerged: (1) strategically using Lifeworld data to achieve biomedical goals; (2) hav-ing an interest in the Lifeworld for itself; (3) integrat-ing the Lifeworld with biomedicine; and (4) referring to another professional. Our results suggest physi-cians engage with patients’ Lifeworld and may ben-efit from both types of interpreters’ understanding of the patient’s specific situations. A professional in-terpreter is likely to transmit the patient’s Lifeworld utterances to the physician. A family member, on the other hand, may provide extra biomedical and Lifeworld information, but also prevent the patient’s Lifeworld accounts from reaching the physician. Physicians’ training should include advice on how to work with all types of interpreters and interpret-ers’ training should include mediation competencies in order to enhance their ability to promote the pro-cesses of co-construction of meaning.Publication Restreint Through interpreters’ eyes : comparing roles of professional and family interpreters(Elsevier Ireland Ltd., 2008-01-01) Rosenberg, Ellen; Leanza, Yvan; Seller, RobbynObjective We describe and compare the perceptions of professional and family member interpreters concerning their roles and tasks as interpreters in primary care clinical encounters. Methods Encounters between physicians (19) and patients (24) accompanied by a professional (6) or a family (9) interpreter were videotaped. Stimulated recall was used to elicit interpreters’ perceptions of their role in the clinical encounter. We analyzed transcriptions of the interpreter interviews using Atlas-ti software. Results The roles professional interpreters identified were: information transfer; creating a safe environment for the patient; mediation between cultures; maintaining professional boundaries. Family interpreters perceived their roles (facilitating understanding; ensuring diagnosis and treatment; interacting with the health care system) as part of their responsibilities as a family member. Conclusion Professional interpreters act mainly to ensure information transfer. Family interpreters act mainly as a third participant often speaking as themselves rather than rendering the words of doctor and patient into the other's language. Practice implications To obtain the maximum benefit from a professional interpreter the physician must invite the interpreter to act as an advocate for the patient and a culture broker. Physicians should always use a professional interpreter to ensure accurate information transfer. A family member should often be included in encounters to serve as a valuable patient advocate.