Keeping it patient-centred

When it comes to patient-related content, the translator has to consider a couple of important aspects. It goes without saying that medical content, due to its association with the preservation and prolongation of life, holds a special status among the scientific disciplines. An error in a medical text can potentially have repercussions beyond financial loss.
For that reason, special diligence is needed when writing, publishing and distributing patient-related content. This includes the process of translating patient-facing documentation into a foreign language.

The second point I would like to highlight is Confidentiality.
Medical Translators must follow the same rules which apply to other healthcare personnel when it comes to writing, distributing and the storage of clinical notes or patient documents. In the age of digital patient records, particular care is required for the handling of such information. Translators in the medical field should be following the recommendations regarding health data governance, such as the Caldicott Principles in the UK.
And consequently, apply confidentiality standards at each step of the translation process.

Informing a female patient

Types of Patient-facing documents:

  • Consent forms
    Used to inform patients about Treatment or Clinical Trials with the aim to obtain informed consent.

  • Medication package insert
    This piece of paper is found in every medication package and is often just called Patient Leaflet. It provides information about the drug, its use and side effects.

  • Medical devices for Patients (Packaging and Labelling)
    Content in relation to medical devices includes instructions about the safe and proper use of the device. In addition, it contains particulars like, “sterile”, the name and address of the manufacturer, storage conditions, etc.

  • Referral letters / Outpatient letters
    This written communication between Specialists or between health professionals from Primary to Secondary Care Trusts was traditionally not intended for patients. The trend today, however, is to include patient at every step of their care and they can opt-in to receive a copy of such letters.

  • Patient education
    This content aims at improving the understanding of medical conditions, diagnosis, treatment, or disability.

  • Patient records (including handwritten Notes)
    These notes are not usually intended for patients but can be requested for complaints or when moving into a different country.

  • Lifestyle advice
    This is an important part of Public Health education and disease prevention – such as information about vaccination or cancer screening. This type of content is often associated with a marketing pitch.

Do you speak “doctor”?

Apart from being fluent in German, English and French, I also speak “doctor”. You might have heard this language too, perhaps on television or during an outpatient appointment.

This is the language of Physicians and the voice of evidence-based medicine, the naming of illness, the digging for “the cause”, the talking about meticulous procedures, the deliberating on treatment and response. It is also the language of lousy handwriting and ridiculous abbreviations.
In German, the physician’s jargon is even more removed from the layperson, as it is stuffed with Latin words.

In my opinion, a medical document is best translated by someone who also speaks “doctor” and grasps the essence of a text.

What do you need to consider when translating patient information?

How to write patient-facing content

  1. Use simple language

    Write in a tone and style that patients can easily understand. Put yourself into the shoes of the reader, or better, imagine you would have to explain the subject matter to a 10-year-old child.

  2. Create easy-to-read sentences

    Use short sentences with concise context. Keep jargon at a minimum. If you feel that using a specialist term might benefit the flow of the text, mention the lay term first followed by the specialist / medical name. If there is no lay term, give a definition of the specialist term. Use active voice and avoid complex terminology.

  3. Use patient-first language

    Do not define a person by his or her condition, use people-first language when talking of patients with an illness. For instance, use “person with diabetes” instead of “diabetic”. For disabled people use words that respect them as active individuals, avoid passive language.

  4. Respect Privacy and Confidentiality

    Respect privacy and confidentiality when using patient information – follow the guidelines of good medical practice even if you’re not a doctor.

  5. Substantiate your Advice

    Mainly for authors: When giving advice, try to support it with evidence. Your text will become more credible and trustworthy.

  6. Protect vulnerable Patients

    Be aware of patients’ vulnerability and do not exploit their search for hope.

  7. Get feedback

    Before delivering the translation to the client, make sure you collect feedback from another person.

Patient Records

The General Medical Council (GMC) states that in providing care doctors must keep clear, accurate and legible records that report relevant clinical findings, decisions made, the information given to patients, treatment prescribed and who is making the record and when. Unfortunately, this is not always the case. Especially documentation in hospital records is often short, packed with abbreviations and poorly written – incomprehensible to a layperson.
By switching to digital patient records hospitals have eliminated the problem of the poorly legible handwriting, but not the other issues. A person who has a routine in deciphering such notes knows that they contain the most vital information. They reveal the thought process of the author such as suspicions, worries and certainties.

Example:
A simple term in a hospital record, like “neurologically intact” indicates that the author has performed an examination of the nervous system which did not reveal any abnormalities. But it also means that he or she has considered – and refuted – a potential neurological differential diagnosis. A purely syntactic translation here could neglect this fact and end up lacking information.