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Table 2 Hsieh’s Bilingual Health Model

From: The evolution of a healthcare interpreting service mapped against the bilingual health communication model: a historical qualitative case study

Summary of the BHC model with its four areas or circles
A. Communicative Goals: The basis of the BHC Model is that interpreter-mediated medical encounters are seen as a goal-oriented communicative activity. ‘In everyday talk, individuals hold multiple goals (e.g. task, identity and relationship goals) that are often negotiated and coordinated rather than explicitly discussed’ ([15]:137).
B. Individual agency: In the BHC Model, individual agency is the condition needed for the fulfilment of communicative goals. Individual agency is the ‘socially constructed and contextually situated self that is rooted in everyday practices and sites that call forth and supply its meanings’ ([15]:139).
C. System norms ‘move the understanding of interpreter-mediated interactions beyond the examination of individual performances and behaviours. Each individual in an interpreter-mediated medical encounter assumes certain roles, functions and behaviours under the influences and frames of the system(s)’. System means ‘the social systems and cultures in which there are specific norms, values and worldviews that are imposed upon individuals within the system’ ([15]:140). It appears that providers belong to the ‘culture of medicine’, in which there are specific views about conceptualising health and illness: this, in turn, can make a patient’s cultural representations ‘incompatible if not incomprehensible’.
D. Quality and Equality of Care (QEC): QEC is the overarching value of the BHC Model. ‘Although QEC can be a communicative goal when applied in context, it also serves as an all-encompassing value that integrates differences between systems, providing an ultimate value that guides the interpretation of competing systems. In other words, when individuals experience conflict due to competing or conflicting system norms, they rely on the guiding value of QEC to resolve their differences ([15]:143).