The aim of this descriptive study was to collect data to generate a theory that described and explained health care communication among family nurse practitioners (FNPs), interpreters, and Cambodian refugee patients in primary care settings. Data were obtained in five clinics from ten Cambodian-speaking interpreters and eight family nurse practitioners through semi-structured interviews and observations of health care interactions among the FNP, interpreter, and Cambodian refugee patient. A grounded theory methodology was used for data analysis and theory development.

Data analysis revealed that the interpreter engaged in the processes of getting, determining the relevance of, and handling the information in the interaction. The success of the interpreter in these processes depended on the ability to move from an outside to an inside position with both the patient and the FNP. The conditions for becoming an inside person included: (1) personal traits congruent with both cultures, (2) knowledge and shared experience with both cultures, (3) formal and informal education, (4) ability in both languages, (5) health care and interpreter training and experience, and (6) the relationship with the patient and FNP provider. Other factors that influenced the interaction included the context of the diagnostic medical interview as well as the clinic setting and function. Individuals in the interaction assumed one of three styles of interpretation that were either patient, provider, or interpreter focused. Components involved in the process of interpreting information either facilitated or impeded the outcome. The explanatory model of intercultural communication that evolved from the theory can be used to improve communication with and provide culturally sensitive and appropriate health care to non-English-speaking patients.