Investigating comprehensibility in translated Patient Information Leaflets
The last two decades have seen an increased focus on providing patients with lay-friendly, easily understood information, with the purpose of involving patients in their own health, and enabling them to make informed decisions. Producing health information suitable for lay people can be a difficult feat considering the complexity of the information as well as the knowledge asymmetry which often exists between the expert sender and the lay receiver. These problems are further exacerbated when health communication is translated as is often the case for example in the EU. The Patient Information Leaflet (PIL), which informs about dosage, side effects etc. for medication, is one such genre, which in the EU is translated into all 24 EU languages, and which legally must be easy to understand for patients (European Parliament and of the Council, 2001). However, despite this legal requirement, a study by Askehave & Zethsen (2002) has shown that translated Danish PILs were, without exception, more complex than their English source texts. To further explore this increase in complexity, a study investigating the extent of this change in comprehensibility and the possible reasons for it was conducted. This paper thus reports on a mixed-methods study of translated PILs. In the first part of the study, contrastive textual analysis of 54 PILs translated from English into Danish is performed. To perform any kind of translation analysis, the concept of translation quality assessment must be taken into consideration. From a functionalist perspective, a particular expression or utterance does not in itself have the characteristic of being correct or incorrect (Nord, 1997). Within functionalism, translation errors, and thus quality, are therefore inherently closely linked to the translation skopos. For PIL translation, one of the main skopoi is producing a target text that is “written and designed to be clear and understandable, enabling the users to act appropriately, when necessary with the help of health professionals” (Article 63(2) of Directive 2001/83/EC). Two main elements are thus important: first, the PIL must be translated using language that is clear and understandable, which could be termed “plain language”. This is thus related to the linguistic complexity of PILs. Examples could be the use of complex syntax such as nominalisation or the use of long compound nouns. Second, PIL translations must be understandable for lay people, in this study termed “lay-friendly”. This is related to medical expert register such as the use of complex medical terminology. Both of these categories are thus linked to the concept of comprehensibility. Results show that translators make many micro level translation choices that lead to increased complexity in relation to lay-friendliness in the Danish translations, such as the use of Latin-Greek-based expert terminology. The translation of medical register is especially problematic for comprehensibility because there are major differences between the usage of medical terms in different languages, i.e. in what constitutes expert and lay register. English medical language, and medical language in general, is mainly based on terminology made up of roots, prefixes and suffixes drawn from Greek and Latin (van Hoof, 1998, p. 49). The same is true for Danish medical language; however, this is only the case for Danish medical language used by experts for experts. The reason is that Latin was not incorporated into all European languages to the same extent (Zethsen, 2004, p. 132), which means that for example English often uses a Latin-based term both in expert and lay registers, whereas Danish (as well as German and other Scandinavian languages) has doublets, i.e. both the Latin-based term belonging primarily to an expert register, and a native word belonging to a lay register. Therefore, when translating medical genres for lay people, the translator must also focus on differences in language use, and must thus also have intralingual translation competence. In addition to the findings related to the use of Latin/Greek-based terms, the study also demonstrates an extensive use of long compound nouns and nominalizations in the translations. All these findings are thus in contrast to the work on the universal of simplification in translation (see e.g. Baker, 1996; Kruger, 2004). So why is this? The second part of the study seeks to gain an understanding of the reasoning behind the translation strategies used in PILs by conducting two focus groups with PIL translators. Results of the focus groups show that the lack of comprehensibility in PILs is not so much linked to lack of translation competence or to other intratextual reasons, as to extratextual constraints such as tight deadlines for translation, poor mandatory templates and authoritative bodies and reviewers without interlingual and intralingual translation knowledge. This suggest that, in order to improve the comprehensibility of translated PILs, the regulations governing the genre and the agents involved in this process need to be further educated on the intricacies of translation – both from a intralingual and an interlingual perspective. Key words: comprehensibility, extratextual constraints, intralingual translation, Patient Information Leaflets, plain language References: Askehave, I., & Zethsen, K. K. (2002). Translating for Laymen. Perspectives: Studies in Translatology, 10(1), 15-29. Baker, M. (1996). Corpus-based translation studies: The challenges that lie ahead. Benjamins Translation Library, 18, 175-186. European Parliament and of the Council. (2001). Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001. Kruger, A. (2004). Corpus-based translation research: its development and implications for general, literary and Bible translation. Acta Theologica, 22(1), 70-106. Nord, C. (1997). Translating as a purposeful activity: functionalist approaches explained. Manchester: St. Jerome. van Hoof, H. (1998). The Language of Medicine: A Comparative Ministudy of English and French. In H. Fischbach (Ed.), Translation and Medicine (pp. 49-64). Amsterdam/Philadelphia: John Benjamins Publishing Company. Zethsen, K. K. (2004). Latin-based terms: True or false friends? Target, 16(1), 125-142.
Main Research Area:
7th EST Congress - Translation Studies: Centres and Peripheries, 2013