Linguistically Appropriate Services
Lack of interpreter services as well as lack of culturally and linguistically appropriate health education materials has been associated with patient dissatisfaction, poor comprehension, low treatment compliance, and lower quality health care (Advocates for Youth, 2008). For example, when predominantly Spanish-speaking patients were discharged from an emergency room, they were less likely than predominantly English-speaking patients to understand their diagnosis, medications, treatment plans, and follow-up care instructions. Consequently, predominantly Spanish-speaking patients were also less likely to indicate satisfaction with their health care and were often reluctant to return for follow-ups (Betancourt
(1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus, and Giroux. Karliner, L. S., Jacobs, E. A., Chen, A. H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited english proficiency?
Many patients who live in these communities have low literacy levels, and often need help completing medical forms, intake assessments, reading their medical results, bills as well as educational materials. Additional resources for this population should include pictorial pamphlets, medical interpreters and low literacy literature for these patients. Including family members in the process will help nurses bridge the culture and linguistic gaps in communication and care. Integrating knowledge and respect for various cultures, their belief systems, and values will facilitate better health care compliance and yield better
Some practical obstacles that hinder the delivery of proficient and economical services include differences in language, cultural and knowledge of health issues. However, the prudent advanced practice nurse (APN) considers these obstacles to communication when providing patient-centered care. Nevertheless, when language barriers are not addressed, the provision of quality care to patient and families are undermined, which then transcends to both economic and ethical dilemmas. According to the centers for disease control and prevention (CDC, 2016), the gateway to healthcare is often hindered to a great extent by the lack of the ability to communicate medical necessities due to language barrier. In any clinical setting, efficient patient communication is essential in the delivery and accessibility of quality care and safety.
A vital foundation for a high-quality care delivery is an efficacious communication between the patient and the healthcare providers (Gengler & Jarrell, 2015). Fadiman (1997) recounted the conflict between a refugee family from Laos and a small hospital in California over the care of Lia Lee, a Hmong girl with severe epilepsy, in her book The Spirit Catches You and You Fall Down. Despite both sides wanting the best care for Lia, the lack of cross-cultural communication between her Hmong family and her American doctors, lead to her tragedy (Fadiman, 1997). Awareness regarding the disparities in culture and language of our patient with ours and how to address them should be taken into account when providing healthcare since the life of a
Effective communication with patients is critical to the safety and quality care. From the last two decades ,number of researches has been conducted on the impact of language barrier on health and healthcare. It is observed that language barriers are the main cause of medical errors, complication and adverse event. But due to data limitations ,limited researches on impacts of language barrier has been conducted in Canadian setting. However, the researches conducted on other countries on the impact of language barrier on quality of care is applicable in the Canadian context. Some researches shows that there are several barrier which affect quality of care and patient safety. Now, researches has begun to know the complexity of language, culture, race, health literacy that may affect patient care. Current approaches are moved towards the knowledge of risk of language barrier rather than implementation of effective, evidence informed strategies.
(2013) discussed the issue of lack of english skills being a primary barrier for patients receiving adequate health care. The article also mentions how studies have shown that Spanish speaking Latinos are less satisfied with the health care that they received in determine whether comparison to their English speaking counterparts. The purpose of the study was to Spanish speaking Latinos have an increased quality of care when provided with an interpreter during their visit. The population for the study was 30 patients in the Washington, DC metropolitan area, whose primary language was spanish. The intervention implied that the use of interpreters will improve the quality of healthcare received by non english speaking patients. The comparison aimed at urging providers to make an effort to provide legally appropriate care to patients who are unable to speak english. The outcome of the study was that miscommunication between healthcare workers can end up causing medical mistakes and liabilities. It was found that when facilities provided patients with interpreter services, the patient perception of quality care was
Non-English speaking citizens and immigrants are receiving improper medical care because of the miscommunication. The people who cannot speak English well are misunderstood, when they go to free clinics or hospital emergency rooms and attempt to explain their symptoms and illness or cannot understand the doctors or medical profession that are trying to help them. ” Interpreters are omitting questions about drug allergies. Patients are not telling nurses the correct symptoms. A mother misunderstood by putting oral antibiotic into the ears of the child instead of the mouth. The Puerto Rican word for mumps is not the same in Central America, so a child was mistreated. A doctor mistakenly told a parent to put a steroid crème on entire child instead of just the face” (Yolanda Prtida, 2005). Language barriers in the medical field are dangerous and some times even fatal. There is definitely a need for more translators in hospitals and doctors office. Clear communication is essential for safe quality healthcare. Poor communication can lead to disastrous outcomes, especially for patients with limited or no English ability.
According to the 2011 U.S. Census, twenty-one percent of the population speaks other language at home besides English. Hence, one of the biggest challenges in Healthcare is the language barrier between the providers, Health care administrators and patients that speak foreign languages. This poses a challenge for medical entities,
To determine the impact of language barriers on informed consent documentation in a clinical setting. We found from different research patients who spoke English were almost twice as likely as patients with limited English proficiency to have documentation of informed consent for 3 invasive medical procedures while hospitalized at a large urban hospital with on-site interpreter services. The relationship between primary language and informed consent documentation was not affected by patient age, gender, primary diagnosis, procedure, or medical service. The differences we found in rates of informed consent documentation between LEP and English-speaking patients are substantial and suggest disparities in the process of informed consent. Whereas
I see many challenges in regards to providing care to patients that do not speak English especially in the healthcare realm. From the very beginning we need to know what is wrong, what happened, how long it has been going for, what medical history they have, allergies, and medication taken. How can we treat what we do not know is wrong? In order to probably do some root cause analysis you need to drill down and see what is going on, which cannot be done if you cannot communicate. Also, you do not know what I making things better. These non-English speaking individuals will have unmet needs because of my inability to
Furthermore, the literature used consists of level V and VI of evidence (LoBiondo-Wood & Haber, 2013). This included three peer-reviewed, scholarly articles that were level V evidence, systematic reviews of qualitative studies. Additionally, there were two articles that were level VI evidence, a single qualitative study. A limitation to one of the studies by Ginieniewicz & McKenzie (2014) is that they are focusing on a specific immigrant population, Latin Americans in Canada. Two of the articles, written by Chadwick & Collins (2015) and Lum, Swartz, & Kwan (2016) emphasize the importance of language barriers in primary care, rather than specifically mental health. When discussing the language barriers there was an insufficient amount of detail about the language proficiency and which areas that needed to be met in order to successfully have a conversation between the health care practitioner and the client without confusion. Brisset et al. (2013) is the only article which discusses the different type of
One of the greatest things about nursing is that we have the opportunity to share with different cultures and learn about them. Our patients are complex; they each have their religion, culture, and life choices. Delivering health advice and not knowing much about a patient’s cultural background will influence how the patient may perceive the nurses’ advice. The article that I did my research on was published in 2011, by Perez-Avila, Sobralske and Katz; the name of the article is “No Comprendo: Practice Considerations When Caring for Latinos With Limited English Proficiency in the United States Health Care System”. In the United States, Hispanics form the largest minority. Most of this community has limited English
With the increasing immigrant population a third barrier affecting access to health care is a cultural barrier. Culture barriers can include values and beliefs, language and race and ethnicity. Health beliefs and behavior can become a barrier when patients decide not to seek medical treatment and instead turn to home remedies and healers when treating illnesses. Approximately 10% of Americans speak a language other than English and can be classified ad being limited in their proficiency. For these patients language becomes a barrier and they are less likely to receive optimal medical treatment (Flores, 2006). Horton and Johnson (2010) stress the importance of communication in reducing disparities and increasing the trust of patients in the health care system. As reported by the American College of Physicians, evidence reveals that racial and ethnic minorities are more likely to receive inferior care when compared with non-minorities. This occurs even when minorities have access to insurance and adequate income (Racial and ethnic disparities in health care, 2010).
Can you imagine the how the healthcare industry would be without language, what seems to be impossible to imagine is the everyday reality of some patients because of their native language. Language is a major contribution to the health disparities that some populations face, because it makes it difficult for some patients to communicate their problems as well as understand the care they provided. Language contributes to the health disparities that some populations face because it creates a barrier between the patient and the care provider, making it difficult for a patient to receive proper care. Language barriers create a communication gap between a patient and a provider, forcing the patient to feel misunderstood and unable to trust his/her provider to properly care for them. I come from a family that speaks more than one language, so I have seen the impact language barriers can have on someone who doesn’t speak fluent English.
Effective communication is important in providing safe health care. Miscommunication can lead to many errors, which can inadvertently affect compliance, accurate diagnosis, and health promotion. There are a variety of translation services offered in the United States; however,