Home

Communication

As more and more populations move and mix and merge with larger populations, it becomes correspondingly important that health-care workers become fluent in another language, or at the very least are trained to recognize cultural differences. For the foreseeable future, it will be important that nursing faculties in this country prepare their students for this changing population of patients.

The only way to increase quality of nursing performance is a commitment to increase the cultural and linguistic awareness and sensitivity of all members of the profession as well as to cultural and linguistic differences. (Salimbene,1999, p.29]

One reason this is important is the need for caregivers to realize that their patients may not fully understand their situation.

Ethnic groups may face inequality in access to health care. When a patient�s first language is not English, it can be difficult to reinforce information given in response to identified health promotion needs. Some information has been translated and printed, but leaflets are of little use to older Asian patients who are unable to read. (Daddy and Clegg, 2001, p. 41)

In addition to not being able to read English, the patient may not be able to read "body language" in the way it is intended. Certain cultures may place different values on eye contact, or on physical proximity, or on tone of voice.

It is important for nurses to be aware that cultural groups vary widely in their ideas about appropriate body stances and proximity gesture, languages, listening styles, and eye contact. (Narayanasamy, 1999-2, p.743)

Any weakness in the communication link will impede the ability of the nurse to get to know the patient. Research suggests that the more the nurse knows a patient, the greater degree of advocacy.

The degree to which the nurse knew the patient personally impacted the degree of communication. Personal knowledge of the patient and his/her health care desires put the nurse in an excellent position to act as the patient's advocate between the individual and the health care system (Narayanasamy, 1999-2, p. 743)

One answer to the problem of lack of communication between people of different cultures is to use interpreters. However, quite apart from the increased cost of this measure, and the logistics of physically co-ordinating the translators, this solution is not sufficient. "Interpreters often don't translate minor concerns to the nurse, because the interpreter feels it is too trivial" (Narayanasamy, 1999, p. 666). Furthermore, "The interpreter may interpret rather than translate the client's problem (ibid, p.666)." In addition, the interpreter may lack fluency or cultural understanding:

While translators are helpful, they may not always be available, particularly given the wide range of languages. Even when one can be found, they have their own values and beliefs that can effect the accuracy with which the client's and clinician's messages are conveyed (Bonder, et al., 2001, p. 41).