Communication barriers

Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers. To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision making about goals of care with seriously ill hospitalized patients and their families and (2) their own willingness and the acceptability for other clinicians to engage in this process. Multicenter survey of medical teaching units of nurses, internal medicine residents, and staff physicians from participating units at 13 university-based hospitals from 5 Canadian provinces. Importance of 21 barriers to goals of care discussions rated on a 7-point scale (1 = extremely unimportant; 7 = extremely important). Between September 2012 and March 2013, questionnaires were returned by 1256 of 1617 eligible clinicians, for a...

Aim.  This paper reports on the second phase of a national study in Wales. The research aimed to assess the level of Welsh language awareness amongst healthcare professionals across Wales, and to identify the factors that enhance language choice within service delivery.Background.  The literature suggests that language sensitive healthcare practice is central to ensuring high quality care. However, it is evident that language barriers continue to compromise the quality of care within nursing and other health services. One issue that has received little attention is the level of language awareness that healthcare professionals currently demonstrate. Furthermore the factors that influence language choice for bilingual/multilingual speakers are not well explored in the literature.Methods.  The study involved semi-structured interviews with a range of healthcare professionals in acute and community settings across Wales. Using a systematic sampling matrix, a purposeful sample of 83 professionals was selected to participate. Twenty-seven of the respondents were nurses, health visitors and midwives. The interviews focussed on the factors that facilitate or impede language sensitive healthcare practice. All interviews were audiotaped and, using a framework analysis approach, conceptual codes were developed and defined and categories and sub-categories were constructed to create thematic charts.Findings.  Three main themes were identified: care enhancement, which focussed on the process and outcome of offering language choice to bilingual patients; organizational issues, which reflected issues relating to the infrastructure of service provision; and training implications, which focused on Welsh language learning in health care.Conclusions.  Complex dynamics of language use are in operation within bilingual healthcare settings and organizational as well as individual factors are important in facilitating appropriate language use. Many of the issues highlighted are not peculiar to the Welsh context, but apply to healthcare settings across the world, where other minority languages are in use.

Patients with social phobia report experiencing negative images of themselves performing poorly when in feared social situations. The present study investigates whether such negative self‐imagery (based on memory of past social situations) contaminates social interactions. High socially anxious volunteers participated in two conversations with another volunteer (conversational partner). During one conversation, the socially anxious volunteers held in mind a negative

There remain large discrepancies between pediatricians' practice patterns and the American Academy of Pediatrics (AAP) guidelines for the assessment and treatment of children with attention-deficit/hyperactivity disorder (ADHD). Several studies raise additional concerns about access to ADHD treatment for girls, blacks, and poorer individuals. Barriers may occur at multiple levels, including identification and referral by school personnel, parents' help-seeking behavior, diagnosis by the medical provider, treatment decisions, and acceptance of treatment. Such findings confirm the importance of establishing appropriate mechanisms to ensure that children of both genders and all socioeconomic, racial, and ethnic groups receive appropriate assessment and treatment. Publication of the AAP ADHD toolkit provides resources to assist with implementing the ADHD guidelines in clinical practice. These resources address a number of the barriers to office implementation, including unfamili...

The purpose of this chapter is to examine how language barriers contribute to health disparities among ethnic and racial minorities in the United States. A literature search was systematically conducted using selected computer databases (MEDLINE and CINAHL). Searches were limited to English-language-published research in the years from 1985 to 2003. A total of 47 published articles were included in this review. Overall these studies indicate that language barriers are associated with longer visit time per clinic visit, less frequent clinic visits, less understanding of physician's explanation, more lab tests, more emergency room visits, less follow-up, and less satisfaction with health services. The results also indicate that people who are older, poorer, and female tend to have severe language barriers compared to those who are younger, wealthier, and male. Improvement of communication between patients and providers in relation to health disparity consists of cultural competenc...

The increasing proportion of culturally diverse groups within the United Kingdom has meant that the issue of language barriers in the research situation must be addressed. The recruitment of respondents with English as a second language (ESL) to research studies is essential if their potentially unique and valid perspective is to be acknowledged. This can, however, pose several difficulties for the researcher which need to be recognized and addressed if valid data are to be collected. This paper outlines some of the challenges encountered in one study and describes strategies which were employed to meet these challenges.

Communication with culturally and linguistically diverse (CLD) patients has been shown to be difficult. This study describes nurses' experiences of communicating with CLD patients in an acute care setting. A purposive sample of registered nurses and certified midwives (n=23) were interviewed. Main findings were: interpreters, bilingual health workers and combinations of different strategies were used to communicate with CLD patients; some nurses showed empathy, respect and a willingness to make an effort in the communication process with others showing an ethnocentric orientation. Main recommendations were: prioritising access to appropriate linguistic services, providing nurses with support from health care workers, e.g., bilingual health care workers who are able to provide more in-depth information, increasing nurses' understanding of legal issues within patient encounters, supporting nurses to translate their awareness of cultural diversity into acceptance of, appreciati...