Intercultural Communication Barriers: A Misdiagnosis Simply Due to a Miscommunication — How Intercultural Communication can Help Guarantee Equal Treatment for all Patients.
By Trevor, Mónica, Kevin, SweetPea, and Edilberto
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Communication is one of the main characteristics that make us human beings, being effective in the communication process is very important in every single context of our lives, especially in settings like the healthcare system where interactions are crucial elements to succeed in solving health problems, expressing symptoms, diagnosing, prescribing medication, and decision making, and so on. To achieve that, the language used must be clear, precise, vagueness-free, and very specific. Consequently, it is important to raise and develop awareness of intercultural communication skills to guarantee patients’ welfare and not limit anyone’s access to potential healthcare information. Intercultural communication should not be a barrier to guarantee equality and quality in medical and health scenarios.
Ineffective cross-cultural interactions and language barriers cause a great impact on the cost and the quality of healthcare. These language barriers lead to misunderstandings in the patients’ and doctors’ back-and-forth interactions which causes the medical service offered by the healthcare system to not be as expected. Some institutions have decided to propose interpreters’ services in their hospitals and clinics, but having interpreters demands an increase in health service due to the patients or their families must pay for this service, as a consequence, just a few people could be able to afford it, and most others will have to face up to the complex difficulties. These phenomena are analyzed in a study conducted by Al shamsi, Almutair, Al Mashrafi, and Al Kalbani, in 2020 called Implications of language barriers for healthcare: a systematic review.
Some relevant features like ethnic identity, beliefs, spirituality, religiosity, or vision of the world may also affect the quality of healthcare provided by the government institutions. Most of the time health providers are not aware of the others’ (patients and their families) inner essence. These aspects create difficulties in communication and a lack of confidence towards doctors and towards the health system itself. It is well-known differences are not accepted and steps are not taken to understand these differences, thereby the healthcare system seems to be unable to offer a good service. It can be seen in the example presented in The spirit catches you and you fall down by Anne Fadiman, where a Hmong girl suffers a disease that may be treated, but due to misunderstandings as a result of costumes deeply rooted in culture, this girl gets worse and dies.
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An important area to consider is how cultural values in healthcare can limit available treatment. Having the wrong treatment in the worst cases can be fatal. These complications happen because varying cultures value and communicate health information differently. Due to these orientations, doctors may suggest care that’s more culturally appropriate rather than what’s best compared to other success rates. While this may not be a huge issue on the surface, these limitations do put some cultures at a disadvantage. Due to these disadvantages, additional training is needed to make sure culture doesn’t limit available healthcare options. A common way cultures are compared is by their position on individualism and collectivism. These viewpoints affect what aspects of health and health communication a culture might value. A collectivist culture may promote general information for a group or outbreak control; contrasting to that, an individualistic culture may promote self-help or care for specific diseases. One good example of this is Choi’s & McKeever (2020) study comparing the CDC’s Tweets from individualist USA and collectivist South Korea. Results show that the KCDC is more likely to use collective words in their Tweets than the CDC. It was also proven that the KCDC was more likely to share information regarding foreign contagious diseases (2020).
These findings show how the same information can be communicated differently from culture to culture. Health and healthcare information has the potential to save lives so it should be available to everyone. An increase in training for intercultural communication would mean more people having access to all health knowledge available instead of just what their culture orients to. This increase is needed due to cultures valuing healthcare information differently. These values influence what care is recommended. By having more training in intercultural communication, we can have better treatment and save more lives.
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Intercultural communication is not focused on or a top priority for patients and doctors. The lack of communication is a huge obstacle in the healthcare field. In our growing society doctors work on patients of all backgrounds. Without proper communication, detrimental impacts will arise and affect the patient, in the worst case resulting in death. A great example of this is in (“Take as Directed” from The Spirit Catches You and You Fall Down. 2020), Lia Lee tragically passed away from the lack of cross-cultural communication. When brought to the hospital doctors did their best to properly diagnose Lee, however, she was not properly diagnosed until a few months after. Lee’s parents could not understand the instructions of the doctors. These skills which are vital in the health setting can be acquired through training to prevent such tragedies like Lee’s. Precisely targeting the individual aspects of the patient, such as sharing the same interests and having thoughtful conversations, strengthens the bond with the doctor. As said by Emma Patternote (2020), “patient’s views could guide training for doctors.”. With proper training, doctors can create a synergistic environment where interactions can be seen from both directions. More doctors need to be trained to communicate with patients of all backgrounds. The lack of intercultural communication continues to grow in developing societies. However, with enough training doctors can address patients’ problems and illnesses
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The aforementioned aspects that constitute culture, such as personal beliefs, ethnic identity, language, among others, should be considered when addressing people. All these elements influence the comprehension and interpretation of information by people. Therefore, considering using effective elements such as the patient’s culture, values, beliefs, and communication when working in the medical field is essential. Trying to help patients whose language is a different language, regarding and taking into account beliefs, could help to establish a more comfortable communication or less stressful between doctor and patient. Finally, we highly believe that people working in the health system or medical field should be trained in intercultural communication skills, a language shouldn’t be a barrier to understanding.
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References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of language barriers for healthcare: a systematic review. Oman medical journal, 35(2), e122.Doi: 10.5001/omj.2020.40
Centers for Disease Control and Prevention [@CDCgov]. (2021, August 13). The #DeltaVariant is more dangerous than other variants of the virus that causes #COVID19. Get vaccinated as soon as you [Tweet]. Twitter. https://twitter.com/CDCgov/status/1426261270718652420
Choi, M., & McKeever, B. (2020). Culture and Health Communication: A Comparative Content Analysis of Tweets from the United States and Korea. International Journal Of Communication, 14, 20. Retrieved from https://ijoc.org/index.php/ijoc/article/view/10696
ClarkCollegeCCE. ( 2011, May 17). Cultural Awareness for Healthcare Professionals — Promo (English version) [Video] YouTube. https://www.youtube.com/watch?v=Gxp_7aRA_tQ&t=9s
Fadiman, A. (2012). The spirit catches you and you fall down: A Hmong Child, her American doctors, and the collision of two cultures. Macmillan
Hidelberg University Hospital. (2021) Interpreters at Heidelber University Hospital. [Online image]. https://www.heidelberg-university-hospital.com/service-information/interpreters
Phisicianapply.ca orientation. (2018, Jun 26) Cross-cultural communication — Part 2 — Selecting an Interpreter. [Video]. YouTube. https://www.youtube.com/watch?v=NqzZnakzDAY
