Trained medical professionals attend to patients of diverse ethno-cultural backgrounds, different age groups, different sexes, as well as patients with different educational backgrounds something that that makes communication between them more multifarious and difficult. Professionals in this field are required by law that they increase their communication competencies in culturally diverse healthcare contexts, where the cultural diversity of patients and staff challenges the professionals in the field. It is believed that the intercultural lens is appropriate for understanding the issue of intercultural communication, which usually involves miscommunication in hospital settings (Coiera and Tombs, 1996). The refresher course the medical officers are to go through will go a long way in ensuring that they improve on their communication skills. This has been necessitated by the fact that the world has been transformed to a small village as a result of globalization. With globalization, comes the assimilation of different cultures together. Hence, in the process of medical consultation, a medical officer is likely to receive patients from various cultural backgrounds. That, therefore, implies that the medical officer ought to understand the patient through communication (Ley, 1998). That way, better prescription will be given and the patient stands a chance of regaining the lost health. The main focus of the issue under study is on the hospital environment where essentially different cultures come together which, may lead to intergroup conflict and miscommunication.
Hospitals are multicultural entities that have ethnically and culturally diverse staff. Specifically in western countries, many members of staff are either foreign or foreign trained, or patients and probably their families may come from many places of origin. In the health context, this diverse range of health professionals and their patients lead to challenges due to inter-specialty backgrounds. Each health profession, either physiotherapists or nurses has its own language, norms and rules that coexist, but which are rarely shared among the professions. Besides each profession having its own culture, each patient who enters a hospital is fronted with a territory that is unfamiliar to them, and that has a different culture. According to Storti (1994), when inter-specialty and inter-professional cultural differences are combined, the problem of communication becomes more complex. The physician-patient encounter is intercultural and as such requires a skills-based model of communication that is culturally competent.
The delivery of healthcare has been found to occur in a social-ethnical background that is complex having an environment of patients and professionals from different disciplinary, social and ethnic backgrounds. Navigating an effective and safe path through this complexity can be challenging for healthcare professionals that are seeking to provide care and for those patients who are seeking care. It is common knowledge that a good communication is vital to effective health care as it assists in accurate diagnosis and treatment. For instance lack of understanding concerning treatment legmen has been linked to poor compliance of the patient (Ley, 1998). In turn, impaired compliance can impede the health outcomes of a patient. Health communication researchers have done a study that has increasingly focused on safety of the patient, and on improving patient outcomes, and demonstrating the important role of poor or problematic communication.
Therefore, improving communication can be seen as a vital factor in the outcomes for patients. Trummer et al. (2005) conducted a study experiment on the impact brought about as a result of improved communication. In the experiment, patients who were due to undergo heart surgery were assigned to either an intervention group or a control. In the earlier group, the nursing and medical staff was provided with training in patient empowerment strategies. The outcomes indicated that improved communication exhibited by the medical staff led to significantly better health outcomes and shorter stays in hospital for those patients who were in the intervention group (Storti, 1994).
There can be two main approaches to communication in the healthcare set-up: skills based, which is intercultural communication competence, and system based, which is a macro-level critiques of the health setting. Another key, which is frequently missed, aspect is that of intergroup communication that is the language an those non-verbal behavior that are characterizing interactions between health providers and patients, on the one hand, and among professionals in the field of health on the other hand (Ley, 1998). This will then include intergroup and intercultural issues in the doctor-patient communication, inter-professional and inter-specialty communication, and multidisciplinary team communication among the health professionals.
Cultural diversity can contribute to various interactions in hospital settings whereby it can present a barrier to effective communication. Even when ethnic issues are not evident in the health care communication, other cultural barriers in the social system of medicine may impede effective communication and result in intergroup conflict. One of the approaches in health care communication for health care professionals, and which the study recommends, is intercultural communication competence (Cargile & Giles, 1996). Worth noting herein is the fact that the ethnical differences may result in swerving and contradictory exemplifications of health, illness, as well as therapy in the process of offering healthcare. As a result, the healing process in patients is prone to be hindered and at its worst, the healing process may result to more serious illness (Ley, 1998). Cultural proficiency and efficiency in health care is a multi-faceted, and it is inescapable features of emergent ethnically adapted involvements.
Intercultural communication competence is an approach in health communication which can be a solution to barriers to effective communication in culturally diverse and other health-related encounters. Much of the focus in this approach of health communication has been on skills training and communication competence (Ley, 1998). This focus mirrors the work in research into traditional intercultural communication. Experience from the history has shown that when communication improvement is addressed especially in the field of healthcare, education then focuses on training health professionals in interpersonal skills that include active listening, paraphrasing, and assertiveness. This makes it evident that communication competence is a critical component to effective communication (Cargile & Giles, 1996).
Intercultural communication competence training has much that it is worth recommending. The training has been very popular with health professionals who want to get through difficult communication situations with their colleagues or those patients who are from other cultures, or where there is conflict. This approach’s main focus is on interpersonal communication between individuals, and it starts with the assumption that inefficiency of skill on the part of one or more participants in a scenario where there is interaction, may lead to miscommunication and ultimately misunderstanding (Cargile & Giles, 1996). Often a time, misunderstanding between the participants is caused by cultural differences. For instance, there are a variety of different attitudes to being treated by a doctor of the opposite gender among Anglo and Arab patients, and in some cases members of the Arab group may refuse to see an opposite gender doctor, something that can be bewildering to the majority members of those Anglo-Celtic countries. In a similar scenario, pain is expressed through a different behavior by northern European who can be regarded as under-expressers and the southern European over-expresser patients, given that doctors over-rely on patients for them to describe the type and extent of the pain precisely (Cegala, 2006). Such differences that are based on culture can lead to miscommunication, some degree of mutual stigma and inappropriate treatment. Cases of this nature can be addressed in a straightforward way through knowledge and skills training.
The intercultural communication competence approach emphasizes the knowledge, which is usually the knowledge about the impact of culture on professional communication. At the same time, those dimensions where culture differ, and the communication skills that are needed in difficult situations. As such, the approach is concrete and problem based, and then assumes that more skilled and more knowledgeable communication will be more effective, meaning that speakers will understand each other better leading to better problem resolutions (Cargile & Giles, 1996). Intercultural communication training works well in situations where the above explained is the case in both intercultural and within-culture contexts, for instance in training physicians to give bad news, which is often a difficult and unfamiliar situation for then, or even in history taking.
The application of competence training to intercultural communications problems without considering the motivations and cognitions of interactions may make a false assumption that the parties in an interaction are always motivated to engage in effective communication (Storti, 1994). Just as two parties that are interacting from cultural groups in a conflict may not desire a common and effective interaction, so too this can be phenomena in a hospital setting. As it is in the above case, people may be motivated to linguistic and cultural issues. Research that was done by Cegala (2006) found out that, compared with majority groups, ethnic minorities were less likely to be referred to for medical treatment, and besides, there were reduced levels of compliance with treatment instructions as exhibited by patients. The conclusion in this research was that there was inadequate attention that was paid to communication and its consequences, and that this given area was insufficiently theorized.
Communication is equally imperative in the medical consultation the same way it is in all aspects of life. But because medical consultation can be equated to getting better treatments, it can be placed a niche higher than the other forms of communication (Storti, 1994). The process of medical communication ought to have an ultimate intention of not only passing the information from patient to medical stuff, but it also ought to build confidence on the side of the patient. It is such reliance that will go a long way in assisting a patient in comprehending the disease affecting him/her as well as accept the treatment that will be offered (Trummer, Gallois, & Giles, 2005). Moreover, any miscommunication that may arise as a result of ineffective communication between the patient and the medical officers may turn to be deadly. That, therefore, necessitates proper training on the side of the officers.
Culture, as it has been indicated herein can be deduced to have an influence in the process of medical and healthcare provisions to patient. There are various approaches that can be applied towards the attainment of better communication in the healthcare settings. Such approaches can include strategies such as involving professional translation services in the process of offering healthcare services to those that are for from different cultural background (Cegala, 2006). The other way that can be used to solve the intercommunication challenges in the healthcare sector is by the use of co-workers as language translators. Through the use of co-workers translations, appropriate communication can take place as well as an increased chance of getting healed by the medical treatments that can be offered (Trummer, Gallois, & Giles, 2005). On the other hand, making use of gestures in the process of communication between the patient and the doctor will ensure that better services are offered. Such may include mimics, eye contact, as well as demonstrations.
Health is a critical part of life, and as such, it is required that safety and appropriateness of health care is given importance from both patients and providers. Professional communication in healthcare setting raises every type of intercultural matter, from ethnicity, national culture, through to intergroup issues that surround professional, social and personal identity (Cegala, 2006). While the health setting points clearly to the similarity in communication across cultural divides and intergroup related contexts. It can be concluded that intercultural communications competence can help healthcare providers and those seeking healthcare services to understand one another better (Trummer, Gallois, & Giles, 2005). It is recommended that the competence skill can help participants in healthcare scenarios to get through difficult communication situations that involve colleagues and patients from other cultures.
Cargile, C., and Giles, H. (1996). Intercultural communication training review. Yearbook, 19.
Cegala, D. (2006). Emerging trends and future directions in patiend communication skills. Health communication, 20(2): 123-29.
Coiera, E. and Tombs, V. (1996). Communication behaviors in a hospital setting: an observational study. British medical journal, 316(7132): 673-76.
Cultural Diversity, Intercultural Communication and Social Justice Continuing Studies · University of Victoria: https://www.uvcs.uvic.ca/intercultural/
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Trummer, O., Gallois, C., Giles, H. (2005). Communication accommodation theory: a look back and a look ahead. Thousand Oak, CA: Sage.