EFFECTS OF COMMUNICATION CHALLENGES ON HEALTHCARE

Authors: Dr. Mahero Toboso, Dr. Nangila Arnety & Dr. Wycliffe Ayieko

ABSTRACT

Through language, a patient accesses the health care system, gets to learn about available services, so as to make decisions about her or his health. Language is also the means by which the health care provider accesses a patient’s beliefs about health and illness, and thus creates an opportunity to address and reconcile different belief systems. In essence, communication between nurses and patients is the heart of nursing care. Communication between patients and chemists is also key to their access to healthcare. Such patients visit chemist for self-medication or to procure medicine for themselves or their families. The multilingual situation in Kenya and many African countries can complicate communication between healthcare providers and their patients. Such complications can cause language barriers that can impair access to healthcare. This is due to low literacy levels and challenges in understanding languages of wider communication such as English and Kiswahili for the case of Kenya. Under these circumstances, translation and interpretation become key to alleviating or eliminating communication barriers. This paper discuses linguistic challenges in access to healthcare in Kenya and proposes translation and interpretation as a way of dealing with the challenges. It argues that in a highly multilingual situation as is the case in Kenya, Translation and interpretation is a significant way of addressing challenges in medical access.

Keywords: Communication Challenges, Language Barriers, Patient-Provider Communication, Nursing Care, Pharmacy Communication, Multilingualism in Healthcare, Health Literacy, Linguistic Diversity, English and Kiswahili in Healthcare, Healthcare Access in Kenya.

REFERENCES

  • ———. 2005. CHIS 2001 Technical Report—Revised CHIS 2001 Weights. Los Angeles: UCLA Center for Health Policy Research. 1976; 8(2):122–31.
  • Baker, D. W., R. Hayes, and J. P. Fortier. (1998). Interpreter Use and Satisfaction with Interpersonal Language Barriers Aspects of Care for Spanish-Speaking Patients. Medical Care 36(10): 1461–1470.
  • Baker, D. W., R. M. Parker, M. V. Williams, W. C. Coates, and K. Pitikin. 1996. Use and Effectiveness of Interpreters in an Emergency Department. Journal of the American Medical Association 275(10): 783–788. California Health Interview Survey (CHIS). 2002. CHIS 2001 Methodology Series: Report 2—Data Collection Methods. Los Angeles: UCLA Center for Health Policy Research.
  • Batal, J. H. Maselli, and J. S. Kutner. (2002). Effect of Spanish Interpretation Method on Patient Satisfaction in an Urban Walk-in Clinic. Journal of General Internal Medicine 17(8): 641–645.
  • Bowen S. Language barriers in access to health care. Ottawa, Ontario: Health Canada Ottawa; 2000.
  • Can J Behav Sci Revue canadienne des sciences du comportement. Chu C. Cross-cultural health issues in contemporary Australia. Ethnicity Health. 1998; 3(1–2):125–34.
  • David, R. A., and M. Rhee. 1998. The Impact of Language as a Barrier to Effective Health Care in an Underserved Urban Hispanic Community. Mount Sinai Journal of Medicine 65(5–6): 393–397. Flores, G., M. Abreu, M. A. Olivar, and B. Kastner. 1998. Access Barriers to Health Care for Latino Children. Archives of Pediatric Adolescent Medicine 152(11): 1119–1125.
  • Exploratory Study. J Appl Commun Res. 2012; 40(4):368–83.
  • Flores, G., M. B. Laws, S. J. Mayo, B. Zuckerman, M. Abreu, L. Medina, and E. J. Hardt. (2003). Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters. Pediatrics 111(1): 6–14.
  • Gallois C, Giles H, Joens E, Cargile AC, Ota H. Accommodating intercultural encounters: Elaborations and extensions. In: Wiseman RL, editor. Intercultural Communication Theory. Thousand Oaks, CA: Sage; 1995. p. 115–47.
  • Ginsberg, C., V. Martin, D. Andrulis, Y. ShawTaylor, and C. McGregor. (1995). Interpretation and Translation Services in Health Care: A Survey of U.S. Public and Private Teaching Hospitals. Washington, D.C.: National Public Health and Hospital Institute.
  • Goodman, D., N. and C. Pryor. (2002). What a Difference an Interpreter Can Make: Health Care Experiences of Uninsured with Limited English Proficiency. Boston: The Access Project.
  • Hawryluk, M. 2002. Doctors Shouldn’t Pay for Translators. Interpreters’ Fees Often Exceed Medicaid Payments for Office Visits. American Medical News Jan. 14.
  • Hawthorne L. The globalisation of the nursing workforce: barriers confronting overseas qualified nurses in Australia. Nurs Inq. 2001;8(4):213–29.
  • Institute of Medicine. (2002). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, D.C.: National Academy Press. Ku, L., and G. Flores. 2005. Pay Now or Pay Later: Providing Interpreter Services in Health Care. Health Affairs 24(2): 435–444. Ku, intercultural communication. Thousand Oaks, CA: Sage; 2005. p. 121–48.
  • Jacobs E, Chen AHM, Karliner LS, Agger-Gupta N, Mutha S. The need for more research on language barriers in health care: A proposed research agenda. Milbank Q. 2006;84(1):111–33.
  • Landers, S. J. (2000). Doctors Resent Being Forced to Find, Pay for Interpreters. American Medical News Nov. 20. Lee, L. J., H. A.
  • LeSon, S., and M. E. Gershwin. 1995. Risk Factors for Asthmatic Patients Requiring Intubation. I. Observations in Children. Journal of Asthma 32(4): 285–294.
  • Manson, A. 1988. Language Concordance as a Determinant of Patient Compliance and Emergency Room Use in Patients with Asthma. Medical Care 26(12): 1119–1128.
  • McGarvey, E. L., G. J. Clavet, J. B. Johnson II, A. Butler, K. O. Cook, and B. Pennino. 2003. Cancer Screening Practices and Attitudes: Comparison of Low-Income Women in Three Ethnic Groups. Ethnicity and Health 8(1): 71–82.
  • Obel, G. A. Kimetto R. &  Mwangi, P. M. (2013).  An Investigation Of Effect Of Language Barrier On Effective Communication For The Provision Of Quality Healthcare: A Case Of Kericho County Health Facilities, Kenya.  Scientific Research Journal (SCIRJ), Volume 1, Issue February 2013. Found at http://dx.doi.org/10.31364/SCIRJ/v8.i2.2020.P0220743
  • Perez-Stable, E. J., A. Napoles-Springer, and J. M. Miramontes. 1997. The Effects of Ethnicity and Language on Medical Outcomes of Patients with Hypertension or Diabetes. Medical Care 35(12): 1212–1219.
  • Ponce, N. A., S. A. Lavarreda, W. Yen, E. R. Brown, C. DiSogra, and D. Satter. 2004. Translation Methodology in the California Health Interview Survey: Challenges in Language Translation for a Major Survey. Public Health Reports 119: 1–18.
  • Ponce, N., and L. Penserga. 2002. Language Access in Health: Why the Policy and Practice Inertia? Harvard Health Policy Review 3(2): 47–53. Presidential Executive Order 13166. 2000. Improving Access to Services for Persons with Limited English Proficiency. Federal Register 65: 50121.
  • Renata F. I. et.al. (2015). Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. Meuter et al. BMC Health Services Research (2015) 15:371
  • Schenker Y, Wang F, Selig SJ, Ng R, Fernandez A. The impact of language barriers on documentation of informed consent at a hospital with on-site interpreter services. J Gen Intern Med. 2007;22 Suppl 2:294–9.
  • Schmidley, D. 2003. The Foreign-Born Population in the United States: March 2002 (P20-539). Washington, D.C.: Department of Commerce, U.S. Census Bureau.
  • Segalowitz N. Cognitive bases of second language fluency. New York: Routledge; 2010.
  • Segalowitz N. Communicative incompetence and the non-fluent bilingual.
  • Tocher, T. M., and E. Larson. 1998. Quality of Diabetes Care for Non-English-Speaking Patients. A Comparative Study. Western Journal of Medicine 168(6): 504–511.
  • U.S. Department of Health and Human Services, Office of Civil Rights. 2003. Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition against National Origin Discrimination Affecting Limited English Proficient Persons. Federal Register 47311–47323.
  • Waidmann, L., and T. (2003). How Race/Ethnicity, Immigration Status and Language Affect Health Insurance Coverage, Access to Care and Quality
  • Youdelman, M., and J. Perkins 2002. Providing Language Interpretation Services in Health Care Settings: Examples from the Field. New York: Commonwealth Fund.
  • Baker, D. W. et al., (1996). Use and Effectiveness of Interpreters in an Emergency department, JAMA 275 (Mar 13, 1996): pp783-788
  • Cohen A. L. and Christakis D. A. (2006). Primary language of parent is associated with disparities in pediatric preventive care. J Pediatr. 2006; 148: 254–258.
  • Douglas, W. (1993). Many Tongues Spoken, Students Translate at Clinics & Hospitals. Newsday, Jan. 3, 1993, pp 39.
  • Hafner, L. (1992). Translation Is Not Enough: Interpreting in a Medical Setting. Western Journal of Medicine 157 (Sept. 1992): pp255-259.
  • Hagland, M. M (1993). Crossing Cultures: Hospitals Begin Breaking Down the Barriers to Care. Hospitals 67 (May 20, 1993). pp29.
  • Lewis, M (1998). Translators Provide a Critical Link for Foreign-Born Patients, San Jose Mercury News, Nov. 25, 1988, p. 1A
  • Perkins, J. (1999). Overcoming Language Barriers to Health Care. Popular Government Fall 1999 pp 38-44
  • Steven Woloshin et al., (1995). Language Barriers in Medicine in the United States, JAMA 273 (Mar. 1, 1995): pp 724-728.
  • Weech-Maldano R., et.al (2003). Race/ethnicity, language, and patients’ assessments of care in Medicaid managed care. Health Serv Res. 2003; 38: 789–808.
  • World Bank (2014).  Improving Health Care for Kenya’s Poor. Found online at www.worldbank.org>news>2014