Abstract
This chapter reviews the linguistic and cultural challenges, which arise between non-Arabic speaking healthcare providers and Arabic-speaking patients in two different multicultural settings. The United Arab Emirates and the United States are used as examples. A mixed method approach was followed in the data collection phase of the research. Secondary sources, observations in different healthcare units, and semistructured interviews with patients and healthcare providers from two hospitals in both countries were the main methods of data collection. Communication barriers between stakeholders stem from the lack of cultural and linguistic competencies of both healthcare givers and patients. Some solutions to these problems are provided with a focus on the importance of cultural competency in medical settings and its impact on patient satisfaction, cost efficiency, and improved healthcare and research outcomes.
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References
American College of Physicians. (2004). Racial and ethnic disparities in health care: A position paper of the American College of Physicians. Annals of Internal Medicine, 141(3), 226–232.
American College of Physicians. (2010). Racial and ethnic disparities in health care, Philadelphia: American College of Physicians; 2010: Policy Paper. (Available from American College of Physicians, 190Â N. Independence Mall West, Philadelphia, PA 19106.)
Asante, M. K., & Gudykunst, W. B. (Eds.). (1989). Handbook of international and intercultural communication. London: SAGE
Baker, D. W., Hayes, R., & Fortier, J. P. (1998). Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Medical Care, 36(10), 1461–1470. http://www.jstor.org/stable/3767075. Accessed 10 June 2012.
Barrett, S., Dyer, C., & Westpheling, K. (2008). Language access: Understanding the barriers and challenges in primary care settings. McLean: Association of Clinicians for the Underserved
Beach, M. C., Saha, S., & Cooper, L. A. (2006).The role and relationship of cultural competence and patient-centeredness in healthcare quality. The Common Wealth Fund, 36. http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2006/. Accessed 19 June 2012.
Bernstein, J., Bernstein, E., Dave, A., Hardt, E., James, T., Linden, J., Mitchell, P, Oishi, T, Safi, C. (2002). Trained medical interpreters in the emergency department: Effects on services, subsequent charges, and follow-up. Journal of Immigrant Health, 4(4), 171–184. doi:10.1023/A:1020125425820
Bischoff, A., Bovier, P. A., Rrustemi, I., Gariazzo, F., Eytan, A., & Loutan, L. (2003). Language barriers between nurses and asylum seekers: Their impact on symptom reporting and referral. Social Science and Medicine, 57(3), 503–512. doi:10.1016/S0277-9536(02)00376-3
Blendon, R. J., Buhr, T., Cassidy, E. F., Pérez, D. J., Sussman, T., Benson, J. M., & Herrmann, M. J. (2008). Disparities in physician care: Experiences and perceptions of a multi-ethnic America. Health Affairs, 27(2), 507–517. doi:10.1377/hlthaff.27.2.507
Bourdieu, P. (1976). The economics of linguistic exchanges. Social Science Information, 16(6), 645–668. doi:10.1177/053901847701600601
Brislin, R. W. (1981). Cross-cultural encounters: Face-to-face interaction. New York: Pergamon.
Brotherton, S. E., Rockey, P. H., & Etzel, S. I. (2004). US graduate medical education: 2003–2004. The Journal of the American Medical Association, 292(9), 1032–1037. http://jama.jamanetwork.com/article.aspx?articleid=199359. Accessed 11 June 2012.
Chen, P. W. (16 July 2009). Doctor and patient: bridging the culture gap. The New York Times. http://www.nytimes.com/2009/07/16/health/16chen.html?_r=2&pagewanted=1&hpw. Accessed 25 Oct 2012.
Condon, J. C., & Yousef, F. (1975). An introduction to intercultural communication. Indianapolis: The Bobbs-Merill Company.
David, R. A., & Rhee, M. (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. http://www.vdh.virginia.gov/ohpp/clasact/documents/CLASact/research3/13_David.pdf. Accessed 11 Nov 2011.
DerGurahian, J. (2008). Comparative satisfaction. Modern Healthcare, 38(13), 6–7. http://ezproxy.aus.edu/login?url=http://search.proquest.com/docview/211942254?accountid=16946. Accessed 10 Jan 2013.
Eisenstadt, S. N. (1989). Introduction: Culture and social structure in recent sociological analysis. In H. Hafercamp (Ed.), Social structure and culture (pp. 5–11). Berlin: Walter de Gruyter.
Farmer, R., Miller, D., & Lawrenson, R., (1996). Epidemiology and public health medicine (4th ed.). Oxford: Blackwell Science.
Flores, G., Laws, B., Mayo, S., Zucherman, B., Abreu, M., Medina, L., & Handt, E. (2003). Errors in medical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics, 111(1), 6–14
Fox, R. C. (2005). Cultural competence and the culture of medicine. The New England Journal of Medicine, 353(13), 1316–1319. http://ezproxy.aus.edu/login?url=http://search.proquest.com/docview/223926633?accountid=16946. Accessed 11 July 2012.
Garcia, E. A., Roy, L. C., Okada, P. J., Perkins, S. D., & Wiebe, R. A. (2004). A comparison of the influence of hospital-trained, ad hoc, and telephone interpreters on perceived satisfaction of limited English-proficient parents presenting to a pediatric emergency department. Pediatric Emergency Care, 20(6), 373–378.
Goode, T. W., Dunne, M. C., & Bronheim, S. M. (2006). The evidence base for cultural and linguistic competency in health care. The Commonwealth Fund, 37. http://commonwealthfund.org/usr_doc/Goode_evidencebasecultlinguisticcomp_962.pdf. Accessed 11 April 2013.
Gumperz, J. J., Jupp, T. C., & Roberts, C. (1979). Crosstalk: A study of cross-cultural communication. Souhthall: National Center for Industrial Language Training.
Hall, S. (1981). Cultural studies: Two paradigms. In T. Bennett, G. Martin, C. Mercer, & J. Woollacott (Eds.), Culture, ideology and social processes (pp. 19–38). London: Batsford (in association with the Open University Press).
Halligan, P. (2006). Caring for patients of islamic denomination: Critical care nurses’ experiences in Saudi Arabia. Journal of Clinical Nursing, 15,1565–1573.
Hampers, L. C., Cha, S., Gutglass, D. J., Binns, H. J., & Krug, S. E. (1999). Language barriers and resource utilization in a pediatric emergency department. Pediatrics, 103(6), 1253–1256. doi:10.1542/peds.103.6.1253.
Hornberger, J., Itakura, H., & Wilson, S. R. (1997). Bridging language and cultural barriers between physicians and patients. Public Health Reports, 112(5), 410–417. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1381949/pdf/pubhealthrep00038-0056.pdf. Accessed 24 June 2013.
Hutchinson, T. A., & Dobkin, P. L. (2009). Mindful medicine practice: Just another fad? Canadian Family Physician, 55(8), 778–779. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726084/pdf/0550778.pdf. Accessed 11 May 2013.
Jacobs, E. A., Agger-Gupta, N., Chen, A. H., Piotrowski, A., & Hardt, E. J. (2003). Language barriers in healthcare settings: An annotated bibliography of the research literature. Woodland Hills: The California Endowment.
Jandt, F. E. (2012). An introduction to intercultural communication: Identities in a global community (5th ed.). London: SAGE Publications.
Kay, P. & Kempton, W. (1984). What is the Sapir-Whorf hypothesis? American Anthropologist, 86(1), 65–79. http://www.jstor.org/stable/679389. Accessed 11 April 2012.
Kirkman-Liff, B., & Mondragon, D. (1991). Language of interview: Relevance for research of Southwest Hispanics. American Journal of Public Health, 81(11), 1399–1404. doi:10.2105/AJPH.81.11.1399.
Kumaş-Tan, Z., Beagan, B., & Loppie, C. (2007). Measures of cultural competence: Examining hidden assumptions. Academic Medicine, 86(6), 548–557. http://culturalmeded.stanford.edu/pdf%20docs/KurmasTan%20Examining%20Hidden%20Assumptions.pdf. Accessed 11 June 2011.
Munoz, C., Broka, C., & Mohamad, S. (2009). Development of a multidisciplinary course in cultural competence for nursing and human service professions. Journal of Nursing Education, 48(9), 495–503.
Office of Minority Health (2009). National Standards on Culturally and Linguistically appropriate Services (CLAS). http://www.omhrc.gov/templates/browse.aspx. Accessed 14 Sept 2011
Raddawi, R. (2006). Web based communication process to facilitate dialogue between English speaking healthcare providers and non-English speaking patients in United Arab Emirates and United States hospitals. TranslationWatch Quarterly, 2(2), 74–92. Sydney: TSI.
Raddawi, R. (2007). The role of translation in second language teaching: Customized software for vocabulary learning. In proceedings of the second international translation conference. experiences, expertise and technologies in translation. Amman. April 27–29th Arab Thought Foundation Press.
Rasheed, A. (2009). Expat numbers rise rapidly as UAE population touches 6m. Gulfnews. http://gulfnews.com/news/gulf/uae/general/expat-numbers-rise-rapidly-as-uae-population-touches-6m-1.505602. Accessed 5 June 2011
Rideout, V. (2007). Parents, children & media. A Kaiser family foundation survey. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7638.pdf. Accessed 11 May 2013
Rousseau, D. L., & Garcia-Retamero, R. (2007). Identity, power, and threat perception: A cross-national experimental study. The Journal of Conflict Resolution, 51(5), 711–744. doi:10.1177/0022002707304813.
Samovar, L. A., Porter, R. E., & McDaniel, E. R. (Eds.). (2011). Intercultural communication: A reader (13th ed.). Boston: Wadsworth Publishing.
Sarangi, S. (2011). Intercultural or not? In Zhu Hua (Ed.), The language and intercultural communication reader (pp. 261–276). London: Routledge.
Street, B. (1993). Culture is a verb. In D. Graddol, L. Thompson, & M. Byram (Eds.), Language and culture (pp. 23–43). Clevedon: BAAL and Multilingual Matters.
Suurmond, J., & Seeleman, C. (2006). Shared decision-making in an Intercultural context: Barriers in the interaction between physicians and immigrant patients. PatientEducation and Counseling, 60(2), 253–259. doi:10.1016/j.pec.2005.01.012.
The Emirates Center for Strategic Studies and Research periodical (June 2008). Abu Dhabi.
Thornton, R. (1988). Culture: A contemporary definition. In E. Boonzaier & J. Sharp (Eds.), Keywords (pp. 17–28). Cape Town: David Philip.
United States Census. (2010). Census, briefs and reports. Population distribution and change: 2000 to 2010. www.census gov/2010 census/. Accessed 11 Aug 2011.
Weissman, J. S., Betancourt, J., Campbell, E. G., Park, E. R., Kim, M., Clarridge, B., Blumenthal D., Lee K. C., Maina, A. W. (2005). Resident physicians’ preparedness to provide cross-cultural care. Journal of the American Medical Association, 294(9), 1058–1067. doi:10.1001/jama.294.9.1058.
Wolfson, N. (1989). Perspectives: Sociolinguistics and TESOL. Rowley: Newbury House.
Wu, E., & Martinez, M. (2006). Taking cultural competency from theory to action. The Commonwealth Fund, 38. http://www.commonwealthfund.org. Accessed 15 July, 2013.
Youdelman M. K. (2008). The medical tongue: U.S. laws and policies on language access. Health Affairs, 27(2), 424–433. doi:10.1377/hlthaff.27.2.424.
Zhu, H. (Ed.). (2011). The language and intercultural communication reader. London: Routledge.
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Conclusion
Linguistic and cultural diversity are a salient feature of today’s globalized world and therefore, effective communication between stakeholders is indispensable. The medical setting is no exception. Medical caregivers and patients should engage in a cultural competency campaign for a successful healing process, better patient satisfaction, cost efficiency , and improved healthcare and research outcomes. This entails understanding and tolerance of the culture and language skills of each party.
Cultural differences are not always the reason for misunderstanding or miscommunication in intercultural interaction. Participants can create a common ground by seeking to know the other. In healthcare like in any other professional setting where humans are in constant interaction, the communication process should be based on the principle of altercentrism rather than egocentrism.
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Raddawi, R. (2015). Intercultural (Mis-) Communication in Medical Settings: Cultural Difference or Cultural Incompetence?. In: Raddawi, R. (eds) Intercultural Communication with Arabs. Springer, Singapore. https://doi.org/10.1007/978-981-287-254-8_11
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DOI: https://doi.org/10.1007/978-981-287-254-8_11
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