Case study analysis
Introduction
The case study is titled “Enhancing Culturally Competent Health Communication: Constructing Understanding between Providers and Culturally Diverse Patients,” by Claudia V. Angelelli and Patricia Geist-Martin. The case revolves around a 30 year old first-time pregnant patient named Ramira. She is from rural Mexico and speaks only Spanish. She is having her prenatal appointment in her second month of pregnancy. The nurse has to use an interpreter to inform Ramira that an amniocentesis can be done on her to establish the health of the baby. Annette is the interpreter who has 2 years of experience working as a medical interpreter, bilingual assistant and translator. She interprets on a speaker phone coming from the consultation room, where she facilitates the interaction between the patient and nurse who are communicating face-to-face. The aim of the case study is demonstrate the dynamics of interpreting a language is it not just a process of translating the very words spoken by each participant. It is made clear that the process is more complicated if there is “collision” of cultural communities. The case study teaches the importance of examining and understanding why cultural differences can result in communication breakdowns.
There is increased challenge in a health care setting where an interpreter is relied on to not only bridge the provider’s and patient cultural communities but also to seek answers to questions that both the provider and patient raise in the course of the communication. There is difficulty in the construction of reciprocal understanding, the correct transformation of both semantic and pragmatic content, together with the linguistic facilitator role of the interpreter. To the care provider, the interpreter is the tool that keeps the patient on track while the same interpreter is a co-conversationalist to the interpreter. In the case, the aspect of important and valuable is lost between the nurse and the patient. In general, the case explores the complex interactions of healthcare provider-patient communication where the two neither share the same cultural nor linguistic background, the extent of understanding when there is an interpreter, and the distance/closeness between the care provider, interpreter, and the patient.
Discussion
Cultural competence refers to a set of “congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables the system or professionals to work effectively in cross–cultural situations”. Attaining cultural competence in health care entails both interpersonal as well as organizational interventions along with strategies that serve to overcome those differences. In the course of communicating with patients of different cultural and linguistic differences, health care professionals often encounter, and are obliged to learn to handle, complex differences in the communication styles, expectations, attitudes, and perceptions. Cultural competence has a number of benefits in health care: first, it limits disparities that occur in health services while increasing detection of culture-specific complications. Secondly, it has great impact on the health status of the culturally diverse communities. Thus communication should be customized to satisfy the patient’s social, cultural, as well as linguistic needs. It is vital that the different parties of the communication process become aware of their own biases that are part of their own cultural backgrounds so as to reduce the barriers that limit understanding of one another (Nova Scotia Department of Health, 2005).
A culturally competent physician is one who is able to offer patient-centered care by working on their own attitudes and behaviors to meet the needs and desires of a different patient in relation to their emotional, social, cultural, and psychological issuers on the biomedical issue at hand. To this effect, a culturally competent caregiver is able to run an effective interview with a culturally different patient, with the help of the interpreter, and come up with an acceptable diagnosis and treatment plan (Misra-Herbert, 2003).
In order to achieve the correct diagnosis and treatment plan for such patients, the health providers needs to use the services of a qualified or professional interpreter. Using family or friends of the patient is not a good idea because they are often reluctant to discuss some issues and may occasionally distort the information. Some of the cultural issues that may particular problems during such cross-cultural encounters relate to authority, communication styles, physical contact, sexuality, gender, and family. With the modern high technology, there is always the danger of defining medical care in the context of sophisticated tests and high-tech screening apparatus while most decisions relating to diagnosis and treatment are reached basing on the medical information the patient provides to the caregiver (Ray, 2005). It therefore goes that anything that hinders the patient from completely expressing their condition and expectations during such cross-cultural communication have the potential to compromise the accuracy and quality of the diagnosis and diagnosis plans. As a result, it is upon the health providers to get the patient’s understanding of his/her illness using interpreting skills in both verbal and nonverbal communication (Misra-Herbert, 2003).
Conclusion
The case underscores that the importance to enhance our understanding of varied health beliefs and practices so as to satisfy the diverse, unmet, health care needs or expectations of those seeking health care. Cross-cultural caring regards health care as a social process where caregivers and patients each present a set of beliefs, practices and expectations to the medical encounter. As a result, there is always miscommunication, noncompliance, divergent concepts of the illness and its remedies, different values & preferences of physicians and their patients which serve to limit the benefits of caring and technology. This translates that it is highly complicated and challenging to negotiate understanding with and among such multicultural health-cum-illness communities because of the clashing cultural and political systems.
References:
Misra-Hebert, D. A. (2003). Physician cultural competence: cross-cultural communication improves care. Retrieved from: http://www.ccjm.org/content/70/4/289.full.pdf
Nova Scotia. (2005). A Cultural Competence Guide for Primary Health Care Professionals in Nova Scotia. Retrieved from: http://healthteamnovascotia.ca/cultural_competence/Cultural_Competence_guide_for_Primary_Health_Care_Professionals.pdf
Ray, B. E. (2005). Health Communication in Practice: A Case Study Approach. Routledge.
