For Teachers & Professionals
Communication plays a very important role in health care practice, as a way of exchanging health information and a mean of building a trusting relationship. It opens the way to a shared decision-making process. In multicultural societies, there are challenges like a lack of shared meaning and differences in language and cultural practices. These factors can lead to misunderstanding and hinder the trust relationship. Factors such as language barriers, gender, and privacy concerns present significant challenges in intercultural communication between patients and health professionals. Topics such as sexual health are even more delicate. Discussions about sex are often considered taboo and in some cultures, sexual health is regarded as a matter that belongs to the female domain. In other cultures, knowledge about sexual and reproductive health is very limited due to a lack of education or open discussions. Sexual health, which relates to behaviour, is influenced by the cultural values and beliefs of the wider society, this may also create an isolating environment for sexual minority populations, such as members of the LGBTQIA+ community.
Intercultural communication is the study and practice of communication across cultural contexts. Intercultural communication, as a part of health and medical education, aims to increase physicians’ understanding of the importance of effective communication in healthcare settings.
What are the factors hindering communication?
1. Language barriers
Patients from other cultures and with immigrant backgrounds often lack basic or everyday language commands when communicating with doctors and nurses in the local language. Patients may be shy or find it hard to express some concepts in a language different from their own. For example, patients may lack medical terminology even if they possess everyday basic language.
Health professionals have a preference to see patients who can speak the local language. Patients who speak little of the local language can sometimes be considered illiterate even if they are fluent in another language. This can lead to misunderstandings between patients and doctors. Medical terminologies, such as the names of vaccinations and diseases, are often not included in language lessons.
Health professionals have used interpretation and translation services to support patients overcome language barriers during their consultation sessions and appointments, but when interpreters are used, they can themselves become barriers in communication between patients and health professionals on sexual health-related topics. Interpreters who are fluent in both languages may still lack the necessary medical terminology and interpreters who are not fluent in both languages may still be hired to assist in communication due to the high demand for interpreting services. This could result in information being misinterpreted and inaccurate diagnoses and prescriptions.
The style of communication is also important: patients from cultures where “small talk” or socialization is considered an essential role in establishing a trusting relationship might find it challenging when communicating with health professionals who prioritize professionalism and efficiency in a work environment.
Gender segregation due to cultural traditions and religious beliefs can create huge barriers between female patients and male health professionals. Female patients from cultures with gender segregation report feeling uncomfortable being seen by male doctors or nurses. This could lead to patients refusing to turn up for scheduled appointments, to the delay of treatments, and to the waste of medical resources. Gender also has an impact on patients’ decision-making as some patients with immigrant backgrounds may be influenced by the male guardianship system.
In some cultures, it is considered acceptable to share private information with family members as a way of getting family support. For some doctors, this may be a problem and consider that sharing a patient’s information with his/her family members is a breach of confidentiality. At the same time, other patients have low trust for practitioners in the host country and are concerned that their private information may be leaked out by them, nurses, or interpreters to their local communities.
Language, gender, and confidentiality of information are believed to play major roles in the intercultural communication process. Being aware of these factors may help professionals improve communication with patients in a culturally sensitive way. Some practical culturally sensitive communication skills include checking the patient’s language ability, being aware of cultural differences (e. g. saying something about treatment habits in one’s own country or asking the patient about his/her cultural habits for the specific disease), and adapting the diagnosis and treatment policy to the context of the patient (e. g. the doctor asks if the prescription use of the medication is possible and satisfactory for the patient, were considered relevant because these skills facilitate mutual understanding and respect). Other relevant skills lay in the field of expectation management (e. g. exploring the patient’s view on the reason for the consultation or the patient’s expectation of the consultation), showing interest in the patient’s family and checking if the patient understood the information given, which is relevant as it might help to clarify possible misunderstandings.
Paternotte, E., Scheele, F., Seeleman, C.M. et al. (2016). Intercultural doctor-patient communication in daily outpatient care: relevant communication skills. Perspect Med Educ 5, 268–275. https://doi.org/10.1007/s40037-016-0288-y
Zhao, X. (2021). Challenges and barriers in intercultural communication between patients with immigration backgrounds and health professionals: a systematic literature review. Health Communication. ISSN 1041-0236 https://doi.org/10.1080/10410236.2021.1980188
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