When East Meets West in Medical Settings: Cultural Issues Dr'Rana Rddawi, American University of Sha

1
When East Meets West in Medical
Settings Cultural Issues Dr.Rana Rddawi,
American University of SharjahDepartment of
Englishrradawi_at_aus.edu
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Cultural Issues in Medical settings

• Purpose of Paper
• Shed light on linguistic and cultural challenges
  facing healthcare providers and patients today
• Focus on the importance of Cultural Competency in
  healthcare
• Solutions

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Cultural Issues in Medical settings

• Examples USA/UAE
• Intercultural Communication definition
• when people of different cultures communicate
  mainly face-to face by sending and receiving
  messages.

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Cultural Issues in Medical settings

• Intercultural Communication
• New field of research in the latter half of the
  20th century due to globalization and intensive
  immigration

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Language differences

• Language differences
• In the US, more than 49 million speak languages
  other than English
• 22 million have low-proficiency in English
  (Samovar et al. 2007)

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Language differences

• In the United Arab Emirates, there are 800,000
  local Emiratis against 5 million expatriates,
  including Asians, Arabs, Americans, French, and
  Iranians (Gulfnews.com) among whom 10 only speak
  Arabic

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Language differences

• The rate of errors by human interpreters due to
  language barriers is 31 per clinical encounter
  and omissions are the most frequent type.Errors
  in Medical Interpretation and their Potential
  Clinical Consequences in Pediatrics
  Encounters)(Karliner et al. 2004)

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Language Barriers impact

• Negative effects on
• elicit exact symptoms
• treatment preferences
• explain treatments

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Source Karliner LS, Perez-Stable EJ,
Gildengorin G The language divide. The
importance of training in the use of interpreters
for outpatient practice J Gen Intern
Med.19(2)175-83
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Language Barriers impact

• Inefficient ad hoc interpreters in US hospitals
• Shortage of 24 h available interpreters
• Absence of interpreters for rare languages

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Language Barriers impact

• The problematic in UAE healthcare units larger
  due to the quasi total absence of professional
  medical interpreters (The Emirates Center For
  Strategic Studies and Research, 2008)
• 30 of the population are locals
• 70 divided between 10 (Arabs) and 90 (speakers
  of other languages)

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Language Barriers impact

• poor communication is a barrier to good
  patient-centered care.
• Non verbal communication taken for granted and
  can lead to false diagnosis
• In emergency cases , language barriers can be
  serious
• Translation services are required in all
  facilities as part of Joint Commission
  accreditation (DerGurahian, 2008).

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Cultural Differences

• Cultural Differences
• Culture set of beliefs, traditions and attitudes
  shared by a community/shared experiences
  /heritage of shared experiences
• i.e. attitude towards treatment
• Mind-body dichotomy biomedicine vs. alternative
  medicine, holistic etc

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Cultural Differences

• Taboos
• Religiously /ethnically sensitive issues
• Direct vs. indirect style in telling the truth to
  patient (low context vs. high context
  cultures)-speech rules (Wolfson)
• The Right To Know (biomedicine/low context) vs.
  The Right Not To Know (high context/Confucian)
• The psychological status of the patient is part
  of the healing process

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Cultural Differences

• A number of studies show that misunderstandings
  that stem from cultural differences and language
  barriers have resulted in

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Language and Culture Barriers Result

• Language and culture barriers result in
• poor patient-healthcare provider relationships
• incorrect diagnosis
• lack of informed consent
• lower patient satisfaction
• malpractice suits
• (V. Whitman Davis, 2008)

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Solutions

• Solution
• Needs for interpreters
• Respect privacy
• Cultural Competency awareness and emphasis for
  all parties involved in the process)
• Increase diversity of healthcare professionals
  (avoid bias/ethnocentrism/stereotyping
• Training to support cross-cultural care

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Solutions (continued)

• Solution (continued)
• Cultural competence
• mutual understanding of the different cultural
  perspectives of each party.
• Use of technology (translation center/Call
  center)
• Innovative Programs (Navigator) to help
  immigrants and nonnative speakers of English deal
  with complexities of the US health care
  system-Intercultural communication courses
• Cultural Brokering

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Conclusion

• Conclusion
• Effective communication between medicine
  caregivers and patients is a must for a
  successful healing process. This entails mutual
  understanding of the different cultural
  perspectives and language skills of each party.