What are the basic competencies needed by practitioners for effective intercultural communication?

By: Dominique Diaz, Gustavo Echeverry, Alex Edjourian, & Yaman A. Shqeirat

Chandler Gilbert Community College/ Universidad de la Sabana

Due to the advancements in technology that are being experienced across the world, alongside the mass immigration seen today, intercultural interactions are taking place more frequently than ever before. For many healthcare professionals, this means they must learn to interact with people from different cultures on a regular day to day basis. Healthcare practitioners not only face the natural barriers of communicating with patients who may not be familiar with their local language, but may also face additional challenges interacting with patients who might have different customs, beliefs, and traditions and vice versa. The desire to welcome diversity and show respect to all types of people has a long history in countries who experience high rates of immigration. This has generated settings of great ethnic and cultural diversity; a situation that has put healthcare systems in the market for new strategies that facilitate better doctor-patient relationships. As it will be presented in this essay, we share the idea that good intercultural communication and competence is vital for high quality medical care.

KEYWORDS:

Intercultural communication, Health system, Migration, Cultural diversity.

INTRODUCTION

In late 2019, the world took note of a virus that was swiftly spreading in Wuhan, China, dubbed COVID-19. A few months later, on March 11, 2020 COVID-19 was declared a global pandemic by the World Health Organization (WHO), the first time since H1N1 influenza was proclaimed a pandemic in 2009. Media outlets all over the world started to spread information about the virus through different channels, the target audience in most cases was a key factor on how that information was presented. The pandemic exposed that, although immigrant populations were entitled to proper healthcare, language barriers and a failure by the system to incorporate their cultural needs, has left them with less than satisfactory service.

IT’S MORE THAN WORDS

Much of intercultural communication research studies on healthcare services focus on barriers imposed by speaking different languages (Al Shamsi et al., 2020), thus ignoring other elements of communication such as tone, vocal intensity, gestures, facial expressions, eye contact, etc. Simply put, it is deemed inefficient to invest resources into combating an illness on an individual level, with such large masses constantly immigrating and with such a plethora of cultures mixed into the large cauldron we call our community.

GETTING TO KNOW THE DIFFERENCES

According to studies, the best method for the healthcare system to respond to the enormous number of immigrants entering each country is to treat each person as an individual with different views, accepting his/her differences and acknowledging the language and cultural barriers that may come along with them. This is most evident in the distribution of national health expenditures relayed by the Center for Medicare and Medicaid Services (CMS). The chart provided by the CMS shows little to no change in the distributions of national health expenditures in the last decade; showing a failure to attempt to adapt by the healthcare system, in order to provide the large number of immigrants, who have immigrated in that period, better healthcare services.

HEALTH, COMMUNICATION AND THE MIGRANT POPULATION

According to the UN, in 2019 there was an international immigrant stock of 271 million people. This was doubling the amount registered 30 years ago by the same agency (UN- Department of Economic and Social Affairs, 2019). As the immigrant numbers rapidly increase, countries need to adapt to the massive shift they will experience in even their own cultures. Since healthcare practices include many social interactions, in which two substantial elements are the language and the culture, the lack of understanding of the core of these concepts, interfere with the accessibility of quick and efficient health services. Carmen Valero (Valero-Garces, 2014) talks about the characteristics of immigrant populations and how they face many difficulties in accessing adequate health services due to language proficiency, lack of familiarity with the practices of developed healthcare services, low socio-economic status, law enforcement issues and many others. Mental health is also a frequent issue that these communities experience due to the stress .

IT’S ALL ABOUT THE PATIENT’S NEEDS

Doctors who give the same care to different patients regardless of background are satisfied in the long run. In 2017 Paternotte, E., van Dulmen, S., Bank, L., Seeleman, C., Scherpbier, A., & Scheele, F. conducted a study to explore patients’ preferences and experiences regarding intercultural communication: such as the patients wanting to be treated with respect and a solid counseling from the doctor on how to treat their specific illness or wounds. Many participants mentioned that they felt comfortable when the doctor talked in an accessible way, such as: speaking slowly, using short sentences, explaining topics in various ways and avoiding medical jargon. The Norwegian natives explained in the study that by being able to communicate to the Dutch doctor through simple terms and understanding they felt safe in his care. The Participants in this study enjoyed having a doctor who treated each of them uniquely instead of looking at them like a type of disease. What made the participants feel a sense of respect is when the doctor was able to ask them questions it not only made them feel respected but also confirmed he understood. WHO expressed the dire need of a system in healthcare that catered to all patients foreign or domestic. Doctors who give the same care to different types of patients, are able to create a safe place for patients that enables them to feel comforted while being consolidated properly. As long as the doctor was professional the patients felt open to them.

BEING A NON-SWEDISH PHYSICIAN IN SWEDEN

Berbyuk, N., Allwood, J., and Edebäck, C conducted a research study in 2005 in which they took into account patient-physician experiences in Sweden and looked at them more closely. Sweden is changing from a monocultural to a multicultural society quickly, and because of this, Sweden’s healthcare system has struggled to adapt to the intercultural communication needed to provide proper care to their patients, as well as, physicians. The study compared the work of non-Swedish physicians employed in Sweden with their work-related interactions between them and Swedish healthcare personnel and made tables of the surveys conducted. The surveys conducted were about: misunderstanding in communication between non-Swedish physicians and Swedish health care personnel, language proficiency, professional competence, and the responses of Swedish health care personnel concerning views on power distance. The results of the survey made evident that the intercultural communication experienced in the Swedish healthcare system by non-Swedish physicians was found to be difficult due to misunderstandings between patients and co workers, made possible by inability to communicate via language.

BENEFITS:

Studies show that healthcare professionals are slowly adopting new ways of communicating with their patients, which in turn helps boost patient morale. Also, this aspect of approaching mass interactions in healthcare makes it easier to conduct medical studies and collect information.

AT THE END

Intercultural communication not only implies approaching different languages and cultures, but also the effort to rethink one’s own cultural identity. Not only is it a requirement to acknowledge the culture of the person who receives care but also of the one who provides it. When evaluating the behavior or beliefs of the recipients of care, one should be able to confront their own values about health and disease, since such is what they implore the former to do. According to studies, the best way for the healthcare system to respond to the massive influx of migrants into each country is to treat each person as an individual, as obvious as it may seem, and to recognize the linguistic and cultural obstacles that may arise. It is proposed that incorporating intercultural communication into the healthcare professional practice as a basic tool for a better quality of service for the migrant population can increase patient satisfaction as well as the efficiency in patient-physician interactions.

REFERENCES:

Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of Language Barriers for Healthcare: A Systematic Review. Oman Medical Journal, 35(2), 122. https://doi.org/10.5001/omj.2020.40

Berbyuk, N., Allwood, J., & Edebäck, C. (2005). Being a Non-Swedish Physician in Sweden: A Comparison of the Views on Work Related Communication of Non-Swedish Physicians and Swedish Health Care Personnel. Intercultural Communication, 8. https://immi.se/intercultural/nr8/berbyuk.htm

Choi, M., & McKeever, B. W. (2020). Culture and Health Communication: A Comparative Content Analysis of Tweets from the United States and Korea. International Journal of Communication, 14, 4035–4054.

Paternotte, E., van Dulmen, S., Bank, L., Seeleman, C., Scherpbier, A., & Scheele, F. (2017). Intercultural communication through the eyes of patients: experiences and preferences. International Journal of Medical Education, 8, 170–175. https://doi.org/10.5116/IJME.591B.19F9

United Nations — Department of Economic and Social Affairs. (2019, August). United Nations Population Division | Department of Economic and Social Affairs. https://www.un.org/en/development/desa/population/migration/data/estimates2/estimates19.asp

Valero-Garces, C. (2014). Health, Communication and Multicultural Communities: Topics on Intercultural Communication for Healthcare Professionals (Cambridge Scholars Publishing (ed.)). https://books.google.com.co/books?id=DpvyoAEACAAJ