For as long as globalization is and has been taking place at alarming rate, cross cultural interactions are taking place in the different health settings. These have altered the main forms in which communication takes place, that is the verbal and the non-verbal. In addition to this, communication is very important between the medical professionals as well as between the professionals and the patients.
Generally, effective communication allows patients to get access to medical care more so; it opens up a pathway for an understanding to take place between the patient and the medical professionals. This in most cases applies where consent has to be given by a patient or the next of kin to a patient before any medical procedure takes place. This paper looks at the impacts of culture on the communication process within a health setting with a specific reference to the American culture.
Various scholars have gone to the extent of trying to explain what culture means. However, culture according to Lee (2003) is the design in which human behavior is amalgamated. This includes the different beliefs, practices, customs and values that a social group practices and believes in (p.4).
Modern day health care system involves quite a number of interfaces as well as patient handoffs amongst several health care practitioners. This takes place in various levels of not only educational training but also occupational training. For effective clinical practice to take place there has to be situations where important information is not just communicated but should be communicated accurately.
In an event where this does not take place at it should, the patient’s safety therefore stands on the line. This may take place in different forms. For instance, when information is misinterpreted this may lead to a misdiagnosis by a medical personnel hence the under treatment of a patient or even worse.
Different cultures vary significantly depending on the region, the ethnic composition of a population as well as the different values shared by the people of a nation. There are positive influences that culture has had on the communication process in any health setting. For instance, it has enabled organizations to set standards for which they are meant to live up to. Goals in various health care institutions have been able to be achieved due to a particular national culture that is meant to be up held.
Culture depending on an individual’s where about has been able to provide a means of survival. For instance, a patient from china might find solace anywhere near china town in the United States. This is because around there he can get good Chinese food and more so, chances are that he might get attended to by the Chinese medical officials. This also applies to the Chinese doctors in the same setting. This means that they can be able to communicate to each other on the various treatments that they can go through.
Culture through communication helps people identify with each other in a given health setting. For example, given the numerous immigrants from different parts of the world into the United States, it is rather reliving when and Indian or a Chinese medical professional gets to associate with another individual from the same nation. Therefore, this shows that through culture, various people get to communicate and therefore enhances unity and appreciation for another individual’s culture ( Lee, 2003, p. 7)
With special reference to the American culture, there are immigrants from most parts of the world hence this has not only had a negative impact on the mainstream American culture. In addition to this, one of the most important sectors that have been affected by the immigration element is the U.S is the health and the health care system.
The main domains however as mentioned by Penn et al (1995), are the preferred treatment, health behavior, seeking health care, interactions with health providers and acceptability of health care(p. 65).
It is of paramount importance that the health providers and the patients establish a good relationship and this can be done effectively through communication. However, there are various cultural aspects that may hinder communication from taking place in any health setting.
For instance, the stereotypes that arise from a culturally diverse health setting may prevent effective communication from taking place. An example being that, a white patient may not be pleased when he is referred to an African American doctor. Therefore he may be very reluctant to reveal any problems that he might be having hence the services offered may end up being substandard (Servellen, 2009 .p. 238).
Another negative impact is that of language barriers between the different cultures. Given that language is the key element in any effective communication process, the different cultures have different languages.
For instance the over 5% of the Asian community are still fragmented further in that, the Chinese speak mandarin, Indians speak Hindu and so on. This has therefore made it harder for the patients and the physicians in parts of the U.S to understand each other and reach a consensus on the way forward regarding the health status of the patient.
In other instances as explained by Lee culture may negatively affect communication in that, some cultures do not uphold such acts as an individual being assertive or openly challenge opinions. This may result to certain medical professionals such as nurses communicating their grievances as well as concerns in an indirect manner.
The risk of indirect communication is that it might be interpreted wrongly by fellow nurses or other medical colleagues. Moreover, there are cultures that hinder non-verbal communication in that they may ascribe some specific negative meaning to eye contact , facial expressions as well as voice tone.
Hierarchical culture , according to Rosenstein & O’Daniel (2006) also contributes to a communication hindrance in a particular health setting. This is due to the fact that the physicians are at the top of the hierarchy leading to an assumption that everything is going on very well while the other staff feels there are problems.
This may therefore lead to a decrease in the collaborative interactions efforts, which are necessary for proper treatments to take place. In addition to this, an intimidating act by an individual at the top of the hierarchy may lead to the hindrance in communication between these two groups (p.5)
As Lee (2003) mentions, there are ways in which health care systems can take action regarding the needs of the linguistically and culturally diverse populations. This can be done by working on becoming culturally competent (p.4). Cultural competency has been clearly defined by Lee (2003) as a “set of congruent behaviors, attitudes and policies that come together in a system, agency or amongst professionals and enables that system, agency or those professionals to work effectively in cross cultural situations (p.182).
This means that there has to be strategies put in place in order to provide a common understanding between the patients and physicians who are basically from different cultural backgrounds. This will enhance communication amidst the two parties and which in most cases results to good medical outcomes. The communication process goes on to the next level where subjective feelings are established. These include trust, mutual satisfaction and empathy among others.
In the quest of doing away with cultural barriers that hinder effective communication in the health care system, it is important that the American medical schools encourage its students to learn two or more languages.
For instance given a large and still growing percentage of the Spanish- speaking individuals in the nation, it would be advisable for the doctors and other medical practitioners to learn Spanish. Of course they need to not only learn the language but a little bit of the culture as well. This would ensure successful communication in any health care setting.
So much more can be done in order to improve the situation in a health setting. Team collaboration is an important principle that should be applied in every health institution. This principle emphasizes that there should be extensive cooperation between and among health care professionals.
Cooperation is also recommended in areas such as in decision making on the formulations of plans meant to improve health care provided to the patients. More so, teamwork should be emphasized and should be formed on the basis of trust and respect regardless of the cultural background of a particular physician. The division into teams will definitely improve the communication between the various professionals, as there will be a sense of dependency among them given that they are all working together towards the same goal.
In addition to the above recommendations, the health institutions may go ahead and provide language services as proposed by Lee (2003). By this, he advises that there should be trained medical interpreters who are meant to enhance communication between the patient and the physician.
It is however very important the interpreters understand the non-verbal cues and their meanings in different cultures alongside understanding the language (p.14). This practice may however require a health institution to allocate more funds to ensure the constant provision of this service.
Concisely, globalization has played a big role in the increase of cultural diversity in the different health settings. Using the United States as the case study, it is a representative of one of the most diverse cultures globally. However, the health institutions have felt the impact of this diversity most of them being harmful to not only the patients but also the medical personnel such as the nurses and the surgeons.
Even though the national culture provides that every American citizen has a right to good medical care, there are loopholes that still need to be fixed. However, there are recommendations on how such diversity can be used to the advantage of its patients and more so the medical professionals. For instance, the requirement that both parties should endeavor to learn an additional foreign language to enhance communication in any health setting.
References
Lee, S. (2003). A review of language and other communication barriers in heath Care. Web.
Penn, N.E, Kar, S. Kramer,J. & Skinner, J. (1995). Ethnic Minorities, Health Care Systems, and Behavior. Health Psychology 14 (7): 641-646.
Rosenstein, H & O’Daniel,M. (2006). Professional Communication and Team collaboration. Web.
Servellen, V. (2009). Communication skills for the Health Care Professional: Concepts, Practice and Evidence. (2nd ed.). Massachusetts; Jones and Bartlett publishers.