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The demographics of the United States are more diverse than ever now, and with that diversity follows a mix of cultures and languages. Communication often poses problems, and that can be extremely detrimental if in a healthcare situation. Consider if the patient and healthcare provider do not understand each other properly, and therefore, symptoms and causes, among other things, are not being adequately given, assessed, and/or provided. The quality of care is diminished.Indeed, lack of effective communication is one of the main causes of medical errors. Barriers to effective communication include differences in language and cultural differences. (Wilson-Stronks, 2007).

In order to improve quality of care in healthcare, communication among healthcare providers, administrators, educators and persons of different cultures should be improved to promote more effective translation of ideas and an understanding of and respect for cultural beliefs.This brief essay will describe first and foremost steps that healthcare providers, administrators and educators can take to improve effective communication, and then it will take a look at the above-mentioned barriers and patients’ obligations to facilitate communication. Culture and Healthcare Providers, Administrators & Educators As already implied, communication between healthcare providers and organizations and the patient, as well as the patient’s family, is the key component to quality care.Through effective communication, patient-specific data is collected, which serves as the basis for accurate diagnosis and prognosis. To improve one’s health or medical situation, it is noted that the patient must be involved in his treatment planning, that he must provide informed consent, and that the patient should be educated on his medical condition, and that effective communication is made possible if it is bidirectional between participants.In order to be bidirectional, healthcare providers and organizations should, according to a project undertaken by the Child and Adolescent Health Measurement Initiative (CAHMI), the Florida Initiative for Children’s Healthcare Quality (FLICHQ), and All Children’s Hospital (together known as “the Initiative”) (October 2005), attempt to adhere to certain standards. For instance, according to the Initiative (October 2005), providers, administrators and educators should provide “respectful care that is provided in a manner compatible with [the patients] cultural health beliefs and practices and preferred language.

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” (p. 7). One means to do so, is for healthcare organizations to “recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area” (the Initiative, October 2005, p.

7), and provide “staff at all levels and across all disciplines … ongoing education and training in culturally and linguistically appropriate service delivery” (the Initiative, October 2005, p. 7). Furthermore, healthcare organizations must provide the following services: 1.“language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited english [sic] proficiency at all point of contact, in a timely manner during all hours of operation,” (p. 7) 2. “verbal offers and written notices informing [patient/consumers] of their right to receive language assistance services” in their own preferred language, (p.

7) 3. “easily understood patient-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area,” (p.7) 4. integrated “cultural and linguistic competence-related measures” in the healthcare organization’s “internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations,” (p. 7) 5. the maintenance of a “current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area,” (p.7) 6.

participatory and collaborative partnerships with communities (p. 7), and but not limited to 7. culturally and linguistically sensitive conflict and grievance resolution processes that are “capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients/consumers. These measures, if taken seriously, have the great potential of not only improving quality of care, but also to promote the translation of ideas and respect for different cultures.However, as mentioned, in order for effective communication to exist, the communication must be bidirectional, and although healthcare providers, administrators and educators bear the largest burden in executing effective communication, it is ultimately up to the patients to ensure its success. The barriers to communications, mentioned above must be addressed and challenged accordingly. Barriers to Effective Communication & Patients’ Obligations There are several issues related to patients who have limited English capabilities.

First, just the mere language difference is a barrier to effective communication. (Divi et al. , 2007, p. 60). To further complicate an already complicated situation, some patients may believe that they are sufficiently proficient in English. The patient may believe he understands the professional healthcare provider, but in the end actually misunderstands.

(Wilson-Stronks, 2007). Evidently, both the patient and the healthcare providers may misjudge the language barrier between them, and thus, mitigate communication and establish a foundation for poor quality care.It is up to the patient to advise the professional that he is not proficient in English. Cultural differences are often, and rightly so, associated with linguistic differences, and are another barrier to effective communication with regard to healthcare.

Yet culture goes beyond language differences, such that it is about one’s perception of the world, his values and morals. The barrier it presents in this instance is that some cultures place different meanings to certain words and ideas, and may not permit certain medical procedures or medicine. Also, and according to Divi et al.

(2007), cultural differences between the provider and the patient poses potential risks, such that one or the other may stereotype individuals by their culture, or misunderstand the effects of their cultural beliefs. The patient, to overcome this barrier, must again speak up about his concerns, to advise the providers’ information about their culture and what they prefer or do not prefer. It is wise to participate fully in one’s planning of any kind of treatment, and to provide information that is necessary to help the provider plan appropriately. The Benefits of a Multicultural Society ; Healthcare SystemBefore change can transpire into real meaningful change that promotes more effective communication in the healthcare system, it needs to be understood what the benefits of this change will be. In doing so, there will be incentive to put for the effort for this much needed and desired change. Living in a multi-cultural society does have its disadvantages, most notably what has already been considered, and that is language and cultural differences that oftentimes preclude peoples of these cultures and languages to transcend to the next culture, or dominant culture.People fear difference, but in that difference is a pool of learning opportunities.

It must be noted that cultures are not stagnant; they are living entities that must in themselves change in order to survive. By embracing other cultures, one does not have to “give up” his/her own culture, but can enrich that culture. Take for instance the richness of Eastern medicine, which is now being explored more and more by those of the dominant U. S.

American culture.For instance, the physical and psychological benefits of acupuncture are very well known, and acupuncture is offered under many healthcare plans that traditionally offered only “western” medicine. The American Institute of Eastern Medicine incorporates both Western and Eastern medicine and knowledge to enrich its resources for knowledge and provide its patients with an array of various medical and therapeutic possibilities. The institute has conducted a study on the TCM formulation, known as “Wang’s Juemmingjing extract” in the treatment of diabetes mellitus.(Xian et al.

, 2002). It has been found to be very effective with no side effects, unlike the serious side effects caused by traditional medicines used to treat diabetes mellitus, e. g. Avandia that causes diarrhea, headaches, among other things, heart failure (Saltiel, 2008). Sandra Harding (Spring 1994) writes that multicultural perspectives provide more comprehensive and less distorted understandings of the arts, social sciences, literature, history, and, of course, science and medicine.Instead of having a one-sided view, there is an array of views that may enhance each other or indeed shed light on serious issues that must be addressed. When there is effective communication, then misunderstandings are limited.

Effective communication promotes an environment where the patient may feel freer to discuss his/her thoughts and opinions, worries and concerns, all of which are influenced by that person’s culture. Furthermore, a doctor may learn about any misconceptions the patient may have and address those issues. To better understand this, an example might help.A study was undertaken in Australia with the Greek minority population. (Goldstein et al.

, 2002). The Greek community is one of the most established cultures in Australia. They, however and according to the study, have different perspectives on cancer than the dominant culture of Australia. According to the study (Goldstein et al. , 2002), Greeks misunderstand the causes and outcomes of cancer. In fact, per their cultural beliefs, cancer is regarded as shameful.

If diagnosed with cancer, Greeks will not disclose it to anyone, unless it is to an immediate family member.(Goldstein et al, 2002). If the one who has cancer cannot speak English, and therefore had a family member translate the diagnosis and prognosis, the study found that the family member’s softened the doctor’s diagnosis so as to reduce the amount of shame the patient would feel. (Goldstein et al. 2002). This study demonstrates the importance that the doctor be able to communicate with the patient, so that s/he can explain that there is nothing shameful about cancer, and to advise the patient of his/her complete diagnosis and prognosis.

Conclusion: Effective Communication by Promotion of Cultural Understanding As mentioned in the opening of this essay, the United States is more diverse than it has ever been, and will continue to be so. Recent reports that white people will be the minority in several decades is evidence of this growing change. Spanish speaking Americans are increasing rapidly, as are Arabic and Chinese speaking Americans, along with that are the various cultures among and within each of those groups.As the U. S. is a country of immigrants, and as it is that healthcare providers, administrators and educators are under a duty to provide quality care and information for all citizens and residents and even illegal immigrants, they bear the burden of ensuring that programs are implemented to improve communication. That said, patients of different languages and cultures are under an obligation to become participants in their healthcare.If greater effective communication is provided on both ends, then it follows that maybe better respect for and understanding of cultures will result in and outside of the healthcare system, making for a healthier society overall.

References The Child and Adolescent Health Measurement Initiative, The Flroida Initiative for Children’s Healthcare Quality, & All Children’s Hospital. (October 2005) Communication and Culture: The Common Denominator in Improving Quality and Safety of Care for Children. Retrieved September 28, 2008, from http://socialwork. duhs. duke.

edu/wysiwyg/downloads/Toolkit_final. pdf. Goldstein, D. , B.

Thewes, and P. Butow. (26 June 2002) Communicating in a multicultural society II: Greek community attitudes towards cancer in Australia.

Internal Medicine Journal, Vol. 32, Iss. 7, 289 – 296. Harding, Sandra G. (Spring 1994) Is Science Multicultural? : Challenges, Resources, Opportunities, Uncertainties.

Configurations, Vol. 2, No. 2, 301-330. Divi C. , Koss R.

G. , Schmaltz S. P. , Loeb J. M. (2007) Language proficiency and adverse events in U. S. hospitals: a pilot study.

International Journal of Quality Health Care, 19, 60–67. Wilson-Stronks, Galvez E. (2007) Hospitals, Language, and Culture: A Snapshot of the Nation.

Oakbrook Terrace, IL: The Joint Commission. Saltiel, Emmanuel, FASHP, FCCP and Jay W. Marks, MD. (2008) Avandia. Retrieved October 2, 2008 from http://www. medicinenet. com/rosiglitazone/article. htm.

Xian, Wang, Weichun Lu, Guangying Huang, Fuer Lun, Qingnian Tu, Bingkun He, Qianbing Zhang, Yoshiyuki Takei, Tatsuo Osihara, and Nobuhiro Sato. (2002) Effects of the TCM Formulation “Wang’s Juemingjing Extract” in the Treatment of Diabetes Mellitus. Eastern Medicine, Vol. 18, No. 3, 1-7.

Retrieved October 2, 2008 from http://www. americaninstituteofeasternmedicine. com/KetsumeiseiClinical. pdf.

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