Assessing language barriers in health facilities in Malawi.

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Amelia Taylor, Paul Kazembe
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引用次数: 0

Abstract

Background: Language barriers in healthcare lead to miscommunication between professionals and patients, thereby reducing the quality of and equitable access to healthcare. In African countries, the recognition and formal study of these barriers is severely limited despite Africa having more languages than any other continent. Our study investigates language barriers in healthcare facilities in Zomba district in Malawi, where three major local languages are spoken.

Methods: We employed a mixed methods approach and conducted a questionnaire-led study. Data were gathered at 22 health facilities, from 79 healthcare professionals and 312 outpatients using a semi-structured questionnaire. Findings were corroborated using document analysis to review legislation and policies, curriculum documents and patient notes.

Results: Language discordance emerged as a problem for professionals and patients. Both faced challenges due to vocabulary limitations for medical terms in English and Chichewa. Professionals did not receive training on how to effectively communicate medical concepts in local languages. Most patients did not speak English, which was used for all written records. Patient understanding of the information given to them verbally during consultations or in written health notes was very low, and this diminished their confidence in the diagnosis or treatment they received. Social factors including gender, age or patient experience, as well as patient literacy or perceived low literacy, poor rapport between healthcare professionals and patients, and a lack of privacy during consultations all exacerbated communication issues. Consequences of language barriers included unsatisfactory care experiences and compromised exchanges of health information. Strategies used by professionals to cope with these challenges were flexibility in the choice of language, reliance on physical checks and non-verbal communication indicators and the occasional use of ad-hoc interpretations.

Conclusion: Language barriers in healthcare facilities in Malawi have serious implications on the quality of healthcare provided. We propose solutions such as the development of dictionaries with phrases for symptoms and conditions, sensitisation courses that incorporate language considerations for both professionals and patients. Policies such as the provision of interpreters and staff allocation are discussed. We recognise that coordinated efforts at national and international levels are key to securing significant funding for effective interventions.

评估马拉维医疗机构中的语言障碍。
背景:医疗保健中的语言障碍会导致专业人员和患者之间沟通不畅,从而降低医疗保健的质量和公平性。在非洲国家,尽管非洲的语言种类比其他任何大陆都多,但对这些障碍的认识和正式研究却非常有限。我们的研究调查了马拉维松巴地区医疗机构中的语言障碍,该地区使用三种主要的当地语言:我们采用了混合方法,开展了一项以问卷调查为主导的研究。采用半结构式问卷调查法,在 22 家医疗机构收集了 79 名医疗专业人员和 312 名门诊患者的数据。研究结果还通过文件分析法对立法和政策、课程文件和病人笔记进行了核实:结果:语言不协调是专业人员和患者面临的一个问题。由于英语和奇切瓦语医疗术语词汇量的限制,双方都面临着挑战。专业人员没有接受过如何用当地语言有效传达医学概念的培训。大多数患者不会说英语,所有书面记录都使用英语。患者对问诊时口头提供的信息或书面健康记录的理解程度非常低,这削弱了他们对所接受的诊断或治疗的信心。包括性别、年龄或患者经历在内的社会因素,以及患者识字率或被认为识字率低、医护人员与患者之间关系不融洽、就诊时缺乏隐私等因素都加剧了沟通问题。语言障碍的后果包括护理体验不尽人意和健康信息交流受到影响。专业人员应对这些挑战的策略包括灵活选择语言、依赖身体检查和非语言沟通指标,以及偶尔使用临时翻译:马拉维医疗机构中的语言障碍严重影响了医疗质量。我们提出了一些解决方案,如编写包含症状和病症短语的字典,为专业人员和患者开设包含语言注意事项的宣传课程。我们还讨论了提供翻译和人员分配等政策。我们认识到,国家和国际层面的协调努力是确保为有效干预措施提供大量资金的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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