The assessment and documentation of language and communication needs in healthcare systems: current practices and future directions for coordinating safe, patient-centered care

Documenting language barriers in a general hospital psychiatry setting

Previous research has demonstrated that without the use of professional interpreters, language barriers interfere with patient care. The literature recommends documenting the presence of language barriers in medical charts. To our knowledge, this mixed methods study is the first to examine language documentation practices in a Canadian inpatient psychiatry setting. The research team interviewed 122 patients admitted to a tertiary care psychiatry ward in Montreal, Canada between 2016-2017 to assess their ability to communicate in the healthcare establishment's languages (English/French). Nineteen participants identified as having a language barrier were selected for a qualitative analysis of the retrospective audit of their medical charts. The presence of a language barrier was reflected in 68% of these charts. When a language barrier was documented, professional interpreters were never used. Our qualitative analysis, informed by literature on medical discourse, aimed to provide clinical, administrative, and organizational recommendations to optimize the utilization of interpreting services in psychiatric wards. Documentation of language data was inconsistently collected, often vague, and shed light on the clinical challenges involved in differentiating language barriers from psychopathology. Normalization of limited care for language diverse patients was reflected in the clinical notes. Findings show that a change of organizational culture is imperative to provide optimal care to language diverse patients. We recommend clinician education and standardization of documentation practices, along with institutional policies supporting the systematic use of professional interpreters in mental healthcare settings, to maximize human rights and patient safety, and to bring medical practices to an acceptable standard of care.

Experiences in the workplace community and the influence of community experiences on ENP courses for nursing professionals

BACKGROUND

A nursing community can be described as a discourse community or a Community of Practice (CoP). No matter what type, a nursing community exerts influences on its group members' worldviews, perspectives and beliefs.

OBJECTIVES

The purpose of this research is to explore what nurses' experiences of membership within the nursing community are and how such experiences influence nurses' views of English for nursing purposes (ENP) courses.

DESIGN

A qualitative case study was conducted in a medical centre in Taiwan in which many foreign patients seek medical treatment and in which English is highly valued.

PARTICIPANTS

Nine nurses who had at least three years working experience in relation to clinical practice participated in the study.

METHODS

Semi-structured interviews and shadowing observations were the two primary methods of data collection.

RESULTS

Five themes emerged: (1) building of the nurse-patient relationship, (2) provision of patient-centred care, (3) negative caring experiences, (4) professional identity, and (5) perspectives on ENP courses.

CONCLUSIONS

Nurses' connection with the community led for them to a focus in their working lives. This determined their perceptions of ENP courses.

Socio-linguistic analysis of the Charter of Citizens' Rights and Obligations in Health Services

The aim of this study is to carry out a socio-linguistic analysis of the dissemination of the Charter of Citizens' Rights and Obligations in Public Health Services. We designed a qualitative investigation using observation and content analysis. A deductive analysis technique was followed, based on the "SPEAKING" model categories. The data analysis suggests a clear framework of rights and obligations has been established, but is not very familiar to patients and relatives. We can conclude that despite the widespread dissemination and publicity of the Citizens' Charter of Rights and Obligations, we still need the involvement of professionals. Nurses can develop a fundamental role in this process.