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sharing of information and instructions. The best clinical outcomes can be achieved in
situations where all sensor elements are incorporated in practice (Cote, D. 2013). In this
case, there can be communication between the care provider and the patients. Also, another
demand professionalism since a lot of critical issues are reliant on the types of information
(Horňáková, A. n.d). Professional health service providers are expected to tailor their services
on the cultural background of a patient. Other vital issues that have to be considered include
gender of the patient, age, ethnicity as well as socio-economic statuses. Cultural competence
communicating with patient or professionals from other cultures. This calls for intercultural
competence where professionals have a task of exceeding high tolerance and understanding.
In some cases, nurses may be required to seek the services of interpreters, especially where
there is a language barrier. While translation may be a valid option for countering language
barrier, some terms may not be accurately communicated, and this can lead to errors. Such
misfortunes that arise from language barrier can have adverse effects on the patient outcome.
paper will delve into a case where cultural competency proved to be a great issue of concern
Case Review
This case has been retrieved from Association of Schools and Colleges of Optimetry
(2016). In the case, a nurse explains a situation faced while working at a hospital facility in
Intercultural Communication in Healthcare 3
India. In the case, an issue arose where there was conflict in the traditional religious beliefs
and the professionally approved medical intervention. The patient that the nurse was
attending to was 83 years old who strictly adhered to the norms and tradition of her Navajo
tradition. This proved to be a major challenge to all the medical attendants responsible for the
patient’s case. It must be noted that the Navajo community is one of the indegenous groups
that make up the Indian tribes living along the Colorado River.
According to the information provided by the nurse, the 83-year old patient had
complained of low vision six years ago. This low vision was accompanied by severe and
boring pain in the eye. In addition, the patient's health history revealed evidence of
hypertension as well as rheumatoid arthritis that had never been treated over the years. The
lack of treatment has been attributed to the patient’s strict adherence to the traditional norms
and culture.
During all sessions, it was required to have a translator to help in the communication
process. The was a language barrier which meant that the patient could not understand the
nurses and the vice versa was also true. The translator had a responsibility of enabling the
flow of information between the patient and the care provider. This also made it possible for
the nurse to understand the ethnic and religious background of the 83-year-old. It was
revealed that the old lady was never keen to adhere to the prescriptions made by nurses and
opted for the instructions given by a native expert. These varying situations made it hard to
for the nurse to convince the patient. Furthermore, it was hard for the nurse to express
specific opinions in the manner he desired. The nurse later revealed that the mission was a
success and the old lady was able to consider the nurse's prescriptions after numerous failed
attempts to stick to the native doctor’s instructions. The care provider had to make sure that
a foreigner, expected to deliver healthcare services to an old lady who speaks a different
Intercultural Communication in Healthcare 4
healthcare can be threatening to a life of a patient. It has also been indicated by Mueter, R. et
al. (2015) that linguistic differences are a delicate issue in the field of health that has to be
addressed using correct steps. In this case, the nurse was not conversant with the language of
the patient, and the patient was not familiar with the language of the care provider.
In this case, a nurse is required to communicate with a patient to facilitate the healing
process. However, there will be no communication due to the differences in the languages. It
has been established that the services of a translator were considered. However, this does not
guarantee that every single word from the nurse was accurately translated into the native
language that the old lady understood. For instance, some words in one language may not
have a meaning in another language due to other elements such as cultural differences. For
example, lifestyle management is critical in diabetes control. On the other hand, the old lady
may have a different interpretation of lifestyle management to imply strict adherence to her
consideration without compromising cultural beliefs of the aged lady. However, this was
challenging since the woman had been loyal to her tradition for many years. She believed that
everything prescribed in her culture is the best. This creates a situation known as a cultural
Door (2018), conflict may arise between the care provider and a patient if former fails to
respect and recognize and respect the beliefs and traditions of the former. For instance, the
woman, in this case, the study had a different societal lifestyle. This belief oriented the old
lady to a native doctor as compared to medical nurses. It explains the reason why it was easy
for the patient to trust in a traditions nurse’s instructions and not that of a qualified med
practitioner.
Intercultural Communication in Healthcare 5
communication (Holliday, A., Kullman, J., & Hyde, M. 2016). For instance, some signs used
to communicate in one language can be insulting in other cultures. For example, most Asian
women do not prefer to shake hands for long with people of different sex. This
conservativeness can have a greater impact on the communication process between a nurse
and a patient. This situation has not been illustrated in the case being discussed, but some
women in other cultures are not allowed to mingle with men as this is considered immoral.
The discordance of cultural practices can have many sensitive elements that can hamper the
patient-nurse relationship.
According to Admin INSCOL Healthcare (2015), people from different cultures have
varying interpretetion of signs made during a communication process. For example, the Arab
culture requirs one to avoid eye contact whenever talking to their superiors or seniors. This is
considered as a sig of respect for the seniors. Therefore, a challenge may arise whenever a
young female nurse is expected to attend to and elderly patient of the Arab culture. Admin
INSCOL Healthcare (2015) has also identified that pocketing while talking is considered
disrespectful in most cultures from the South American region. It has also been stated that
most patients from Russia would offer the nurse a kiss on the cheek as a sign of appreciation.
Therefore, the non-verbial elements of communication should be applied with caution. The
sensitive non-verbal sign. In addition, it has varying interpretations across different cultures
in the world. Sensitivity often arises when it comes to the person making the eye contact and
the lasting period. On the one hand, some cultures from Latin America expect one to maintain
eye contact as a sign of respect to a conversation. On the other hand, other traditions from
Asia expect juniors to avoid this type of sign whenever talking to seniors who are also
Intercultural Communication in Healthcare 6
considered as respect. Therefore, healthcare providers must understand the impact of their
made through touch. For example, a firm handshake in the US is considered an appropriate
gesture. In France, it is normal to give a kiss on a cheek whenever greeting and touching on
the head of a South American child is fine. However, in Asia, the head is considered as a
consecrated part of the body that must be respected, and this includes avoiding to touch the
head of another person. Most parts of the Middle-East, as well as members ascribed to the
Islam religion, consider the left hand as a body part responsible for handling hygiene of the
body. This means that the left hand cannot be used to offer or accept gifts in this culture. The
significance of touch between male and female also varies across cultures.
Gestures
Gestures can bear different meaning during a conversation [ CITATION Adm15 \l
1033 ]. For instance, nodding the head in the US is a sign of acceptance or rejection
depending on the direction of nodding. A thumbs up gesture in the US implies that something
is fine, on the other hand, the same symbol in Japan means money. It has also been
established that the same sign means a zero in Belgium, Argentina, France and Portugal.
Facial Expression
Facial expressions such as winking and mouth movement may have different
as a romantic gesture that may allso imply a sexual invitation.On the other hand, the winking
among the Chinese is considered as a rude gesture. Therefore, such signs cannot be
mood, and concetration (Bernstein, R. 2017). The slouching postuure in Taiwan is viewed as
a sign of disrespect. In the US, if one stands with his or her arms on the waist is considered as
Intercultural Communication in Healthcare 7
a sign of power. The same posture in Argentina can be regarded as a challenge or invitation
for a challenge.
Sign Languag in Medical Care
The deaf and dumb may also are sensitive to the various body movements, and they
often interpret such gestures. The interpretation may be base on previous training, cultural
values or past experiences. Therefore, signs may also be important whenever communicating
with a deaf patient. A nurse must be sure to use the correct sign or use the services of an
expert. According to Yani, F. H. (2017), care providers must learn a sign language to facilitate
the PCC for the deaf. Also, a deeper understanding of the sign language makes it possible for
the patient and the physician to understand each other without difficulties. This ensures that
information is accurately conveyed and interpreted (Nicodemus, B., & Metzger, M. 2014).
perception of the approach (Yang, P. 2017). However, the case of the old woman presents a
unique situation with two different viewpoints with regards to treatment. The patient believes
in the native doctor who makes the communication process futile. On the other hand, the
nurse has to challenge this negative belief without polarizing the patient.
Community Door (2018) has illustrated that the difference in the perception of illness
can affect patient outcome. This variance can arise from the difference in culture between the
care provider and the care-recipient. In this case, the native doctor has always been the
priority for the old lady. However, this belief did not benefit the health of the patient, and as a
also among professionals (Paternotte, E. et al., 2016). For instance, the approaches used by
one nurse may not auger well with the beliefe of another professional. However, in this
particular situation, the nurse and the translator had similar perceptions which resulted in a
seamless communication. It implies that the information provided by the nurse was
Intercultural Communication in Healthcare 8
accurately translated to a language that the old lady understands. Therefore the two care
providers had a similar perception which reduced the probability of conflict of interest in the
treatment plan.
ICC Between Patient and Nurse
According to Paternotte, E. et al. (2016) intercultural communication (ICC) is an
important factor between the nurse and a patient. This was justified through a research that
was conducted by Paternotte, E. et al. (2016). In their research, the primary focus was on
Dutch nurses handling non-Dutch patients in Netherlands. While most of the nurses in the
study had ICC skillls, it was concluded that many ICC skills are known to physicians. It was
also concluded that there is an overlap between the aspect of ICC and patient centered
communication (PCC). Paternotte, E. et al. (2016) have argued that the relevance of ICC in
practice has increased in the past decade. It has been determined that several factors can have
a greater influence on the levels of ICC. For instance, the role of the family in the PCC, as
instance, in the case of the 83-year-old lady, it is clear that the levels of hope of the patient are
low. This is because the patient has a cultural bias opinion regarding health remedies which
involves seeking the help of a native doctor. It took time and intervention from people who
understand the culture to help change the levels of expectations of the woman.
Paternotte, E. et al. (2016) have further highlighted the significance of ICC skills in
the reflection of patients feelings. Nurses are expected to listen, apply concrete language and
empathize with patients. However, this a can be a more significant challenge in case of
language or cultural barrier. For instance, in the case of the old lady, the nurse could only
show empathy and facial expressions after the translator had performed his or her job.
According to an an argument documented by Cote, D. (2013), evident cultural
differences between a patient and a nurse or nurse can lead to conflict during the presentation
of illness and therapy related issues. This can negatively affect the healing process of a
patient. It is possible to argue that divergence of interest was vivid in the initial stages of the
Intercultural Communication in Healthcare 9
case being reviewd in this paper. The old lady had divided opinions regarding remedies to
health and this made her reluctant to adopt medicaly proven remedies. Hoowever, the right
approaches were adopted by the new nurse to ensure that convergence was attained and that
Cote, D. (2013) reveals that cultural competence in the sphere of healthcare is multifaceted.
This implies that the orgaanization as well as health policies must highilght the vital nature of
ICC in PCC.The multifaceted nature of ICC has also been recognized by (Kirschbaum, K.
2017) who has also indicated that both verbal and non-verbal communication can be sources
communication are culturally linked. For instance the verbal and non-verbal communication
have negative impacts on ICC. For instance, if the interpreter in the case of the 83-year-old
lady lacked adequate knowledge regarding the job, the nurse's message could not have been
passed across. Alternatively, part of the message could have been exacerbated due to
unprofessional issues such as bias. Therefore, in case a translator is required to facilitate ICC
process, he or she must be competent. The competence entails a primary understanding of the
role and the impact of the communication process on PCC as well as the outcome. In
addition, the translator must have a deeper understanding of the two cultures likely to
conflict. In this case, he or she will exercise caution whenever sensitive issues arise. Finally,
it is vital to adequately train the translators and enhance their understanding in the field
(Kirschbaum, K. 2017).
Healthcare and Religion
According to Intercultural communication and healthcare (n.d), illness and death are
associated with both healthcare as well as religion. However, there is always a tendency of
it should be noted that this religion is an important determinant of healthcare. It has been
established that the old lady would initially prefer the services of a native doctor or a
religious specialist. This is always a case in many primitive societies as they have more belief
with care as they may have a more significant impact on a patient’s perceptions.
While medication can always be the best option, the power of non-medical
a significant determinant of the treatment process of any patient (Jeter, B. R. 2016). It has
been recommended that caregivers take time to understand and appreciate the religion of a
patient. A patient should understand that a nurse only plays a part that does not substitute the
supremacy of their faith. For instance, a nurse should respect the idea held by most Christians
that ‘physicians treat, but God heals.’ This understanding will help reduce intercultural
conflicts.
Recommendations
It has been evident that the case of the 83-year-old was successful due to the excellent
approaches to facilitate ICC. However, not all cases may be similar to errors may occur due
to lack of ICC knowledge. A mistake may also arise from the transfer of values from one
culture to another. To avoid such instances, Horňáková, A. (n.d) has presented several
patient. At times, this can be determined by looking at the name of the patient or inquiring
from other professional. Nurses in who have been posted in a completely new environment
must make an effort to understand the culture of the people they expect to serve.
Learn Foreign Language
Nurses can take a personal initiative to learn a foreign language as well as culture
(Yang, P. 2017). This knowledge will help them during interaction with patients. In situations
where sensitive information has to be shared between the nurse and a patient, an interpreter
may be considered an intruder. Therefore, a nurse who learns a foreign language can
Intercultural Communication in Healthcare 11
comfortably handle his or her patients without third party intervention. In addition, the nurse
who understands a specific culture of a patient can help them later in expressing ideas as well
as feelings. Patients can always be contented in an occasion where they are handled with
nurses who appreciate the former’s cultural values. This can be best achieved by beginning to
learn the basic terms used in communication such as greeting phrases. Learning can also be
Therefore, nurses must be able to understand the appropriate symbols and gesture that will
make the patient comfortable. For instance, a male nurse working in Argentina cannot wink
to learn and understand a patient from a different culture. In PCC approach, the patient's
preferences are prioritized and integrated into the treatment plan. This implies that the
information held by the patient or family members of a sick person is critical. In addition, it is
professionalism. Despite the fact that the patient was reluctant to accept the physician’s
diagnosis, the nurse in charge kept trying. Therefore, careproviders who encounter different
cultures must understand that religion is not universal. It is also essential to respect that fact
that every culture is vital in its own right. To this effect, nurses must recognize the fact that
suggested that nurses should use simple terms or common words. Such words are easy to
understand, learn or interpret. Care providers should adhere to the basic rules of grammar and
Conclusion
The input of intercultural communication in patient-centered care cannot be
underestimated. Nurses will always face these challenges whenever required to handle
patients from different cultural backgrounds. In some instances, there can be variation in
language, culture and signs or gestures used in communication. This requires care providers
83-year-old lady from India has been reviewed. It has been established that the nurses that
patient were from different cultures. On her part, the old lady was keen to practice her
cultural values which did not advocate for medical intervention in case of illness. Another
challenge was the language barrier which required the intervention of an interpreter. The
success of the process highlights the significance of correct application of ICC techniques.
Intercultural Communication in Healthcare 13
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