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Two way communication: How to test both sides of an emergency tool
Abstract
This paper aims to present an innovative methodology to test and validate the comprehension and utilization of visual e-health in a context of medical Emergency from both healthcare professionals' and patients' perspectives.
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Standing at the crossroads of anthropology, communication, industrial design and new technology theories, this article describes the communication challenges posed during hospital emergencies resulting from linguistic and cultural differences between health care professionals and patients. In order to overcome communication barriers, the proposal of a visual solution was analyzed. Likewise, the problem was studied based on the concepts of perception, comprehension, interpretation and graphic representation according to visual culture and semiotics theories. One hundred and fifty images showing symptoms were analyzed in order to identify a pluricultural iconographic code. Results enabled to develop a list of design criteria and create the application: “My Symptoms
Communication can be seen as the main ingredient in medical care. In reviewing doctor-patient communication, the following topics are addressed: (1) different purposes of medical communication; (2) analysis of doctor-patient communication; (3) specific communicative behaviors; (4) the influence of communicative behaviors on patient outcomes; and (5) concluding remarks. Three different purposes of communication are identified, namely: (a) creating a good inter-personal relationship; (b) exchanging information; and (c) making treatment-related decisions. Communication during medical encounters can be analyzed by using different interaction analysis systems (IAS). These systems differ with regard to their clinical relevance, observational strategy, reliability/validity and channels of communicative behavior. Several communicative behaviors that occur in consultations are discussed: instrumental (cure oriented) vs affective (care oriented) behavior, verbal vs non-verbal behavior, privacy behavior, high vs low controlling behavior, and medical vs everyday language vocabularies. Consequences of specific physician behaviors on certain patient outcomes, namely: satisfaction, compliance/adherence to treatment, recall and understanding of information, and health status/psychiatric morbidity are described. Finally, a framework relating background, process and outcome variables is presented.
Standing at the crossroads of anthropology, communication, industrial design and new technology theories, this article describes the communication challenges posed during hospital emergencies resulting from linguistic and cultural differences between health care professionals and patients. In order to overcome communication barriers, the proposal of a visual solution was analyzed. Likewise, the problem was studied based on the concepts of perception, comprehension, interpretation and graphic representation according to visual culture and semiotics theories. One hundred and ffty images showing symptoms were analyzed in order to identify a pluricultural iconographic code. Results enabled to develop a list of design criteria and create the application: "My Symptoms Translator" as an option to overcome verbal language barriers and cultural differences.
Language differences between physician and patient can affect the doctor-patient encounter and patient recall. This study addresses differences in the variables of recall and question-asking behavior in the interaction between Hispanic patients seen by bilingual physicians and Hispanic patients seen by monolingual (English-speaking) physicians. The study involved 5I Hispanic patients who were seen at the Internal Medicine Associates (IMA) clinic at the Mount Sinai Medical Center in New York City in June 1989. Patients were observed during their interactions with physicians, and the information gathered was then compared to the information obtained in a personal interview immediately following the encounter. The results demonstrated that Hispanic patients seen by bilingual physicians had better recall and asked more questions than did Hispanic patients seen by monolingual physicians. These findings suggest that when physician and patient communicate in the same language and have similar cultures, the patient understands the information given by the physician better and participates more actively in the interaction. Thus language and cultural awareness have important implications in the utilization of health care services by Hispanics.
An exit interview was conducted during March, 1994 on 314 patients treated and released from the Emergency Department at Kern Medical Center in Bakersfield, California. The questionnaire was designed to assess understanding of diagnosis, prescribed medications, additional instructions, and plans for follow-up care. The patients' own perceptions of the adequacy of communication and whom they considered the most important source of information were also determined. Overall, patients correctly identified 59% of their instructions. The performance of the English speaking and the Spanish speaking patients was compared. Spanish speaking patients scored significantly lower on all questions. The physician was identified by most patients (63.8%) as the source of the most information.
Culture and ethnicity have often been cited as barriers in establishing an effective and satisfying doctor-patient relationship. The aim of this paper is to gain more insight in intercultural medical communication difficulties by reviewing observational studies on intercultural doctor-patient communication. In addition, a research model for studying this topic in future research is proposed.
A literature review using online databases (Pubmed, Psychlit) was performed.
Findings reveal major differences in doctor-patient communication as a consequence of patients' ethnic backgrounds. Doctors behave less affectively when interacting with ethnic minority patients compared to White patients. Ethnic minority patients themselves are also less verbally expressive; they seem to be less assertive and affective during the medical encounter than White patients.
Most reviewed studies did not relate communication behaviour to possible antecedent culture-related variables, nor did they assess the effect of cultural variations in doctor-patient communication on outcomes, leaving us in the dark about reasons for and consequences of differences in intercultural medical communication. Five key predictors of culture-related communication problems are identified in the literature: (1) cultural differences in explanatory models of health and illness; (2) differences in cultural values; (3) cultural differences in patients' preferences for doctor-patient relationships; (4) racism/perceptual biases; (5) linguistic barriers. It is concluded that by incorporating these variables into a research model future research on this topic can be enhanced, both from a theoretical and a methodological perspective.
Using a cultural sensitive approach in medical communication is recommended.
Valuation des Systmes Symboliques des Symptmes Biomdicaux Pour la Cration Dune Interface Graphique Pluriculturelle de Lchelle de Triage Canadien
- Juliana Alvarez