Unit 10: Lesson 5: Intercultural Communication

Lesson 5: Intercultural Communication

Lesson 5: Intercultural Communication

Health science professionals will often work with people of diverse backgrounds, cultures, nationalities, and races throughout their careers. Over the past several decades, there has been an increasing move toward greater sensitivity to these differences in communication. Whether communicating in written or oral forms, discussion can be affected by cultural differences.

Culture can affect communication and the healthcare system in multiple ways. One of the first challenges that can arise in intercultural communication involves differences in perception. Studies have found that our cultural backgrounds influence our perceptions of events, illnesses, and aspects of our health. For example, a 1992 study on breast cancer found that African American women were less likely than other races to see breast cancer as a serious illness because they were more likely to have strong religious beliefs that God would take care of them. This is just one example of how our cultural backgrounds, including religion and worldviews, influence how we think about and perceive illness and healthcare.

Healthcare professionals must understand how a person's cultural background can influence their actions and perceptions about their health. In some cases, patients have been seen as noncompliant with directives about their health when the patients and healthcare professionals just perceived an issue differently. These gaps can create resentment, hard feelings, and other adverse effects on the relationship between patients and healthcare professionals, and these issues can affect the treatment and care of the patient. In some cases, this might lead to patients deciding to change doctors or to stop treatment altogether.

Cultural differences can also affect verbal communication in healthcare settings. The most significant challenge is when patients and healthcare professionals speak different languages. Even when interpreters are used, some words do not translate well into other languages, which can impact the communication's overall meaning. Some studies on language barriers in healthcare settings have found that information about symptoms can be misinterpreted, leading to misdiagnosis or treatment misunderstandings. The challenges of communicating in different languages are also compounded in many healthcare settings by the anxiety, fear, and confusion experienced by many patients. Adding communication barriers on top of those emotions can create even more difficult situations for both patients and healthcare providers.

Even when individuals speak the same language, there still may be cultural differences that affect communication in healthcare settings. For example, some Native American cultures may use metaphors to communicate. Healthcare professionals who are not aware of this cultural difference may become confused. However, if they are aware of the differences in cultural communication, they may be able to incorporate the differences in beliefs and practices into their conversations about illnesses and treatments. Another cultural difference impacting healthcare is a culture's practice of asking questions. In some cultures, it is expected to feel comfortable asking questions of others, including those in positions of authority. In other cultures, it may be deemed rude or disrespectful to question another person or someone in a position of authority. Finally, some cultures have differing preferences on how much information people want to receive about their illnesses. One study found that Americans with Korean or Mexican cultural roots were less likely to want to know that they were going to die from a disease than Americans with African or European cultural backgrounds.

Nonverbal communication can also be affected by cultural differences. As discussed in a previous unit, nonverbal communication can be essential to health communication. People may use nonverbal cues to help them better understand what they are being told and to feel reassurance in a healthcare setting. However, cultural differences can challenge nonverbal communication since people may interpret nonverbal cues based on what they mean in their own cultures.

One way cultural differences in nonverbal communication affect healthcare is in expressing pain. Different cultures may have various ways of expressing nonverbally that they are in pain. In some cultures, it may be considered weak to show signs of pain, while in other cultures, grimacing or crying can be acceptable cues to demonstrate pain. For cultures that tend not to show pain visibly, it may be more difficult for healthcare professionals to determine an appropriate medication dosage for adequate pain relief.

Given these challenges in intercultural communication, what can healthcare settings and health science professionals do to bridge these differences and promote better understanding? One of the most essential things that professionals can do is develop skills that will help them bridge and negotiate cultural differences in communication. The term cultural brokerage has been used to describe this skill of bridging gaps between traditional medical communication and patients' particular cultural aspects.

Cultural brokerage is one aspect of culturally sensitive care, and it is based on respect, knowledge, and negotiation. Healthcare professionals can question patients' beliefs and attitudes regarding their illnesses and symptoms. This may help the healthcare provider better understand a patient's religious and cultural beliefs. Throughout the process, respect for the patient and their belief is also essential in culturally sensitive care. While a healthcare professional may not believe the same things as a patient, it can be helpful to incorporate the patient's beliefs and cultural practices into treating illness. For example, suppose a patient believes prayer can help with an illness. In that case, the healthcare professional might arrange for a chaplain or other religious leader to meet with the person and pray for them during treatment for their disease. This way, the patient's beliefs and cultural practices are incorporated into the treatment plan. Although this may not always be possible, healthcare professionals may find it helpful to be sensitive to their patient's beliefs and practices and to encourage their use whenever possible; in addition, they can use negotiation to help balance the patient's cultural practices and beliefs with the prescribed treatment. Respecting that each patient has a choice in treatment and helping patients find balance during treatment can make a great deal of difference in the overall process.

In this unit, we learned more about some of the changes in health informatics due to medical technology advances. We knew about some advantages and disadvantages of electronic records, what makes data effective, the different types of threats to electronic data, and changes in health informatics, such as e-prescribing and e-mail use. We also learned more about how cultural differences affect communication and informatics and how healthcare professionals can reduce any adverse effects of cultural differences in these areas.

Think About

1. How is technology affecting health communications?
2. What are some advantages and disadvantages of paper and electronic records?
3. What is e-prescribing? What are the benefits and drawbacks of this practice?
4. What is telemedicine? How is this being used in the health sciences?
5. How can intercultural differences impact healthcare?