Implementation of pictorial support for communication with people who have been forced to flee: Experiences from neonatal care

Thunberg, Gunilla; Ferm, Ulrika; Blom, Åsa; Karlsson, Malin; Nilsson, Stefan

doi:10.1177/1367493518819210

Cited by 13 publications

(16 citation statements)

References 26 publications

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“…They furthermore pointed out that their use interrupted the mother–nurse conversation. Thunberg, Ferm, Blom, Karlsson, and Nilsson (2019) hold that pictorial communication aids may make families more communicative and increase parental involvement in care of the infant.…”

Section: Discussionmentioning

confidence: 99%

When a common language is missing: Nurse–mother communication in the NICU. A qualitative study

Kynoe

Fugelseth

Hanssen

2020

Journal of Clinical Nursing

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Aims and objectives To explore how communication in neonatal intensive care units (NICUs) between immigrant mothers and nurses take place without having a common language, and how these mothers experience their NICU stay. Background Admission of infants to NICU affects both parents and infants. Immigrant mothers constitute a vulnerable hospital population in need of culturally, linguistically and individually tailored information. Design and methods The study had a qualitative design reported according to the COREQ criteria. Eight mothers who spoke neither Scandinavian nor English went through individual semi‐structured interviews. Six mother–nurse interactions were observed, and eight nurses' experiences were explored through focus‐group interviews. All interviews were audio recorded and transcribed verbatim. The analysis was thematic and hermeneutic in character. Results Interpreters were present during the consultations with the physicians, but rarely during the daily nurse‐mother interactions. Nurses focused on daily routines, infant care guidance and mother–infant attachment. The mothers learned through demonstrations and hands‐on guidance. Language barriers made it difficult to assess the mothers' understanding, but the mothers expressed that they felt adequately included in the care of their infant and well informed and guided. Even so, both mothers and nurses expressed desire to use interpreters more regularly. The pictorial communication boards available lacked important vocabulary needed in neonatal nursing contexts and their use furthermore interrupted the mother–nurse conversation. Conclusion Body language, simple words, guesswork, trial and error characterised the nurse–mother interaction. The nurses adopted various communication strategies to help the mothers understand and give them a voice. Competent interpreters were used during meetings with physicians, but not during daily bedside guidance and information giving by nurses. Relevance to clinical practice Knowledge of immigrant mothers' and nurses' communication strategies and how both parties think, feel and act to overcome communication problem is necessary to improve clinical practice and reduce communication barriers.

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Section: Discussionmentioning

confidence: 99%

When a common language is missing: Nurse–mother communication in the NICU. A qualitative study

Kynoe

Fugelseth

Hanssen

2020

Journal of Clinical Nursing

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“…Although these types of apps are useful for communicating preset phrases, they are not able to replace professional interpreters [39,41]. To manage interactions with illiterate migrants, picture-based information and communication boards, partially available online, have been developed [42]. In addition, Google Translate, though criticized, is often used to manage language problems in intercultural interactions [32,43].…”

Section: Digitalization and Migrant Carementioning

confidence: 99%

Perspectives of Nurses and Doulas on the Use of Information and Communication Technology in Intercultural Pediatric Care: Qualitative Pilot Study

Lindström

Pozo

2020

JMIR Pediatr Parent

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Background Sweden is rapidly becoming an increasingly multicultural and digitalized society. Encounters between pediatric nurses and migrant mothers, who are often primary caregivers, are impeded by language problems and cultural differences. To support mothers, doulas, who are women having the same linguistic and cultural backgrounds, serve as cultural bridges in interactions with health care professionals. In addition, information and communication technology (ICT) can potentially be used to manage interactions owing to its accessibility. Objective The objective of this study was to investigate the role of ICT in managing communicative challenges related to language problems and cultural differences in encounters with migrant mothers from the perspectives of Swedish pediatric nurses and doulas. Methods Deep semistructured interviews with five pediatric nurses and four doulas from a migrant-dense urban area in western Sweden were audio recorded, transcribed, and analyzed using thematic content analysis. Results The results showed that ICT contributes to mitigating communicative challenges in interactions by providing opportunities for nurses and migrant mothers to receive distance interpreting via telephones and to themselves interpret using language translation apps. Using images and films from the internet is especially beneficial while discussing complex and culturally sensitive issues to complement or substitute verbal messages. These findings suggest that ICT helps enable migrant mothers to play a more active role in interactions with health care professionals. This has important implications for their involvement in other areas, such as child care, language learning, and integration in Sweden. Conclusions The findings of this study suggest that ICT can be a bridging tool between health care professionals and migrants. The advantages and disadvantages of translation tools should be discussed to ensure that quality communication occurs in health care interactions and that health information is accessible. This study also suggests the development of targeted multimodal digital support, including pictorial and video resources, for pediatric care services.

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“…Neonatalavdelningar har i allmänhet dygnet runt verksamhet, och tillgången till tolk är begränsad under jourtid. Bildstöd kan vid dessa tillfällen vara ett användbart komplement (Thunberg et al, 2018).…”

Section: $ Diskussionunclassified

“…Föräldrarna kunde ibland rent spontant ta upp sin telefon och visa översättningsprogram för vårdpersonalen. Forskning visar dock att när kroppsspråk användes kan missförstånd uppstå beroende på att vanliga uttryck kan vara av en annan betydelse i en annan kultur (Thunberg et al, 2018).…”

Section: $ Diskussionunclassified

“…Vårdpersonalen uttryckte även att de i sitt arbete uppmärksammade att föräldrarna blev isolerade då de varken kunde kommunicera med vårdpersonalen eller övriga familjer som har sitt barn vårdat på neonatalavdelningen (studie II). Tidigare studier bekräftar att föräldrars isolering på avdelningen ofta är beroende på språkbarriärer, och speciellt för mammorna då de oftast har sämre kunskaper i svenska språket (Thunberg et al, 2018;Williams, Oulton, Sell & Wray, 2018).…”

Section: $ Diskussionunclassified

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Immigrant parents' experiences of communicating with healthcare professionals at the neonatal unit: An interview study

Patriksson

Nilsson

Wigert

2019

Journal of Neonatal Nursing

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Gothenburg 2019 Cover illustration: Per-Anders Nilsson Säg till om du önskar tolk Kommunikation i neonatalvård mellan föräldrar och vårdpersonal när språkbarriärer föreligger © Katarina Patriksson 2019 katarina.patriksson@vgregion.se ISBN 978-91-7833-416-2 (PRINT) ISBN 978-91-7833-417-9 (PDF) http:/hdl.handle.net/2077/59062 Printed in Gothenburg, Sweden 2019 Printed by BrandFactory Till min familj, till Hulda. Alla lyckliga familjer är lyckliga på samma sätt, men varje olycklig familj är olycklig på sitt eget sätt. ABSTRACTFamily-centred neonatal care encourages parents to participate in the care of their child. When language barriers exist between healthcare personnel and parents, a third party is needed to achieve satisfactory communication. Difficulties in direct communication increase the risk of misunderstanding between healthcare personnel and parents, and may lead to elevated anxiety among parents. The overarching objective of this dissertation was to increase knowledge concerning the communication difficulties that arise between parents and healthcare personnel when language barriers are present. Study I is a quantitative questionnaire study analysing the use of interpreters and awareness of the guidelines for their use. Study II is a qualitative interview study describing the experiences of care personnel regarding communication with parents. Study III is a qualitative interview study of parents who speak Arabic through an interpreter, describing their experiences of having their child under care in the neonatal ward and communicating with care providers. Study IV is a qualitative observational study elucidating the communication difficulties that arise between healthcare personnel and parents when their child is under care in the neonatal ward and language barriers are present. The results show that healthcare personnel lack guidelines for the use of interpreters, and that interpreters are mainly used in the context of medically oriented discussions. Healthcare personnel expressed anxiety and frustration because the information they wished to communicate to parents was misunderstood. The parents expressed gratitude for the warmth and concern of the healthcare personnel despite inadequate communication. Communication was complicated by the constant need to have a third party present to interpret. Our observations revealed that language was not the only significant barrier, and that cultural differences could also lead to misunderstandings. Cultural interpreters or cultural navigators were used to facilitate communication; they were not trained interpreters, but did speak several frequently occurring languages. These individuals were made available to the parents and were able to interpret situations that could arise during nursing care, or to clarify when misunderstandings arose between parents and healthcare personnel. When the father spoke Swedish but the mother did not, the father often wished to interpret for his partner; however, such offers were rarely accepted by healthcare personnel, who instead ...

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Implementation of pictorial support for communication with people who have been forced to flee: Experiences from neonatal care

Cited by 13 publications

References 26 publications

When a common language is missing: Nurse–mother communication in the NICU. A qualitative study

When a common language is missing: Nurse–mother communication in the NICU. A qualitative study

Perspectives of Nurses and Doulas on the Use of Information and Communication Technology in Intercultural Pediatric Care: Qualitative Pilot Study

Immigrant parents' experiences of communicating with healthcare professionals at the neonatal unit: An interview study

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