Sociocultural and linguistic boundaries influencing intercultural communication between nurses and Moroccan patients in southern Spain: a focused ethnography

Abstract

BackgroundDuring the last 25 years, cultural diversity has increased substantially with global migration. In more recent years this has become highly evident in the south of Spain with its steadily increasing Moroccan population. The accompanying differences in ethnocultural values and traditions between the host and newcomer populations may greatly impact healthcare interactions and thus also effective provision of care. This landscape provides for excellent exploration of intercultural communication in healthcare settings and elucidation of possible ways to overcome existing barriers to provision of culturally competent care by nurses. This study aimed to ascertain how nurses perceive their intercultural communication with Moroccan patients and what barriers are evident which may be preventing effective communication and care.MethodsA focused ethnography was conducted with semi-structured interviews of 32 nurses in three public hospitals in southern Spain. Interviews were audio-recorded and transcribed verbatim before undergoing translation and back-translation between Spanish and English. Data was managed, classified and ordered with the aid of AQUAD.6 (Günter L. Huber, Tübingen, Germany) qualitative data analysis software.ResultsAs an important dimension of cultural competence, findings from the interviews with nurses in this study were interpreted within the framework of intercultural communication. Various barriers, for which we have termed “boundaries”, seem to exist preventing effective communication between nurses and their patients. The substantial language barrier seems to negatively affect communication. Relations between the nurses and their Moroccan patients are also marked by prejudices and social stereotypes which likely compromise the provision of culturally appropriate care.ConclusionsThe language barrier may compromise nursing care delivery and could be readily overcome by implementation of professional interpretation within the hospital settings. Moreover, it is essential that the nurses of southern Spain are educated in the provision of culturally appropriate and sensitive care.

The Encounters and Challenges of Ethnography as a Methodology in Health Research

“…However, we found health researchers conducting ethnographic research rarely discuss ethical concerns that they might have encountered during the conduct of their research (Braaf et al, 2014;Bright et al, 2012;Carroll et al, 2008;Gates et al, 2001;Kidd & Finlayson, 2010;Liu et al, 2012;Pino et al, 2013). In ethnographic research, extensive efforts need to be made to attend more closely to ethical dilemma researchers face while conducting their research.…”

“…Researchers should be explicit about their ontological and epistemological stance to better understand the perspective from which they explore and find answers for their research question. Many authors claim that their study is a ''focused ethnography,'' even though methodological background information commonly focuses on ''qualitative methods'' or ''ethnography,'' in a general manner (Gustafsson et al, 2013;Magilvy, McMahon, Bachman, Roark, & Evenson, 1987;Pino et al, 2013). In conclusion, we recommend that health researchers conducting ethnography be more explicit in detailing their ''tradition and paradigm of inquiry '' (O'Byrne, 2007'' (O'Byrne, , p. 1389.…”

“…We have examined a large body of literature in health research which indicates that qualitative studies conducted in health research have overlooked the importance of the ontological and epistemological underpinnings (Braaf et al, 2014;Bright et al, 2012;Carroll et al, 2008;Kidd & Finlayson, 2010;McCabe & Holmes, 2013;Pino, Soriano, & Higginbottom, 2013). Epistemology is the theory of understanding.…”

Nurses Communication Barriers in Healthcare Centers: Patients’ Perspectives

“…Difficult language in the daily routine of healthcare activities, different culture, age, and gender diversity, are the most apparent factors may have a great effect on proper communication. [32,33] Most of the Saudi patients in healthcare centers commented on their language which is not familiar with most of the nurses "language fluency, even they are Saudi. Not only due to various verbalization and pronunciation manner, but also, due to different rural native speech modes.…”

Determination of the reliability and validity of intercultural awareness and intercultural effectiveness scales<p>Kültürlerarası farkındalık ve kültürlerarası etkililik ölçeklerinin güvenirlik ve geçerliğinin belirlenmesi

“…Sağlık çalışanlarının farklı kültürlerden gelen hastalara bakım verirken kültürlerarası iletişim alanında yaşadıkları problemleri tanımlamak için birçok araştırma yapılmıştır. (Ryan, 2002;Eckhardt et al, 2006;Vydelingum, 2006;Ayaz & Bilgili, 2009;Jirwe, Gerrish & Emami, 2010;Tanrıverdi ve ark., 2010;Hudelson et al, 2011;Pino et al, 2013). Kültürlerarası iletişim alanında yaşanılan bu problemler hastaların düşük kalitede hemşirelik bakımı almalarına ve yetersiz bilgi edinmelerine neden olmuştur.…”