Miscommunication Barriers in Health Care
Effective communication skills are essential in all health care settings; it helps to build a good provider-patient relationship. The 2010 US Census data shows that the United States population is growing and becoming more diverse than ever. With the increase in the diverse population, healthcare workers are being exposed to a vast number of different cultures causing barriers when treating a patient from a different country. Cross-cultural communication barriers such as language, nonverbal, and responses to pain can affect a person’s health care delivery.
Culture is a framework that directs human behavior. It is a person’s values, beliefs, and attitudes. “In health care, language and literacy barriers adversely affect clinical effectiveness, medical decision-making, medication adherence, and patient’s understanding of and access to service” (Taylor, Nicolle, and Maguire, 2013). Language barriers limit a person’s ability to communicate their health needs. In some cultures, women are not allowed to talk with a male stranger, making it hard for her to communicate her medical needs here in America. In order to help with the language barrier, some providers may use other strategies, such as, drawings and hand signals to compensate for the gaps in communication. Providers should be aware that patients cannot follow advice if they do not understand the provider’s instructions. Having an interpreter present during treatment and consultation is one way that can assist with the misinterpretation issues. US law mandates that physicians who accept patients with federal payers must provide language translation when required (Vidaeff, Mong, Kernga, 2015).
Health literacy is also a communication barrier between provider and patient. Persons from other cultures may not speak or read English well. People from other cultures may not be familiar with medical terms and can become scared or confused if they have a health condition that requires complicated care. One way to increase a person’s health literacy is to provide information and services so that he/she can understand the medical terminology and their diagnosis. This can be done by having handouts written in different languages in physician offices and at hospitals.
Nonverbal communication is not a universal form of communication; it does not translate across cultures and can lead to misunderstanding. For example, the use of a finger or hand to indicate “come here, please”. In some cultures, the hand gesture is used to beckon dogs and could be considered offensive. Another form of nonverbal communication that can be misleading is eye contact. Americans look directly into each other’s eyes when talking to each other. Some cultures use the lack of contact as a sign of respect or humility; therefore, they may not look at a physician directly in the eyes when he is talking to them. African-Americans express emotions in a dramatic way, whereas Asians tend to be quieter, withdrawn and private (Eubanks, McFarland, Mixer, Munoz, Pacquiao, Wenger, 2010).
Culture has a significant role in a person’s decision to control their pain. Two people from two different cultures can have the same pain, but their responses are totally different. A person’s response to pain is a barrier that may cause unnecessary suffering and inequalities (Briggs, 2008). Providers must increase their awareness in cultural competency in order to treat a person who is from another culture and in pain. For instance, Northern European and Asian cultures tend to withdraw socially. They will express their pain less than someone from a Hispanic or Middle Eastern background. Those cultures will verbalize their pain and expect other to react to it. The expectation of pain treatment in the United States is proper pain management. However, in many countries, people do not have access to pain medication. Health care providers should understand what is appropriate for their patient within the cultural context.
The provider should be careful not to stereotype cultures, but be sure to pay attention to the individual. Viadeff et al. (2015) noted that familiarizing oneself with some general principals of a patient’s culture can be useful, but stereotyping is always inadequate.
Although nursing professionals are trained on cultural competence, cultural beliefs run strong and can have a significant impact on someone’s health. Providers must do everything possible to make sure communication is successful with their patients. Providers should also understand how cultural factors affect a patient’s physical health and be sensitive to the patient’s cultural beliefs. Cross-cultural communication skills become important in uncovering the miscommunications that will prevent treatment.

References
Briggs, E. (2008). Cultural perspectives on pain management. The Journal of Perioperative Practice, 18(11), 468-71. Retrieved from http://search.proquest.com/docview/217746813?accountid=458
Eubanks, R. L., McFarland, M. R., Mixer, S. J., Munoz, C., Pacquiao, D. F., & Wenger, A. Z. (2010). Cross-Cultural Communication. Journal of Transcultural Nursing, 21(Supplement 1), 135S-150S. doi:10.1177/1043659610374322
Taylor, S. P., Nicolle, C., & Maguire, M. (2013). Cross-cultural communication barriers in health care. Nursing Standard, 27(31), 35-43. Retrieved from http://search.proquest.com.contentproxy.phoenix.edu/docview/1346243624?accountid=458
Viadeff, A. C., Mong, M., & Kernga, A. J. (2015, January). Cross-cultural barriers to health care. Southern Medical Journal, 108(1), 1-4. doi:10.14423/SMJ.0000000000000221