Patients can only make informed decisions and participate in the care process if they understand the information provided to them. This includes their follow-up care through information about educational and training resources available from the hospital or from community resources through relationships established by the hospital. Community resources help support continuing health promotion and disease prevention education. This follow-up care information from the hospital or from established community resources is to meet the patient’s ongoing health needs or to achieve their health goals.
Particular attention is given to the format and language used in communicating with and providing education to patients and families. Patients respond differently to spoken instructions, printed materials, videotapes, demonstrations, and so on. Also, it is important to understand the language preferred.
A written statement appropriate to a patient’s age, understanding, and language posted in a hospital is an example to inform the patient and the family’s responsibility on their rights and to understand their responsibilities in the care process of the patient as an inpatient or registration as an outpatient.
Medicine information leaflets is another example of printed materials, but associated with the distribution of medicines. The format used in medicine information leaflets must take into account the order of information which is presented. This order effect is related to the perceived importance of the information which affects people’s understanding and memory of the information presented. For example, patients are likely to remember better about side effects of medicine administered to them irrespective of its relative position in a medicine leaflet in contrast to instructions on dosage and how to take their medicine, which they ought to remember better. Thus the need for key information about drug administration to be given near to the start of a medicines information leaflet.
Hospitals frequently serve communities with a diverse population. One or more languages spoken by patients in the community serviced by the hospital could be used in a loose-leaf folder or file cards. Translators in your community can help build standardised lists for the most commonly heard languages in your community. Technical terms, slang, or phrases with a double or colloquial meaning should be avoided.
Research has shown that a patient speaking the same native language as the doctor (as well as a nurse of other healthcare provider) has the advantage of greater rapport with a patient. They gave better explanations of treatment. Patients had better understanding of instructions, showed a greater recall and asked questions, and undoubtedly understood printed materials better.
If there are differences in the language used between doctors (as well as a nurse or other healthcare provider) and patients, then family members or interpreters/translators may need to assist with the education or translate materials.
Wherever possible, it is better to use a professional interpreter. A trained interpreter often understands the culture of the person, as well as the language. The skilled interpreter can explain nonverbal cues, in addition to what the patient says.
The interpreter is an invaluable staff resource rather than a family member, child translator – a child member of the family, should be used only as a last resort especially to communicate important clinical and other information and education, and non-family members.
A hospital could also develop a list of its employees or individuals to contact in the community who speak a second language and are willing to act as translators of printed materials, videotapes, demonstrations, and so on.
Sometimes, a family member or significant other can act as an interpreter. Having a member of the family translate may be inappropriate. It is important for the doctor as well as a nurse or other healthcare provider to recognise the limitations of family members and non-family members when they are used to translate or interpret in overcoming any patient barriers to communication and understanding.
The foregoing paragraphs ensues the compliance with the Joint Commission International (JCI) Standard MCI.3, that is “Patient and family communication and education are provided in an understandable format and language.”
In a hospital that is undergoing the process of accreditation and has adopted the JCI quality standards, then the hospital must comply with providing patient and family communication and education in an understandable format and in an understandable language as I have outlined above. The hospital would therefore satisfy the JCI Standard MCI.3, ME 1 and 2. If the hospital has a policy and practices to engage professional interpreters rather than using family members as interpreters and translators and ensuring that child translators are only used as last resorts, then the hospital complies with the JCI Standard MCI.3, ME 3.
References:
Caroline, BR & Mary, TK 2012, Textbook of basic nursing, 10th edn, Wolters Kluwer Health, Lippincott Williams & Wilkins, Philadelphia, USA
Dianne, B 2007, Health communication Theory and practice, Open University Press, NY, USA
Joint Commission International 2010, Joint Commission International Accreditation Standards For Hospitals, 4th edn, JCI, USA
Sue, CD & Patricia, KL 2011, Fundamentals of Nursing: Standards & Practice, 4th edn, Delmar, Cengage Learning, NY, USA
