Local government sector. Private individual non-organisation. Social business sector. Social housing sector. Interests Please select your areas of interest. Branding, intellectual property and reputational management. Childcare and safety. Company secretary update. Data protection. Dispute resolution and mediation. Faith charities. Finance and funding. Fundraising charities. Housing management and litigation. HR and employment. Published by Royal College of Midwives, 18 January This guidance from the Royal College of Midwives provides valuable, focussed, clinically relevant and evidencebased information and advice on the inextricably linked issues of parental mental Read Summary.
Published by Royal College of Midwives, 01 January A new maternity model for women and families, midwives and maternity support workers The Royal College of Midwives embarked on a project to explore the public health role of midwives, maternity The optimum length of appointment to obtain data appropriate for transcribing and analysing was determined as 15—20 min.
Broad consultation with Directors of Nursing at each site, and with Nurse Unit Managers NUMs , determined that the optimal process of initial patient and practitioner identification will be via the NUMs. An equivalent number of interactions will be recorded between participants who share the same L1, and those who do not share the same L1, in order to assess the effect of linguistic ability on the quality of the interaction and the communication of health-related information.
Patients and practitioners who speak either English or Chinese Mandarin or Cantonese as their L1 will be invited to participate, with initial recruitment facilitated by the NUMs. Chinese was chosen as the other language because it is the most common language spoken in South East Queensland after English. Depending on patient demographics, practitioners will be recorded in at least two interactions with patients.
Patients will participate in one recorded interaction only. The patient cohort will comprise a minimum of 40 monolingual English and 40 bilingual or polyglot Chinese-English speakers. These patients will form dyads with 40 practitioners 20 monolingual English, 20 bilingual or polyglot Chinese-English , such that each practitioner will be recorded with at least two patients, one with whom they share an L1 i. We anticipate that most conversations will be in English.
However, it is likely that practitioner and patient may resort to their common L1 if not English when that facilitates their communication.
Conversations assisted by an interpreter will also be recorded. The practitioners will be recruited from multiple professions, including clinical nurses, midwives and pharmacists, thus allowing evaluation of a range of conversational dynamics. Practitioners willing to participate in the research will be administered an information sheet and consent form, as well as a Language Background Questionnaire LBQ , in advance of the video recording.
Patients who are either language concordant or discrepant will be identified in a number of ways. Second, practitioners who have consented to take part will identify potential patients and contact the research team directly to inform them of a potential participant. Third, poster advertising will be used across the hospital and in local press to inform the public about the research and request that they get in touch should they be visiting the hospital as a patient and are interested in taking part in the study.
All information, consent and questionnaire forms will be available in a choice of English, Traditional Chinese or Simplified Chinese, allowing patients to select their preferred language. After providing informed consent, patients will participate in a video recording session during their hospital appointment. It should be noted that audio-only recording will be used if video recording is not possible. Basic language and L2 proficiency background information will be obtained using the LBQ including self-rated proficiency for L1 and L2 , for both patients and practitioners.
This questionnaire was based on the work of two of the authors RM and NS , described in [ 19 ] and adapted from [ 20 ]. In addition, patients will be asked to complete a short questionnaire to rate the perceived effectiveness of communication with the practitioner after their appointment has ended. Patients and practitioners who speak more than two languages e. Patients who are identified as having requested the assistance of an interpreter will be recorded, provided that they have consented to take part in the study.
There will be no video recording of appointments where patients are expected to receive a physical examination by the practitioner. All conversations will be transcribed in preparation for both qualitative and quantitative analyses. The transcripts will be analysed using Discursis [ 21 ], which will look at periods of engagement between patient and practitioner, with a focus on the extent to which communicative needs were met.
In terms of communication content, Discursis will also allow us to investigate the extent to which expressions of likelihood and risk are used, and the extent to which they are linked to changes in convergence. Paralinguistic features such as tempo or pitch will also be available for analysis, for example convergence in register i.
Data from the LBQ e. The metrics derived from these conversations can then be used to compare with the LBQ and the outcome measures from the post-appointment questionnaire for both qualitative and quantitative analyses. The qualitative analysis will look at accommodation, as well as target the occurrence of specific adverb phrases and how they operate in the context of discussing health risk.
The study will yield, for the first time, information about the flow of language-concordant and language-discrepant communication, as a function of whether the clinician or the patient is the L2 speaker.
Understanding L2 communication in a health context is important because inadequate communication may have negative consequences, including increased psychological stress to the patient, medically significant communication errors and misunderstandings of potential health risk. Understanding the linguistic and cultural elements of these interactions will help us understand how potentially serious outcomes can arise during language-discrepant interactions, and address these at both theoretical and practical levels.
One of the practical challenges of this study is that of obtaining sufficient numbers of each possible practitioner-patient combination. Because L2 speakers are allowed, and indeed encouraged, to seek assistance from an interpreter, there are likely to be a number of conversations where an interpreter may be present and involved to a greater or lesser degree in supporting the communication between practitioner and patient.
These conversations will be analysed separately to enable an analysis of the impact of interpreter presence. Another challenge is posed by the need to balance language concordant and discordant conversations with the need to capture conversations that vary in the extent to which their content focuses on risks to the patient. As discussed above, a wide number of departments in each hospital are targeted to mitigate the problem of obtaining conversations that do not vary sufficiently in patient-risk content.
The bilingual speakers, be they practitioners or patients, are likely to have mastered more than the two languages focused on here. The background information obtained will allow further analysis of the possible differential impact of bilingual versus multilingual language use on the clarity of conversations. In summary, to address the problem of language barriers successfully, we must know when they are most likely to arise and what their specific nature is.
To do so, new research methods must be developed, and a theoretical framework formulated to generate research questions and guide research. Steegers Eric and M. Essink-Bot Marie-Louise. Background: The present study aims to explore to what extent midwives experience barriers in providing information about prenatal screening for Down syndrome to women from diverse ethnic backgrounds, and to assess their competences to overcome these barriers.
Data were obtained on perceived ethnic-related differences and barriers in providing information on prenatal screening, preparedness to provide cultural competent care, and the use of translated materials and professional translators. Midwives especially felt incompetent to provide information to pregnant women that hardly speak and understand Dutch.
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