Abstracts
Abstract
The experiences of multilingual patients communicating with unilingual healthcare providers have been largely unexplored. The aim of this study was to investigate the experiences of bilingual stroke patients within the Canadian healthcare context. A secondary analysis was completed with data from a multiple case study of the experiences of seven, low-income bilingual Francophone stroke survivors living in a predominately English area. Data included semi-structured interviews, chart reviews and language proficiency assessments. Results demonstrated that bilingual survivors experience unique challenges, including limited French health vocabulary, use of non-standard French, and generally low health literacy levels in both languages. Participants with aphasia often used English and French interchangeably, leading to the potential for miscommunication when providers were not bilingual. The study highlights the importance of having bilingual healthcare providers when bilingual stroke survivors have communication or cognitive limitations.
Keywords:
- Stroke,
- language,
- bilingualism,
- healthcare,
- literacy
Résumé
Peu d’études ont porté sur les expériences de communication entre des patients multilingues et des professionnels de la santé unilingues. Cette étude explore les expériences vécues dans le système de santé canadien par des patients bilingues qui ont subi un accident vasculaire cérébral (AVC). Une analyse secondaire a été réalisée des données d’une étude de cas multiples menée auprès de sept victimes d’AVC francophones bilingues vivant dans une région majoritairement anglophone. Les données proviennent d’entrevues semi-structurées, de l’examen de dossiers médicaux et d’évaluations des compétences linguistiques. Les résultats démontrent que ces survivants bilingues d’un AVC font face à des défis particuliers, dont un vocabulaire français limité relatif à la santé, l’utilisation d’un français non standard et un niveau de littéracie généralement pauvre dans les deux langues. Les participants atteints d’aphasie utilisaient souvent le français et l’anglais de façon interchangeable, ce qui donnait lieu parfois à des erreurs de communication avec les professionnels unilingues. Cette étude souligne l’importance d’utiliser des professionnels bilingues lorsque des patients bilingues qui ont subi un AVC ont des difficultés de communication ou des limites cognitives.
Mots-clés :
- AVC,
- langue,
- bilinguisme,
- soins de santé,
- littératie
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Appendices
Bibliography
- Bowen, Sarah (2015). Impact des barrières linguistiques sur la sécurité des patients et la qualité des soins, Ottawa, Canada : Société Santé en français.
- Brach, Cindy (2017). “The journey to become a health literate organization: A snapshot of health system improvement”, Studies in Health Technology and Informatics, vol. 240, pp. 203-237.
- Brach, Cindy, Debra Keller, Lyla M. Hernandez, Cynthia Baur, Ruth Parker, Benard Dreyer, … Dean Schillinger (2012). Ten attributes of health literate health care organizations, Participants in the workgroup on attributes of a health literate organization of the IOM Roundtable on Health Literacy, National Academy of Sciences.
- Brunborg, Birgit, & Siri Ytrehus (2014). “Sense of well-being 10 years after stroke”, Journal of Clinical Nursing, vol. 23, n° 7-8, pp. 1055-1063, https://doi.org/10.1111/jocn.12324
- Cruz-Flores, Salvador, Alejandro Rabinstein, Jose Biller, Mitchell S.V. Elkind, Patrick Griffith, Philip Gorelick, … Amy L. Valderrama (2011). “Racial-ethnic disparities in stroke care: The American experience: A statement for healthcare professionals from the American Heart Association/American Stroke Association”, Stroke: A Journal of Cerebral Circulation, vol. 42, n° 7, pp. 2091-2116. https://doi.org/10.1161/STR.0b013e3182213e24
- De Moissac, Danielle, & Sarah Bowen (2018). “Impact of language barriers on quality of care and patient safety for official language minority Francophones in Canada”, Journal of Patient Experience, vol. 6, no 1, pp. 24-32, https://doi.org/10.1177/2374373518769008
- Dilworth, Thomas, Dave Mott, & Henry Young (2009). “Pharmacists’ communication with Spanish-speaking patients: A review of the literature to establish an agenda for future research”, Research in Social and Administrative Pharmacy, vol. 5, n° 2, pp. 108-120, https://doi.org/10.1016/j.sapharm.2008.05.005
- Fielding, Ruth (2015). Multilingualism in the Australian suburbs: A framework for exploring bilingual identity, Singapore: Springer, https://doi.org/10.1007/978-981-287-453-5
- Gagnon-Arpin, Isabelle, Louise Bouchard, Anne Leis, & Mathieu Bélanger (2014). “Accès et utilisation des services de santé en langue minoritaire”, in Rodrigue Landry (Ed.), La vie dans une langue officielle minoritaire au Canada (pp. 195-221), Quebec, Canada: Presses de l’Université Laval.
- Government of Ontario (2016). Designation of public service agencies (Regulation 398/93) – French language health services, http://www.health.gov.on.ca/en/public/programs/flhs/designation.aspx consulted on November 21, 2017.
- Heart and Stroke Foundation (2017). Different strokes: Stroke recovery across the ages, Ottawa, Canada: Heart and Stroke Foundation.
- Johansson, Marjana, & Martyna Śliwa (2016). “‘It is English and there is no alternative’: Intersectionality, language and social/organizational differentiation of Polish migrants in the UK”, Gender, Work & Organization, vol. 23, n° 3, pp. 296-309, https://doi.org/10.1111/gwao.12049
- Kagan, Aura (1998). “Supported conversation for adults with aphasia: Methods and resources for training conversation partners”, Aphasiology, vol. 12, no 9, pp. 816-830, https://doi.org/10.1080/02687039808249575
- Karliner, Leah, Andrew Auerbach, Anna Nápoles, Dean Schillinger, Dana Nickleach, & Eliseo Pérez-Stable (2012), “Language barriers and understanding of hospital discharge instructions”, Medical Care, vol. 50, n° 4, pp. 283-289, https://doi.org/10.1097/MLR.0b013e318249c949
- Leblanc, Matthieu (2010). “Le français, langue minoritaire, en milieu de travail : des représentations linguistiques à l’insécurité linguistique”, Nouvelles Perspectives En Sciences Sociales, vol. 6, n° 1, pp. 17-63, https://doi.org/10.7202/1000482ar
- Luk, Gigi, & Ellen Bialystok (2013). “Bilingualism is not a categorical variable: Interaction between language proficiency and usage”, Journal of Cognitive Psychology, vol. 25, n° 5, pp. 605-621, https://doi.org/10.1080/20445911.2013.795574
- Magasi, Susan, Elizabeth Durkin, Michael Wolf, & Anne Deutsch (2009). “Rehabilitation consumers’ use and understanding of quality information: A health literacy perspective”, Archives of Physical Medicine and Rehabilitation, vol. 90, n° 2, pp. 206-212, https://doi.org/10.1016/j.apmr.2008.07.023
- Miles, Matthew, A. Michael Huberman, & Johnny Saldaña (2014). Qualitative data analysis: A methods sourcebook (3rd ed.), Thousand Oaks, CA: Sage Publications Inc.
- Mold, Freda, Charles Wolfe, & Chistopher Mckevitt (2006). “Falling through the net of stroke care”, Health and Social Care in the Community, vol.14, n° 4, pp. 349-356, https://doi.org/10.1111/j.1365-2524.2006.00630.x
- Mougeon, Raymond (1995). “Diversité sociolinguistique au sein d’une communauté francophone minoritaire : les Franco-Ontariens”, Linx, vol. 33, pp. 47-69, https://doi.org/10.3406/linx.1995.1391
- Patton, Michael Quinn (2015). Qualitative research and evaluation methods (4th ed.), Thousand Oaks, CA: Sage Publications Inc.
- Savard, Jacinthe, Kate Bigney, Lucy-Ann Kubina, Sébastien Savard, & Marie Drolet (2020). “Structural facilitators and barriers to access to and continuity of French-language healthcare and social services in Ontario’s Champlain region”, Healthcare Policy, vol. 16, n° 1, 78-94.
- Shaw, Susan J., Christina Huebner, Julie Armin, Kathryn Orzech, & James Vivian (2009). “The role of culture in health literacy and chronic disease screening and management”, Journal of Immigrant and Minority Health, vol. 11, n° 6, pp. 531-531, https://doi.org/10.1007/s10903-008-9149-z
- Stake, Robert E. (1994). “Case studies”, in N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (pp. 236-247), Thousand Oaks, CA: Sage Publications Inc.
- Stake, Robert E. (1995). The art of case study research, Thousand Oaks, CA: Sage Publications Inc.
- Stake, Robert E. (2006). Multiple case study analysis, New York, NY: The Guilford Press.
- Statistics Canada (2010). Section 1: Definitions of Canada’s French speaking population,http://www.statcan.gc.ca/pub/89-642-x/2010001/article/section1-eng.htm consulted on February 1, 2015.
- Statistics Canada (2015). Low income cut-offs, http://www.statcan.gc.ca/pub/75f0002m/2009002/s2-eng.htm consulted on January 30, 2017.
- Statistics Canada (2017). English-French bilingualism reaches new heights, https://www12.statcan.gc.ca/census-recensement/2016/as-sa/98-200-x/2016009/98-200-x2016009-eng.cfm consulted on September 3, 2018.
- Taylor, Elizabeth, & Fiona Jones (2014). “Lost in translation: Exploring therapists’ experiences of providing stroke rehabilitation across a language barrier”, Disability and Rehabilitation, vol. 36, n° 25, pp. 2127-2135, https://doi.org/10.3109/09638288.2014.892636
- Vallerand, Robert, & Wayne Halliwell (1983). “Vers une méthodologie de validation trans-culturelle de questionnaires psychologiques: Implications pour la psychologie du sport”, Canadian Journal of Applied Sport Sciences, pp. 9-18.
- Willis, Danny G., Susan Sullivan-Bolyai, Kathleen Knafl, & Marlene Z. Cohen (2016). “Distinguishing features and similarities between descriptive phenomenological and qualitative description research”, Western Journal of Nursing Research, vol. 38, no 9, 1185-1204, https://doi.org/10.1177/0193945916645499
- Yeun G, Emily H., Amy Szeto, Denyse Richardson, Suk-han Lai, Eva Lim & Jill I. Cameron (2015). “The experiences and needs of Chinese-Canadian stroke survivors and family caregivers as they re-integrate into the community”, Health & Social Care in the Community, vol. 23, n° 5, pp. 523-531. https://doi.org/10.1111/hsc.12164