An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta
An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta
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DOI：
10.1016/j.midw.2014.09.009
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发表时间：
2015-02-01
期刊：
影响因子：
2.7
通讯作者：
Paton, Patricia
中科院分区：
文献类型：
--
作者：
Higginbottom, Gina M. A.;Safipour, Jalal;Paton, Patricia
背景：加拿大的许多移民和民族文化群体在获得医疗保健方面面临巨大障碍，包括语言障碍。尽管很少有关于在加拿大寻求产科护理的移民妇女所面临的沟通障碍的研究，但医疗机构中沟通不畅的负面后果已有充分记录。本研究从加拿大艾伯塔省南部一个小城市的移民妇女、医疗保健提供者和社会服务提供者的角度确定了孕产服务中沟通困难的本质。方法：采用有目的的滚雪球抽样方法，对 31 名参与者进行了访谈，进行了重点民族志研究。社区内的一名社区联络员和几名看门人在需要时协助招募和口译（n=1）。所有采访均被录音，音频文件由专业转录员逐字转录。根据 Roper 和 Shapira (2000) 阐述的人种学数据分析原则对数据进行分析，因为 (1) 与人种学数据的相关性，(2) 该方法的清晰度和透明度，(3) 系统的分析方法，以及 (4) 该方法与计算机辅助定性分析软件程序（例如 Atlas.ti（ATLAS ti Scientific Software Development GmbH，德国））的兼容性。这个过程包括 (1) 描述性标签编码，(2) 模式排序，(3) 识别异常值，(4) 生成主题，(5) 概括以生成结构和理论，以及 (6) 包括研究人员反思的记忆。研究结果：确定了四个主题，包括言语交流、非共享意义、建立关系的非言语交流以及创伤、文化和开放交流。沟通困难不仅限于语言能力问题，还包括非语言沟通及其与共同意义的关系，以及影响开放沟通、可及的医疗保健以及孕产妇结局的潜在移民前历史和文化因素的相互作用。结论：这项研究提供了有关孕产妇保健沟通的见解。各方可能都会遇到沟通方面的挑战，但医疗保健提供者以及医疗保健管理和专业机构内部的人员仍有责任确保提供者具备促进文化上适当的护理所需的技能。 (C) 2014 Elsevier Ltd. 保留所有权利。
Background: many immigrant and ethno-cultural groups in Canada face substantial barriers to accessing health care including language barriers. The negative consequences of miscommunication in health care settings are well documented although there has been little research on communication barriers facing immigrant women seeking maternity care in Canada. This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada.Methods: a focused ethnography was undertaken incorporating interviews with 31 participants recruited using purposive and snowball sampling. A community liaison and several gatekeepers within the community assisted with recruitment and interpretation where needed (n=1). All interviews were recorded and audio files were transcribed verbatim by a professional transcriptionist. The data was analysed drawing upon principles expounded by Roper and Shapira (2000) for the analysis of ethnographic data, because of (1) the relevance to ethnographic data, (2) the clarity and transparency of the approach, (3) the systematic approach to analysis, and (4) the compatibility of the approach with computer assisted qualitative analysis software programs such as Atlas.ti (ATLAS ti Scientific Software Development GmbH, Germany). This process included (1) coding for descriptive labels, (2) sorting for patterns, (3) identification of outliers, (4) generation of themes, (5) generalising to generate constructs and theories, and (6) memoing including researcher reflections.Findings: four main themes were identified including verbal communication, unshared meaning, nonverbal communication to build relationships, and trauma, culture and open communication. Communication difficulties extended beyond matters of language competency to those encompassing nonverbal communication and its relation to shared meaning as well as the interplay of underlying pre migration history and cultural factors which affect open communication, accessible health care and perhaps also maternal outcomes.Conclusion: this study provided insights regarding maternity health care communication. Communication challenges may be experienced by all parties, yet the Onus remains for health care providers and for those within health care management and professional bodies to ensure that providers are equipped with the skills necessary to facilitate culturally appropriate care. (C) 2014 Elsevier Ltd. All rights reserved.