Perceptions of the need for minority languages by nurses in Southern Taiwan

  • Mei-Hui Tsai National Cheng Kung University
  • Huan-Fang Lee National Cheng Kung University
  • Shuen-Lin Jeng National Cheng Kung University
  • Sheng-Che Lin Tainan City Government
  • Li-Wei Hsieh Tainan Hospital
  • Jen-Pin Chuang Tainan Hospital
  • Elizabeth A. Jacobs University of Wisconsin
Keywords: ethnic minority language, language barrier, medical Taiwanese, need assessment, nursing

Abstract

Background: While language barriers between healthcare providers and minority-language-speaking patients often lead to miscommunication and jeopardize patient safety, language audits of the former have received little attention.Goal: Based on the context in Southern Taiwan, where the elderly population mainly speaks the local dialect Taiwanese, this study examines nurses' perceptions of their proficiency in and need for medical Taiwanese (‘MED-TW'), and attitudes toward it.

Method: A questionnaire survey was conducted among 859 nurses from three levels of healthcare units: primary care stations (H1), a regional hospital (H2) and a medical center (H3).

Results: Nurses from the rural-based H1 unit displayed significantly stronger needs for Taiwanese (TW) than those from urban-based H2 and H3. Specifically, H1 nurses reported encounters with the largest proportion of TW-speaking clients (p<0.001) and the highest frequency of using TW with clients (p<0.001). However, H1 nurses' self-evaluation of their TW proficiency revealed a lower score than those of the H2 and H3 nurses, especially with regard to medical TW proficiency (p<0.05). Finally, while nurses with a high command of TW felt it helped their work, those with a low level did not feel this impacted their performance.

Conclusion: Nurses working in locations where the use of the minority language is prevalent would benefit more from learning this language.

Author Biographies

Mei-Hui Tsai, National Cheng Kung University

Mei-Hui Tsai, PhD in Linguistics, is a full Professor at National Cheng Kung University, Taiwan. Her research interests include medical discourse, Taiwanese for medical purposes and the application of her research to medical education in Taiwan.

Huan-Fang Lee, National Cheng Kung University

Huan-Fang Lee, PhD in Nursing, is an Assistant Professor of the Nursing Department at National Cheng Kung University, Taiwan. Her research interests include nursing administration, nurses’ health, critical care and adult nursing.

Shuen-Lin Jeng, National Cheng Kung University

Shuen-Lin Jeng, PhD in Statistics, is an Associate Professor of Statistics at National Cheng Kung University, Taiwan. His research interests include product reliability, statistical modeling, statistical computing, industrial statistics, bioinformatics and data mining.

Sheng-Che Lin, Tainan City Government

Sheng-Che Lin, MD, PhD, is the Director of the Public Health Bureau, Tainan City Government, Taiwan.

Li-Wei Hsieh, Tainan Hospital

Li-Wei Hsieh, MA, is the Head of the Nursing Department, Tainan Hospital of Health and Welfare, Taiwan.

Jen-Pin Chuang, Tainan Hospital

Jen-Pin Chuang, MD, and Master of Medicine, is currently the Superintendent of Sinhua Branch, Tainan Hospital, Ministry of Health and Welfare, Taiwan. His research interests include surgical oncology, colorectal cancer treatment and general surgery.

Elizabeth A. Jacobs, University of Wisconsin

Elizabeth A. Jacobs, MD, MAPP, is a Professor in the Department of Medicine, Division of General Internal Medicine and in the Department of Population Health Sciences.

References

Allan, H. T. and Westwood, S. (2016) English language skills requirements for internationally educated nurses working in the care industry: Barriers to UK registration or institutionalised discrimination? International Journal of Nursing Studies 54: 1-4. https://doi.org/10.1016/j.ijnurstu.2014.12.006

Antia, B. E. and Bertin, F. D. (2004) Nigeria. Multilingualism and healthcare in Nigeria: A management perspective. Communication & Medicine 1 (2): 107-117. https://doi.org/10.1515/come.2004.1.2.107

Brua, C. (2008) Role-blurring and ethical grey zones associated with lay interpreters: Three case studies. Communication & Medicine 5 (1): 73-79. https://doi.org/10.1558/cam.v5i1.73

Chan, H. C. (1994) Language Shift in Taiwan: Social and Political Determinants. Unpublished doctoral dissertation. Georgetown University, Washington, DC.

Chan, L. K. (2012) Language barriers in medical education in Hong Kong. In N. G. Patil and L. K. Chan (eds) Making Sense in Communication, 25-30. Hong Kong: Institute of Medical and Health Sciences Education.

Chern, C. L. (2010) General English programs at universities in Taiwan: Curriculum design and implementations. Chang Gung Journal of Humanities and Social Sciences 3 (2): 253-274.

Chia, H. U., Johnson, R., Chia, H. L. and Olive, F. (1999) English for college students in Taiwan: A study of perceptions of English needs in a medical context. English for Specific Purposes 18 (2): 107-119. https://doi.org/10.1016/S0889-4906(97)00052-5

Clark, T., Sleath, B. and Rubin, R. H. (2004) Influence of ethnicity and language concordance on physician-patient agreement about recommended changes in patient health behavior. Patient Education and Counseling 53 (1): 87-93. https://doi.org/10.1016/S0738-3991(03)00109-5

Ferguson, W. J. and Candib, L. M. (2002) Culture, language, and the doctor-patient relationship. Family Medicine 34 (5): 353-361.

Fortier, J. P., Strobel, C. and Aguilera, E. (1998) Language barriers to health care: Federal and state initiatives, 1990-1995. Journal of Health Care for the Poor and Underserved 9 (suppl.): S81-S100.
https://doi.org/10.1353/hpu.2010.0692

Hays, R. B., Pearse, P, Cooper, C. W. and Sanderson, L. (1996) Language background and communication skills of medical students. Ethnicity and Health 1 (4): 383-388.
https://doi.org/10.1080/13557858.1996.9961807

Ho, M. J., Gosselin, K., Chandratilake, M., Monrouxe, L. V. and Rees, C. E. (2016) Taiwanese medical students’ narratives of intercultural professionalism dilemmas: Exploring tensions between Western medicine and Taiwanese culture. Advances in Health Sciences Education 22 (2): 429-445.
https://doi.org/10.1007/s10459-016-9738-x

Huang, S. F. (1993) Language, Society and Ethnic Identity: A Sociolinguistic Study on Taiwan. Taipei: Crane.

Hughes, L., Brookes, C., Cocker, C., John, D. N., Jones, A. and Longley, M. (2008) The Role of the Welsh Language in Community Pharmacy Service Provision in Wales. London: Pharmacy Practice Research Trust.

Hull, M. (2016) Medical language proficiency: A discussion of interprofessional language competencies and potential for patient risk. International Journal of Nursing Studies 54: 158-172.
https://doi.org/10.1016/j.ijnurstu.2015.02.015

Karliner, L. S., Auerbach, A., Napoles, A. Schillinger, D., Nickleach, D. and Perez-Stable, E. J. (2012) Language barriers and understanding of hospital discharge instructions. Medical Care 50 (4): 283-289. https://doi.org/10.1097/MLR.0b013e318249c949

Kosonen, K. (2017) Non-dominant - instead of minority - languages in education as a focus of research: Why? Paper presented at the 16th International Conference on Minority Languages, Jyväskylä and Närpes, Finland, 28-30 August.

Lee, I. and Wang, H. H. (2002) Perceived occupational stress and related factors in public health nurses. Journal of Nursing Research 10 (4): 253-260. https://doi.org/10.1097/01.JNR.0000347606.91295.76

Lin, P. L., Ho, M. Y., Tzeng, L. C. and Lu, K. Y. (2005) Work, stress professional commitment among nurses in community health centers. Journal of Evidence-Based Nursing 1 (2): 132-139.

Madoc-Jones, I. (2004) Linguistic sensitivity, indigenous peoples and the mental health system in Wales. International Journal of Mental Health Nursing 13 (4): 216-224.
https://doi.org/10.1111/j.1440-0979.2004.00337.x

Maneze, D., Everett, B., Kirby, S., DiGiacomo, M., Davidson P. M. and Salamonson, Y. (2016) ‘I have only little English’: Language anxiety of Filipino migrants with chronic disease. Ethnicity and Health 21 (6): 596-608. https://doi.org/10.1080/13557858.2016.1143091

Manson, A. (1988) Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Medical Care 26 (12): 1119-1128. https://doi.org/10.1097/00005650-198812000-00003

Miguel, C. S., Rogan, F., Kilstoff, K. and Brown, D. (2006) Clinically speaking: A communication skills program for students from non-English speaking backgrounds. Nurse Education in Practice 6 (5): 268-274. https://doi.org/10.1016/j.nepr.2006.02.004

Mutchler, J. E., Bacigalupe, G., Coppin, A. and Gottlieb, A. (2007) Language barriers surrounding medication use among older Latinos. Journal of Cross-Cultural Gerontology 22 (1): 101-114.
https://doi.org/10.1007/s10823-006-9021-3

Pochhacker, F. (2000) Language barriers in Vienna hospitals. Ethnicity and Health 5 (2): 113-119.
https://doi.org/10.1080/713667449

Roberts, G. W., Irvine, F. E., Jones, P. R., Spencer, L. H., Baker, C. R. and Williams, C. (2007) Language awareness in the bilingual healthcare setting: A national survey. International Journal of Nursing Studies, 44 (7): 1177-1186. https://doi.org/10.1016/j.ijnurstu.2006.03.019

Tan, L. K. (2011) Taiwanese college students’ language consciousness. Journal of Taiwanese Vernacular 3 (2): 4-25.

Tsai, M. H. (2015) A pragmatic approach to dialect maintenance: A survey of the course development of Taiwanese for medical purposes and its implications for the curriculum planning of professional language courses in Taiwan. Journal of Taiwanese Vernacular 7 (2): 4-29. 10.6621/JTV.2015.0702.02

Tsao, F. F. (1997) Ethnic Language Policies: A Comparison across the Taiwan Strait. Taipei: Crane.

Tzeng, H. M. (2005) Crisis management and medical disputes related to nursing practice. Journal of Nursing 52 (2): 48-55.

Van Rosse, F., de Bruijne, M., Suurmond, J., Essink-Bot, M.-L. and Wagner, C. (2016) Language barriers and patient safety risks in hospital care: A mixed methods study. International Journal of Nursing Studies 54: 45-53. https://doi.org/10.1016/j.ijnurstu.2015.03.012

Welsh Language Policy Unit (2015) More than just Words: Delivering the ‘Active Offer’ Information Pack - Health. Available online: http://gov.wales/docs/dhss/publications/150928activeofferhealthen.pdf

Yang, M.-N. and Su, S.-M. (2003) A study of Taiwanese nursing students’ and in-service nurses’ English needs. Journal of Chang Gung Institute of Technology 2: 267-284.

Yeh, H.-N., Hui-chen C. and Yuh-show, C. (2004) Language use in Taiwan: Language proficiency and domain analysis. Journal of Taiwan Normal University: Humanities & Social Sciences 49 (1): 75-108.
Published
2019-07-03
How to Cite
Tsai, M.-H., Lee, H.-F., Jeng, S.-L., Lin, S.-C., Hsieh, L.-W., Chuang, J.-P., & Jacobs, E. A. (2019). Perceptions of the need for minority languages by nurses in Southern Taiwan. Communication & Medicine, 15(1), 90-104. https://doi.org/10.1558/cam.33283
Section
Articles