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Challenging Spanish: ways for nurses to become bilingual.

A desire to provide culturally competent care to an increasing population of non-English-speakers may lead some nurses to consider learning another language as a way to minimize cross-cultural communication barriers. Nurses wishing to learn a second language may be surprised at the variety of ways to acquire bilingual skills, particularly in Spanish, the most common foreign language encountered in the United States. Reasons to learn Spanish are discussed and ways to do so are reviewed. Learning Spanish or another language can enrich the nurse-patient relationship, enhance nurses' self-esteem, and advance nurses' employment opportunities. Bilingual proficiency in English and Spanish (or another language) should be regarded as an authentic clinical skill supporting nurses' cultural and clinical competencies.

Communication Barriers↗

Increasing the linguistic competence of the nurse with limited English proficiency.

Teaching linguistic competence to nursing students educated in the United States but whose families are recent immigrants is a difficult task for nurse educators. Although students may easily learn the mechanics of a new language, the cultural differences must also be addressed. In the face of the current nursing shortage, it is critically important that strategies to improve linguistic competence be incorporated into curricular efforts. This article describes integrated skills reinforcement as one academic strategy to improve reading, speaking, listening, and writing skills. Suggestions are made for incorporating and evaluating these techniques.

Cultural Diversity↗

Hablamos Español: crossing communication barriers with the Latino population.

This article outlines the retrospective study of a pilot project to teach Spanish phrases related to health care to students of an associate degree nursing program. This project was initiated in response to the documented increase in the Latino population in upstate South Carolina. In the decade from 1990 to 2000, four counties in this region documented increases in the Latino population at greater than 60%. The nursing faculty began teaching simple Spanish phrases prior to each lecture and provided opportunities for students to earn extra credit points on unit examinations for correct translations. The planning and implementation process is described, and descriptive statistics are documented to provide a basic evaluation of success rates for the participating students. The focus of this project was to facilitate communication with Latino clients by teaching students common phrases and simple questions in the Spanish language.

Communication Barriers↗

The effect of demographic variables on achievement in and satisfaction with online coursework.

Although an ethnically diverse health care workforce is considered necessary to meet the needs of our multicultural society, little attention has been given to the effect of language in distance-delivered coursework. A population of ethnically diverse nurse practitioner and physician assistant students at three institutions was studied to determine the effect of demographic variables, such as native language, gender, and prior computer experience, on both successful completion of and satisfaction with online coursework. No significant difference was found in academic achievement of native and non-native English speakers, nor in course satisfaction between these two groups. In addition, neither gender nor prior computer experience affected either academic achievement or course satisfaction.

Adult↗

Developing a course to teach Spanish for health care professionals.

To make the baccalaureate nursing curriculum more responsive to changing U.S. demographics, the School of Nursing at The University of Texas at Austin instituted a required course, titled Spanish for Health Care Professionals. This course, developed in collaboration with the University's Department of Spanish and Portuguese, focuses on conversational Spanish using the communicative language teaching approach, rather than grammar and medical terminology instruction. Class activities, along with course materials, are linked to nursing practice. Course assignments are designed to develop authentic communication in reading, writing, listening, speaking, and understanding culture, and students demonstrated oral and written linguistic gains in relation to their Spanish fluency and accuracy. Because the Hispanic population is now the largest minority group in the United States, this course will help nurses communicate with Spanish-speaking patients.

Attitude of Health Personnel↗

[The effects of associative strength between lexical and conceptual representations on word processing in second language learners].

The purpose of this study was to examine how the learning experience affects associative strength between lexical representations of first and second language (L1, and L2) and conceptual representation, and word processing. The critical experimental manipulations were L2 proficiency, word frequency, and matching direction. The subjects were advanced learners and beginners. Association strength was assessed by measuring reaction time and error rate in translation recognition tasks with three sets of English (L2) and Japanese (L1) words that were high or low frequency, and corresponding pictures. The results showed that (1)the two associations involving L2 words were stronger when L2 word frequency was high, (2)both L2-L1 and L2-Picture association were strengthened with L2 proficiency. However, (3)there was no difference between L2-L1 and L2-Picture conditions. Moreover, (4) the association between L1 words and pictures were strong regardless of L2 proficiency or word frequency. These results suggest that L2 learning experience strengthens both associations involving L2 words.

Association↗

Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration: a preliminary study.

BACKGROUND: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is an established instrument to measure the perceived work relationship between physicians and nurses. The survey addresses areas of autonomy and decision making, interprofessional education and relations, psychosocial care, teamwork, and shared responsibility. The aim of this prelimiary study was to adapt the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration for use in Turkey and test its psychometric properties and utility in clinical and research practice. METHODS: The process of cross-cultural adaptation and validation followed the guidelines provided in the existing literature. First, three bilingual health professionals independently translated the original questionnaire into Turkish and a consensus version was generated. Then, three other translators, blind to the original questionnaire, performed a back translation into English to confirm the accuracy of the translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of two nurses and two physicians. The field-testing for face validity was done in a group of ten monolingual physicians and nurses. Reliability was assessed with test-retest reliability and construct validity was confirmed with factor analysis. RESULTS: The mean time of questionnaire administration was 3 minutes and 45 seconds. The test-retest reliability was 0.75, and Cronbach's coefficient alpha was 0.71 for the entire sample. The findings of the factor analysis indicated that the Turkish version of Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was comprised of the following four factors: 'physician-nurse relationships', 'shared education', 'nursing role in patient care', and 'accountability and responsibility of nurses.' CONCLUSION: The overall findings of this study indicate that the Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is a psychometrically sound tool with satisfactory measurement characteristics including construct validity and internal consistency reliability. This instrument may be useful in assessing the effectiveness of educational programs designed to enhance collaboration between physicians and nurses, whether these programs are aimed at residents and graduate nursing students or practicing physicians and nurses.

Adult↗

'You find yourself.' Perceptions of nursing students from non-English speaking backgrounds of the effect of an intensive language support program on their oral clinical communication skills.

Nurses of ethnically diverse backgrounds are essential in providing multicultural populations in western societies with culturally and linguistically competent health care. However, many nurses from non-English speaking backgrounds (NESB) are at high risk of failure in university programs particularly during clinical placements. Few studies investigate the clinical experiences of students from NESB and strategies to support their learning. This study describes perceptions of fifteen undergraduate nursing students from NESB about their first clinical placement in an Australian university program and the effect of a language support program on their oral clinical communication skills. Three categories arose: *Wanting to belong but feeling excluded; *Wanting to learn how to...; and *You find yourself. While many students find clinical placement challenging, it appeared difficult for students in this study as language and cultural adjustments required some modification of their usual ways of thinking and communicating, often without coping strategies available to other students.

Adaptation, Psychological↗

Clinical trials in Russia and Eastern Europe: recruitment and quality.

OBJECTIVE: To review the current situation of clinical trials in Russia and Eastern Europe. FINDINGS: The volume of clinical trials in these territories is increasing. The quality of the data obtained, ethical care and compliance with Good Clinical Practice guidelines is at least as good as anywhere else. United States Food and Drug Administration inspection data indicate that sites in these countries are often superior to those elsewhere. Large-scale clinical trials conducted in these territories have been subsequently published in mainstream journals. Territory-specific attention must be paid to communications' equipment and language. However, this is countered, for example, by the fact that most clinical research associates in Russia hold degrees in medicine, that patients with previously untreated disease are more easily found than in North America or Western Europe, and the participation of large, purpose-built, healthcare institutions. CONCLUSION: Eastern Europe and Russia are well-established locales for clinical trials. These territories offer a solution to the competition for patients among clinical trials in North America or Western Europe.

Clinical Trials as Topic↗

Processing of conceptual relationships within simple Czech and English sentences--ERPs and behavioral correlates.

The paper presents findings of an experiment the participants of which were native Czech speakers (L1 ) possessed of perfect knowledge of English (L2). We assumed that the subjects could process differently each of the three types of English and Czech sentences; the first type represented correct sentences, the other two violated sentences. Violated sentences differed in the precise relationship between the verbs, their preceding noun phrases, and their preceding context. ERPs to critical verbs, the accuracy rate for both English and Czech sentences processing and decision time for each were evaluated. Participants' personality traits were assessed too. It has been shown that our subjects, who learned English after the age of 15, displayed significant differences in all measured parameters. It was especially the longer latency N400, the lower accuracy rate of English sentence processing, the longer decision time, and the same dynamics of all measured ERPs parameters. Possible causes of these differences are discussed.

Adult↗

The efficacy of bilingual health advocacy in ethnic minority patients with cancer.

AIM: This research aims to establish the efficacy of introducing trained bilingual health advocates to non-English speaking cancer patients. METHOD: Male and female Bengali advocates received appropriate training. They were then given a group of patients to manage, while a control group received no such intervention. Outcomes were determined at the baseline and after three months. The study finally concludes in April 2000. RESULTS: The progress so far shows that the advocates had only recruited half of the expected number of Bengali cancer patients. Focus groups showed, however, that healthcare professionals felt that their training was inadequate to overcome the language and cultural barriers, and many were distressed that they were not meeting the needs of minority ethnic patients. CONCLUSION: The authors anticipate that this study will concur with research in other health sectors where bilingual health advocacy has been beneficial, and that future care will be better informed as a result.

Humans↗

Management of diabetes in South Asian communities in the UK.

This article discusses some of the specific challenges related to the management of diabetes in patients of South Asian origin. Communicating information that considers cultural, religious and language differences is important to promote effective self-management. The South Asian population in the UK is at greater risk of developing type 2 diabetes, and cultural practices such as fasting if not managed properly can lead to deterioration in their condition. The use of appropriate information and educators with Asian language skills and an understanding of the local population's culture are important to improve self-management of diabetes in these patients.

Attitude to Health↗

Mandarin and English single word processing studied with functional magnetic resonance imaging.

The cortical organization of language in bilinguals remains disputed. We studied 24 right-handed fluent bilinguals: 15 exposed to both Mandarin and English before the age of 6 years; and nine exposed to Mandarin in early childhood but English only after the age of 12 years. Blood oxygen level-dependent contrast functional magnetic resonance imaging was performed while subjects performed cued word generation in each language. Fixation was the control task. In both languages, activations were present in the prefrontal, temporal, and parietal regions, and the supplementary motor area. Activations in the prefrontal region were compared by (1) locating peak activations and (2) counting the number of voxels that exceeded a statistical threshold. Although there were differences in the magnitude of activation between the pair of languages, no subject showed significant differences in peak-location or hemispheric asymmetry of activations in the prefrontal language areas. Early and late bilinguals showed a similar pattern of overlapping activations. There are no significant differences in the cortical areas activated for both Mandarin and English at the single word level, irrespective of age of acquisition of either language.

Adolescent↗