Abstract
Healthcare encounters involving participants from diverse linguistic backgrounds are becoming more common due to the globalisation of health care and increasing migration levels. Research suggests that this diversity has a significant impact on health outcomes; however less is known about how it is managed in the actual consultation process. This article presents an analysis of antenatal screening consultations video recorded in Hong Kong, using conversation analysis. We consider how the use of a second or subsequent language impacts on these consultations, and on discussions and decisions about further action. The presence or absence of shared first language did not appear to affect the extent to which particular courses of action were promoted or recommended. Recommendations were a common occurrence across consultations with and without shared first language. However, we argue that the routine use of recommendations can be consequential, as second language speakers may have more limited resources to interrogate or contest these. This finding has implications for the ability for professionals to maximise patient involvement in decision-making.
Highlights
IntroductionIt means that we have consultations that can be categorised into three distinct groups: those that are conducted in the first language for both parties; those conducted in a second or subsequent language for one party; and those conducted in a second or subsequent language for both
This paper reports on data collected as part of a study to address key issues in the practice of antenatal screening for fetal abnormality in Hong Kong
It means that we have consultations that can be categorised into three distinct groups: those that are conducted in the first language for both parties; those conducted in a second or subsequent language for one party; and those conducted in a second or subsequent language for both
Summary
It means that we have consultations that can be categorised into three distinct groups: those that are conducted in the first language for both parties; those conducted in a second or subsequent language for one party; and those conducted in a second or subsequent language for both Through analysis of this data set, we aim to shed light on how linguistic diversity is managed in these consultations and to identify the impact this has on the way test results are discussed and decisions are made. There has been a proliferation of research in medical sociology, medical anthropology and medical education examining the role of culture in healthcare more generally, and in a genetic counselling context (for an overview, see Zayts and Pilnick 2014). There is a tendency to focus on the outcomes of interactions rather than the process, for example miscommunication causing dissatisfaction and stress for both providers and patients (Kreps & Thornton 1984, Ulrey and Amason 2001)
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