Diasporic healthcare providers: An analysis of multilingual healthcare interactions in Hong Kong

Abstract

This presentation examines the underexplored intersection of two international research agendas: the impact of globalization on healthcare, and health literacy and communication. Researchers in the fields of health, psychology and sociology have established a causal relationship between clinical communication and patient outcomes in general healthcare, both in terms of satisfaction and health status, with work also examining the relationship between real-time interactions and such outcomes (Heritage at al 2007). Research exploring diasporas has predominantly examined the issue of macro transitions and healthcare provision from the patient perspective (Crosby, 2013). Our interdisciplinary team’s publicly-funded project (GRF: 760112) is examining the notion from the perspective of the clinical provider, specifically, the globally mobile clinical academic using English as the lingua franca in an Asian hospital. Recent findings on ‘mediated interpreting’ have indicated how the assisting para-professional, in this case a bilingual or multilingual Dental Surgery Assistant (DSA), performs the dual capabilities of clinical assistant and interpreter for expatriate clinical academic dentists in Hong Kong (Bridges et al., 2011, 2015). In this presentation, we explore the overarching question, how do global intersections impact on the health literacy and clinical communication of multilingual communities in Asia? We adopt a multivariate framework (Heritage et al., 2007) to examine the relationship between patient functional oral health literacy, patient satisfaction and interactional analysis from a video corpus of multilingual primary care consultations (n=120). In a sub-set of 61 recorded multilingual consultations, patients agreed to undertake additional instruments measuring oral health literacy and satisfaction. Conversation Analysis (CA) of interactional patterns supports detailed analysis of the layers of complexity involved in the management of communicative and social interactions critical to effective healthcare delivery, in the specific case of clinical dentistry. References Bridges, S., Drew, P., Zayts, O., McGrath, C., Yiu, C. K. Y., Wong, H. M., & Au, T. K. F. (2015). Interpretermediated dentistry. Social Science & Medicine, 132(0), 197-207. Retrieved from doi:http://dx.doi.org/10.1016/j.socscimed.2015.03.018 Bridges, S. M., Yiu, C. K. Y., & McGrath, C. P. (2011). Multilingual interactions in clinical dental education: A focus on mediated interpreting. Communication & Medicine (Equinox Publishing Group), 8(3), 197-210. doi:10.1558/cam.v8i3.197 Crosby, S.S., 2013. Primary care management of non-English-speaking refugees who have experienced trauma: a clinical review. JAMA 310 (5), 519e528. Heritage, J., Robinson, J. D., Elliott, M. N., Beckett, M., & Wilkes, M. (2007). Reducing patients’ unmet concerns in primary care: The difference one word can make. Journal of General Internal Medicine, 22(10), 1429-1433.