Säg till om du önskar tolk - Kommunikation i neonatalvård mellan föräldrar och vårdpersonal när språkbarriärer föreligger

Abstract

Family-centred neonatal care encourages parents to participate in the care of their child. When language barriers exist between healthcare personnel and parents, a third party is needed to achieve satisfactory communication. Difficulties in direct communication increase the risk of misunderstanding between healthcare personnel and parents, and may lead to elevated anxiety among parents. The overarching objective of this dissertation was to increase knowledge concerning the communication difficulties that arise between parents and healthcare personnel when language barriers are present. Study I is a quantitative questionnaire study analysing the use of interpreters and awareness of the guidelines for their use. Study II is a qualitative interview study describing the experiences of care personnel regarding communication with parents. Study III is a qualitative interview study of parents who speak Arabic through an interpreter, describing their experiences of having their child under care in the neonatal ward and communicating with care providers. Study IV is a qualitative observational study elucidating the communication difficulties that arise between healthcare personnel and parents when their child is under care in the neonatal ward and language barriers are present. The results show that healthcare personnel lack guidelines for the use of interpreters, and that interpreters are mainly used in the context of medically oriented discussions. Healthcare personnel expressed anxiety and frustration because the information they wished to communicate to parents was misunderstood. The parents expressed gratitude for the warmth and concern of the healthcare personnel despite inadequate communication. Communication was complicated by the constant need to have a third party present to interpret. Our observations revealed that language was not the only significant barrier, and that cultural differences could also lead to misunderstandings. Cultural interpreters or cultural navigators were used to facilitate communication; they were not trained interpreters, but did speak several frequently occurring languages. These individuals were made available to the parents and were able to interpret situations that could arise during nursing care, or to clarify when misunderstandings arose between parents and healthcare personnel. When the father spoke Swedish but the mother did not, the father often wished to interpret for his partner; however, such offers were rarely accepted by healthcare personnel, who instead preferred to call in an interpreter. The results of the study suggest that parents who encounter language barriers should be offered the services of an interpreter for discussions related to medical issues or to the care and treatment of the child. Information must be available in the parents’ native language, and parents must also be given the opportunity to participate in the care of their child, which requires complete understanding of all communications. Parents should be provided with the opportunity to speak their minds, should they so desire. Healthcare personnel must also be aware of how vulnerable parents with language barriers may become when information cannot be directly conveyed.