Research Literacy for Health Practice: Melbourne Hospital Case Study

This report examines research literacy in the context of health practice, specifically focusing on transcultural communication within a healthcare setting. It begins by highlighting the challenges of communication barriers in a multicultural environment, using a case study from a Melbourne hospital to illustrate the impact of linguistic and cultural differences on patient care. The report emphasizes the importance of cross-cultural communication skills, including the effective use of interpreters and the cultivation of cultural competency among healthcare professionals. It then addresses ethical considerations, such as informed consent, autonomy, beneficence, non-maleficence, and justice, in the context of implementing cross-cultural communication strategies. The report concludes by advocating for the integration of cross-cultural communication as a best practice to improve patient satisfaction, health outcomes, and reduce medical errors, and includes recommendations for ethical practices in a focus group setting. The references include various research papers from sources like Elsevier, CRC Press, and Nursingmidwiferyboard.gov.au.

Running head: RESEARCH LITERACY FOR HEALTH PRACTICE
Research literacy for health practice
Name of the Student
Name of the University
Author note

1RESEARCH LITERACY FOR HEALTH PRACTICE
Introduction
Transcultural communication is difficult to be implemented in health care as the patient’s
expect the health care professions to understand their preferences. On the other hand, the care
providers face difficulty due to linguistic barriers, and missing of non-verbal messages, even
when the translators are present. It is the common issue where the health care professionals fail
to acknowledge the similarities and differences in people from culturally diverse background
(Holland 2017). Australia being the multicultural society demands Transcultural nursing in the
health care organisation. The crux of Transcultural nursing is good communication between the
health care providers and the patients. Communication in Transcultural nursing refers to
acknowledging the individual’s culture, beliefs and practices. It is the best practice necessary to
bridge the cultural gap. It will ensure the acceptable Transcultural care. Various strategies have
been developed to address this issue but there lies an uncertainty about communication change.
This issue has been prominently highlighted in the recent and old peer review journals (Giger
2016). In regards to the issue, the essay discusses the relevant literature pertaining to the issue
and the evidence based information regarding the best practice as solution.
Part 1
As a research manager, I have identified from my research that in Melbourne hospital, a
client of refugee background was admitted to emergency department. He was suspected with TB
and was isolated. There was no hospital staff that spoke Kirundi, Swahili or Congolese
languages. Since, the patient’s children spoke English no interpreter was recruited. Later a social
worker who visited the client arranged for an interpreter. It was discovered later that the client

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was afraid of dying of AIDS, which was then highly prevalent in Africa
(Professionalsaustralia.org.au 2017).
In the health care industry, I have observed that the professionals have to interact with
peers and patients from different cultural background. Thus, nurses require communication in
different forms to advocate their patients. When nurses fail to communicate with people from
culturally and linguistically diverse communities, the patients interpret it as bias, prejudice,
consequently influencing the quality of care.
The best practice solution to the barriers in Transcultural nursing is the cultivation of the
cross-cultural communication skills. According to Taylor et al. (2013), there must be
efficient and skilful use of the interpreter’s cultural competency. Interpreters, nurses
and physicians must learn the culturally competent communication skills both verbal and no
verbal. These skills are required to identify the patient’s values, practices, beliefs, unique health
care needs and perceptions. These skills are required in all types of health settings may it be
palliative, geriatric care, mental health, paediatric and any other setting. It includes use of basic
grammar, simple and common words, knowing the multilingual signs, bilingual words and
phrases, pictograms, and asking politely for paraphrasing important points. Cultural competency
while communication includes starting a statement with “Is it clear or can you understand”. The
literature also suggests that there is a need of culturally fluent approach for nurses to cultivate
good communication skills in nursing. Other factors necessary to implement this solution are
awareness, sensitivity, good listening, and patience. It will help improve the
communication across cultures. It will also ensure the personal and professional
relationships (Silverman et al. 2016).

3RESEARCH LITERACY FOR HEALTH PRACTICE
Various strategies, models and theories have been developed to improve
communication style in Transcultural nursing. However, there are barriers to
implementing theory into practice. For instance, a Middle Eastern patient in ICU
may suddenly wake up and request seriously to pray facing Mecca. Similarly,
Chinese patient may refuse to take pain relief medicine, post operation
considering it an impolite offer. In order to deal with these challenging
situations, the nurse must have comprehensive understanding of the ethnic and
cultural norms of culturally diverse people living in the society (Giger, 2016). In
addition the, patients may fear using interpreters for breach of privacy and
confidentiality of the information. It prevents the professionals from establishing
the therapeutic relationship. The cost of using interpreters is high and is not
always possible to recruit them in stressful environment. The indigenous
Australians in remote areas and other ethnic minorities face language barrier
commonly. They thus, lack access to health care facilities. It also hinders the
process of clinical handover and conveying of critical information (Espinosa et al. 2013).
Cross-cultural training is the best way to promote effective communication in health care. It will
improve the skills and attitudes of health care professionals to interact effectively with refugees,
immigrant nurses and patients and other patients from culturally and linguistically diverse
communities (Lee et al. 2015).
Part 2
A focus group can be recruited in Melbourne hospital comprising of the doctors, nurses
and the other health care staff to implement the solution of cross cultural communication skills.
However, the focused group participants must have awareness of the ethical implications

4RESEARCH LITERACY FOR HEALTH PRACTICE
associated with the communication in diverse health care system. Ethics is an important
parameter for health care providers as they deal with life and death of people. They are
accountable for misdiagnosis, medical errors and misinterpretations in clinical care (Kourkouta
and Papathanasiou 2014). Thus, ethical factors must be considered before implementing the
cross-cultural communication system.
Informed consent is the heart of any research process. It is the fundamental health
behaviour. If the participants do not know that they are part of research, it may not serve the
purpose. Other ethical implications arise due to breach of four principles that is autonomy,
beneficence, non-maleficence and justice (Ganz et al. 2015). Non-maleficence is the obligation
of not inflicting any intentional harm to the participants by the researcher. Due to language
barrier, a health care provider may unintentionally harm a patient
(Nursingmidwiferyboard.gov.au. 2017). Eliminating miscommunication between the conveyer
and recipient reduces the gap and help to achieve the research aims and objectives. The same in
cross-cultural nursing when practiced ensures beneficence of patients. Justice refers to ethical
decision making. It involves equal participation of all the members of the focused group and
respecting their opinions, rights, preferences and given equal opportunity to give ideas. The
health care providers must also engage in making justice to the patients by respecting their
cultural norms and beliefs and ensure safety. Right to autonomy of all research participants
should be ensured. They must have autonomy to withdraw from the project anytime and their
valuable contribution. Similarly in health care setting, they must have the health care providers
must ensure patient’s autonomy in health care decisions (Nursingmidwiferyboard.gov.au. 2017).
The research project comprise of low risk as it deals with health care providers and
targets people who can give consent and are all above 18 years old. The research project will be

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conducted in the Melbourne hospital itself in a safe environment. The focused group only
involves in discussions and there is no scope of troubled spots. A written consent will be given
by the researcher to ensure the protection of privacy and confidentiality of the information
collected during focused group discussion (Sellman 2016). Thus, I think it will be helpful to
successfully complete the ethics application form as there will be no breach of justice, autonomy,
respect and confidentiality.
Conclusion
Cross-cultural communication is an effective tool to address the health issues of
culturally diverse patients. It determines patient satisfaction and improvement in the health
outcomes. It is a best practice to decrease the rate of medical errors. To avoid communication
gap it is necessary to eliminate the cultural gap. By knowing the multilingual signs, bilingual
words and phrases, pictograms and other customs of Indigenous patients, refugees and other
immigrants, their needs can be identified rapidly. It will prevent delay in diagnosis and provide
solutions in a proactive manner. As a ethics advisor the recommendation has been reviewed and
the ethical implications related to recruitment of focus group has been discussed. The
implications has been related with the ethics application form.

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References
Espinosa, M., Keller, H. and Westphal, N., 2013, June. Educational outcomes and effects on
cross-cultural communication skills of an international experience for undergraduate STEM
students through Michigan Technological University's Pavlis Institute for Global Technological
Leadership. In Proc. of the 120th ASEE Annual Conference, Atlanta, GA (pp. 23-26).
Ganz, F.D., Wagner, N. and Toren, O., 2015. Nurse middle manager ethical dilemmas and moral
distress. Nursing ethics, 22(1), pp.43-51.
Giger, J.N., 2016. Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier Health
Sciences.
Holland, K., 2017. Cultural awareness in nursing and health care: an introductory text. CRC
Press.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia socio-
medica, 26(1), p.65.
Lee, A.L., Mader, E.M. and Morley, C.P., 2015. Teaching Cross-Cultural Communication Skills
Online. Family medicine, 47(4), pp.302-8.
Nursingmidwiferyboard.gov.au. 2017. Nursing and Midwifery Board of Australia - Professional
standards. [online] Available at: http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-
Statements/Professional-standards.aspx [Accessed 22 Aug. 2017].
Professionalsaustralia.org.au., 2017. THE CASE FOR CHANGE Consequences and costs of
failures in the translating and interpreting industry. [online]

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http://www.professionalsaustralia.org.au. Available at:
http://www.professionalsaustralia.org.au/translators-interpreters/wp-content/uploads/sites/
43/2015/03/The-Case-for-Change_EMAIL.pdf [Accessed 24 Aug. 2017].
Sellman, D., 2016. The practice of nursing research: getting ready for ‘ethics’ and the matter of
character. Nursing inquiry, 23(1), pp.24-31.
Silverman, J., Kurtz, S. and Draper, J., 2016. Skills for communicating with patients. CRC Press.
Taylor, S.P., Nicolle, C. and Maguire, M., 2013. Cross-cultural communication barriers in health
care. Nursing Standard, 27(31), pp.35-43.