Key points are not available for this paper at this time.
OBJECTIVES: To identify factors limiting the effectiveness of communication between Aboriginal patients with end-stage renal disease and healthcare workers, and to identify strategies for improving communication. DESIGN: Qualitative study, gathering data through (a) videotaped interactions between patients and staff, and (b) in-depth interviews with all participants, in their first language, about their perceptions of the interaction, their interpretation of the video record and their broader experience with intercultural communication. SETTING: A satellite dialysis unit in suburban Darwin, Northern Territory. The interactions occurred between March and July 2001. PARTICIPANTS: Aboriginal patients from the Yolngu language group of north-east Arnhem Land and their medical, nursing and allied professional carers. MAIN OUTCOME MEASURES: Factors influencing the quality of communication. RESULTS: A shared understanding of key concepts was rarely achieved. Miscommunication often went unrecognised. Sources of miscommunication included lack of patient control over the language, timing, content and circumstances of interactions; differing modes of discourse; dominance of biomedical knowledge and marginalisation of Yolngu knowledge; absence of opportunities and resources to construct a body of shared understanding; cultural and linguistic distance; lack of staff training in intercultural communication; and lack of involvement of trained interpreters. CONCLUSIONS: Miscommunication is pervasive. Trained interpreters provide only a partial solution. Fundamental change is required for Aboriginal patients to have significant input into the management of their illness. Educational resources are needed to facilitate a shared understanding, not only of renal physiology, disease and treatment, but also of the cultural, social and economic dimensions of the illness experience of Aboriginal people.
Cass et al. (Wed,) studied this question.