Abstract
Like Canada, Wales, UK is a bilingual nation: the Welsh language is an important part of its national identity and legislative framework. This has implications for the delivery of public sector services, particularly in the context of health and social care, where responding to the language needs of service users is fundamental to quality health care provision. Nevertheless, despite the strengthening policy commitment for a whole-system approach towards enhancing Welsh language services, there is a paucity of evidence to guide best practice in organizational planning in health care settings.
This commentary outlines the context and significance of bilingual health care provision in Wales and the implications for building and embedding the evidence base. It calls for further work to translate our knowledge and understanding of language-appropriate practice to provide more effective and sensitive health care services; and to close the implementation gap between evidence and practice. Given the relevance of this challenge for health care providers in Canada who plan and deliver services for French-language minorities, this approach has resonance across our research communities. Thus, in our common pursuit to establish integrated knowledge translation research for language-appropriate health care systems, this commentary offers a focus for reflection, discussion and collaborative action.
Key Words: Knowledge management, language, minority health, organizational change, Wales
Résumé
Tout comme le Canada, le pays de Galles, au Royaume-Uni, est une nation bilingue: la langue galloise est un élément important de son identité nationale et de son cadre législatif. Cette situation a des implications pour la prestation de services publics, en particulier dans le domaine des services sociaux et de santé, où il est essentiel de répondre aux besoins linguistiques des utilisateurs de services pour assurer des soins de qualité. Néanmoins, en dépit de l’engagement politique pour offrir davantage de services sociaux et de santé en gallois, on manque d’éléments qui orienteraient l’élaboration de pratiques exemplaires en matière de planification et d’organisation des services de santé.
Ce commentaire décrit le contexte et l’importance de la prestation des soins de santé bilingues au Pays de Galles et les prérequis pour élaborer et intégrer une base de données probantes. Il appelle à davantage transférer et appliquer les connaissances acquises sur la pratique dans la langue appropriée pour fournir des services de santé plus efficaces et adaptés, et combler le fossé qui existe actuellement au niveau de la mise en œuvre entre la recherche et la pratique. Compte tenu de la pertinence de ce défi pour les fournisseurs de soins de santé au Canada qui planifient et fournissent des services pour les minorités de langue française, cette approche a une certaine résonnance dans nos communautés de recherche. Ainsi, dans notre quête commune de recherche et de transfert des connaissances pour mettre en place des systèmes de santé dans la langue appropriée, ce commentaire propose une mise au point pour la réflexion, la discussion et l’action en collaboration.
Mots Clés: gestion des connaissances, langue, santé des minorités, changement organisationnel, Pays de Galles
Footnotes
Acknowledgements: The ELAN project is funded by the National Institute for Social Care and Health Research, Welsh Government.
Conflict of Interest: None to declare.
References
- 1.Office for National Statistics. Census 2001, Report on the Welsh Language. 2004. [Google Scholar]
- 2.May S. Uncommon languages: The challenges and possibilities of minority language rights. J Multiling Multicul. 2000;21:366–85. doi: 10.1080/01434630008666411. [DOI] [Google Scholar]
- 3.Misell A. Welsh in the Health Service: The Scope, Nature and Adequacy of Welsh Language Provision in the National Health Service in Wales. Cardiff, Wales: Welsh Consumer Council; 2000. [Google Scholar]
- 4.Welsh Language Board. Overview of Annual Monitoring Reports 2009/10: NHS Health Boards and NHS Trusts. Cardiff: Welsh Language Board; 2010. [Google Scholar]
- 5.Welsh Government. More than Words: Strategic Framework for Welsh Language Services in Health, Social Services and Social Care. Cardiff: Welsh Government; 2012. [Google Scholar]
- 6.Jacobs E, Chen A, Karliner L, Agger-Guta N, Mutha S. The need for more research on language barriers in healthcare: A proposed research agenda. Milbank Q. 2006;84(1):111–33. doi: 10.1111/j.1468-0009.2006.00440.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Irvine F, Roberts G, Jones P, Spencer L, Baker C, Williams C. Communicative sensitivity in the bilingual healthcare setting: A qualitative study of language awareness. J Adv Nurs. 2006;53(4):1–13. doi: 10.1111/j.1365-2648.2006.03733.x. [DOI] [PubMed] [Google Scholar]
- 8.Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O. Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep. 2003;118:293–302. doi: 10.1016/S0033-3549(04)50253-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Pawson R, Tilley N. Realistic Evaluation. London, UK: Sage; 1997. [Google Scholar]
- 10.Rycroft-Malone J, McCormack B, Hutchinson AM, DeCorby K, Bucknall TK, Kent B, et al. Realist synthesis: Illustrating the method for implementation research. Implement Sci. 2012;7:33. doi: 10.1186/1748-5908-7-33. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. doi: 10.1186/1748-5908-4-50. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.French B, Thomas LH, Baker P, Burton C, Pennington L, Roddam H. What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational practice. Implement Sci. 2009;4:28. doi: 10.1186/1748-5908-4-28. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Rycroft Malone J, Kitson A, Harvey G, McCormack B, Seers K, Titchen A, Estabrooks C. Ingredients for change: Revisiting a conceptual framework. Qual Saf Health Care. 2002;11(2):174–80. doi: 10.1136/qhc.11.2.174. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Greve CH. Organisational Learning from Performance Feedback. Cambridge, UK: Cambridge University Press; 2003. [Google Scholar]
- 15.ELAN (Enhancing Language Awareness in NISCHR CRC). Available at: https://doi.org/llais.org/news/news.php.en?menu=7&catid=3872&subid=0 (Accessed June 20, 2012).