West Yorkshire, especially Bradford and Leeds are multi-cultural societies, given the percentage of ethnic minorities, for examples South Asians living in the region. 32.1% of Bradford population is of a South Asian origin, while in Leeds, this ratio stands at 9.7%. However, this diversity and multi culturalism seemingly has not translated to multi-linguist approach when it comes to healthcare.
A latest study by University of Leeds, titled, “Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford,” looked at the issues faced by South Asian communities, when communicating with healthcare staff. The study found that people from South Asian communities are facing increased pain at the end of life due to language barriers.
The study explored the experiences and attitudes of patients and family carers from South Asian communities about pain and its management within advanced disease or serious illness.
The study communicates multiple anecdotes described by participants who listed out issues they faced due to language issues.
A research participant was misdiagnosed with Sciatica, before finally being diagnosed with advanced Cancer. He is quoted expressing his frustration in the paper.
“The doctor said it’s sciatica. Cos, I told him, I said look, it’s hurting me here… When I had this ‘so called’ sciatica pain, and this doctor… I went to him, and at that time I had lost my appetite, you know, I was losing a lot of weight. So, I went and told him, doctor I don’t think it’s sciatica, it’s got to be something else, why am I losing weight, why am I not eating?”
Poor communication also has resulted in delay in treatment, another patient’s family member recalls his ordeal.
“We were getting fed up with the GP…they would say ‘well I just saw you last week, I can’t do anything, it’s just pain.’ So, I did go back a month later to complain what they’d been delaying, why didn’t they refer him properly, but basically, they, they didn’t refer him on time because they didn’t think there was anything serious”.
Even those having a conversational level of English, find trouble when they are met with technical terms when communicating with a healthcare worker. Another person of South Asian origin recalls this difficulty faced by their parents.
“Mum and Dad’s English are good, like they can have conversation, but I think sometimes you know, when things get a bit technical, and there is that technically language there, it kind of baffles them, and they kind of go quiet. Especially my dad at the minute because of what he’s, when you’re in pain, you can’t be bothered; you just think, do you know what, leave me alone. And I think for my mum, it’s like oh, [quieter voice] ‘I didn’t quite understand that’.”
Lead researcher Dr Gemma Clarke, Marie Curie Senior Research Fellow in the School of Medicine, said: “Healthcare professionals must ensure that people living with painful and serious conditions can have access to effective pain medication.
“This study demonstrates why investment in medical interpreters and translated information about illness and pain medication would be beneficial to many people across Bradford and Leeds.
“Anyone working with patients and carers affected by terminal illness must work hard to remove any barriers that exist, whether they be cultural, language-based or otherwise.”
Ruby Bhatti OBE, Independent Patient and Public Involvement Representative for Bradford, said: “Our findings have given us a greater understanding of the barriers we need to overcome to support more patients and carers from this diverse community.
“Bringing together academics, healthcare professionals and patient groups has put us in a better position to address these barriers, bringing about positive change and ensuring the support for carers and patients will be there regardless of background, education or social factors.
“Collaboration such as this can help to ensure that patients and their carers are truly at the centre of the support they need and we hope our findings can inspire other groups to take this approach.”
The findings also suggested that a greater awareness of low and medium English language proficiency is required across healthcare services, even for those with conversational English. Improvements in written materials on pain medication could also help improve pain management and adherence to medication. Working with communities to produce accessible and clear information on pain medication could relieve some patients’ anxieties about pain medication and improve understanding for those with lower health literacy.