Logo Gwerddon
Y Coleg Cymraeg Cenedlaethol
Chwilio
Cymraeg / English

Effaith iaith ar adsefydlu corfforol: Astudiaeth o ddylanwad iaith ar effeithiolrwydd therapi mewn cymuned Gymraeg

Back
Effaith iaith ar adsefydlu corfforol: Astudiaeth o ddylanwad iaith ar effeithiolrwydd therapi mewn cymuned Gymraeg
(The effect of language on physical rehabilitation: A study of the influence of language on the effectiveness of therapy in a Welsh-speaking community)

Huw Dylan Owen and Steve Morris

In an area of Wales where 50% of the population is bilingual one community physical rehabilitation service had no Welsh-speaking therapists. An internationally standardised outcome measure was used to assess the effectiveness of rehabilitation in this area. This revealed that Welsh speaking patients had significantly poorer results from rehabilitation than non-Welsh speakers (p<0.05), while there was no significant difference where the therapists were bilingual. The results suggest that therapists’ ability to speak patients’ first language impacts on therapy effectiveness. The percentage of individuals who could speak Welsh referred (by health or social care professionals) was compared with the percentage of Welsh speakers which would have been anticipated given the percentage in the general population. Significantly fewer Welsh speakers were referred to the rehabilitation service than the anticipated percentage (p<0.001). Whilst this suggests professionals’ inability to speak Welsh may impact negatively on access to services for Welsh speakers, there may be other multifactorial psycho-social reasons to consider.

1,423 Kb

Reference:

 
  	Huw Dylan Owen and Steve Morris, 'Effaith iaith ar adsefydlu corfforol: Astudiaeth o ddylanwad iaith ar effeithiolrwydd therapi mewn cymuned Gymraeg', Gwerddon, 10/11, August 2012, 83-112.

Keywords

 
    Welsh, bilingual, language, therapy, healthcare, social care.

Bibliography:

 
  	
    

  1. Arad Consulting (2008), Evaluation of the Welsh Language in Healthcare Awards (Caerdydd: Arad Consulting Ltd).
    2. 

  2. Baker, C. (2001), Foundations of bilingual education and bilingualism (3ydd argraffiad, Clevedon: Multilingual Matters).
    3. 

  3. Baxter, C. (1997), ‘The case for bilingual workers within the maternity services’, British Journal of Midwifery, 5, 568-72.
    4. 

  4. Beaufort Research (2008), Arolwg omnibws o siaradwyr Cymraeg (Caerdydd: Beaufort Research).
    5. 

  5. Black, T. M., Soltis, T., a Bartlett, C. (1999), ‘Using the Functional Independence Measure instrument to predict stroke rehabilitation outcomes’, Rehabilitation Nursing, 24 (3), 109-14, 121.
    6. 

  6. Brock, K. A., Goldie, P. A., a Greenwood, K. M. (2002), ‘Evaluating the effectiveness of stroke rehabilitation: Choosing a discriminative measure’, Archives of Physical Medicine and Rehabilitation, 83 (1), 92-9.
    7. 

  7. Brosseau, L. a Wolfson, C. (1994), ‘The inter-rater reliability and construct validity of the Functional Independence Measure for multiple sclerosis subjects’, Clinical Rehabilitation, 8, 107-15.
    8. 

  8. Bwrdd yr Iaith Gymraeg (2008), Arolygon defnydd iaith 2004-06 (Caerdydd: Bwrdd yr Iaith Gymraeg).
    9. 

  9. Carrasquillo, O., Orav, E. J., Brennan, T. A., et al. (1999), ‘Impact of language barriers on patient satisfaction in an emergency department’, Journal of General Inernal Medicine, 14, 82-7.
    10. 

  10. Cavanagh, S. J., Hogan, K., Gordon,V., et al. (2000), ‘Stroke-specific FIM models in an urban population’, Journal of Neurological Nursing, 32, 17-21.
    11. 

  11. Chau, N., Dalter, S., Andre, J. M., et al. (1994), ‘Inter-rater agreement of two functional independence scales: The Functional Independence Measure (FIM) and a subjective uniform continuous scale’, Disability Rehabilitation, 16 (2), 63-71.
    12. 

  12. Cifu, D., Keyser-Marcus, L., Lopez, E., et al. (1997), ‘Acute predictors of successful return to work 1 year after traumatic brain injury: A multicenter analysis’, Archives of Physical Medicine and Rehabilitation, 78 (2), 125-31.
    13. 

  13. Cioffi, R. (2003), ‘Communicating with culturally and linguistically diverse patients in an acute care setting: nurses’ experiences’, International Journal of Nursing Studies, 40 (3), 299-306.
    14. 

  14. Clark, M. M. (1983), ‘Cultural context of medical practice’, Western Journal of Medicine, 139, 806-10.
    15. 

  15. Corrigan, J. D., Smith-Knapp, K. a Granger, C. V. (1997), ‘Validity of the functional independence measure for persons with traumatic brain injury’, Archive of Physical Medicine and Rehabilitation, 78 (8), 828-34.
    16. 

  16. Cylchlythyr Iechyd Cymru (2008), Cryfhau’r ddarpariaeth Gymraeg o fewn gwasanaethau’r GIG yng Nghymru (Caerdydd: Llywodraeth Cynulliad Cymru, WHC (2008) 002).
    17. 

  17. Cynulliad Cenedlaethol Cymru (2003), Ystadegau Cenedlaethol (Caerdydd: Cynulliad Cenedlaethol Cymru).
    18. 

  18. David, R. A., a Rhee, M. (1998), ‘ The Impact of Language as a Barrier to Effective Health Care in an Underserved Urban Hispanic Community’, Mount Sinai Journal of Medicine, 65 (5-6), 393-7.
    19. 

  19. Davies, D. R. (1999), ‘Welsh Psyche: implications for psychological services’, International Review of Psychiatry, 11, 197-211.
    20. 

  20. Davies, E. (1999), The Language of a Caring Service. Guidance on providing a sensitive bilingual service, focusing on the health, social care and justice sectors (Caerdydd: Bwrdd yr Iaith Gymraeg).
    21. 

  21. Davies, E. (2010), Different Words Different Worlds, The concept of language choice in social work and social care (Caerdydd: Cyngor Gofal Cymru).
    22. 

  22. Davies, K. (1997), ‘Gofal Iechyd yn yr Ysbyty’, yn Roberts, G. (gol.), Deall ein Gilydd (Llangefni: Y Gymdeithas Gymraeg ar gyfer Nyrsys, Bydwragedd ac Ymwelwyr Iechyd), tt. 19-20.
    23. 

  23. Daving, Y., Andren, E., Nordholm, L., et al. (2001), ‘Reliability of an interview approach to the Functional Independence Measure’, Clinical Rehabilitation, 15 (3), 301-10.
    24. 

  24. Dodds, T. A., Martin, D. P., Stolov, W. C., et al. (1993), ‘A validation of the functional independence measurement and its performance among rehabilitation inpatients’, Archive of Physical Medicine and Rehabilitation, 74 (5), 531-6.
    25. 

  25. Dromerick, A. W., Edwards, D. F. a Diringer, M. N. (2003), ‘Sensitivity to changes in disability after stroke: A comparison of four scales useful in clinical trials’, Journal of Rehabilitation Research and Development, 40, 1-8.
    26. 

  26. Dunckley, M., Hughes, R., Addington-Hall, J., et al. (2003), ‘Language translation of outcome measurement tools: views of health professionals’, International Journal of Palliative Nursing, 9 (2), 49-55.
    27. 

  27. Gerrish, K. (2001), ‘The nature and effect of communication difficulties arising from interactions between district nurses and South Asian patients and their carers’, Journal of Advanced Nursing, 33 (5), 566-74.
    28. 

  28. Granger, C.V., Hamilton, B.B., Keith, R.A., et al. (1986), ‘Advance in functional assessment for medical rehabilitation’, Topics in Geriatric Rehabilitation, 1, 59-74.
    29. 

  29. Granger, C. V., Cotter, A. C., Hamilton, B. B., et al. (1990), ‘Functional assessment scales: A study of persons with multiple sclerosis’, Archive of Physical Medicine and Rehabilitation, 71, 870-5.
    30. 

  30. Granger, C. V., Cotter, A. C., Hamilton, B. B., et al. (1993), ‘Functional assessment scales: A study of persons with stroke’, Archive of Physical Medicine and Rehabilitation, 74 (2), 133-8.
    31. 

  31. Gurka, J. A., Felmingham, K., Baguley, I. J., et al. (1999), ‘Utility of the functional assessment measure after discharge from inpatient rehabilitation’, Journal of Head Trauma Rehabilitation, 14 (3), 247-56.
    32. 

  32. Haigh, R., Tennant, A., Biering-Su, F., et al. (2001), ‘The use of outcome measures in physical medicine and rehabilitation within Europe’, Journal of Rehabilitation Medicine, 33, 273-8.
    33. 

  33. Hall, K. M., Hamilton, B., Gordon, W. A., et al. (1993), ‘Characteristics and comparisons of functional assessment indices: Disability Rating Scale, Functional Independence Measure and Functional Assessment Measure’, Journal of Head Trauma Rehabilitation, 8 (2), 60-74.
    34. 

  34. Hamilton, B. B., Laughlin, J. A., Fiedler, R. C., et al. (1994), ‘Inter-rater reliability of the 7-level functional independence measure (FIM), Scandinavian Journal of Rehabilitation, 26, 115-9.
    35. 

  35. Hall, K. M., Mann, N., High, W., et al. (1996), ‘Functional measures after traumatic brain injury: Ceiling effects of FIM, FIM+FAM, DRS and CIQ’, Journal of Head Trauma Rehabilitation, 11 (5), 27-39.
    36. 

  36. Heinemann, A. W., Linacre, J. M., Wright, B. D., et al. (1994), ‘Prediction of rehabilitation outcomes with disability measures’, Archives of Physical Medicine and Rehabilitation, 75 (2), 133-43.
    37. 

  37. Hobart, J. C., Lamping, D. L., Freeman, J. A., et al. (2001), ‘Which disability scale for neurologic rehabilitation?’, Neurology, 57, 639-44.
    38. 

  38. Hobart, J. C. a Thompson, A. J. (2001), ‘The five item Barthel index’, Journal of Neurology, Neurosurgery and Psychiatry, 71, 225-30.
    39. 

  39. Hsueh, I-P., Lin, J-H., Jeng, J-S., et al. (2002), ‘Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel index, and 10 item Barthel index in patients with stroke’, Journal of Neurology, Neurosurgery and Psychiatry, 73, 188-90.
    40. 

  40. Hutt, J. (2004), ‘Casglu Momentwm’, Cynhadledd y Gymraeg mewn Gofal Iechyd – Adroddiad y Gynhadledd (Caerdydd: Uned Iaith Gymraeg GIG Cymru).
    41. 

  41. Inouye, M., Kishi, K., Ikeda, Y., et al. (2000), ‘Prediction of functional outcome after stroke rehabilitation’, American Journal of Physical Medicine and Rehabilitation, 79 (6), 513- 18.
    42. 

  42. Irvine, F. E., Roberts, G. W., Jones, P., et al. (2006), ‘Communicative sensitivity in the bilingual healthcare setting: A qualitative study of language awareness’, Journal of Advanced Nursing, 53 (4), 422-34.
    43. 

  43. Irvine, F. E., Roberts, G. W., Tranter, S., et al. (2008), ‘ Using the critical incident technique to explore student nurses’ perceptions of language awareness’, Nurse Education Today, 28, 39-47.
    44. 

  44. Jackson, C. (1998), ‘Medical interpretation: an essential service for non-English-speaking immigrants’, yn Loue, S. (gol.), Handbook of Immigrant Health (New York: Plenum), tt. 61- 79.
    45. 

  45. Jacobs, E. A., Agger-Gupta, N., Chen, A.H., et al. (2003), Language barriers in health care settings (California: The California Endowment).
    46. 

  46. Jaworski, D. M., Kult, T. a Boynton, P. R. (1994), ‘The Functional Independence Measure: A pilot study comparison of observed and reported ratings’, Rehabilitation Nursing, 3, 141-7.
    47. 

  47. Keith, R. A., Granger, C. V., Hamilton, B. B., et al. (1987), ‘The functional independence measure: A new tool for rehabilitation’, Advances in Clinical Rehabilitation, 1, 6-18.
    48. 

  48. Kennedy, R. (2003), ‘Yr Iaith Gymraeg mewn Gofal Iechyd: Safbwynt y Cynulliad’, yn Adroddiad Cynhadledd y Gymraeg Mewn Gofal Iechyd (Caerdydd: Uned Iaith Gymraeg GIG Cymru).
    49. 

  49. Kidd, D., Stewart, G., Baldry, J., et al. (1995), ‘The Functional Independence Measure: A comparative validity and reliability study’, Disability Rehabilitation, 17 (1), 10-14.
    50. 

  50. Kwon, S., Hartzema, A. G., Duncan, P. W., et al. (2004), ‘Relationship among the Barthel Index, the Functional Independence Measure, and the Modified Rankin Scale’, Stroke, 35, 918-23.
    51. 

  51. Linacre, J. M., Heinemann, A. W., Wright, B. D., et al. (1994), ‘The structure and stability of the Functional Independence Measure’, Archives of Physical Medicine and Rehabilitation, 75 (2), 127-32.
    52. 

  52. Llais (2006), Language appropriate practice in health and social care (Caerdydd: Llywodraeth Cynulliad Cymru).
    53. 

  53. Lawton, G., Lundgren-Nilsson, A., Biering-Sorensen, F., et al. (2006), ‘Cross-cultural validity of FIM in spinal cord injury’, Spinal Cord, 44 (12), 746-52.
    54. 

  54. Lundgren-Nilsson A., Grimby G., Ring H., et al. (2005), ‘Cross-cultural validity of functional independence measure items in stroke: a study using Rasch analysis’, Journal of Rehabilitation Medicine, 37 (1), 23-31.
    55. 

  55. Misell, A. (2000), Welsh in the Health Service: The Scope, Nature and Adequacy of Welsh Language Provision in the National Health Service in Wales (Caerdydd: Cyngor Defnyddwyr Cymru).
    56. 

  56. Mokler, P. J., Sandstrom, R., Griffin, M., et al. (2000), ‘Predicting discharge destination for patients with severe motor stroke: Important Functional Tasks’, Neurorehabilitation and Neural Repair, 14 (3), 181-5.
    57. 

  57. Morris, D. (1989), ‘A study of language contact and social networks in Ynys Môn’, Contemporary Wales, 3, 99-117
    58. 

  58. Murphy, K., a Macleod, C. (1993), ‘Nurses’ experiences of caring for ethnic-minority clients’, Journal of Advanced Nursing, 18, 442-50.
    59. 

  59. Nelson, A., Powell-Cope, G., Palacios, P., et al. (2007), ‘Nurse Staffing and Patient Outcomes in Inpatient Rehabilitation Settings’, Rehabilitation Nursing, 32 (5), 179-202.
    60. 

  60. Oczkowski, W. J., Barreca, S. (1993), ‘The functional independence measure: Its use to identify rehabilitation needs in stroke survivors’, Archives of Physical Medicine and Rehabilitation, 74 (12), 1291-4.
    61. 

  61. Ottenbacher, K. J., Hsu, Y., Granger, C. V., et al. (1996), ‘The reliability of the functional independence measure: A quantitative review’, Archives of Physical Medicine and Rehabilitation, 77 (12), 1226-32.
    62. 

  62. Ottenbacher, K. J., Mann, W. C., Granger, C. V., et al. (1994), ‘Inter-rater agreement and stability of functional assessment in the community-based elderly’, Archives of Physical Medicine and Rehabilitation, 75 (12), 1297-1301.
    63. 

  63. Owen, A. (1997), ‘Gofal Iechyd yn y Gymuned “B”’, yn Roberts, G. (gol.), Deall ein Gilydd (Llangefni: Y Gymdeithas Gymraeg ar gyfer Nyrsys, Bydwragedd ac Ymwelwyr Iechyd), tt. 24-5.
    64. 

  64. Pitkin Derose, K., a Baker, D. W. (2000), ‘Limited English proficiency and Latinos’ use of physician services’, Medical Care Research and Review, 57 (1), 76-91.
    65. 

  65. Pollak, N., Rheault, W. a Stoecker, J. L. (1996), ‘Reliability and validity of the FIM for persons aged 80 years and above from a multilevel continuing care retirement community’, Archives of Physical Medicine and Rehabilitation, 77 (10), 1056-61.
    66. 

  66. Povey, M. (1997), ‘Addysg a Hyfforddiant’, yn Roberts, G. (gol.), Deall ein Gilydd (Llangefni: Y Gymdeithas Gymraeg ar gyfer Nyrsys, Bydwragedd ac Ymwelwyr Iechyd), tt. 26-7.
    67. 

  67. Pugh, R., ac Williams, D. (2006), ‘Language policy and provision in social services organizations’, The British Journal of Social Work, 36 (7), 1227-44.
    68. 

  68. Ring, H., Feder, M., Schwartz, J., et al. (1997), ‘Functional measures of first-stroke rehabilitation inpatients: Usefulness of the Functional Independence Measure total score with a clinical rationale’, Archives of Physical Medicine and Rehabilitation, 78 (6), 630- 5.
    69. 

  69. Roberts, G. W., a Paden, L. (2000), ‘Identifying the factors influencing minority language use in health care education settings: A European perspective), Journal of Advanced Nursing, 32 (1), 75-83.
    70. 

  70. Roberts, G., Irvine, F., Jones, P., et al. (2004), Adroddiad am astudiaeth o ymwybyddiaeth o’r Gymraeg yn y ddarpariaeth gofal iechyd yng Nghymru (Caerdydd: Llywodraeth Cynulliad Cymru).
    71. 

  71. Roberts, G., Irvine, F., Richardson, J., et al. (2005), Adroddiad am astudiaeth rychwantu i’r ymwybyddiaeth o iaith mewn iechyd a gofal cymdeithasol (Bangor: Prifysgol Cymru Bangor).
    72. 

  72. Roberts, G. W. (2007), Review of health measurement scales for the Welsh language (Bangor: Llais).
    73. 

  73. Roberts, G. W., Irvine, E. I., Jones, P. R., et al. (2007), ‘Language awareness in the bilingual setting: A national survey’, International Journal of Nursing Studies, 44, 1177-86.
    74. 

  74. Roberts, G. W., Irvine, F. E., Tranter, S., et al. (2010), ‘Identifying priorities for establishing bilingual provision in nurse education: A scoping study’, Nurse Education Today, 30, 623-30.
    75. 

  75. Robinson, M. a Phillips, P. (2003), ‘An investigation into the perceptions of primary care practitioners of their education and development needs for communicating with patients who may not be fluent in English’, Nurse Education Today, 23, 286-98.
    76. 

  76. Rowley, E. (1997), ‘Gofal Iechyd yn y Gymuned “A”’. yn Roberts, G. (gol.), Deall ein Gilydd (Llangefni: Y Gymdeithas Gymraeg ar gyfer Nyrsys, Bydwragedd ac Ymwelwyr Iechyd), tt. 21-3.
    77. 

  77. Segal, M. E., Ditunno, J. F., a Staas, W. E. (1993), ‘Interinstitutional agreement of individual functional independence measure (FIM) items measured at two sites on one sample of SCI patients’, Paraplegia, 31 (10), 622-31.
    78. 

  78. Segal, M. E. a Schall, R. R. (1994), ‘Determining functional/health status and its relation to disability in stroke survivors’, Stroke, 25, 2391-7.
    79. 

  79. Sharrack, B., Hughes, R. A., Soudain, S., et al. (1999), ‘The psychometric properties of clinical rating scales used in multiple sclerosis’, Brain, 122 (1), tt. 141-59.
    80. 

  80. Singh, A., Black, S. E., Herrmann, N., et al. (2000), ‘Functional and neuranatomic correlations in poststroke depression’, Stroke, 31, 637-44.
    81. 

  81. Spencer, L. H., Roberts, G., Irvine, F., et al. (2007), ‘Using cluster analysis to explore survey data’, Nurse Researcher, 15 (1), 37-54.
    82. 

  82. Stineman, M. G., Fiedler, R. C., Granger, C. V., et al. (1998), ‘Functional task benchmarks for stroke rehabilitation’, Archives of Physical Medicine and Rehabilitation, 79, 497-504.
    83. 

  83. Timbeck, R. J. a Spaulding, S. J. (2003), ‘Ability of the Functional Independence Measure to predict rehabilitation outcomes after stroke: A review of the literature’, Physical & Occupational Therapy in Geriatrics, 22 (1), 63-76.
    84. 

  84. Timmins, C. (2002), ‘The impact of language barriers on the health care of Latinos in the US: a review of the literature and guidelines for practice’, Journal of Midwifery and Women’s Health, 47 (3), 80-96.
    85. 

  85. Tranter, S., Irvine, F., Roberts, G., et al. (2010), The role of midwives and health visitors in promoting intergenerational language maintenance in the bilingual setting: perceptions of parents and health professionals’, Journal of Clinical Nursing, 20 (1-2), 204-13.
    86. 

  86. Turner-Stokes, L., Nyein, K., Tuner-Stokes, T., et al. (1999), ‘The UK FIM+FAM: development and evaluation Functional Assessment Measure’, Clinical Rehabilitation, 13 (4), 277-87.
    87. 

  87. Turner-Stokes, L. (2000), Measurement of Outcome in Rehabilitation (Llundain: The British Society of Rehabilitation Medicine).
    88. 

  88. Van Baalen, B., Odding, E., van Woensel, M. P., et al. (2006), ‘Reliability and sensitivity to change of measurement instruments used in a traumatic brain injury population’, Clinical Rehabilitation, 20 (8), 686-700.
    89. 

  89. van der Putten, J. J., Hobart, J. C., Freeman, J. A., et al. (1999), ‘Measuring change in disability after inpatient rehabilitation: Comparison of the responsiveness of the Barthel Index and the Functional Independence Measure’, Journal of Neurology, Neurosurgery and Psychiatry, 66, 480-4.
    90. 

  90. Wallace, D., Duncan, P. W., a Lai, S. M. (2002), ‘Comparison of the responsiveness of the Barthel Index and the motor component of the Functional Independence Measure in stroke: the impact of using different methods for measuring responsiveness’, Journal of Clinical Epidemiology, 55, 922-8.
    91. 

  91. Ween, J. E., Mernoff, S. T., ac Alexander, M. P. (2000), ‘Recovery rates after stroke and their impact on outcome prediction’, Neurorehabilitation and Neural Repair, 14 (3), 229-35.
    92. 

  92. Williams, H. (2002), ‘Sicrhau Dewis Iaith Go Iawn’, yn Siarad yr Anweledig (Caerdydd: GIG Cymru), tt.18-23.
    93. 

  93. Wright, J. (2000), ‘The Functional Assessment Measure’, The Center for Outcome Measurement in Brain Injury, www.tbims.org/combi/FAM [Cyrchwyd 3 Chwefror 2009].
    94.