Répertoire des professionnels francophones de la santé : mise à jour novembre 2010
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Providing quality care to the official language community in minority situation in Saskatchewan
Hortense E Nsoh Tabien, Roger Gauthier, Anne Leis
Characteristics of the Fransaskois community and the need for health services in French
The face of residents in Saskatchewan is changing not only in terms of numbers, but also in terms of linguistic and cultural diversity. Almost 20 000 individuals speak French at home in Saskatchewan but the population is scattered around the province and consists of a number of rural dwellings and small villages such as Willow Bunch or Bellevue in addition to the main urban centers. Francophone communities include a higher proportion of seniors compared to what is found in the majority population. Increasingly, newcomers, immigrants and refugees whose first official language is French are making Saskatchewan their new home. For example, in Saskatoon alone, over 120 families have recently arrived from a number of Francophone African countries and the Conseil des écoles fransaskoise (provincial Francophone school division) reports that at least 11% of its current student body are new immigrants with a variety of mother tongues and the sole knowledge of French. Moreover children and seniors constitute a particularly vulnerable component of the population. Within this context, it is clear that the provision of quality health services in Saskatchewan needs to address the demographic, linguistic and socio-cultural characteristics of the Fransaskois population.
Mounting evidence suggests that French-speaking minorities in Canada may be in poorer health condition than the English-speaking majority population. According to the second report on the health of Francophones in Ontario, a higher percentage of this minority felt they had inadequate access to services in their language, were more likely to suffer from a chronic condition and physically limited in their daily living activities. Distress level was found to be higher among them compared to the Anglophone majority with a higher consumption of medication and tobacco. In the 2007 federal health minister's advisory committee report on the health of Francophone communities in minority situation in Canada, access to health services in their official language was still considered insufficient despite the progress made. For the bilingual francophone, language barrier is often not immediately evident and can be underestimated according to a position paper written by the PEI French Language office. It is commonly known that in situations of vulnerability or emergencies, most people will use their first language (or be more comfortable in their first language). Therefore in instances of distress, worries or anxiety, even those with high proficiency in English may revert to their first language and have trouble functioning in their second or third language.
Linguistic and cultural barriers impeding access to health services and utilization
Compelling evidence demonstrate that language barriers have an adverse effect on access to health services, , comprehension and adherence to treatments, quality of care as well as patient and provider satisfaction. Poor communication is known to increase the use of alternative and/or unnecessary treatment , and it has also been linked with inadequate pain relief , and reduced patient satisfaction. For example, a study on mortality trends in Canada from 1971 to 1996 showed that older, non English speakers, less educated women were less likely to use cervical cancer screening programs and therefore were at higher risk of morbidity and mortality. Minority language was also found to be an independent correlate of patient-reported drug complications. According to Bowen ,19 , language barriers can impact health service utilization by either decreasing the utilization of preventive and screening services, which later may translate into a later presentation and more costly services due to the seriousness of the condition. On the other hand, when faced with a language barrier, an overcautious health care provider may prescribe additional tests and refer to specialist care in situations when this may not be required. In either case, the health system efficiency is decreased and the related costs of linguistic barriers to the system are huge.
Addressing socio-linguistic and ethnic barriers for more effective patient-provider communication
Quality and safety are critical issues for health care systems around the world and these indicators have been an integral part of efforts to improve health care delivery in Canada and to renew accreditation successfully. Many studies and reviews have shown that the quality of health care services is closely tied to the ability of health care providers to assist, advice, direct and educate health services users. , The ability to understand and be understood is an essential component of effective relationships between health care providers and users. These skills become particularly critical when the health and well-being of patients require changing behaviours, developing new habits or following treatment and drug regimens.
Effective communication with patients is intimately related to the safety and quality of care. When clinicians and their patients speak different languages, patient care and clinical outcomes are bound to suffer. Indeed, if a clinician and a patient cannot understand each other, it is less likely that the patient will be able to effectively communicate his or her complaints or that the clinician will be able to effectively communicate a diagnosis and recommendations. , Not only are these patients at risk of misunderstanding of and low compliance to care plans, they also tend to have worse access to care, receive poorer quality care and consequently, they are less satisfied with their physicians and the overall care they receive. Studies also show that language-concordant provider-patient settings lead to higher rates of patient satisfaction, better well-being and functioning, better medication adherence, improved patient visit recall, and better interaction between patient and physician. , , , Hence, health care access in one's own language leads to better communication, patient empowerment, and better outcomes translating into better quality of service.
Moreover, access to quality and safe health services is much more than merely showing respect for the culture and the language of the person using the service. It is germane to effective communication and to the alliance that the health care provider can forge with his or her patient. For Ibrahim and colleagues, “issues of access to care include a complex mix of cultural factors and individual preferences of patients, characteristics, and practices of healthcare professionals (such as racism, stereotyping, bias, discrimination, and lack of cultural safety), and the system of delivery of health care (such as composition of the workforce, location of facilities, costs of access, and involvement of different ethnic groups in shaping health policy and allocation of resources)” Therefore, in order to minimize and eliminate these barriers, it seems imperative to build an effective health care system that takes into account the diversity of needs and involves all key players in the system. Finally, as you already know, this imperative has been recently emphasized through the first recommendation of the document entitled the Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education, whereby “both individually and collectively, physicians and faculties must respond to the diverse needs of individuals and communities throughout Canada, as well as meet international responsibilities to the global community.”(p.16)
Building partnerships for a better access to health services in French in Saskatchewan
The Government of Saskatchewan recognizes that linguistic duality is a fundamental characteristic of Canada and that the Saskatchewan's Francophone community is an important component of that linguistic duality. In 2003, the provincial government adopted a French-language Services Policy under which to develop French-language services in priority areas in close consultation with the Francophone community in order to support its vitality. This policy applies to the provincial government, its ministries, crown corporations and other agencies. In addition, a website Bonjour Saskatchewan includes a wide range of information and a number of useful links in French at www.bonjour.gov.sk.ca
The réseau santé en français (RSFS) or Saskatchewan network for health services in French
The RSFS is the Saskatchewan provincial network for health services in French, affiliated with the Société santé en français (SSF), which are both funded by Health Canada and the Public Health Agency of Canada. Under this national umbrella, 17 affiliated provincial and territorial networks share the common mission of working synergistically with provincial governments and authorities towards providing better access to quality French-language health programs and services in order to improve the health status of Francophone and Acadian minority communities.
The RSFS networks with 5 key partner groups; policy makers, academic institutions, health managers, communities, and health practitioners, to foster access to quality French language services in the areas of health and social services. The RSFS is partnering in activities such as awareness raising, networking, health promotion in the government's priority areas, identification of human resources who speak French and it is assisting with the planning of French-language services, and various support services such as language training and translation.
For example, the RSFS has compiled a directory of French speaking health care professionals with the latest update completed in November 2010. This directory is also on line at the following link: http://www.rsfs.ca/opFichier/_4aR0QKY4uLJ4_12377.pdf
Moreover, since 2005, under the social accountability committee of the College of Medicine at the University of Saskatchewan, the health training in French (HTiF) sub-committee has been networking medical students and residents who speak some French in order to sensitize them to the need of the Fransaskois population and strengthen their French language skills. Each year, we also organize medical terminology in French workshops in Regina and Saskatoon and are able to provide CME credits to your members who attend this day long training. Recently on March 17 and 18, 2011, two medical terminology workshops were facilitated, by Dr. Jean Roy, assistant dean and director of the Francophone Office at the Faculty of Medicine in Ottawa. Twenty specialists, family physicians, medical students and other health professionals enjoyed this problem-based learning event in a supportive and interprofessional setting.
How can your organization help? As a provider, how can you help?
1. Identification of linguistic skills in your membership:
As a start, if regulatory bodies could capture information on the linguistic skills of their membership, this would help identify the existing capacity to provide services in French and also assist in the focus for recruitment and training efforts.
The RSFS is available to help your organization generate additional practical approaches. Some suggestions include the following:
o Encourage your French-speaking colleagues to self-identify on their annual licensure renewal form or other registration mechanism.
o Surveys (with email or letter)
o Use of questionnaire linked to your website
o Consider hiring at least one staff member who is fluent in French.
o Spread the word.
o Add a link to the RSFS on your website.
2. Making health services in French visible and actively offering French services was found to be very effective in better responding to the needs of the minority population and increasing satisfaction. The suggestions below provide some ideas for your consideration:
o Find out which health providers are bilingual for referral purposes.
o Encourage use of active offer (such as a pin, notices on front door or desk).
o Encourage to ask francophone clients if they would feel more comfortable receiving services or handouts in French
3. Linguistic training and cultural adaptation:
o Encourage health regions and other agencies to authorize continuing medical education in French for interested professionals and staff
o Provide materials and professional development activities for your bilingual professionals which would contribute to improving the quality of services In French.
Please get in touch with our office. We look forward to hearing from you to see how we can be of further assistance.
References
Baker DW, Parker RM, Williams MV, Clark WS, Nurss J. The relationship of patient reading ability to self-reported health and use of health services. Am. J Public Health 1997; 87, 1027-1030.
Bouchard L, Gaboury I, Chomienne MH, Gilbert A, Dubois L. Health in Language Minority Situation. Health Care Policy. 2009;4(4).
Picard L, Allaire G. Deuxième Rapport sur la santé des francophones de l'Ontario. Programme de recherche, d'éducation et de développement en santé publique Institut franco-ontarien et Université Laurentienne (2005).
The Consultative Committee for French-Speaking Minority Communities. Towards a New Leadership for the Improvement of Health Services in French, Report to the Federal Minister of Health, February 2007
The Impact of Communication Challenges on the Delivery of Quality Health Care to
Minority Language Clients & Communities. A Position Paper submitted by the PEI French Language Health Services Network. In collaboration with the Société Santé en français, March 2007
Gany F, Ngo-Metzger Q. Language Barriers in Health Care: Special Supplement to the Journal of General Internal Medicine, Journal of General Internal Medicine November 2007; 22(Suppl. 2)
Schyve PM. Language Differences as a Barrier to Quality and Safety in Health Care: The Joint Commission Perspective. J Gen Intern Med 2007; 22(Suppl 2):360–1
Betancourt, J. R., Carrillo, J. E., & Green, A. R. (1999). Hypertension in multicultural and minority populations: linking communication to compliance. Curr. Hypertens. Rep., 1, 482-488.
Smedley BD, Stith AY, Nelson AR (eds) Committee on understanding and eliminating racial and ethnic disparities in health care. Unequal treatment: confronting racial and ethnic disparities in health care. Institute of Medicine The national academic press, 2003.
Bernard A, Whitaker M, Ray M, Rockich A, Barton-Baxter M, Barnes SL, Boulanger B, Tsuei B, Kearney P. Impact of Language Barrier on Acute Care Medical Professionals Is Dependent Upon Role J Prof Nurs 2006; 22:355– 8.
Tasaki, K. , Maskarinec, G. , Shumay, D. M. , Tatsumura, Y. and Kakai, H. Communication between physicians and cancer patients about complementary and alternative medicine: Exploring patients' perspectives. Psycho-Oncology 2002 11:3, 212-220.
Bylund, Carma L. , D'Agostino, Thomas A. , Ho, Evelyn Y. and Chewning, Betty A. Improving Clinical Communication and Promoting Health through Concordance-Based Patient Education. Communication Education 2010 July; 59:3, 294 - 311.
Anderson KO, Richman SP, Hurley J, Palos G, Valero V, Mendoza TR, Gning I, Cleeland CS. Cancer pain management among underserved minority outpatients: perceived needs and barriers to optimal control. Cancer. 2002 Apr 15;94(8):2295-304.
J O'Donnell, S Maurice, and T Beattie. Emergency analgesia in the paediatric population. Part III Non-pharmacological measures of pain relief and anxiolysis. Emerg Med J. 2002 May; 19(3): 195–197.
Carrasquillo O, Orav EJ, Brennan TA, Burstin HR. Impact of language barriers on patient satisfaction in an emergency department. J Gen Intern Med. 1999 Feb;14(2):82-7.
Wilkins R, Berthelot J-M, Edward NG. Trends in mortality by neighbourhood income in urban Canada from 1971 to 1996. Supplement to Health Reports, 2002 (Statistics Canada, Catalogue 82-003);13: 45-72
Gandhi TK, Burstin HR, Cook EF, Puopolo AL, Haas JS, Brennan TA, Bates DW. Drug Complications in Outpatients. J Gen Intern Med. 2000 March; 15(3): 149–154.
Bowen S & WRHA Language Barriers Committee. Marginalized evidence: Effective knowledge translation strategies for low awareness issues. Healthcare Management Forum 2006; 19 (3), 38-44
Bowen S & WRHA Language Barriers Committee. Language barriers within the Winnipeg regional health authority: Evidence and implications. September, 2004.
Yeo SA. Language barriers and access to care. Chap 4 pp 59-73, Annual Review Of Nursing Research.2004.
Bowen S. Language Barriers in Access to Health Care. Health Systems. Division, Health Policy and Communications Branch, Health Canada.
Jacobs E, Chen AHM, Karliner LS, Agger-Gupta N, Mutha S. The need for more research on language barriers in health care: A proposed research agenda.” The Milbank Quarterly 2006; 84 (1): 111-133
Jessica Gregg and Somnath Saha. Communicative Competence: A Framework for Understanding Language Barriers in Health Care. Gen Intern Med. 2007 November; 22(Suppl 2): 368–370.
Somnath Saha and Alicia Fernandez. Language Barriers in Health Care. J Gen Intern Med. 2007 November; 22 (Suppl 2): 281–282.
González HM, Vega WA, Tarraf W. Health Care Quality Perceptions among Foreign-Born Latinos and the Importance of Speaking the Same Language. Journal of the American Board of Family Medicine 2010; 23 (6): 745-752.
Freeman, G.K., H. Rai, J.J. Walker, J.G.R. Howie, D.J. Heaney, and M. Maxwell. 2002. Non-English Speakers Consulting with the GP in Their Own Language: A Cross-Sectional Survey. British Journal of General Practice 52: 36–38.
Lee, L.J., H.A. Batal, J.H. Maselli, and J.S. Kutner. 2002. Effect of Spanish Interpretation Method on Patient Satisfaction in an Urban Walk-In Clinic. Journal of General Internal Medicine 17(8):641–45.
Perez-Stable, E.J., A. Napoles-Springer, and J.M. Miramontes. 1997. The Effects of Ethnicity and Language on Medical Outcomes of Patients with Hypertension or Diabetes. Medical Care 35: 1212–19.
Ibrahim SA, Thomas SB, Fine MJ. Achieving health equity: an incremental journey. Am J Pub Health 2003;93:1619-21.
The Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education, January 2010. retrieved on April 7, 2011 at http://www.afmc.ca/fmec/pdf/collective_vision.pdf
Établissements, associations, réseaux de santé francophones:
Réseautage communautaire
Clinique communautaire francophone: projet en cours d'élaboration à Saskatoon
Centres d'appui à la famille et à l'enfant:
. CAFE la Passerelle à Saskatoon 306-65
. CAFE la Ritournelle à Régina 306-522-3240
www.apfcafe.caFoyers d'accueil pour Ainés :
. Manoir Marchildon à North Battleford : (306) 445 5153
Adresse 1301-112ème rue S9A 2L6
. Foyer Jésus Marie à Bellevue (St-Isidore): (306) 423 5341
Adresse C.P 64 S0K 3Y0
. Foyer D'Youville/Hôpital Saint-Joseph (Gravelbourg) : (306) 648-3185
www.gravelbourg.ca/html/f/residents/healthcare.html . Château Providence à Saint-Brieux : (306) 275 2227
Adresse 340-501 1ère avenue S0K 3V0
Soins/aide à domicile : organisés à partir du service social de la régie de santé. Pour la région de Saskatoon, vous pouvez contactez Dianne Lepage au (306) 258 4623
Réseautage provincial
Associations Professionnelles de Santé (self regulating) en Saskatchewanwww.gov.sk.ca/search?a=1Collège des Médecins et Chirurgiens de Saskatchewan www.quadrant.net/cpssAssociation de Massothérapie en SK:
www.saskmassagetherapy.com/?page=22 SAHO(Saskatchewan Association of Health Organizations):
www.saho.org/portal.jsp?y3uQUnbK9L2RmSZs02CjV07uLqTm3dRsVPrudLymh6Y=SAHO is a non-profit, non-government association of health agencies in Saskatchewan. Members include Saskatchewan's regional health authorities and the Saskatchewan Cancer Agency, independent hospitals and special care homes, as well as various agencies and associations that provide health services, education and/or regulations.
En mouvement:
www.en-mouvement.ca Associations des Parents Fransaskois:
www.parentsfransaskois.cadans le cadre
des services d'appui à la famille et à l'enfance, l'objectif de l'APF est de rassembler l'ensemble des initiatives contribuant au
bien-être des familles grâce à un vaste réseau de services en éducation,
en santé et dans les secteurs des services sociaux et de l'aide juridique.
Réseautage national
Société Santé en Français-SSF :
santefrancais.caAssociation Médicale Canadienne :
www.amc.ca Collège des Médecins de Famille du Canada :
www.cfpc.ca/french/CFPC/CLFM/ebm/default.asp?s=1Associations nationales de spécialistes :
crmcc.medical.org/links/nss_f.php Autres organisations de santé au Canada :
crmcc.medical.org/links/othercan_f.php Fondation des maladies du cœur :
www.fmcoeur.ca Diabète Québec :
www.diabete.qc.caOstéoporose Canada :
www.osteoporosecanada.caSociété de l'arthrite :
www.arthrite.ca Association canadienne pour la santé mentale :
www.cmha.caCentre de toxicomanie et de Santé mentale :
www.camh.caCentre canadien de lutte contre l'alcoolisme et les toxicomanies (CCLAT) :
www.cclat.caAssociation dentaire canadienne :
www.cda-adc.ca Les diététistes du Canada :
www.dietitians.ca Association canadienne de protection médicale :
www.cmpa-acpm.ca Aidants en réseau :
www.caregiver-connect.ca/fr-fr/Pages/Home.aspxLe portail entraide-et-partage aidants en réseau a été créé pour que vous puissiez prendre soin de vous et de la personne à laquelle vous venez en aide et nouer des liens et mettre en commun vos expériences avec d'autres aidantes et aidants familiaux.
La Coalition canadienne des aidantes et aidants naturels :
www.ccc-ccan.ca Association canadienne de soins palliatifs (1-800-668-2785) :
www.chpca.netLe site contient des renseignements destinés aux aidants naturels, professionnels et bénévoles et constitue un bon point de départ pour la recherche d'information en raison de ses liens vers de nombreuses autres ressources Web, notamment les associations provinciales de soins palliatifs. L'ACSP offre aux aidants un guide gratuit intitulé Guide des aidants naturels : Un manuel de soins de fin de vie, qu'il est possible de commander en ligne. De là, vous pouvez aussi consulter l'excellent site
Leçons de vie qui est un programme d'envergure nationale qui vise à fournir des ressources aux patients, aux soignants et aux professionnels de la santé concernés par les soins palliatifs au Canada :
www.living-lessons.org/francais/index.asp Carrefour virtuel canadien des soins palliatifs (1-866-288-4803):
www.virtualhospice.ca/en_US/Main+Site+Navigation/Home.aspxLe Carrefour virtuel canadien des soins palliatifs offre de l'information pour les aidants naturels, des cybersalons, des babillards ainsi que la possibilité de poser, en ligne, des questions d'ordre général à un professionnel des soins de santé.
RIFSSSO : Regroupement des Intervenantes et Intervenants Francophones en Santé et Services Sociaux de l'Ontario:
www.rifssso.caSanté Canada :
www.hc-sc.gc.ca Agence de Santé Publique du canada :
www.santépublique.gc.ca Association Canadienne de Santé Publique (ACSP) :
www.cpha.caRéseautage international :
REFIPS : Réseau Francophone International pour la Promotion de la Santé
www.refips.orgOMS :
www.who.int/fr Association médicale mondiale :
www.wma.net Comité international de la Croix-Rouge :
www.icrc.org Médecins sans frontières :
www.msf.org Pan American Health Organization:
new.paho.org 
