Macquarie University
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An exploration of interactions in intercultural nurse-patient encounters

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posted on 2022-03-28, 02:05 authored by Tonia Crawford
This research explores interactions between registered nurses (RNs) from culturally and linguistically diverse (CALD) backgrounds and their patients in the Australian healthcare setting. Increasing migration of healthcare workers and patients to Australia has led to increasing language and cultural diversity in the workplace. This has led to concerns regarding the management of clinical communication in a second language, and the communicative competence of healthcare workers from CALD backgrounds which can impact on health outcomes and patient safety (Chiang & Crickmore, 2009; Hamilton & Woodward-Kron, 2010; Shen et al., 2012). Yet, rarely has linguistic analysis of intercultural communication between patients and health providers occurred (Collins, Peters, & Watt, 2011; Ulrey & Amason, 2001). The aim of this project is to explore communication between RNs from CALD backgrounds and their patients in the workplace, using the knowledge to contribute towards greater awareness of communication strategies that support communicative competence. Data is drawn from two phases. Phase one involved interviews of RNs from CALD backgrounds. Five themes emerged through thematic analysis of the data, with the central theme of ‘adjustment’ identified as fundamental to the experiences of the RNs. This theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability. The second phase involved participant observations and audio-recording of interactions between the RNs and their patients. Interactional sociolinguistic (IS) and theme orientated discourse analysis of the second phase identified ‘Focal themes’ (Roberts & Sarangi, 2005) that include the display of empathy, building of rapport, and the provision of empowering patient education. Discourse analysis of this interactional data has made available the strategic, discursive choices that these RNs make. It also provides resources for communication training workshops that support the development of communicative competence of RNs who are new to the Australian healthcare environment, therefore supporting improved health outcomes and patient safety.


Table of Contents

Chapter 1. Introduction to the study -- Chapter 2. New perspectives on understanding cultural diversity in nurse-patient communication -- Chap[ter 3. “Are we on the same wavelength?” International nurses and the process of confronting and adjusting to clinical communication in Australia -- Chapter 4. The consequences of diverse empathic responses in intercultural nurse-patient interactions : a discourse analysis -- Chapter 5. Tracing the discursive development of rapport in intercultural nurse-patient interactions -- Chapter 6. The interactional consequences of ‘empowering discourse’ in intercultural patient education -- Chapter 7. Supporting patient education using schema theory : a discourse analysis -- Chapter 8. Conclusion -- References -- Appendices.


Bibliography: pages 179-198 Thesis by publication.

Awarding Institution

Macquarie University

Degree Type

Thesis PhD


PhD, Macquarie University, Faculty of Human Sciences, Department of Linguistics

Department, Centre or School

Department of Linguistics

Year of Award


Principal Supervisor

Peter Roger

Additional Supervisor 1

Sally Candlin


Copyright Tonia Crawford 2017. Copyright disclaimer:






1 online resource (xvi, 207 pages)

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