Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the open-ended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though pre-pregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.
Barriers ; Perception ; Pre-pregnancy Care ; Sarawak

This study was designated to investigate communication barriers of nurses in clinical settings. This study was done in 2 phases, first content analysis on descriptions of 50 nurses in three general hospitals and 40 nursing students on communication barriers for nurses in clinical settings, and second a survey to investigate the factors related to communication barriers and the relation between the nurse's characteristics and the extent of communication barriers in clinical settings from two nurses educators, 13 nursing students who experienced clinical practice and 71 nurses in 11 general hospitals. The results are as follows : 1. Through content analysis, 11 properties of communication barriers for nurses in clinical settings were identified. These were inappropriate communication style as a nurse, lack of professionalism, in appropriate control of emotions, lack of knowledge about the clincal setting, the lack of preparation about content of communication, the problem in trust relation, differences in priorities in needs, uncontroleable situation for nurses, inappropriate nurses' perception about patients, conflict with medical team and inadequate systematic support were identified and grouped in to four categories, communicator, message, feedback and communication context. 2. The four factors in communication barriers for nurses in the clinical setting were identified and named as ambiguity in the nurses' position, lack of confidence, difference in perspectives with patients and inadequate nurse -patient relationship. 3. There was a significant difference (F=5.31, P=0.0022, F=3.62, p=0.0316, F=2.80, P=0.067, F=9.01, p=0.0003) among the groups according to work place in rating the extent of the communication barrier in the clinical setting and In the four factors, the nurses working in the psychiatric patient unit rated the communication barrier in the clinical setting lowest among the groups. There was a significant negative correlation between the length of the nurses's carrier and the extent of communication barrier in three factors, ambiguity in the nurses' position, lack of confidence and inadequate nurse-patient relationship.
Communication Barriers* ; Hospitals, General ; Humans ; Students, Nursing ; Workplace

OBJECTIVES: The purpose of this study is to analyze the current status of nutrition education programs for multicultural families and to provide policy suggestions for improvement. METHODS: In-depth interviews of a total of 21 multicultural experts were conducted; 15 people were interviewed individually, while 6 people were interviewed in groups of three. RESULTS: In-depth interviews revealed various problems related to the operation of nutrition education programs. The causes of problems were analyzed and categorized as four factors: systemic, practical, environmental and cultural. As for the systematic factors, insufficient linkage between related organizations and duplicate performance of several projects were identified as concerns Establishment of a control tower and strengthening the linkage among the related organizations may be needed to address this concern. With regard to practical factors, the study identified that language barriers, and lack of nutritional education media and tools translated into multicultural languages were limiting factors. These limitations the development of nutrition education materials that aretranslated into multiple languages, implementation of education programs that are different from the Korean education, and by providing interpreters. As for the environmental factors, low educational level and poor nutritional knowledge of multicultural women made it difficult for them to understand the contents of the education. Demonstration, practical training and urgent education on pregnancy and childbirth nutrition were identified as needs to address these concerns. Withregard to cultural factors, food culture conflict with Korean families, and difficulties in home practices were detected as concerns. Participants in the study suggested that getting education with family and facilitation of weekend and nighttime programs health of this community. CONCLUSIONS: Further studies are needed to adopt more effective and efficient nutrition intervention to promote the healthy eating of the married immigrant women based on the study results.
Communication Barriers ; Eating ; Education* ; Emigrants and Immigrants* ; Female ; Humans ; Korea* ; Marriage* ; Parturition ; Pregnancy

Infectious disease consultation contributes to optimal antibiotic use as well as improved treatment outcomes in many infectious diseases, especially severe infections like bacteremia. However, communication and language matter in consultations between clinicians. Communication barriers are even more complex among professionals who speak Korean, since there are significant challenges for practicing medicine while relying on language translations. This review aims to address some of the components that should be included in infectious diseases consultations for Korean-speaking specialists.
Bacteremia ; Communicable Diseases* ; Communication Barriers ; Consultants* ; Humans ; Referral and Consultation ; Specialization ; Translations

PURPOSE: The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals. METHODS: Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach. RESULTS: The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.' CONCLUSION: The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.
Communication Barriers ; Cultural Characteristics ; Emigrants and Immigrants* ; Humans ; Nursing ; Politics ; Qualitative Research

INTRODUCTIONThis paper looks at the barriers to effective postgraduate study potentially experienced by learners in the United Kingdom if their first language is not English. As part of the internationalisation of higher education, we are seeing a welcome increase in students leaving their home country to study. This brings benefits to both home and visiting students as they learn more about each other and come to understand differences and build on aspects they have in common. However it also brings specific challenges of linguistic capability, differences in cultural expectations of the role of learners and teachers and in the understanding of the nature of postgraduate study. English medium higher education institutions worldwide are increasingly engaged in development of courses on English for academic purposes, or for academic writing. There is even a Journal of English for Academic Purposes, with co-editors from Hong Kong and the UK. Previous research has tended to concentrate on teacher-centred issues such as maintaining the integrity of assessments (including a focus on inadvertent plagiarism), practical aspects such as familiarity and expertise with information technology and more recently an understanding that acculturation has a part to play in maximising the success of students moving from one country's academic model to another.

MATERIALS AND METHODSThis was a qualitative project during which students whose first language was not English were interviewed. Thirteen postgraduate students on a masters award in medical education were engaged in semi structured interviews to elicit their experiences, views and suggestions.

RESULTSThree themes emerged as important to the students in this study: understanding and being understood is not just due to the words we use; the nature of postgraduate study is not universal; and the need to maintain personal identity.

The patient-physician relationship has a pivotal impact on the inflammatory bowel disease (IBD) outcomes. However, there are many challenges in the patient-physician relationship; lag time in diagnosis which results in frustration and an anchoring bias against the treating gastroenterologist, the widespread availability of medical information on the internet has resulted in patients having their own ideas of treatment, which may be incongruent from the treating physicians’ goals resulting in patient physician discordance. Because IBD is an incurable disease, the goal of treatment is to sustain remission. To achieve this, patients may have to go through several lines of treatment. The period of receiving stepping up, top down or even accelerated stepping up medications may result in a lot of frustration and anxiety for the patient and may compromise the patient-physician relationship. IBD patients are also prone to psychological distress that further compromises the patient-physician relationship. Despite numerous published data regarding the medical and surgical treatment options available for IBD, there is a lack of data regarding methods to improve the therapeutic patient-physician relationship. In this review article, we aim to encapsulate the challenges faced in the patient-physician relationship and ways to overcome in for an improved outcome in IBD.
Anxiety ; Bias (Epidemiology) ; Communication Barriers ; Diagnosis ; Frustration ; Humans ; Inflammatory Bowel Diseases* ; Internet

A crude drug “Dang-Gui”, belonging to the genus Angelica, has been used as a traditional herbal medicine in Asia. Various studies have investigated the chemical components and pharmacological activities of Dang-Gui worldwide. However, domestic research results published in Korean are undervalued in international academia due to language barriers. Therefore, it is necessary to summarize the domestic research findings systematically for greater accessibility. This review focuses on the results published in four Korean pharmaceutical journals between 1970 and 2018, which detail the botanical, phytochemical, and pharmacological properties of three Angelica species (A. gigas, A. sinensis, and A. acutiloba) used as “Dang-Gui” in Korea, China, and Japan.
Angelica ; Angelica sinensis ; Asia ; China ; Communication Barriers ; Herbal Medicine ; Japan ; Korea

PURPOSE: Accurate diagnosis and optimal management of acute appendicitis, despite being the most common surgical emergency encountered in emergency departments, is often delayed in pediatric patients due to nonspecific symptoms and communication barriers, often leading to more complicated cases. The aim of this study is to investigate the diagnostic significance of common laboratory markers. METHODS: A total of 421 patients aged 15 and younger underwent surgical treatment for acute appendicitis. We conducted a retrospective analysis for white blood cell (WBC), C-reactive protein (CRP) and bilirubin. All patients were classified into simple or complicated appendicitis groups based on postoperative histology. RESULTS: The mean age of the patients in the complicated appendicitis group was younger than that in the simple group (P = 0.005). WBC, CRP and bilirubin levels were significantly higher in the complicated appendicitis group (P < 0.001, <0.001, 0.002). The relative risk for complicated appendicitis was calculated using age, WBC, CRP and bilirubin. Elevated CRP levels were associated with the highest risk for complicated appendicitis (hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.38 to 4.65) followed by WBC (HR, 2.42; 95% CI, 1.07 to 5.46) and bilirubin (HR, 2.04; 95% CI, 1.09 to 3.82). The most sensitive markers for diagnosing complicated appendicitis were WBC (95.2%) and CRP (86.3%). Bilirubin levels showed the highest specificity at 74.8%. CONCLUSION: The risk of complicated appendicitis was significantly higher in patients younger than 10 years old. Preoperative WBC, CRP and bilirubin have clinical value in diagnosing complicated appendicitis with a HR of 2.0 to 2.5. Our results suggest that the utilization of WBC, CRP, and bilirubin can assist in the diagnosis of complicated appendicitis in pediatric patients, allowing prompt diagnosis and optimal management.
Aged ; Appendicitis ; Bilirubin ; Biomarkers ; C-Reactive Protein ; Child ; Communication Barriers ; Emergencies ; Humans ; Leukocytes ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: The purpose of the study was to identify and explain the essences and structures of maternal conflicts in Vietnamese married immigrant women in Korea. METHODS: A phenomenological methodology was used for the study. Eleven Vietnamese married immigrant women participated in the study. Verbatim transcripts were analyzed using Colaizzi's method. RESULTS: Four categories, 10 clusters and 26 themes emerged from the data for the experience in maternal conflicts of Vietnamese married immigrant women. The four categories were 'An unprepared young motherhood in another culture', 'Feeling left out of the mother's place along the bands of Nap tai tradition', 'My image is like not-being able to stand alone/be independent' and 'Finding hope in motherhood despite of conflicts and stigmas'. CONCLUSION: Vietnamese married immigrant women experienced not only the negative aspects but also sublimation of maternal conflicts. Based on the results, health professionals need to develop effective nursing interventions toward a positive maternal identity and approach with interculturalism for the Vietnamese married immigrant women in Korea.
Adaptation, Psychological ; Adult ; Communication Barriers ; Emigrants and Immigrants/*psychology ; Family/psychology ; Female ; Humans ; Interviews as Topic ; Marriage ; Maternal Behavior/*psychology ; Pregnancy ; Quality of Life ; Questionnaires ; Republic of Korea ; Vietnam