Magister Educationis - MEd / Writing is an important aspect of language learning and a tool for assessment in Basic and Higher Education across the globe. Learners need to acquire proficient writing skills to learn and to demonstrate their knowledge and creativity. Given the importance of creative writing in expressing one’s thoughts, emotions and imagination, this study sought to investigate how creative writing was taught through the medium of English First Additional Language (FAL) to Grade 9 learners in one primary school in the Western Cape province. It also sought to observe and analyse the teaching strategies employed by teachers in creative writing to Grade 9 learners who were isiXhosa home language speakers, and who were taught all the subjects (except isiXhosa language) through the medium of English (FAL). Through the lens of Vygotsky’s Social Constructivism Theory, this study explored how the learners’ social context and language played a role in the teaching-learning process. The Social Constructivism theory assumes that the home environment is a primary factor in learning and it is concerned with how learning is facilitated in the classroom. This study employed a qualitative research design by making use of classroom observations, focus group interviews with randomly selected Grade 9 learners, and an interview with the Grade 9 teacher to determine how English (FAL) creative writing was taught and the barriers encountered by learners when taught writing in this language. Data was collected in a township school in Cape Town where the majority of learners were isiXhosa home language speakers. Thematic data analysis was used to make sense of the collected data. Ethical considerations were observed throughout the data collection process. One of the key findings of this study is that the Grade 9 English teacher made use of a teacher centred approach and code-switching in the teaching and learning of creative writing through the medium of English FAL. The findings also indicate that learners had limited English proficiency due to limited exposure to this language in their home environment. This study concludes that writing in English is a challenge to Grade 9 English FAL learners, and this could impede their success in other subjects across the curriculum.

Denna studie undersöker socialsekreterares upplevelser då språkbarriärer uppstår i kommunikationen mellan dem själva och vårdnadshavare som talar lite eller ingen svenska och är föremål för en barnavårdsutredning. Studien baseras på en tematisk analys av tio kvalitativa intervjuer med socialsekreterare som aktivt jobbar eller har jobbat med utredningsarbete. Analysen har gjorts utifrån tre teoretiska begrepp: objektet, ömsesidig förståelse och lingvistiskt kapital, som tillsammans skapar en djupare förståelse kring interaktioner och kommunikation. Resultaten påvisar olika utmaningar för socialsekreterare och vilka strategier de använder då de möter vårdnadshavare som talar lite eller ingen svenska. De utmaningar som socialsekreterarna upplever består bland annat av svårigheter i relationsskapandet, att det myndighetsspråk de använder i arbetet försvårar kommunikationen, samt det faktum att utredningsprocessen ofta är tolkad. Det påvisas också att socialsekreterarna har flera strategier som de använder sig av i sin kommunikation för att uppnå ömsesidig förståelse mellan de själva och vårdnadshavarna. De mest centrala strategierna är hur de anpassar språket, och hur de på ett medvetet sätt förhåller sig till vårdnadshavarens kulturella bakgrund. Resultatet belyser därutöver det förhållningssätt som socialsekreterare har för att jämna ut maktrelationen genom språket. Det konstateras även att utredningar som präglas av språkbarriärer upplevs som mer tidskrävande och att vårdnadshavare som talar lite eller ingen svenska inte har möjlighet att utredas på samma sätt som svensktalande vårdnadshavare. Trots att socialsekreterarna förefaller vara medvetna om dessa faktorer kan de inte alltid säkerställa att utredningen genomförs rättssäkert. Studien uppvisar att det både saknas forskning och kunskap inom området.

Magister Educationis - MEd / Writing is an important aspect of language learning and a tool for assessment in Basic and Higher Education across the globe. Learners need to acquire proficient writing skills to learn and to demonstrate their knowledge and creativity. Given the importance of creative writing in expressing one’s thoughts, emotions and imagination, this study sought to investigate how creative writing was taught through the medium of English First Additional Language (FAL) to Grade 9 learners in one primary school in the Western Cape province. It also sought to observe and analyse the teaching strategies employed by teachers in creative writing to Grade 9 learners who were isiXhosa home language speakers, and who were taught all the subjects (except isiXhosa language) through the medium of English (FAL). Through the lens of Vygotsky’s Social Constructivism Theory, this study explored how the learners’ social context and language played a role in the teaching-learning process. The Social Constructivism theory assumes that the home environment is a primary factor in learning and it is concerned with how learning is facilitated in the classroom.

Magister Educationis - MEd / Writing is an important aspect of language learning and a tool for assessment in Basic and Higher Education across the globe. Learners need to acquire proficient writing skills to learn and to demonstrate their knowledge and creativity. Given the importance of creative writing in expressing one’s thoughts, emotions and imagination, this study sought to investigate how creative writing was taught through the medium of English First Additional Language (FAL) to Grade 9 learners in one primary school in the Western Cape province. It also sought to observe and analyse the teaching strategies employed by teachers in creative writing to Grade 9 learners who were isiXhosa home language speakers, and who were taught all the subjects (except isiXhosa language) through the medium of English (FAL).

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health literacy as measured by the primary language spoken at home (English or Creole) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt. The conceptual framework used for the study was the second language acquisition theory. Strategic sampling was used to identify 318 Haitian participants; however, only 36 respondents qualified as Haitian immigrants with a relatively high propensity of hypertension. Logistic regression was used to analyze the data. The results showed no statistically significant relationship between language spoken at home and hypertensive medical compliance within the New York Haitian immigrant community. The other variables age and household income proved to be statistically significant, however gender and education did not appear to have as much of an influence on hypertensive medical compliance observed in the participants. The social change implications include the need for health care staff to be aware of the roles that age, gender, income, language, culture, and education may play in regard to health literacy and hypertension medical compliance.

Over 25 million Americans report limited English proficiency (LEP) since 2013, and this number has been steadily increasing over the past few decades as immigration to the United States continues to climb. Due to the expanding heterogeneity of the population, cultural and language barriers became more common in the healthcare field which led to worse patient outcomes, inappropriately ordering too many or too few tests, and decreased use of preventative services. This necessitated further resources and interventions to better accommodate individuals with LEP. In accordance with Title VI of the 1964 Civil Rights Act which was elaborated further in Executive Order 13166, federal agencies were required to provide language services to people with LEP. As a result, more medical institutions began implementing interpreter services. Despite these measures, there is lower-than-expected physician compliance with utilizing these services and considerable variability in services offered depending on the clinical setting. Not only does this perpetuate and potentiate the health disparities that this population already faces, but it can also negatively impact a patient’s agency as they do not have the proper resources to fully advocate for their health. Hence, it is integral to examine the potential reasons why the current infrastructure for interpreter services is still lacking and what can be done to optimize accessibility. This thesis will explore some of these limitations and then offer potential solutions that both institutions and medical professionals can implement in order to provide equitable care to patients with LEP. / Urban Bioethics

The current study explores the experiences of mental health care professionals in Sweden who conduct therapy with the assistance of an interpreter. Seven participants took part in semi-structured interviews that were analyzed using interpretative phenomenological analysis (Smith, 1996). Three main themes emerged from the analysis of the interview transcripts: (1) communication and translation - highlighting the communicative challenges and benefits that arise when using an interpreter, (2) the interpreter as a person and as a professional - describing the variation of interpreters in terms of behavior, personality, roles, and professionalism, and their impact on psychological treatment, and (3) dynamics and relations - featuring the interpreter’s impact on the dynamics and the process of building a patient-therapist alliance. The results show that all participants find it difficult to determine the accuracy of the translation, and several techniques used by the clinician to ensure a correct translation were pointed out. Moreover, findings highlight the essentiality of non-verbal cues and body language in communication and that the role and the behavior, in addition to several personal factors of the interpreter has an impact on the patient-therapist alliance and therapy dynamics. In addition, the study illuminates the patient’s impact on the interpreter as many interpreters themselves have been through traumatic experiences, which in turn may affect the therapeutic process. The findings of the current study show how important it is for clinicians, mental health services, and interpreting services to take the interpreters’ impact on the clinician, the patient, and the therapeutic outcome  into account. The study aims to contribute to a better understanding of clinicians’ experiences of working with interpreters to improve the use of - and collaboration with - interpreters and thereby raise the standard of psychological treatment for refugees and asylum seekers.

Bakgrund: Språkbarriärer ökar globalt i takt med ökande global migration. I hälso- och sjukvården befinner sig sjuksköterskan ofta i möten där språkbarriärer uppstår. Det framkommer att bristande kommunikation har direkt negativa konsekvenser på såväl patient som vårdpersonal. Patientsäkerhet och personcentrerad vård är två områden som påverkas avsevärt av språkbarriärer. För att minska riskerna för bristande patientsäkerhet samt för att stärka den personcentrerade vården behöver hjälpmedel identifieras i syfte att överbrygga språkbarriärer. Syfte: Syftet var att undersöka hur sjuksköterskan upplevde användningen av kommunikationsstöd vid språkbarriär. Metod: En kvalitativ litteraturstudie genomfördes, genom att artiklar hittades i databaserna PubMed och CINAHL. Elva empiriska studier med kvalitativ studiedesign analyserades. Resultat: Resultatet belyser vanligt förekommande hjälpmedel och strategier som sjuksköterskor använder sig av samt deras upplevelser av dessa. Tre huvudkategorier identifierades: Mellanmänsklig kommunikation, Kommunikationshjälpmedel och Upplevda utmaningar med kommunikationsstöd. Till respektive huvudkategori presenteras tre subkategorier vardera. Slutsats: Det framkom att ett flertal hjälpmedel och strategier finns att tillgå. Dock är dess tillförlitlighet, tillgänglighet och användbarhet varierande i kvalitet. Detta resulterar ofta i att kvaliteten på omvårdnaden blir lidande. De kommunikationsstöd som undersökts i denna studie är otillräckliga och behöver kompletteras med andra hjälpmedel eller strategier. Dessa hjälpmedel och strategier behöver således vidareutvecklas. Trots varierande kvalitet anses hjälpmedel underlätta kommunikationen. En slutsats studien kommit fram till är att sjuksköterskor bör använda hjälpmedel i större utsträckning för att överbrygga språkbarriärer. / Background: Language barriers are increasing worldwide as the global migration is increasing. In the healthcare setting the nurse frequently encounters situations in which language barriers occur. It appears that inadequate communication has immediate negative consequences for patients as well as healthcare professionals. Patient safety and person-centered care are two areas significantly impacted by language barriers. To mitigate the risks of compromised patient safety and to enhance person-centered care, assistive devices need to be identified to overcome the language barriers. Aim: To conduct a research of how the nurse perceives communication supports used to overcome language barriers. Method: A qualitative literature review was conducted using two databases, PubMed and CINAHL. Eleven scientific studies with a qualitative design were analyzed. Findings: The findings address tools and strategies the nurses used and their experiences of them. Three main themes were identified, Interpersonal communication, Communication aids and Perceived challenges with the communication supports. With each main theme three subthemes is presented.  Conclusion: A variety of assistive devices and strategies are available. However, their reliability, accessibility, and usability vary in quality. Thus resulting in a frequent compromise in the quality of care. The communication supports examined in this study are insufficient and require supplementation with additional tools or strategies. These communication supports need further development. Despite varying quality, these tools are considered to facilitate communication. A conclusion this study reached is that nurses should incorporate tools more extensively to bridge the language barrier.

Bakgrund Inom hälso- och sjukvården har kommunikationen stor betydelse. Migrationen har bidragit till att Sverige har blivit ett mångspråkigt land. Detta bidrar till att kommunikationshinder (eng. communication barriers) i form av språkbarriärer (eng. language barriers) har blivitallt vanligare inom hälso- och sjukvården. Kommunikationen under ett vårdmöte mellan sjuksköterska och patient har betydelse för att vården patienten tillhandahåller blir adekvat. Därför finns ett behov av att sammanställa aktuell forskning för att öka kunskapen om hur språkbarriärer påverkar vårdmötet. Syfte Syftet var att belysa hur språkbarriärer kan inverka på vårdmötet och beskriva metoder som används för att förebygga språkbarriärer. Metod Studien bygger på en icke systematisk litteraturöversikt och bestod av 17 vetenskapliga originalartiklar. Artiklar av både kvalitativ och kvantitativ metodansats inkluderades. Datainsamling utfördes systematiskt i databaserna PubMed och CINAHL. De inkluderade artiklarna kvalitetsgranskades i fulltext i enlighet med Sophiahemmet Högskolas bedömningsunderlag. Dataanalys utfördes utifrån en integrerad analysmodell för att analysera samt sammanställa resultatet. Resultat I resultatet identifierades två huvudkategorier: Språkbarriärers negativa inverkan på vårdmötet samt Språktolkning som hjälpmedel för att förebygga språkbarriärer. Resultatet visade att språkbarriärer har inverkan på vårdmöten. Studier visar att när sjuksköterska och patient talar samma språk, var det lättare för sjuksköterskan att tillämpa personcentrerad omvårdnad och förebygga medicinska fel. Språktolkning, med hjälp av kvalificerade tolkar, närstående, annan vårdpersonal eller med översättningsverktyg, kan underlätta kommunikationen under ett vårdmöte. Slutsats I denna litteraturöversikt framkommer det att både sjuksköterskor och patienter upplever att språkbarriärer förekommer i dagens sjukvård. Sjuksköterskor och patienter anser att språkbarriärer är ett hinder för sjukvård och omvårdnad. Vidare framkom det att avsaknadav gemensamt språk kan vara ett hinder för personcentrerad omvårdnad. Språkbarriärerkan dock förebyggas med hjälp av olika typer av språktolkning. Språktolkning med hjälpav en kvalificerad tolk vid vårdmöten anses som den mest fördelaktiga åtgärden. / Background In healthcare, communication is of great importance. Immigration has contributed to Sweden becoming a multilingual country. This contributes to the fact that communication barriers in the form of language barriers have become increasingly common in healthcare. Communication during a health care meeting between nurse and patient is important for the health care the patient receives to be correct. Therefore, there is a need to compile current research to increase knowledge of how language barriers affect the health care meeting. Aim The aim was to illuminate how language barriers affect the health care meeting and which methods are available to overcome language barriers. Method The study is based on a non-systematic literature review and consisted of 17 original scientific articles. Articles of both qualitative and quantitative methodological approach were included. Data collection was carried out systematically in the databases PubMed and CINAHL. The included articles were quality checked in full text in accordance with Sophiahemmet University's assessment documents and data analysis was performed from an integrated analysis model to analyze and compile the results. Results In the results, two main categories were identified: The negative impact of language barriers on the health care meeting and Language interpretation as an aid to prevent language barriers. The results showed that language barriers have an impact on health care meetings. Studies show that when nurse and patient speak the same language, it was easier for the nurse to apply person-centered care and medical errors are prevented. Language interpretation, with the help of qualified interpreters, relatives, other healthcare staff or with translation tools, can facilitate communication during health care meetings. Conclusions In this literature review both nurses and patients feel that language barriers exist in today's health care. Nurses and patients consider language barriers to be an obstacle to healthcare and nursing. Furthermore, it emerged that the lack of a common language can be an obstacle to person-centered care. However, language barriers can be overcome with the help of different types of language interpretation. Language interpretation with the help of a qualified interpreter at health care meetings is considered the most beneficial measure. Even technological translation tools can be helpful for simpler language interpretation.

En förutsättning för lärande i förskolan är god kommunikation och att skapa trygghet för barnen. Syftet med studien är att bidra med kunskap om hur man kan minska/undvika språkbarriärer i förskolan genom att ge exempel på hur förskollärare uttrycker att de möter barn med annat modersmål. Studien är kvalitativ och jag har använt semistrukturerade intervjuer som metod för datainsamling. Studien har analyserats genom ett sociokulturellt perspektiv med hjälp av begrepp som proximal utvecklingszon, scaffolding och socialt lärande samt de språkliga begreppen indikativ-, semiotisk- och retorisk funktion. I resultatet framkommer det att de deltagande förskollärarna uppfattar sig själva ha en viktig roll i barnens lärande och kommunikation. Resultatet delas in i fyra kategorier utifrån deltagarnas svar: förskollärarens syn på språkbarriärer, förskollärarens roll, utmaningar och möjligheter i arbetet med språkbarriärer och förskollärarens stöd och hjälpmedel. Förskollärarna ger exempel på hur de stöttar barnens lärande genom verbal och icke-verbal kommunikation samt vilka utmaningar och möjligheter de ser i arbetet med språkbarriärer i förskolan. Det framkommer i resultatet att förskollärarens kompetenser och erfarenheter är av stor vikt för hur undervisningen bedrivs samt i hur barnens behov tillgodoses i förhållande till språkliga barriärer. / One condition for learning in preschool is good communication and to create security for the children. The purpose of this study is to elucidate how to reduce/avoid the occurrence of language barriers in preschool by giving examples of preschool teacher’s expression on work with them. The study is qualitative, and semi-structured interviews have been used as a method of collecting empirical data. The study has been analyzed through a sociocultural perspective using the concepts of the zone of proximal development, scaffolding, and social learning as well as the linguistic concepts of indicative-, semiotic-, and rhetorical functions. The results show that the participating preschool teachers perceive themselves as having an important role in the children’s learning and communication. The results are divided into four categories from the participants answers: preschool teachers view on language barriers, the role of preschool teachers, challenges and possibilities in working with language barriers and preschool teachers support and aids. The preschool teachers also provide examples of how they support children’s learning through verbal and nonverbal communication as well as which challenges and opportunities they encounter in the work of language barriers in a preschool setting. The results show that preschool teacher’s competence and experiences is of great importance for how the education is conducted and to make sure that children who experience language barriers are accommodated to.