oa Current Allergy & Clinical Immunology - Use of asthma terminology by Xhosa-speaking patients in South Africa - how it affects asthma-control questionnaires and questionnaire-based epidemiological studies : review article

Volume 20 Number 2
  • ISSN : 1609-3607



. Language and cultural differences between Xhosa-speaking patients and English-speaking health-care providers have been documented as factors causing miscommunication in the South African setting. Large epidemiological studies on asthma prevalence utilise questionnaires rather than direct assessment of asthma. Studies may be conducted in English with respondents not perfectly familiar with this language, or may utilise questionnaires that have been translated into a local language. Respiratory medical terminology may not be equivalently understood between the two groups. This may affect the validity of questionnaire-based assessment of the prevalence of asthma and wheezing.

. To describe differences in the definitions of common respiratory medical terminology by patients and doctors.
. In-depth, semi-structured interviews were conducted with three speech communities: 8 English-speaking doctors, and 33 Xhosa-speaking parents, with an education level of grade 12 or less and recruited from two areas in a paediatric teaching hospital, the short-stay ward and the allergy clinic. Definitions were elicited for common respiratory terminology in both Xhosa and English. Differences in the definitions of terminology were identified.
. Terminology is used differently by Xhosa-speaking patients and English-speaking doctors. Most Xhosa words were not part of the doctors' vocabulary, and some common English words were not part of the parents' vocabulary. Where words were part of the vocabulary of both groups, significant differences existed in the definitions, with many clinically significant discordances being apparent. For example, the word is not used exclusively for a medical diagnosis of asthma. Words for asthma symptoms were also poorly understood by respondents, with the words and being defined by only a minority of respondents in ways concordant with medical practitioners. This may lead to difficulties in communication and either falsely raise or decrease the prevalence of questionnaire- based assessments of wheezing and asthma, depending on the composition of the group interviewed and the language of the questionnaire.

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