Effective communication is critical to delivering high-quality, person-centered healthcare. Patients who speak English as a second language often face language barriers that can impede their interactions with healthcare providers, leading to disparities in healthcare access and outcomes. This qualitative study explores how Korean American immigrant women (KAIW) navigate language barriers in the U.S. healthcare setting. We conducted thematic analysis of 25 semi-structured interviews with KAIW in 2020–2021 and developed two key themes: 1) Preparing ahead: making the most of medical visits (i.e., “Dr. Google” and “Friends can help or hurt.”), and 2) Make it make sense (i.e., Comfort vs. reluctance to engage, “It still eluded me even with the interpreter’s help.” and Leveraging support from family and friends). These findings highlight how language barriers contribute to health disparities and underscore the importance of recognizing language as a critical social determinant of health. Healthcare providers should be aware of the lived experiences of KAIW in navigating the U.S. healthcare system. Recognizing these experiences can promote more equitable, patient-centered care and help reduce barriers to clear communication and effective treatment.
Background Doctor-patient relationship is a crucial aspect of cancer care that is likely to have a huge impact on clinical cancer care. The present study aims to investigate the difference between Egyptian male and female oncologists’ attitudes towards their cancer patients to detect different discursive practices and performances that may carry social meanings and/or are constitutive of a specific gendered identity. The study is particularly concerned with oncologists’ interactions with patients at Al-Azhar University Hospitals in Cairo that have been recently awarded for their outstanding role in supporting the healthcare system in Egypt. Methods The corpus of the study consists of a survey designed to detect the doctors’ hidden ideologies and attitudes. The analytical framework of the study anchored on Howie Giles’ (1973) Communication Accommodation Theory. This study employs a mixed-methods approach, integrating quantitative analysis of survey data with qualitative discourse analysis of oncologists’ communicative practices. Results The study results identify potential inadequacies of Giles’ model when applied to the medical sphere. Results of the study show that both male and female oncologists at the concerned hospitals share a general empathetic attitude towards their patients. Quantitative analysis showed no significant gender differences across most communication items (p > 0.05), except for Q26 (p = 0.006), where female doctors used divergence as a form of redirecting patients' personal narratives to maintain professional focus. Qualitative thematic analysis, following Braun and Clarke's reflexive approach, complemented these findings and identified cultural sensitivity, emotional engagement, simplified language, and active listening as key themes, defined by analytic significance rather than frequency counts. Conclusion The findings suggest that gender differences in oncologist-patient communication are minimal rather than extensive. The sole statistically significant difference, greater divergence among female doctors in response to personal narratives, points to context-sensitive boundary management rather than a lack of accommodation. Notably, higher divergence scores among female oncologists reflected structured emotional engagement, integrating active listening and empathy with clinical redirection, rather than emotional detachment. The study recommends that medical training programs should focus on shared communicative competencies while remaining attentive to context-specific adaptations.
Vocabulary learning constitutes a core component of second language acquisition, yet it is frequently associated with heightened anxiety and reduced learner wellbeing, particularly in examination-oriented EFL contexts. Gamified instruction has been proposed as a pedagogical approach capable of enhancing engagement while mitigating affective barriers; however, empirical evidence examining its combined effects on linguistic and psychological outcomes remains limited in higher education settings. This study investigated the impact of gamified vocabulary instruction on vocabulary learning, foreign language anxiety, and learner well-being among undergraduate EFL learners. Employing a quasi-experimental pretest–posttest design, data were collected from 240 students across eight intact class sections. Four sections received gamified instruction, while four followed non-gamified instructional practices. A vocabulary knowledge test and questionnaires measuring foreign language anxiety and learner wellbeing were administered before and after a six-week instructional intervention. Quantitative analyses revealed that learners in the gamified condition showed greater vocabulary gains, lower posttest anxiety, and higher posttest wellbeing than learners in the non-gamified condition. The between-group effects were large for vocabulary learning (d = 1.05), foreign language anxiety (d = 0.99), and learner wellbeing (d = 1.03). These findings suggest that gamified vocabulary instruction may support both cognitive and affective dimensions of language learning, although the results should be interpreted cautiously in light of the quasi-experimental design, short intervention period, and reliance on self-report measures for affective outcomes.
This study investigates the use of metaphor to construct the meaning of ‘death’ in Paul Kalanithi’s memoir, When Breath Becomes Air. Utilizing the framework of Conceptual Metaphor Theory and a mixed-methods approach, this study has the following objectives: a) to pinpoint Kalanithi’s death-related metaphors in the primary authorial narrative; b) to categorize these metaphors into broad death metaphor frames and primary metaphor subtypes; c) to analyze their distribution; and d) to explore their contextual meanings within the scope of a medical literary autobiography, and the unique blending of Kalanithi’s identities as a neurosurgeon and a dying patient. Metaphors were identified using the MIPVU method and a coding framework that identified metaphor source domains and conceptual metaphor frameworks. The source domain, the lexical unit, its semantic vicinity, and pertinent conceptual metaphor literature and co-texts provided the metaphorical analysis, which identified 211 instances of death discourse metaphors, classified into five metaphor frames and ten metaphor subtypes. The most common metaphorical frame was Motion/Transition, accounting for 70 occurrences (33.2%), with death is departure and death is the end of a journey as subtypes. Agentive Personification was next, with 55 occurrences (26.0%), with death is a visitor/intruder, death is an adversary, and death is a reaper. Obscurity/Force was the third most common frame, with death is darkness and death is a natural force, with 47 occurrences (22.3%). death is the end of a play/the final act and life and death are dancers/players contribute to the Performance/Closure frame, with 26 occurrences (12.3%). Finally, the Bodily/Biomedical Failure frame, through death as a fatal mechanical breakdown, was noted 13 times (6.2%). These results show that the predominant conceptualization of death is as a transition or movement, followed by an agentive presence, an overwhelming or obscuring force, a concluding performance, and a biomedical breakdown. Furthermore, the results demonstrate how illness discourse, by its nature, blends medical discourse with personal and existential discourse and modifies conventional death metaphors.
Background Autism Spectrum Disorder (ASD) is a multidimensional neurodevelopmental condition affecting communication, psychological well-being, social participation, and quality of life. However, it appears limited research in Sub-Saharan Africa has examined these domains within an integrated framework. The study developed and tested an Integrated Assessment Model (IAM) for measuring language impairment, health, and well-being among children with ASD in Ghana. Methods A quantitative cross-sectional design guided the study. Data were collected from 150 children with ASD using the Integrated Language and Well-being Assessment Battery (ILWAB), which assessed structural language, functional communication, neuro-communication functioning, psychological health, physiological well-being, and social adaptability. Data were analyzed using descriptive and inferential statistics. Results Findings showed that language impairment among children with ASD was predominantly concentrated in functional-social communication domains. Strong negative relationships were found between language impairment and psychological as well as social well-being, while physiological well-being showed comparatively weaker associations. SEM results indicated that functional language significantly associated psychological health (β = −0.79, p < .001) and social adaptability (β = −0.88, p < .001), with psychological health serving as a significant mediating pathway. Network analysis identified social interactional competence, pragmatic skills, expressive language, and communicative intent as dominant hub variables within the ASD communication system. The IAM demonstrated strong psychometric quality and associative performance, with excellent model fit and high classification accuracy across outcome domains (AUC = 0.89–0.95). Conclusion The study demonstrates that ASD-related language impairment is best understood as an interconnected system of communication, psychological functioning, and social participation. The findings support the need for integrated and context-responsive assessment and intervention frameworks for children with ASD in Ghana and similar low-resource settings.
