Biomedicine: Fully Funded Coleg Cymraeg Cenedlaethol and Swansea Welsh Medium PhD Scholarship: The Impact of Language on Eye Health in Optical Practices in Wales (RS656)

Funding providers: Coleg Cymraeg Cenedlaethol and Swansea University

Subject areas: Health care (Optometry) 

Project start date: 1 October 2024 (Enrolment open from mid-September)

Project supervisors:

• Dr Alwena Morgan (a.h.morgan@swansea.ac.uk)
• Dr Jeff Davies
• Dr Luke Roberts
• Dr Jennifer Acton (Cardiff University)

Aligned programme of study: PhD in Medical and Health Care Studies (Biomedicine)

Mode of study: Full-time

Project description: 

Effective communication is an integral part of standard health care but the importance of using the patient's first language as part of their care has not been strongly established (Irvine et al.2006). Language choice is even more important for specific groups of vulnerable patients such as children or the elderly, who have not learned/lost bilingual skills, as well as people who suffer from mental health illnesses (Martin et al. 2018). Defects due to language barriers can lead to a communication gap between patients and clinicians which then has negative effects on patient safety and outcomes including medical errors, readmissions to hospital, lower numbers of outpatients, lack of use of preventive services, lack of compliance with medication, and lack of effective management of chronic conditions (Bowen 2015; van Rose et al. 2015). 

There is literature suggesting that a lack of care in a patient's mother tongue is associated with the severity of particular eye conditions at the time of diagnosis. More specifically, in the USA, non-English speaking glaucoma patients have worse results in their initial visual field test (Visual Field (VF) test) compared to English speakers (Altangerel et al.2009; Halawa et al.2022). But these studies did not see a link between the severity of disease progression and language. However, a lack of linguistic concordance between a patient and their doctor contributes to non-compliance with a treatment plan (Moissac & Bowen, 2019). Furthermore, there is an increased likelihood of developing glaucoma in patients with the chronic illness Diabetes (Zhao et al.2015), where a lack of English proficiency has been shown to contribute to poor diabetes management among the Latino population in the USA (Fernandez et al.2010). Thus, it is possible that a lack of language concordance could contribute to increased severity of chronic eye conditions.  

Although there is evidence of a link between the language of care and the severity of some chronic conditions, there is a lack of evidence in the field of optometry and as a result many opticians are either unaware or doubtful of the possible negative impact of a lack of care in the patient’s mother tongue. In 2023 a questionnaire was provided to optical practices in Wales, asking about their experiences of linguistic barriers in optical care and their opinion on the Welsh 'active offer'. The responses included comments that convey that some see a need for bilingual care in Wales (Figure 1). But also, comments suggested that some opticians in Wales are not aware of the possible impact of a lack of care in the patient's mother tongue and are not likely to agree with the Welsh government's 'More Than Words' plan and strategy, which describes the intention to increase the number of bilingual health carers (Figure 1). We see from these comments that there is a need for direct evidence of the impact of a lack of care in the Welsh language on Welsh patients in the field of optometry. Therefore, for this project we intend to investigate the impact of care in Welsh language on chronic eye conditions.

Applicants are encouraged to submit initial inquiries about submission awards - and to do so before the closing date; submit these enquiries to the relevant staff member(s) in the faculty. 

For more details please see here: https://www.swansea.ac.uk/postgraduate/scholarships/research/biomedicine-ccc-su-phd-impact-2024-rs656.php