Effective communication is central to the majority of activities in care settings. In many English-speaking countries, carers working in care settings are increasingly from multilingual and multicultural backgrounds, with many growing up in countries where English is not the primary language. Communication difficulties may impede carers creating meaningful relationships with residents or successful working relationships with colleagues. Misunderstanding may also result in safety issues. To date, however, few studies have investigated what aspects of communication carers from culturally and linguistically diverse (CALD) backgrounds find difficult; nor have these difficulties been modelled theoretically.

This article presents the findings of an interview-based study exploring communication difficulties in care settings in Australia. Three groups of participants were interviewed: (1) 30 personal care assistants (PCAs) from CALD backgrounds, (2) 20 supervisors of PCAs and (3) 18 older people who were receiving care and/or nominated support people who participated on behalf of an older person. The data were thematically analysed. The findings show that the communicative challenges facing new PCAs from CALD backgrounds are numerous, ranging from specific linguistic challenges to more workplace-specific problems. Based on the findings, the article proposes a model of communicative competence of personal care workers. The study has implications for the training of personal care workers from CALD backgrounds.

To identify the greatest difficulties reported by people affected by neurofibromatosis type 2, and to determine the relationship between the primary and secondary effects of the disease.

Postal questionnaire study.

Questionnaire sent to subjects' home addresses.

Eighty-seven adult patients under the care of the Manchester multidisciplinary neurofibromatosis type 2 team were invited to take part.

The response rate was 62 out of 87 (71 per cent).

Respondents' answers emphasised that their greatest problem was deafness, which resulted in communication difficulties with social contacts, close partners, family and friends. Correlation coefficients indicated a relationship between general mood changes and hearing difficulties, social communication problems, balance difficulties and mobility problems. Self-confidence was significantly related only to social communication problems.

The use of a closed set neurofibromatosis type 2 questionnaire identified hearing problems and subsequent communication difficulties as the main problems faced by people with this condition.