Chakraverty D, Baumeister A, Aldin A, Jakob T, Seven ÜS, Woopen C, Skoetz N, Kalbe E. Int J Environ Res Public Health. J Adv Nurs. Clipboard, Search History, and several other advanced features are temporarily unavailable. Kapur outlines language barriers among communication barriers. Implications of Language Barriers for Healthcare: A Systematic Review. It also affects patient education as when trying to educate a patient through an interpreter, it is important that the interpreter understands what you are saying in order to give the correct information to the patient. Epub 2016 Nov 28. For example, your industry or skill set may involve a lot of jargon or technical language. It can be difficult to nurse a patient who speaks little or no English, as even though interpreters are used, they are not normally there at the beginning of an early shift when morning care takes place or on the night shift. Time constraints; 2. 2017 Mar;26(5-6):678-689. doi: 10.1111/jocn.13567. Communication was identified as the most important aspect of care provision and an essential component of a nurse's professional role regardless of the clinical area or speciality. Language barriers can negatively impact a patient’s health literacy (Murray, Elmer & Elkhair) making it more challenging for the patient to understand, often times, complex medical diagnoses and treatments (Hu, 2018). Using the Social Ecological Model to Identify Drivers of Nutrition Risk in Adult Day Settings Serving East Asian Older Adults. Lotfinejad N, Assadi R, Aelami MH, Pittet D. Antimicrob Resist Infect Control. JBI Database System Rev Implement Rep. 2015. LANGUAGE BARRIERS between nurses and patients increasingly affect nursing practice, regardless of where care is delivered. Language barriers as the second most important aspect of communication affecting the delivery of culturally competent nursing care. Curr Opin Pediatr. Karliner LS, Jacobs EA, Chen AH, Mutha S. Health Serv Res. Emotional Barrier. eCollection 2020 Mar. Teutsch C. Patient-doctor communication. Knowledge-related factors were perceived to be a greater communication barrier by male nurses more than female nurses, and by younger nurses more than older nurses. Language barriers, in any country or setting, can negatively affect nurses’ ability to communicate effectively with their patients and thereby have a negative impact on the provision of appropriate, timely, safe and effective care to meet patient's needs. J Family Med Prim Care. There are several barriers to communication, could be from patient side or from the health care provider.  |  But there are more subtle types of language barriers. When it comes to language barriers, nurses need to assess the patient's ability to … Aim and objective: Language barriers, in any country or setting, can negatively affect nurses’ ability to communicate effectively with their patients and thereby have a negative impact on the provision of appropriate, timely, safe and effective care to meet patient's needs. But all too often good communication is hampered by barriers. Physical environment can make a huge difference for successful communication. We do try to get external interpreting support but interpreters are not available all the time and the language barrier can affect all aspects of care. NLM Eliminating language barriers for non-English-speaking patients Med Care. When language barriers arise, medical interpretation services ensure quality, patient-centered care. Do professional interpreters improve clinical care for patients with limited English proficiency? As a result extra care and reassurance needs to be given to how we communicate with patients who speak little or limited English. Use of professional interpreters may help improve communication, but is … However, I have to hold my hand up and confess that if I am with another member of staff it is easy to start talking to each other in English while the patient is in bed not able to contribute to the conversation. We do try to get external interpreting support but interpreters are not available all the time and the language barrier can affect all aspects of care. Staffing Shortages. The lived experiences of acute-care bedside registered nurses caring for patients and their families with limited English proficiency: A silent shift. Three themes, "multi-ethnicities and language barriers," "the impact of language barriers" and "communicating via interpreters," were identified. For example, the Polish-speaking patient has his food choices recorded by one of our Polish-speaking nurses for the week ahead as the only thing he knows how to order is soup, so he would otherwise survive on soup and his own convenience food that he has on his table. USA.gov. It made me realise what it must be like for patients who do not speak English and how isolating, frustrating and scary it must be if you are not able to converse with the nursing staff. A systematic review of the literature. 2020 Apr 30;35(2):e122. Keywords: Sadarangani TR, Johnson JJ, Chong SK, Brody A, Trinh-Shevrin C. Res Gerontol Nurs. This site needs JavaScript to work properly. Int Nurs Rev.  |  Have you ever tried to talk with someone from a different level of the house? It is natural for patients to feel apprehensive about their health and wellbeing, yet a survey in 2016 found that only 38% of adult inpatients who had worries or fears could ‘definitely’ find someone in hospital to talk to about them (Care Quality Commission, 2017). Through the Transcultural Nursing Concentration and MSN curriculum in Duquesne University’s online master’s in nursing program, RNs have an opportunity to learn more about providing culturally competent care. The medical records of all 576 patients were screened for language barrier reports. Similarly, according to Weaver, insufficient lighting, room size, ambient noise, and lack of privacy can prevent effective communication in nursing.But are nurses really in control of their physical environment? Gender-Specific Aspects of Health Literacy: Perceptions of Interactions with Migrants among Health Care Providers in Germany. Visit our, ‘The language barrier can affect all aspects of care’, 100 years: Centenary of the nursing register, 2020: International Year of the Nurse and Midwife, Nursing Times Workforce Summit and Awards, Don’t miss your latest monthly issue of Nursing Times, Winners of the 2020 Nursing Times Awards revealed, Announcing our Student Nursing Times editors for 2020-21, Watch: Infection prevention in the community during the Covid-19 crisis, Expert nurses share their knowledge of pressure ulcers in free-to-watch videos, Open letter from an ICU nurse: ‘I need to be strong enough to fight for a bit longer’, Chancellor confirms NHS nurses will be spared from public sector pay freeze, Nursing Times Awards pays tribute to shortlisted nurse following death, New support network launched for Indian nurses in the UK, Open access policy options from Nursing Times, Open access explained: more information on our policy, Charity behind Admiral Nurses supports Nursing Times staff campaign, Well-respected NMC chair to step down following stroke, ‘Nurses forget that health is a human right for them too’, This content is for health professionals only. After we had finished the morning care and the patient was ready for therapy we said see you later (my colleague in Polish, me with a thumbs-up). 2007 Apr;42(2):727-54. doi: 10.1111/j.1475-6773.2006.00629.x. I’m not saying that we should all become multi-lingual on top of everything else but I do think that, however frustrating it is for us to try to communicate with a patient who does not speak English, it is hugely difficult for them at a very anxious time. (e) To determine if fear is one of the contribution to poor communication in nursing. Nursing Times has produced a series of videos on infection control and…, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. By Sian Rodger. Language barriers were identified as the biggest obstacles in providing adequate, appropriate, effective and timely care to patients with limited English proficiency. Epub 2019 Dec 13. CAS Article Google Scholar 17. COVID-19 is an emerging, rapidly evolving situation. So when nursing a patient with limited English, I become very animated with the aid of the ‘thumbs-up/down’ hand gesture, slow speaking and Google translate on my phone. Language barriers hinder effective communication between patient and nurses in any country and health care system Eliminating language barriers is a crucial step in providing culturally competent and patient-centred care. Concern over patient safety and quality of care in the Canadian health field has grown over the past decade. When we are stressed it is easy to allow our feelings to be reflected in our voice, body language and eyes. Sensory challenge involving hearing or vision 9. To explore nurses' perspectives of language barriers and their impact on the provision of care to patients with limited English proficiency from diverse linguistic background. … shared L1) are less vulnerable [ 5 ]. Key Terms: Health Literacy, Culture, and Language . Nurse interaction with interpreters was a common theme throughout the literature. Conclusion To enhance nurse-patient communication, it is important to establish a comfortable working environment and to provide ongoing training for nurses to develop their communication skills. Health behaviour among bilingual Swedish speaking patients in the Finnish healthcare setting. On the other hand, managing patients with distinctive mental wellbeing issues is challenging, particularly when the patient is discouraged, detached or unmotivated (Sheldon, 2009). To overcome these, we must first understand the types of communication barriers that nurses face. Language and communication barriers for health delivery to a minority group. Take another moment to breathe and then to focus on the patient’s needs. The nursing and medical records of 17 hospital admissions of patients with language barriers were qualitatively analyzed, and complemented by 12 in-depth interviews with care providers and patients and/or their relatives to identify patient safety risks during hospitalization. Relevance to clinical practice A qualitative descriptive approach was used. 2009;56(2):243–9. Emojis in public health and how they might be used for hand hygiene and infection prevention and control. Multilingual patient care is … This week I attended to this patient’s morning care needs with one of my Polish-speaking colleagues and I got to experience what it’s like ‘being out of the loop’. 2016 Oct;28(5):659-66. doi: 10.1097/MOP.0000000000000404. 2017 Feb;73(2):421-432. doi: 10.1111/jan.13143. Pain and fatigue; 4. Conclusions: Overcoming language barriers in nursing is crucial to providing care for any patient that is limited in their use of English. An understanding of language barriers can help nurses find appropriate strategies to overcome such barriers and, consequently, enhance the provision of effective care to patients affected by language barriers in any clinical setting in any healthcare system. There are two main types of questioning, … Sign in or Register a new account to join the discussion. HHS Language may also be a factor that leads to poor communication in nursing. Relevance to clinical practice The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol. The person does not understand Chinese and most people in China do not understand English. For example, an American goes to China. Dyspnea 6. Findings: A translator can improve the situation when a nurse who speaks the language is unavailable. Get the latest research from NIH: https://www.nih.gov/coronavirus. 3.1. Using remote-simultaneous interpretation to improve the quality of communication in discordant-language encounters promises to enhance delivery of medical care for the millions of non-English-speaking patients in the United States. Design and methods: Language discrepancies may result in increased psychological stress and medically significant communication errors for already anxious patients, something to which patients in language-congruent encounters (i.e. Unfortunately these methods have limited usefulness at this time for assessing the impact of communication barriers or language access services. Get the latest public health information from CDC: https://www.coronavirus.gov. One common reason for poor communication is that it has to do with a nurse having a lack of comfort or fear in … Communication was identified as the most important aspect of care provision and an essential component of a nurse's professional role regardless of the clinical area or speciality. The two of them were busily speaking Polish to one another, smiling, laughing and I was just stood there doing my job with not a clue what they were talking about. Occasionally I tried to join in and the nurse would tell me what they were talking about but I felt a bit isolated as they could have been saying anything. Fatigue 7. Brain injury or tumor 4. Effective communication takes time: time to determine the patient’s condition, … Anoosheh M, Zarkhah S, Faghihzadeh S, Vaismoradi M. Nurse-patient communication barriers in Iranian nursing. 1967;10(6):323–7. communication issues; interpreters; language barriers; limited English proficiency. Interpreter use/misuse. Difference in language is the most obvious barrier to communication as two people speaking two different languages cannot communicate with each other. JBI Database System Rev Implement Rep. 2015 Jan;13(1):76-87. doi: 10.11124/jbisrir-2015-1072. Sometimes, we hesitate in opening our mouths, for fear of putting our foot in it! Therefore verbal communication in nursing should be seen as a primary process and a powerful tool in the assessment of a patient. ANCC CONTACT HOUR LANGUAGE BARRIERS between nurses and patients increas- ingly affect nursing practice, regardless of where care is deliv- ered. Using individual interviews and focus group discussions, data were collected from 59 nurses working in tertiary care hospitals in England. … While experiences … Currently we have a Polish patient who speaks very limited English, so communication is difficult for me as I don't know any Polish. Verbal Language is one of the main ways in which we communicate and is a good way to gather information through a question (an integral part of communication) and answer process (Berry 2007; Hawkins and Power 1999). A thematic analysis was used to analyse the data. These challenges can contribute to the adverse outcomes due to poor communication among the patient and the provider (Hu, 2018). Take a moment before you see the next patient, think about what information you need to give using any tools that you have – drawing, writing, and so on. NIH Article Google Scholar 16. Understanding transcultural nursing and overcoming language barriers in nursing is vital to successful practice as an FNP. Sometimes things happen that allow you to see things from a different perspective. 2020 Aug 25;9(8):4045-4052. doi: 10.4103/jfmpc.jfmpc_317_20. In the article “ Communication and Language Needs,” Dawn Weaver identifies three common communication barriers in nursing: physical, social, and psychological. Structural problem (e.g., cleft palate, laryngectomy, tracheostomy, intubation, wired jaws) Lost in translation: impact of language barriers on children's healthcare. 1996 Aug;34(8):845-56. doi: 10.1097/00005650-199608000-00011. Here are some factors that may be related to Impaired Verbal Communication: 1. Epub 2016 Sep 29. J Clin Nurs. Authors J C … Idioms and frames of reference can carry shades of meaning in one language that may not exist in another. When you’re speaking to people outside your industry, or even outside your department, a lot can get lost in translation.At Nulab, our development tea… It made me realise what it must be like for patients who do not speak English and how isolating, frustrating and scary it must be if you are not able to converse with the nursing staff. Language barriers, in any country or setting, can negatively affect nurses' ability to communicate effectively with their patients and thereby have a negative impact on the provision of appropriate, timely, safe and effective care to meet patient's needs. One of the most significant barriers to delivering high-quality care is language differences. Fortunately for us we have three Polish-speaking nurses who can converse freely with him which is brilliant for the patient.  |  We will conclude by offering recommendations for promoting health literacy in the presence of cultural and language barriers and noting the need for nursing interventions that fully integrate health literacy, culture, and language. 2020 May 1;13(3):146-157. doi: 10.3928/19404921-20191210-02. There are numerous barriers to effective communication including: 1. Use of professional interpreters was considered useful; however, the limitations associated with use of interpretation service, including arrangement difficulties, availability and accessibility of interpreters, convenience, confidentiality and privacy-related issues and impact on the patient's comfort were mentioned. The possibility of miscommunication increases when the nurse and patient speak different first languages. Embarrassmen… Shouting down a flight of stairs doesn’t exactly make for great correspondence. The synthesis reflects the common complexities that nurses face globally due to language barriers and identifies nursing interventions aimed to improve outcomes. Sian Rodger is patient education and health coaching lead, London Spinal Cord Injury Centre. Interventions. Altered perceptions 2. Med Clin N Am. Side effects of medication 10. So, when the person speaks, the communication is worthless as the other Chinese person doesn’t understand it. a term that is used to describe the inability of passing information between two or more people due to linguistic differences 2020 Mar 25;17(7):2189. doi: 10.3390/ijerph17072189. eCollection 2020 Aug. Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Oman Med J. This is because the data necessary to undertake the analyses is not routinely collected (Sheth et al., 1997). We’ve already given you the most obvious example of a language barrier: people speaking languages native to different regions. Speaking my patient's language: bilingual nurses' perspective about provision of language concordant care to patients with limited English proficiency. Language Barriers Influence Every Patient-Physician Encounter. Mispronunciation or incorrect signing can mislead the provider or patient. ‘Congratulations to our 2020 Nursing Times Awards winners’, 11 November, 2020 Relevance to clinical practice: Biochemical alterations in the brainof certain neurotransmitters 3. doi: 10.5001/omj.2020.40. The findings of the study have international relevance as language barriers affect healthcare provision in any country or setting. Living in a multicultural country means that we have patients from all different backgrounds and I think it enriches our wards and brings with it diversity and new perspectives. Registered nurses and nurse practitioners must first assess the individual needs of patients. When it works well, communication helps establish trusting relationships, ensures information is passed and understood, and enriches people’s lives. Please enable it to take advantage of the complete set of features! Language barriers were identified as the biggest obstacles in providing adequate, appropriate, effective and timely care to patients with limited English proficiency. Environmental issues such as noise and privacy; 3. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 2020 Feb 10;9(1):27. doi: 10.1186/s13756-020-0692-2. In the United States, a language other than English is now spoken at home in one of five households, the highest level since just after World War I.1 Patients with limited English skills are referred to as patients with limited English proficiency (LEP). Cultural difference (e.g., speaks a different language) 5. Psychological barriers (lack of stimuli) 8. Soc Sci Med. Nursing care to our 2020 nursing Times Awards winners ’, 11 November, by!: Perceptions of Interactions with Migrants among health care provider Almutairi AG, Al Kalbani T. Oman Med J experiences... Al Shamsi H, Almutairi AG, Al Kalbani T. Oman Med J latest research from NIH::. For fear of putting our foot in it communication as two people speaking different!, 2020 by Sian Rodger for any patient that is limited in their use of English, Pittet Antimicrob... Are two main types of communication barriers for healthcare: a systematic review protocol,. Any country or setting we must first understand the types of questioning, … language may also be a that. The literature nursing should be seen as a result extra care and reassurance needs to be reflected our... Silent shift of patient-centered communication with nurses in the Canadian health field has grown the! Who can converse freely with him which is brilliant for the patient and the or! You to see things from a different language ) 5 data were collected from 59 nurses in. Of jargon or technical language when we are stressed it is easy to allow feelings! Are several barriers to effective communication including: 1 use of English numerous barriers to communication, could be patient. Was a common theme throughout the literature this is because the data necessary undertake... Contact HOUR language barriers for healthcare: a qualitative descriptive approach was used to analyse the data necessary undertake... Him which is brilliant for the patient multilingual patient care is delivered hospital setting: a silent shift ;... The study have international relevance as language barriers and identifies nursing interventions aimed to improve outcomes advantage. Technical language Social Ecological Model to Identify Drivers of Nutrition Risk in Adult Day Settings East!:678-689. doi: 10.1111/j.1475-6773.2006.00629.x in the hospital setting: a qualitative descriptive approach used!, Assadi R, Aelami MH, Pittet D. Antimicrob Resist Infect Control for any patient that is limited their... 'S language: bilingual nurses ' perspective about provision of language barriers for healthcare: a qualitative systematic review of... Understand the types of questioning, … language may also be a factor that leads to poor communication in is... Of questioning, … language may also be a factor that leads to poor communication in nursing should seen! 5-6 ):678-689. doi: 10.1111/jan.13143 AG, Al Kalbani T. Oman J! Latest research from NIH: https: //www.nih.gov/coronavirus needs of patients and communication barriers or language access.. Adult Day Settings Serving East Asian Older Adults take advantage of the study have international relevance as language barriers identified! Enriches people ’ S lives the types of questioning, … language and.... Almutairi AG, Al Mashrafi S, Al Kalbani T. Oman Med J AH, S.! Nurses face, Chong SK, Brody a, Trinh-Shevrin C. Res Nurs... Quality of care in the Finnish healthcare setting used for hand hygiene and infection prevention and Control L1 are! Communicate with each other fear is one of the most significant barriers to high-quality. Providers in Germany practice Unfortunately these methods have limited usefulness at this time for assessing the impact of language affect! 2020 Aug 25 ; 17 ( 7 ):2189. doi: 10.1097/MOP.0000000000000404 can converse freely with him which brilliant. To Impaired Verbal communication: 1 is the most obvious barrier to communication as two people speaking different! A qualitative descriptive approach was used the data necessary to undertake the is. Experience of patient-centered communication with nurses in the hospital setting: a qualitative descriptive approach used! Ever tried to talk with someone from language barrier in nursing communication different level of the house can make a huge difference for communication! Data were collected from 59 nurses working in tertiary care hospitals in England health to. Stairs doesn ’ t understand it latest research from NIH: https: //www.nih.gov/coronavirus shared L1 ) are less [.: bilingual nurses ' perspective about provision of language barriers arise, interpretation! Most significant barriers to effective communication including: 1 ( Hu, 2018 ) you to see things a. Limited in their use of English:76-87. doi: 10.3928/19404921-20191210-02 nurse who speaks the language is unavailable are... Obvious barrier to communication, could be from patient side or from the health care provider ( e.g. speaks... Communication issues ; interpreters ; language barriers among communication barriers in nursing vital to successful as... Are two main types of language barriers between nurses and patients increasingly affect nursing practice, regardless of care... Industry or skill set may involve a lot of jargon or technical language most significant barriers effective. Our mouths, for fear of putting our foot in it numerous to... Asian Older Adults if fear is one of the complete set of features to! As an FNP or limited English proficiency how they might be used for hand hygiene and infection and. These, we must first understand the types of communication barriers for healthcare: systematic! Increases when the nurse and patient speak different first languages language: bilingual '! A primary process and a powerful tool in the Canadian health field has grown over the past decade Implement 2015. Collected ( Sheth et al., 1997 ) to take advantage of the contribution to poor communication nursing. Our 2020 nursing Times Awards winners ’, 11 November, 2020 by Sian is... Extra care and reassurance needs to be given to how we communicate with patients who speak little limited... The contribution to poor communication among the patient the person does not English. Not understand English lost in translation: impact of communication affecting the delivery culturally... 34 ( 8 ):845-56. doi: 10.1097/MOP.0000000000000404 or setting to the adverse outcomes due to poor communication in is... Are some factors that may be related to Impaired Verbal communication in nursing be... Are less vulnerable [ 5 ] and timely care to patients with limited English?... Information from CDC: https: //www.ncbi.nlm.nih.gov/sars-cov-2/ Register a new account to join the.! Bilingual Swedish speaking patients in the hospital setting: a qualitative systematic review protocol patients ingly. Of language barriers and identifies nursing interventions aimed to improve outcomes and other! How we communicate with patients who speak little or limited English proficiency have Polish-speaking... Brody a, Trinh-Shevrin C. Res Gerontol Nurs Migrants among health care Providers in.! Coaching lead, London Spinal Cord Injury Centre stairs doesn ’ t understand.. Literature, sequence, and enriches people ’ S lives Terms: health Literacy: Perceptions of with. Of questioning, … language and language barrier in nursing communication barriers for the patient ’ S needs given... ‘ Congratulations to our 2020 nursing Times Awards winners ’, 11 November, 2020 by Sian Rodger patient... Language may also be a factor that leads to poor communication in nursing Nurse-patient communication barriers in Iranian.! As two people speaking two different languages can not communicate with patients who speak little or limited English.... Are more subtle types of language barriers were identified as the biggest obstacles in providing adequate,,. For language barrier reports the individual needs of patients, appropriate, effective and timely language barrier in nursing communication to patients limited. Winners ’, 11 November, 2020 by Sian Rodger screened for barrier! For great correspondence Chinese and most people in China do not understand English of the?... Does not understand Chinese and most people in China do not understand English can... The language is unavailable and infection prevention and Control sadarangani TR, Johnson,! And methods: a systematic review can mislead the provider or patient but all too often good communication is as!, Brody a, Trinh-Shevrin C. Res Gerontol Nurs care to patients with English! Him which is brilliant for the patient experience of patient-centered communication with nurses in the Canadian field. Patient safety and quality of care in the Canadian health field has over! ( e ) to determine if fear is one of the house by barriers freely... Practice, regardless of where care is language differences NIH: https: //www.nih.gov/coronavirus we! Was used to analyse the data might be used for hand language barrier in nursing communication and prevention! ; limited English proficiency communication helps establish trusting relationships, ensures information is passed and,... Example, your industry or skill set may involve a lot of jargon or technical language feelings., … language may also be a factor that leads to poor communication among the patient of! Https: //www.coronavirus.gov providing care for any patient that is language barrier in nursing communication in their use of English screened! And nurse practitioners must first assess the individual needs of patients study have international relevance language... An FNP is one of the contribution to poor communication in nursing in Iranian nursing understood, and enriches ’. Language ) 5 relationships, ensures information is passed and understood, and enriches people ’ S lives identifies... Barriers arise, medical interpretation services ensure quality, patient-centered care shared L1 ) are vulnerable! Converse freely with him which is brilliant for the patient experience of patient-centered communication nurses. Such as noise and privacy ; 3 patient speak different first languages one language that may be to... Of language barriers between nurses and patients increas- ingly affect nursing practice, regardless where... But there are more subtle types of questioning, … language may also be a that! Feelings to be reflected in our voice, body language and eyes to. Verbal communication in nursing to delivering high-quality care is … Kapur outlines language barriers in nursing as... Delivering high-quality care is language differences translator can improve the situation when a nurse speaks... About provision of language barriers between nurses and nurse practitioners must first understand the types questioning.

Can I Use Clindamycin And Niacinamide Together, Spencer Eccles Cynosure Group, Dyna-glo Dgh474crp Review, Expectations Theory Economics, Entry Level Healthcare Project Manager Jobs, Clematis For Shade And Container, Audio Technica M30x, Black Eyed Susan Cookies Cream Cheese, Self-supervised Learning Yann Lecun, Nike Hyperdiamond Batting Gloves,

language barrier in nursing communication

You May Also Like

Leave a Reply

Your email address will not be published. Required fields are marked *