Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language

Abstract

BackgroundMiscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language.Methods/DesignEighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation.DiscussionUnderstanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.

Linguistic Hegemony of English Language in the Medical Context of King Abdullah Hospital

“…According to Alqurashi (2016), English facilitates communication between health professionals from different countries that do not share the same language. These findings support the assessment by Meuter et al (2015) that miscommunication in the healthcare sector can be lifethreatening, especial when patients and healthcare professionals cannot understand each other. For instance, the failure of a clinician to communicate effectively regarding the seriousness of risk can lead to a negative consequence since a patient might fail to comply with instructions (Alkhamis, 2012;Meuter et al, 2015;Bello, 2017).…”

“…In a medical setting, understanding how the medical staff direct patients' attention is an essential feature towards solving the problem of the language barrier. According to Meuter, Gallois, Segalowitz, Ryder, and Hocking (2015), the success of communication depends on whether the message has been packaged appropriately and the listener is capable of inferring the speaker's intention. The Communication Accommodation Theory (CAT) can also be used to understand the negative impact of a language barrier in a healthcare setting (Meuter et al, 2015).…”

“…According to Meuter, Gallois, Segalowitz, Ryder, and Hocking (2015), the success of communication depends on whether the message has been packaged appropriately and the listener is capable of inferring the speaker's intention. The Communication Accommodation Theory (CAT) can also be used to understand the negative impact of a language barrier in a healthcare setting (Meuter et al, 2015). The theory supports the dynamic nature of communication, where different parties bring their own motivations.…”

Critically ill patients' experiences of nursing care in the intensive care unit

“…Reported by Meuter et al . () is language barrier, which contributed to lack of understanding of information and communication in some of the participants who did not understand the local languages in the current study.…”

Still lost in translation: language barriers in South African health care remain

“…16,17 This is inconsistent with the constitutional responsibility of the healthcare system to comply with the needs of the people it serves. Even though the impact of language barriers in multilinguistic societies on healthcare provision is recognised internationally, 11 very little research has been done in this regard in South Africa. Moreover, to date, published studies have focused only on communication between isiXhosa, English and Afrikaans speakers, whilst the country has 11 official languages, as well as many more spoken by smaller language communities.…”