Communication Barriers for Limited English Patients in Healthcare

Introduction

Research on cross-cultural communication reveals significant barriers between healthcare personnel and patients from different ethnic backgrounds. Language barriers are the primary problem, as patients who speak no English or limited English simply cannot communicate effectively with healthcare personnel who do not speak the patient's language. This topic is of major importance both to individual practitioners and to society at large, given the dangerous impact that miscommunication can have in the medical field.

Literature Review

Hagman (2006) reports that many nurses, when surveyed using an instrument known as the Cultural Self-Efficacy Scale, admit to feeling uncomfortable around patients from foreign cultures. One study that measured nurses' level of comfort with African American, Puerto Rican, and Southeast Asian patients revealed that the vast majority of nurses surveyed had very little confidence in their ability to communicate effectively with patients in any of these three categories (Hagman, 2006).

Language barriers are clearly a critical obstacle when it comes to treating limited and non-English-speaking patients. According to the Journal of Health Care for the Poor and Underserved, among non-English speakers who said they needed an interpreter during a healthcare visit, only 48% said they always or usually had one. Of those who were assisted by an interpreter — whether staff, family, or friend — only 70% fully understood what the doctor was saying. Thirty-three percent of Hispanics, compared to 16% of whites, reported at least one of the following: their doctor did not listen to everything they said, they did not fully understand their doctor, or they had questions but did not ask them (Staff, 2005).

Language barriers can be a significant problem not only for adults but also for the children of Hispanic adults who do not speak English proficiently. Flores et al. (2005) report the following statistics:

Impact of Language Barriers on Society

Forty-seven million Americans, or 18% of the U.S. population, speak a language other than English at home. Twenty-one million Americans, or 8% of the population, have limited English proficiency. Among study parents who said they speak English "not at all," 27% of their children were uninsured, compared to only 6% of children whose parents speak English "very well." For six of nine access barriers studied, parents with limited English proficiency were less likely than English-proficient parents to bring their children to a doctor for needed care (Flores et al., 2005, p. 420).

Impact of Language Barriers on Health Care

Society is negatively affected when people do not receive proper medical treatment. Diseases are more likely to spread and healthcare costs are more likely to rise when medical care is subpar. Some patients may actively avoid seeking medical help because of the frustration involved in trying to communicate with medical personnel who do not understand them. This can result in illnesses worsening due to delays in seeking treatment and can even lead to death (Langlie, 2005).

Effective communication between the patient and the healthcare provider is essential not only for making the patient feel comfortable, but also for the actual quality of care they are able to receive (Zabar et al., 2006). If the healthcare provider cannot understand the symptoms the patient is trying to describe, they are at a serious disadvantage when it comes to diagnosing the problem. Likewise, if the patient cannot understand the questions being asked, they may provide answers that are inaccurate or inconsequential. These types of miscommunications can lead to misdiagnoses, improper pharmaceutical prescriptions, the ordering of unnecessary tests, and an overall lower quality of healthcare delivery (Dressler & Pils, 2009).