Communicating with patients who have limited English proficiency can be a great challenge for healthcare professionals, as it is not always possible to have a fluent speaker on hand.

Healthcare providers need to be culturally sensitive and willing to ask questions to avoid making mistakes in conversation with patients of a non-English speaking background.

Key issues when communicating with non-english speaking patients

Healthcare professionals should remain aware of their own values and cultural practices when interacting with patients from different non-English speaking backgrounds. The following tips can help healthcare providers deliver more effective care to foreign patients (1);

• Remain aware of the communication style being used; the tempo and speed should be easy to follow and language should not be overly complex. The communication style may need to be altered in the conversation to suit the context and the patient.

• English proficiency should not be assumed.

• A patient’s level of understanding should not be assumed; patients with little English or strong accents may have medical knowledge, while English speakers may have difficulty understanding medical concepts.

• Patients’ beliefs and attitudes should be respected as people can have different reactions towards illness, life and death. A patient’s explanation or belief about such topics should not be immediately dismissed, as this can create a barrier in the communication process.

• Sensitively observe body language. The patient’s behaviour can give clues whether they understand what is being said. However you need to remain mindful that the same body language can express an alternate meaning in another culture. For example, not maintaining eye contact can be a sign of respect, and smiling can signal apprehension.

Overcoming the language barrier

Even when shorter words and clear sentences are used, you cannot be certain that the patient has fully understood unless the patient acknowledges it with feedback. Head nodding does not count as feedback, as usually this is often a sign of partial comprehension, or to keep harmony in the interaction to avoid contradicting the healthcare provider. Asking open ended questions, which require the patient to form a structured response instead of saying a simple ‘yes’ or ‘no’, can help a healthcare professional gauge the patient’s level of understanding (2).

Healthcare providers should make it clear from the beginning of the conversation that they are happy to repeat or rephrase anything said, and they should ensure they carry on repeating key points and phrases in conversation (2).

Some situations may require the presence of an interpreter. An accredited interpreter should be invited if (1);

• The patient’s English skills are inadequate for the situation
• Patient requests an interpreter
• The information that needs to be communicated is significantly important for the patient’s health

Some patients may be hesitant to engage with an interpreter due to a lack of knowledge of interpreter services, or concerns about privacy and confidentiality. These feelings should be addressed and sensitively explained so that the patient is aware that the interpreters are as equally bound by confidentiality as are their healthcare providers (1).


Sources:


1. Queensland Health
2. Dimensions of Culture