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LETTER TO THE EDITOR
Year : 2022 | Volume
: 35
| Issue : 1 | Page : 37-38
Language barriers related to non-english-speaking patients and effects on nurses and quality of nursing care
Asokan Govindaraj Vaithinathan1, Sayed Ali Hussain2, Mariam Fareed Jawad2, Fatima Ali2, Sara Abdulla2, Muyssar Sabri Awadhalla2
1 Allied Health Department, Public Health Program Department, College of Health Sciences, University of Bahrain, Manama, Kingdom of Bahrain
2 Nursing Program, WHO Collaborating Centre for Nursing Development, College of Health Sciences, University of Bahrain, Zallaq, Manama, Kingdom of Bahrain
Correspondence Address:
Asokan Govindaraj Vaithinathan
Public Health Program Department, College of Health Sciences, University of Bahrain, Post Box: 32038, Zallaq, Manama
Kingdom of Bahrain
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/efh.EfH_101_17
Dear Editor,
The issues of health care in multiethnic cultures are exacerbated by language barriers (LB).[1] In Bahrain, the LB effect is seen in Bahraini nurses providing quality nursing care (QNC) to non-Arabic/non-English-speaking patients (NESP), as well as expatriate nurses caring for Arab or expatriate NESP. The research on LB in health care has largely been descriptive,[2] and there is a lack of data on its impact on nurses and QNC. Therefore, the goal of this nursing student's research was to: (1) identify and characterize the consequences of NESP LB, the magnitude of its effects on Bahraini and expatriate nurses, and the QNC provided at the Salmaniya Medical Complex (SMC) in Bahrain; and (2) explore the facilitators of providing QNC to NESP.
Using a cross-sectional study design, a validated 10-item questionnaire on consequences to LB that categorized effects on nurses (3 items) and delivery of QNC (7 items) with yes/no responses was administered to nurses in medical, surgical, and coronary care wards at SMC. Responses to LB items were compared between the Bahraini and Expatriate groups [Table 1]. To further address NESP, two questions were included to explore “institutional support resources” and “participants' preferred methods” for management solutions.
Table 1. Comparison of Responses to the Consequences of Language Barriers Related to Non-English Speaking Patients between Bahraini and Expatriate Nurses (n=406)Most of the 406 nurses were female Bahrainis (62.8%) with a B.Sc in Nursing and from 6 to 10 years of experience in the surgical ward. Responses to 9 out of 10 consequences were significantly different between the Bahraini and expatriate nurses. In terms of the three items related to possible direct effects on nurses [items 1 to 3 in [Table 1]], Bahraini nurses were more likely to indicate that there were negative consequences/impacts related to LB. Overall, expatriate nurses had much lower effects than Bahrainis, possibly due to balancing the sustainability of an overseas employment with the demands of the profession. In addition, we observed that male Bahrainis with a B.Sc (Nursing) on the medical ward, and 0–5 years of experience, more often indicated significantly negative effects on them.
Patient–nurse misunderstanding, risk of facing hazards/wellness threats, and risk of misdiagnosis or delayed diagnosis were all significantly indicated by a higher proportion of Bahraini nurses. Similarly, a higher number of expatriate nurses strongly agreed with the following three consequences: show low enthusiasm/could not spend adequate time with the patient, affect patient compliance, and a fear of compromised competence. The percentage of nurses who said, “inability to form therapeutic relationship” was very high.
Our findings support reports[3],[4] that LB impedes QNC, creates a void in health-care quality and has an impact on health-care providers. In addressing NESP, 50% of nurses sought translators, 38% used nonverbal communication, 8% visual aids, and 4% opted not to use institutional support resources for NESP. Overall, 20% of nurses approved of the support resources provided by the institution.
We conclude that nurses perceived LB as an impediment to delivering QNC, with significant effects on Bahraini nurses. Our findings may be generalizable to other health-care professionals related to resurrecting Arabic language speaking training and efforts to dispelling LB.
Acknowledgments
We would like to thank the following: Dr. Hashim Ahmed Yousif Al-Sayed, Dean, College of Health Sciences, University of Bahrain for the support and encouragement, all the participants in the study and their administrative heads in the Ministry of Health, Bahrain, and Mr. Richard for statistical assistance.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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