Quality and Safety Issue: Language Barriers in Healthcare, a Qualitative Study of Non-Arab Healthcare Practitioners Caring for Arabic Patients in the UAE

Overview

Journal BMJ Open

Specialty General Medicine

Date 2023 Dec 22

PMID 38135338

Authors

Nabeel Al-Yateem

Heba Hijazi

Ahmad Rajeh Saifan

Alaa Ahmad

Rami Masadeh

Intima Alrimawi

Syed Azizur Rahman

Muhammad Arsyad Subu

Fatma Refaat Ahmed

Affiliations

Soon will be listed here.

Abstract

Objectives: To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice.

Design: Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language.

Setting: Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023.

Participants: 14 purposively selected healthcare practitioners.

Intervention: No specific intervention was implemented; this study primarily aimed at gaining insights through interviews.

Primary And Secondary Outcomes: To understand the implications of language barriers on service quality, patient safety, and healthcare providers' well-being.

Results: Three main themes emerged from our analysis of participants' narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied.

Conclusions: Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

References

Krampe F, Fabry G, Langer T . Overcoming language barriers, enhancing collaboration with interpreters - an interprofessional learning intervention (Interpret2Improve). BMC Med Educ. 2022; 22(1):170. PMC: 8918305. DOI: 10.1186/s12909-022-03213-0. View

Gregg J, Saha S . Communicative competence: a framework for understanding language barriers in health care. J Gen Intern Med. 2007; 22 Suppl 2:368-70. PMC: 2150601. DOI: 10.1007/s11606-007-0364-4. View

Heath M, Hvass A, Wejse C . Interpreter services and effect on healthcare - a systematic review of the impact of different types of interpreters on patient outcome. J Migr Health. 2023; 7:100162. PMC: 9932446. DOI: 10.1016/j.jmh.2023.100162. View

Kaihlanen A, Hietapakka L, Heponiemi T . Increasing cultural awareness: qualitative study of nurses' perceptions about cultural competence training. BMC Nurs. 2019; 18:38. PMC: 6704569. DOI: 10.1186/s12912-019-0363-x. View

Al-Yateem N, Alyateem S, Rossiter R . Cultural and Religious Educational Needs of Overseas Nurses Working in the Kingdom of Saudi Arabia and the United Arab Emirates. Holist Nurs Pract. 2015; 29(4):205-15. DOI: 10.1097/HNP.0000000000000095. View

Sawalha R, Hosseinzadeh H, Bajorek B . Culturally and linguistically diverse patients' perspectives and experiences on medicines management in Australia: a systematic review. Int J Clin Pharm. 2023; 45(4):814-829. DOI: 10.1007/s11096-023-01560-6. View

Pandey M, Maina R, Amoyaw J, Li Y, Kamrul R, Michaels C . Impacts of English language proficiency on healthcare access, use, and outcomes among immigrants: a qualitative study. BMC Health Serv Res. 2021; 21(1):741. PMC: 8314461. DOI: 10.1186/s12913-021-06750-4. View

Meuter R, Gallois C, Segalowitz N, Ryder A, Hocking J . Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC Health Serv Res. 2015; 15:371. PMC: 4566365. DOI: 10.1186/s12913-015-1024-8. View

Shnapper-Cohen M, Dolev N, Itzkovich Y . Social Identity in a public hospital: sources, outcomes, and possible resolutions. Curr Psychol. 2022; :1-12. PMC: 8783653. DOI: 10.1007/s12144-022-02729-4. View

10.

Boylen S, Cherian S, Gill F, Leslie G, Wilson S . Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI Evid Synth. 2020; 18(7):1360-1388. DOI: 10.11124/JBISRIR-D-19-00300. View

11.

Bischoff A, Hudelson P . Communicating with foreign language-speaking patients: is access to professional interpreters enough?. J Travel Med. 2010; 17(1):15-20. DOI: 10.1111/j.1708-8305.2009.00314.x. View

12.

Diamond L, Schenker Y, Curry L, Bradley E, Fernandez A . Getting by: underuse of interpreters by resident physicians. J Gen Intern Med. 2008; 24(2):256-62. PMC: 2628994. DOI: 10.1007/s11606-008-0875-7. View

13.

Ulrey K, Amason P . Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety. Health Commun. 2002; 13(4):449-63. DOI: 10.1207/s15327027hc1304_06. View

14.

Al-Yateem N, Al-Marzouqi A, Dias J, Saifan A, Timmins F . Leadership for professional advancement and evidence-based practice in UAE: Now more than ever. J Nurs Manag. 2020; 29(5):865-868. DOI: 10.1111/jonm.13075. View

15.

Al-Yateem N, Lajam A, Othman M, Ahmed M, Ibrahim S, Halimi A . The impact of cultural healthcare practices on Children's health in the United Arab Emirates: a qualitative study of traditional remedies and implications. Front Public Health. 2023; 11:1266742. PMC: 10593472. DOI: 10.3389/fpubh.2023.1266742. View

16.

Al Shamsi H, Almutairi A, Al Mashrafi S, Al Kalbani T . Implications of Language Barriers for Healthcare: A Systematic Review. Oman Med J. 2020; 35(2):e122. PMC: 7201401. DOI: 10.5001/omj.2020.40. View

17.

Brownie S, Hunter L, Aqtash S, Day G . Establishing Policy Foundations and Regulatory Systems to Enhance Nursing Practice in the United Arab Emirates. Policy Polit Nurs Pract. 2015; 16(1-2):38-50. PMC: 4509875. DOI: 10.1177/1527154415583396. View

18.

Flores G . The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev. 2005; 62(3):255-99. DOI: 10.1177/1077558705275416. View

19.

Karliner L, Jacobs E, Chen A, Mutha S . Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007; 42(2):727-54. PMC: 1955368. DOI: 10.1111/j.1475-6773.2006.00629.x. View

20.

Kawi J, Xu Y . Facilitators and barriers to adjustment of international nurses: an integrative review. Int Nurs Rev. 2009; 56(2):174-83. DOI: 10.1111/j.1466-7657.2008.00705.x. View