BRIDGING THE GAP 1

Bridging the Gap Between Medical Literacy and Language Barriers

Candace Walker

Midwestern State University-Texas

Radiologic Sciences

Research 3503

February 6, 2021
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Introduction

This paper seeks to examine the existing language barriers in health care service and the

impact on quality health care delivery. The research aims at finding a solution on how to bridge

the gap between medical literacy and language barriers. In recent years, there has been a

significant increase in diversity due to globalization. According to UN data (2019), there are

approximately 272 million international documented immigrants worldwide. The figures are

likely to higher than this if the undocumented migrants were to be added. This poses significant

challenges for quality health care delivery since migrants have their cultural practices, norms,

and beliefs, including language that differs from the natives. The language barriers negatively

impact the communication between patients and health care providers, thus affecting the quality

of healthcare service. Therefore, it is important to address the gap between medical literacy and

language barriers to provide culturally competent care to patients, which in turn improves

patients centered care, the satisfaction rate for the involved stakeholders, and the overall quality

of healthcare. The researcher will conduct a literature search language barrier and the impact on

quality healthcare service.

Methodology

A search of relevant literature on different databases through the MUS library was

conducted on different databases, including PubMed, PsycINFO, Medline, Google Scholar, and

Web of Science. The following key terms were used: culturally competent healthcare, culturally

competent healthcare provision, language barrier during healthcare visits, the impact of language

barriers for healthcare, and perception of language barriers to healthcare service. The

publications were limited to the last five years addressing culturally competent articles or

language barriers in relation to healthcare provision to narrow down the search. One of the
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limitations to be considered is the inclusion of different groups of culture, language, and diverse

patients like migrants in addition to racial and ethnic minority groups. The groups are

heterogeneous, and their healthcare need varies significantly.

Discussion

According to Abdelrahim, Elnasha, Khidir et al. (2017), language barriers impact all

types of patients leading to negative health outcomes. Practitioners are likely to misunderstand

patients due to language barriers. Similarly, poor communication poses a significant risk to the

patients, which is supported by (Hommes, Borach, Hartwig, et al., 2018). This is in addition to

healthcare disparities, poor patient adherence, privacy breach, and stress induction. In a highly

diverse environment, patients are at greater risk because of the language barrier that negatively

impacts quality care. For instance, an Italian businessman in Qatar was misjudged for being an

alcoholic, when instead he had a history of epilepsy (Abdelrahim et al., 2017). Different

researchers have found similar results (Al Shamsi, Al Mutairi, Al Mashafi et al., 2020). Despite

language barriers, most interpretations are often informal (Abdelrahim et al., 2017).

Al Shamsi et al. (2020) posits that language barriers in healthcare result in

miscommunication between practitioners and patients, which decreases the rate of satisfaction

among them. This, in turn, reduces the quality of healthcare delivery and patient safety.

According to Al Shamsi et al., the acquisition of interpreters indirectly contributes to increased

cost and the duration of the treatment. Online translation services like Google translate and

MediBabble increase the satisfaction rate by 92% for both practitioners and patients and thus

improves the quality of healthcare services. Al Shamsi et al. concludes that language barriers

reduce the rate of satisfaction for patients and health professionals in addition to decreasing the

quality of healthcare delivery and patient safety. Therefore, the implementation of online
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translating tools like Google Translate and MediBabble may lead to improvement of quality of

healthcare services and the rate of satisfaction.

Similarly, Hommes, Borach, Hartwig, et al. (2018) argue that communication barriers

between health professionals and patients result in healthcare disparities and the effectiveness of

health promotion. Particularly, communication between medical practitioners, deaf and hard of

hearing (HOH) patients due to lack of cultural competence. In their research on American sign

language (ASL), Hommes et al. (2018) found significant differences in preferred communication

between health professionals and deaf/HOH patients. ASL interpreters noted that patients did not

comprehend practitioners’ instructions during the appointments. According to Hommes et al.,

81% of physicians “hardly ever” use “teach-back” methods with patients in ensuring

comprehension of the massage.

Zamora, Kaul, and Kirchoff et al. (2016) conducted a cross-sectional survey on Spanish-

speaking caregivers of pediatric cancer patients while assessing differences in healthcare

experiences between the language groups. Results indicate that migrants are more likely to report

higher rates of quitting or changing careers due to their children’s illnesses. Similarly, Spanish-

speaking caregivers’ children are likely to experience school delay and grade retention. Even

though they reported higher satisfaction with medical care for their children, most stated that the

service would be far much better if they were English natives. According to Zamora et al.,

language barriers coupled with undocumented migration status negatively affects the quality of

decision and healthcare outcome for the Spanish-speaking Caregivers (Zamora et al., 2016).

Therefore, such caregivers may benefit from cultural healthcare giving, which includes Spanish

language resources that increase effective communication and open dialogue about

undocumented immigration status.

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However, according to Handtke, Schilgen & Mosko (2019), there are culturally

competent healthcare interventions, health components, and strategies to provide culturally

competent healthcare. This includes providing care based on different languages, recruitment of

bicultural healthcare experts, emphasizing cultural competence training, and integration of

community health professionals (Handtke et al., 2019). Similarly, culturally competent

healthcare should as well include patient’s families while adapting the surroundings to the

patient’s culture through the provision of ethnic meals described in various languages. This is in

addition to collaboration with minorities and monitoring the organization’s development.

Strategies that promote culturally competent care include the use of telemedicine, outreach

approach, and creation of community health networks

Conclusion

Language barriers negatively impact the quality of healthcare delivery.

Miscommunication and poor communication significantly risk patient’s health and safety. Based

on the literature, the language barrier impacts both patients and healthcare providers' rate of

satisfaction. Therefore, there is a need to bridge the gap between medical literacy and language

barriers, which is essential in ensuring quality healthcare for the patients and satisfaction. This

can be achieved through culturally competent training, adapting the surroundings to the patient’s

culture and family members in addition to the use of a digital application such as Google

Translate and MediBabble for translation and interpretation. Future research should investigate

the effectiveness of cultural competence in healthcare delivery. The study should also address the

current limitation by treating each diverse group differently depending on their native language.
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References

Abdelrahim, H., Elnashar, M., Khidir, A., Killawi, A., Hammoud, M., Al-Khal, A. L., &

Fetters, M. D. (2017). Patient Perspectives on Language Discordance During Healthcare

Visits: Findings from the Extremely High-Density Multicultural State of Qatar. Journal

of Health Communication, 22(4), 355–363. https://doi-

org.databases.msutexas.edu/10.1080/10810730.2017.1296507

Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020).

Implications of Language Barriers for Healthcare: A Systematic Review. Oman Medical

Journal, 35(2), 40–46. https://doi-org.databases.msutexas.edu/10.5001/omj.2020.40

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare –

A scoping review of strategies implemented in healthcare organizations and a model of

culturally competent healthcare providers. PloS One, 14(7), e0219971. https://doi-

org.databases.msutexas.edu/10.1371/journal.pone.0219971

Hommes, R. E., Borash, A. I., Hartwig, K., & Degracia, D. (2018).

American Sign Language Interpreters Perceptions of Barriers to Healthcare

Communication in Deaf and Hard of Hearing Patients. Journal of Community

Health, 43(5), 956–961. https://doi-org.databases.msutexas.edu/10.1007/s10900-018-

0511-3

Zamora, E. R., Kaul, S., Kirchhoff, A. C., Gwilliam, V., Jimenez, O. A., Morreall,

D. K., Montenegro, R. E., Kinney, A. Y., & Fluchel, M. N. (2016). The impact of

language barriers and immigration status on the care experience for Spanish-speaking

caregivers of patients with pediatric cancer. Pediatric Blood & Cancer, 63(12), 2173–

2180. https://doi-org.databases.msutexas.edu/10.1002/pbc.2615