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Impact of Language Barriers on Quality of Care

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Learning Objective

Understand the serious consequences that language barriers can have on the health of Francophones living in minority settings.

 

Introduction

Francophones living in minority settings often face language barriers in health care. These barriers create risks not only for patients, but also for health care professionals and the organizations providing health services.

Language barriers can significantly affect the quality of care. They can lead to diagnostic errors, medical errors, long delays, and inadequate pain management, among other issues. One of the main challenges in ensuring access to services and quality of care is achieving a language match between the care provider and the patient (translated from de Moissac, 2016, p. 37).

 

  • Language discordance

    Language discordance refers to a situation where a patient and their health care provider do not share a common language.

     

    Linguistic insecurity

    “Linguistic insecurity is expressed as discomfort or anxiety when speaking. It refers to a speaker’s own evaluation of their way of speaking as inferior to another language variety that they perceive as “correct” or more prestigious. This insecurity emerges when the speaker becomes aware of a distance between their own language and the variety that they consider to be legitimate.” (Bouchard, Marie-Eve. What is linguistic insecurity and why we should dismantle it. Janvier 2023) 

    A French-speaking person may choose to speak English out of fear of making too many mistakes in French. This may lead to omitting important health information due to a lack of precise vocabulary.

     

    Regional and cultural variations of French

    Several varieties of French coexist in Canada. From one region to another, French speakers use different vocabulary and expressions that reflect their culture.

    • “J’ai mal aux reins.” (“My kidneys hurt.”): The person is not requesting dialysis but rather needs physiotherapy to treat back pain.
    • “Mon enfant s’est engotté avec un bonbon.”: Doctor, what do you make of this, and how would you respond? (In Acadian French, the pronominal verb “s’engotter” refers to choking on something, in this case, “My child choked on a piece of candy.”)

     

    Apparent bilingualism

    Francophones are often bilingual and may work or study in English, but they might struggle to clearly explain symptoms, concerns, or details about an illness (Timony et al., 2016).

    Read the full research report Barriers to offering French language physician services in rural and northern Ontario.

    A common and dangerous misconception is to assume that a person who speaks some English does not need interpretation or a professional who speaks their language. In such cases, there can be an increased safety risk due to an “illusion of communication” (Bowen, 2015).

    Read the full research report The impact of Language Barriers on Patient Safety and Quality of Care.

     

     

    Consulter les ressources

  • On access to health care

    • Delays in booking appointments
    • More complicated admission processes
    • Limited access to information about health services

     

    On quality of care

    • Diagnostic errors
    • Medical errors
    • Delays in receiving services
    • Inadequate medication or treatments

     

    On access to virtual health services

    Online health service portals rarely incorporate the active offer of French services. Even when some pages are available in French, this does not guarantee that services can be provided in that language.

    To provide equitable, patient-centred care for French-speaking patients, health technologies must develop portals that consider the cultural and linguistic diversity of their target audiences.

     

    On respecting ethical standards

    Clear and effective communication with caregivers is essential for patients to understand the implications, risks, and benefits of a proposed treatment.

     

    See the impact of an existing active offer through Doris’s case (In French only)

     

     

    See the impact of a missing active offer through Doris’s case (In French only)

     

     

    To learn more, click here

     

     

    Consulter les ressources

  • Quiz

    Feedback :

    The correct answers are:

    a) A physiotherapist explains the exercise program in English to a French-speaking client who recently arrived from Haiti.

    b) A bilingual French-speaking patient describes her symptoms to the English-speaking doctor: “I have a pain when I stop sitting for a while.”

    In scenario a), in addition to explaining the exercise program in English, the physiotherapist could have provided the client with a handout in French or demonstrated the exercises. This would have helped the client better understand the exercises she needs to do.

    In scenario b), the French-speaking patient is trying to describe her symptoms in English but is unable to express herself clearly. Being bilingual does not necessarily mean being equally comfortable in every situation. A person may be able to work in English in their own field, but not have the linguistic skills needed to accurately describe symptoms or pain.

    Feedback :

    The correct answers are:

    a) She gave me a doctor’s appointment, but I didn’t understand the date and time.

    b) “Take two capsules in the morning before breakfast, and one capsule at bedtime if needed.” I only need to take the medication if necessary.

    In scenario a), the person may miss the appointment and hesitate to book another one. This delays access to the care they need.

    In scenario b), the person does not fully understand the dosage instructions. The treatment may not have the intended positive effects.