The effect of nurse-patient language barrier on patients' satisfaction

To study Saudi patients' perception of nursing care delivered by non-Arabic speaking nurses (NASNs).

A cross-sectional survey of randomly selected patients admitted to King Abdul-Aziz Medical City, Riyadh, Saudi Arabia during the summer of 2009. We conducted structured face-to-face interviews, and the Institutional Review Board approved the study.

We interviewed 116 patients with a 100% response rate. The mean age was 48 years and 47% were men. Half was illiterate or had a low level of education. Eighty percent was served by NASNs. Most believed that the Arabic language is important to provide high quality of care. Two thirds reported difficulties in understanding nursing instructions, and felt that NASNs could not understand their concerns on many occasions. Half believed that NASNs are more susceptible to error. Seventy percent felt uncomfortable dealing with a nurse who cannot communicate in the same language, and 30% question the reliability of information delivered by NASNs. Patients noticed that NASN avoid (50%) or end conversation (70%) due to language barriers. Sixty-one percent reported that NASNs never or rarely called the interpreter. Overall satisfaction of nursing care was high (90%), with no significant difference between patients who were served by Arabic versus NASNs.

Our patients were concerned about the language barrier during nursing care delivery. It may lead to miscommunication and compromise the patient-nurse relationship. Further exploration of this issue is recommended.