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Communicating without a Shared Language: A Qualitative Study of Language Barriers in Language-Discordant Cancer

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Language barriers in cancer care cause miscommunication and impact patient involvement. Professional interpreters are crucial, but time and organizational factors limit effective communication and patient safety.

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Area of Science:

  • Medical Communication
  • Health Disparities
  • Oncology

Background:

  • Language barriers significantly impact health outcomes, particularly for ethnic minorities facing social inequalities.
  • Communicative processes in language-discordant cancer care are under-researched.
  • Understanding these barriers is crucial for improving patient involvement and decision-making.

Purpose of the Study:

  • To investigate communication dynamics between cancer patients with limited Danish proficiency and oncology clinicians.
  • To identify how linguistic barriers influence patient involvement and shared decision-making.
  • To explore the role of professional interpreters and family members in mitigating communication challenges.

Main Methods:

  • 18 participant observations of clinical encounters in oncology settings.
  • Analysis of field notes and transcriptions from audio recordings.
  • Qualitative thematic analysis to identify key communication patterns and challenges.

Main Results:

  • Miscommunication and uncertainty were identified as fundamental linguistic conditions.
  • Time constraints and organizational factors, including reliance on professional interpreters, limited patient involvement.
  • Family members often assumed significant communication roles, increasing clinician ethical dilemmas and patient safety risks when no Danish-speaking relatives were present.

Conclusions:

  • Professional interpreting is vital for understanding but does not eliminate miscommunication.
  • Organizational factors and communication responsibilities significantly affect patient involvement and safety.
  • Addressing linguistic inequality in clinical practice is essential for reducing social inequalities in healthcare.