Communication Skills and Illness Perception Among Non-Japanese-Speaking Patients in Japan

Non-Japanese-speaking patients taking medical treatment in Japan face language barriers and lack of language assistance. Language barriers influence all processes from preventive services to treatment, and insufficient communication can affect patient outcomes. Illness perception, which is related to illness-coping behaviors and self-care behaviors, is an important factor for effective treatment, but no studies have investigated the relationship between communication skills and illness perception among non-Japanese-speaking patients.

The purpose of this cross-sectional study was to assess communication skills utilizing ENDCORE, to clarify the relationship between communication skills and illness perception among non-Japanese-speaking patients in Japan, and to identify the impact of language assistance on these factors.

A web questionnaire survey was conducted between February and April 2024, targeting 1,904 non-Japanese-speaking patients who had visited medical institutions in Japan. The survey items included basic attributes, purpose of the medical visit, Japanese language proficiency, communication tool, language assistance, communication skills (using ENDCORE), and illness perception (using the Brief Illness Perception Questionnaire; B-IPQ). The Kruskal-Wallis test and Mann-Whitney U test were used to examine factors related to the means of ENDCORE scores and B-IPQ scores, and Spearman's rank correlation coefficient was used for correlation analysis.

The analysis included data for 354 participants. Participants who received language assistance scored lower on communication skills than those who did not receive language assistance, but they reported more positive illness perception. For factors related to ENDCORE means, statistically significant differences were observed for country of origin, residence qualifications, Japanese language proficiency, communication tool, and language assistance. For factors related to the B-IPQ means, statistically significant differences were observed for sex, country of origin, residence qualifications, communication tool, and language assistance. The correlation analysis of ENDCORE and the B-IPQ items showed that the sense of control a person feels they have over their illness (r = 0.201, p < .001), the significance of treatment (r = 0.215, p < .001), and understanding of the illness (r = 0.318, p < .001) were weakly positively correlated.

The findings suggest that language assistance for non-Japanese-speaking patients can lead to more beneficial communication between them and their physicians and more positive illness perception for those patients. We also believe that maximizing patients' communication skills will facilitate more appropriate diagnoses and treatments, improve patients' coping behaviors, and contribute to patient safety and quality of medical care.