Abstract
Patients' limited literacy and language fluency of different kinds cause them problems in navigating the medical interview. However, it is not known how physicians' native language skills affect the reported intensity of pain among Finnish emergency patients. Data were collected with two consecutive questionnaires in 16 healthcare centres and outpatient departments along the Finnish coast. Swedish and Finnish speaking 18–65-year-old emergency patients were eligible for this study. Our patients were predominantly Finnish speakers. Patient-rated poor language skills in Finnish among the physicians in ED setting increased statistically significantly pain reported by the Finnish speaking patients and their dissatisfaction with the health service. These patients were also less motivated to adhere to the instructions given by their physician. Patients speaking various languages reported less degree of pain. Foreign physicians' poor language proficiency in Finnish was expected to explain only some of the patients' pain experience. Physicians' good native language skills may help to reduce pain experience. Despite concordant language communication, other unknown barriers in the interaction might reduce the magnitude of pain reported.
Highlights
Healthcare is ideally delivered in language concordance which means that both the patient and the physician speak the same preferred language
The arriving emergency patient was informed by a receptionist or a nurse about the possibility to voluntarily participate in the study
The questionnaire included 43 closed questions, of which 15 were standardised questions about socioeconomic and health conditions used in periodical population surveys in Finland; 23 questions about native and nonnative language proficiency, the relatives’ native language, language spoken at home and stated in registration for population, Finnish or Swedish schooling, and preferred communication language with the general practitioner (GP); and 5 questions about the frequency and quality of health centre visits and the reason for the visit
Summary
Healthcare is ideally delivered in language concordance which means that both the patient and the physician speak the same preferred language. Language barriers cause communication difficulties which may hamper the treatment of a disease [1]. Communication problems with the patients affect the physicians and impede their decision making and adequate medical treatment. On the other hand, limited literacy and insufficient language fluency cause the patients problems in navigating the medical interview. Diagnosing, for example, acute chest pain patients in emergency departments (ED) may be hampered because of language barriers [6]. The patients and physicians might have different explanations for diseases which are reflected in the clinical information gained in the medical interview. Patients suffering from chronic diseases may be exposed to cognitive problems affecting their ability to express reliably vital symptoms such as pain [8, 9]
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