The Impact of Linguistic Concordance and the Active Offer of French Language Services on Patient Satisfaction

Amélie Hien ,Elizabeth Wenghofer ,Patrick Timony ,Alain P. Gauthier

doi:10.28984/drhj.v5i2.359

Abstract

Communication is essential to providing quality primary care. Linguistic concordance between patients and physicians has been linked to improved health outcomes and greater patient satisfaction. Although Canadian Francophones often struggle to access linguistics concordant health services, the concept of the active offer of French Language Services (FLS) has emerged as a means of ensuring the availability of such services and improving the francophone patient experience. However, the impact of language concordance and the active offer of FLS on patient satisfaction among Ontario Francophones remain largely unknown. Patient satisfaction surveys were collected as part of a continuing education program targeted at family physicians in Northeastern Ontario. Participating physicians distributed patient surveys consisting of select patient satisfaction questions from the Physicians Achievement Review (PAR) and select questions from the Active Offer of French Language Services in Minority Context Measure. Valid surveys were received from 235 patients. Just under half of these (44%) identified as Francophones, 62.6% had a French-speaking family physician; however, only 17.2% reported regularly speaking in French with their family physician. As hypothesized, there was a consistent tendency for Francophones who experience stronger linguistic concordance with their family physician to report higher satisfaction scores. Francophones who regularly speak French with their family physicians were more satisfied ( = 4.63) than those who rarely/never speak French ( = 4.29, F(1; 83) = 4.852; p < 0.05). There was also a statistically significant interaction between the patients' language of preference and the service language. Francophones who prefer French and regularly speak it with their family physician (linguistic concordance; adj= 4.82) were significantly more satisfied than those who prefer French yet rarely/never speak it (linguistic discordance; adj= 4.06, F(1; 75) = 11.950; p < 0.001). Furthermore, a positive correlation between patient satisfaction and the active offer was observed in Francophones (r = 0.49, p<0.001). The present findings provide evidence of the impact of linguistically adapted health care services on the satisfaction of Ontario Francophones and suggest that patient satisfaction may be improved through the active offer of FLS. A larger and more diverse sample is required to confirm these findings.

Highlights

Résumé La communication est essentielle pour fournir des soins primaires de qualité
Acronyms used in this article first official language spoken (FOLS) = First Official Language Spoken FLS = French Language Services French-speaking physicians (FSP) = French-Speaking Physicians non-French-speaking physicians (NFSP) = Non-French-Speaking Physicians PAR = Physicians Achievement Review
A total of 235 completed patient surveys were received from 11 physicians who participated in the continuing education program

Summary

Introduction

Résumé La communication est essentielle pour fournir des soins primaires de qualité. La concordance linguistique entre patients et médecins a été liée à de meilleurs résultats de santé et à une plus grande satisfaction du patient. French-speaking physicians are relatively numerous in the province (Gauthier et al, 2012), the majority are located in communities where fewer Francophones reside (Timony et al, 2013), leaving many communities with large Francophone populations potentially underserved Such patient/physician linguistic discordances have been linked to reduced comprehension and compliance with physician instructions, increased risk of adverse medication reactions, increased risk of hospital admission, inadequate chronic disease management, and reduced diagnostic confidence (Bowen, 2001; Garra et al, 2010; Wilson et al, 2005). Communication was considered influential when the physician listened to patient concerns, included patients in the health care process, and provided adequate information Though none of these behaviours are directly related to language, all would be limited in the presence of a language barrier. While some consider patient satisfaction to be the most important indicator of quality given the subjective nature of quality and the importance of the patient experience in developing patient-centred strategies (Faezipour & Ferreira, 2013; Gupta & Rokade, 2016; Naidu, 2009 ), others criticize its validity, given that patient assessments can be emotionally affected and that patients often lack the experience and knowledge needed to effectively evaluate certain physician competencies such as diagnostic and therapeutic interventions (Gill & White, 2009; Naidu, 2009)

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