Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review
Background: Language discordance occurs when the patient and the healthcare provider are not proficient in the same language. Language discordance in the critical care setting is a significant global issue because of its implications in the quality of care and outcomes of patients who do not speak t...
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| Language: | English |
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MDPI AG
2025-03-01
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| Series: | Anesthesia Research |
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| Online Access: | https://www.mdpi.com/2813-5806/2/1/7 |
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| author | Hyun Seong Seo Amanda J. Tsao Michael I. Kim Betty M. Luan-Erfe |
| author_facet | Hyun Seong Seo Amanda J. Tsao Michael I. Kim Betty M. Luan-Erfe |
| author_sort | Hyun Seong Seo |
| collection | DOAJ |
| description | Background: Language discordance occurs when the patient and the healthcare provider are not proficient in the same language. Language discordance in the critical care setting is a significant global issue because of its implications in the quality of care and outcomes of patients who do not speak the primary language of the country in which they receive healthcare. Studies show that language-discordant, critically ill patients have increased use of restraints during mechanical ventilation, increased length of stay, and more frequent complications. Communication challenges are magnified in the intensive care unit because of the medical complexity and frequent need for challenging conversations regarding goals of care. To address language-based disparities in critical care, numerous qualitative studies in recent years have attempted to understand the barriers that providers face when caring for language-discordant patients. Our systematic review is the first to analyze this developing body of literature and identify barriers for which solutions must be sought to ensure equitable care. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and Scopus from inception up to 20 February 2024. From among 2150 articles, nine articles were selected, which included eight qualitative studies and one cross-sectional study. Three studies were high quality, five were moderate quality, and one was low quality. Results: We found four major barriers to caring for language-discordant patients in the critical care setting. These included limitations in providers’ knowledge of best practices in professional medical interpreter use, challenges in navigating interpreters’ multiple roles, and limitations with different interpretive modalities and system constraints. These barriers caused clinicians distress due to clinicians’ desire to provide empathic care that respected patients’ autonomy and ensured patients’ safety and understanding. Conclusion: Interventions to increase providers’ knowledge of best practices, integrate interpreters into the critical care team, strategize the use of interpretation modalities, and address system-based barriers are needed to improve the care of language-discordant, critically ill patients worldwide. |
| format | Article |
| id | doaj-art-edd18b4fbb334e479dd031d88364e6fc |
| institution | DOAJ |
| issn | 2813-5806 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Anesthesia Research |
| spelling | doaj-art-edd18b4fbb334e479dd031d88364e6fc2025-08-20T02:59:14ZengMDPI AGAnesthesia Research2813-58062025-03-0121710.3390/anesthres2010007Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic ReviewHyun Seong Seo0Amanda J. Tsao1Michael I. Kim2Betty M. Luan-Erfe3Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USAKeck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USAKeck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USADepartment of Anesthesiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St., Los Angeles, CA 90033, USABackground: Language discordance occurs when the patient and the healthcare provider are not proficient in the same language. Language discordance in the critical care setting is a significant global issue because of its implications in the quality of care and outcomes of patients who do not speak the primary language of the country in which they receive healthcare. Studies show that language-discordant, critically ill patients have increased use of restraints during mechanical ventilation, increased length of stay, and more frequent complications. Communication challenges are magnified in the intensive care unit because of the medical complexity and frequent need for challenging conversations regarding goals of care. To address language-based disparities in critical care, numerous qualitative studies in recent years have attempted to understand the barriers that providers face when caring for language-discordant patients. Our systematic review is the first to analyze this developing body of literature and identify barriers for which solutions must be sought to ensure equitable care. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and Scopus from inception up to 20 February 2024. From among 2150 articles, nine articles were selected, which included eight qualitative studies and one cross-sectional study. Three studies were high quality, five were moderate quality, and one was low quality. Results: We found four major barriers to caring for language-discordant patients in the critical care setting. These included limitations in providers’ knowledge of best practices in professional medical interpreter use, challenges in navigating interpreters’ multiple roles, and limitations with different interpretive modalities and system constraints. These barriers caused clinicians distress due to clinicians’ desire to provide empathic care that respected patients’ autonomy and ensured patients’ safety and understanding. Conclusion: Interventions to increase providers’ knowledge of best practices, integrate interpreters into the critical care team, strategize the use of interpretation modalities, and address system-based barriers are needed to improve the care of language-discordant, critically ill patients worldwide.https://www.mdpi.com/2813-5806/2/1/7interpreterlanguage-discordantlimited English proficientintensive care unitcritical care |
| spellingShingle | Hyun Seong Seo Amanda J. Tsao Michael I. Kim Betty M. Luan-Erfe Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review Anesthesia Research interpreter language-discordant limited English proficient intensive care unit critical care |
| title | Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review |
| title_full | Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review |
| title_fullStr | Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review |
| title_full_unstemmed | Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review |
| title_short | Providers’ Perspectives on Communication Barriers with Language-Discordant Patients in the Critical Care Setting: A Systematic Review |
| title_sort | providers perspectives on communication barriers with language discordant patients in the critical care setting a systematic review |
| topic | interpreter language-discordant limited English proficient intensive care unit critical care |
| url | https://www.mdpi.com/2813-5806/2/1/7 |
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