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      Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE

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          Abstract

          Objectives

          To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice.

          Design

          Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language.

          Setting

          Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023.

          Participants

          14 purposively selected healthcare practitioners.

          Intervention

          No specific intervention was implemented; this study primarily aimed at gaining insights through interviews.

          Primary and secondary outcomes

          To understand the implications of language barriers on service quality, patient safety, and healthcare providers’ well-being.

          Results

          Three main themes emerged from our analysis of participants’ narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied.

          Conclusions

          Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

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          Most cited references32

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          Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature.

          To determine if professional medical interpreters have a positive impact on clinical care for limited English proficiency (LEP) patients. A systematic literature search, limited to the English language, in PubMed and PsycINFO for publications between 1966 and September 2005, and a search of the Cochrane Library. Any peer-reviewed article which compared at least two language groups, and contained data about professional medical interpreters and addressed communication (errors and comprehension), utilization, clinical outcomes, or satisfaction were included. Of 3,698 references, 28 were found by multiple reviewers to meet inclusion criteria and, of these, 21 assessed professional interpreters separately from ad hoc interpreters. Data were abstracted from each article by two reviewers. Data were collected on the study design, size, comparison groups, analytic technique, interpreter training, and method of determining the participants' need for an interpreter. Each study was evaluated for the effect of interpreter use on four clinical topics that were most likely to either impact or reflect disparities in health and health care. In all four areas examined, use of professional interpreters is associated with improved clinical care more than is use of ad hoc interpreters, and professional interpreters appear to raise the quality of clinical care for LEP patients to approach or equal that for patients without language barriers. Published studies report positive benefits of professional interpreters on communication (errors and comprehension), utilization, clinical outcomes and satisfaction with care.
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            The impact of medical interpreter services on the quality of health care: a systematic review.

            Twenty-one million Americans are limited in English proficiency (LEP), but little is known about the effect of medical interpreter services on health care quality. Asystematic literature review was conducted on the impact of interpreter services on quality of care. Five database searches yielded 2,640 citations and a final database of 36 articles, after applying exclusion criteria. Multiple studies document that quality of care is compromised when LEP patients need but do not get interpreters. LEP patients' quality of care is inferior, and more interpreter errors occur with untrained ad hoc interpreters. Inadequate interpreter services can have serious consequences for patients with mental disorders. Trained professional interpreters and bilingual health care providers positively affect LEP patients' satisfaction, quality of care, and outcomes. Evidence suggests that optimal communication, patient satisfaction, and outcomes and the fewest interpreter errors occur when LEP patients have access to trained professional interpreters or bilingual providers.
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              Implications of Language Barriers for Healthcare: A Systematic Review

              Objectives Language barriers pose challenges in terms of achieving high levels of satisfaction among medical professionals and patients, providing high- quality healthcare and maintaining patient safety. To address these challenges, many larger healthcare institutions offer interpreter services to improve healthcare access, patient satisfaction, and communication. However, these services increase the cost and duration of treatment. The purpose of this review is to investigate the impact of language barriers on healthcare and to suggest solutions to address the challenges. Methods We identified published studies on the implications of language barriers in healthcare using two databases: PubMed and Medline. We included 14 studies that met the selection criteria. These studies were conducted in various countries, both developed and developing, though most came from the US. The 14 studies included 300 918 total participants, with participation in each study ranging from 21 to 22 353 people. Results We found that language barriers in healthcare lead to miscommunication between the medical professional and patient, reducing both parties’ satisfaction and decreasing the quality of healthcare delivery and patient safety. In addition, the review found that interpreter services contribute indirectly to increased cost and the length of treatment visits. One study reported the implementation of online translation tools such as Google Translate and MediBabble in hospitals, which increased the satisfaction of both medical providers and patients (to 92%) and improved the quality of healthcare delivery and patient safety. Language barriers are responsible for reducing the satisfaction of medical providers and patients, as well as the quality of healthcare delivery and patient safety. Many healthcare institutions use interpreter services that increase the cost and length of treatment visits. Conclusions The results of our review suggest that implementing online translation tools such as Google Translate and MediBabble may improve the quality of healthcare and the level of satisfaction among both medical providers and patients.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2023
                22 December 2023
                : 13
                : 12
                : e076326
                Affiliations
                [1 ]departmentCollege of Health Sciences , Ringgold_59105University of Sharjah , Sharjah, UAE
                [2 ]departmentFaculty of Medicine , Ringgold_37251Jordan University of Science and Technology , Irbid, Jordan
                [3 ]departmentFaculty of Nursing , Applied Science Private University , Amman, Jordan
                [4 ]Ringgold_591854Sheikh Shakhbout Medical City , Abu Dabi, UAE
                [5 ]departmentSchool of management , Universiti Sains Malaysia , Penang, Malaysia
                [6 ]Ringgold_8368Georgetown University , Washington, District of Columbia, USA
                [7 ]departmentCritical Care and Emergency Nursing Department, Faculty of Nursing , Alexandria University , Alexandria, Egypt
                Author notes
                [Correspondence to ] Professor Nabeel Al-Yateem; nalyateem@ 123456sharjah.ac.ae
                Author information
                http://orcid.org/0000-0001-5355-8639
                http://orcid.org/0000-0002-1008-8216
                Article
                bmjopen-2023-076326
                10.1136/bmjopen-2023-076326
                10748954
                38135338
                cb4f33ce-c43e-4145-a575-b1afee7af350
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 04 June 2023
                : 23 November 2023
                Categories
                Health Services Research
                1506
                1704
                Original research
                Custom metadata
                unlocked

                Medicine
                health equity,health services accessibility,health services administration & management,international health services,quality in health care,risk management

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