The Association between Patient-Reported Pain and Doctors’ Language Proficiency in Clinical Practice

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.

Bilingualism in the real world: How proficiency, emotion, and personality in a second language impact communication in clinical and legal settings.

“…For example, there is an interesting relationship between patient-experienced pain and patient-doctor interaction success. When patients estimated their physician’s language skill as being high for their own preferred language, patients also reported experiencing less pain (Mustajoki, Forsén, & Kauppila, 2015). Similarly, Miner, Biros, Trainor, Hubbard, and Beltram (2006) found that Native American individuals showed less of a pain decrease compared with other groups after an emergency department pain treatment.…”

“…They were also concerned about their ability to perform ideal practice and regarding the way in which patient consent is achieved (Parsons et al, 2014). Similarly, in situations where doctors were the L2 speakers (and patients the L1 speakers), patients reported greater reluctance to follow the doctors’ instructions, which was associated with higher pain and dissatisfaction with the service (Mustajoki et al, 2015). These findings suggest a difficulty in establishing a trusting and productive relationship between patients and doctors who do not share an L1.…”

Health behaviour among bilingual Swedish speaking patients in the Finnish healthcare setting

“…Similar visit-related findings have been previously confirmed among patients with psychiatric disorders and in the general population experiencing language barriers. [ 22 23 ]…”

“…[ 27 ] Discordant language communication is furthermore associated with misunderstandings, healthcare anxiety, fear and distrust and it has been shown that the doctors language proficiency affects the amount of pain experienced by the patient. [ 9 23 28 29 ]…”