References

Baker DW, Parker RM, Williams MV, Coates WC, Pitkin K. Use and effectiveness of interpreters in an emergency department. J Am Med Assoc. 1996; 275:(10)783-788

Baldonado A, Beymer PL, Barnes K, Starsiak D, Nemivant EB, Anonas-Ternate A. Transcultural nursing practice described by registered nurses and baccalaureate nursing students. J Transcult Nurs. 1998; 9:(2)15-25

Barry CA, Britten N, Barbar N, Bradley C, Stevenson F. Using reflexivity to optimize teamwork in qualitative research. Qual Health Res. 1999; 9:(1)26-44

Impact of Language Barrier on Acute Care Medical Professionals Is Dependent Upon Role. 2006. http//www.sciencedirect.com/science/article/piiS8755722306001542

Bibliotheque et Archives Nationales Du Quebec. 2013. http//bbf.enssib.fr/consulter/bbf-2013-06-0047-008 (accessed 7 March 2019)

Maternity nurse's attitudes towards Mexican-American clients. 2000. https//tinyurl.com/yxvc4plk (accessed 7 March 2019)

Language Barriers Within The Winnipeg Regional Health Authority: Evidence and Implications. 2004. https//tinyurl.com/y2u5kxdb (accessed 7 March 2019)

Bowen GA. Naturalistic inquiry and the saturation concept: a research note. Qual Res. 2008; 8:(1)137-152

Using thematic analysis in psychology. 2008. http//www.tandfonline.com/loi/uqrp20 (accessed 7 March 2019)

Central Intelligence Agency. The World Fact Book. 2019. https//tinyurl.com/cbts48 (accessed 7 March 2019)

Connelly L. M. Pilot studies. Medsurg Nurs. 2008; 17:(6)411-412

Use of Google Translate in medical communication: evaluation of accuracy. 2014. http//www.bmj.com/content/349/bmj.g7392 (accessed 7 March 2019)

Denscomb M. The Good Research Guide: For small scale research, 4th edn. Glasgow: Open University Press. Bell and Bain Ltd; 2010

Kuwait: Audit and Statistics Section; 2016

Divi C, Koss RG, Schmaltz SP, Loeb JM. Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health Care. 2007; 19:(2)60-67

Drennan G. Counting the Cost of Language Services in Psychiatry. South African Med J (Suid-Afrikaanse Tydskrif Vir Geneeskunde). 1996; 86:(4)343-345

The importance of language and culture in pediatric care: Case studies from the Latino community. 2000. http//www.sciencedirect.com/science/article/pii/S0022347600847423 (accessed 7 March 2019)

Gadon M, Balch G, Jacobs E. Caring for Patients with Limited English Proficiency: The Perspectives of Small Group Practitioners. J Gen Intern Med. 2007; 22:(2)341-346

Language Barrier in Health Care. 2010. http//digitalcommons..edu/srhonorsprog/175/ (accessed 7 March 2019)

Khan TM, Hassali MA, Al-Haddad MSM. Patient-physician Communication Barrier: A Pilot Study Evaluating Patient Experiences. J Young Pharm. 2011; 3:(3)250-255

Kreuger R, Casey M. Focus Groups: a practical guide for applied research, 4th edn. United Kingdom: Sage Publications; 2009

Kuo D, Fagan MJ. Satisfaction with methods of Spanish interpretation in an ambulatory care clinic. J Gen Intern Med. 1999; 14:(9)547-550

Lee LJ, Batal HA, Maselli JH, Kutner JS. Effect of Spanish interpretation method on patient satisfaction in an urban walk-in clinic. J Gen Intern Med. 2002; 17:(8)641-650

Lincoln YS, Guba EG. Naturalistic Inquiry.Newbury Park (CA): Sage; 1985

Qualitative Research Methods: Data Collector's Field Guide. 2005. https//tinyurl.com/y58gd7ck (accessed 4 March 2019)

Research Methods: A Practical Guide for Social Sciences. 2010. https//tinyurl.com/yy3gqb6z (accessed 7 March 2019)

Mazor SS, Hampers LC, Chande VT, Krug SE. Teaching Spanish to Pediatric Emergency Physicians: Effects on Patient Satisfaction. Arch Pediatr Adolesc Med. 2002; 156:(7)693-695

Moser A, Korstjens I. Series: Practical Guidance to Qualitative Research. Part 3: Sampling, Data Collection and Analysis. Eur J Gen Pract. 2017; 1-10

Narayan L. Addressing language barriers to healthcare in India. Natl Med J India. 2013; 26:(4)236-238

Overcoming communication barriers in emergency situations: some basic tools. 2011. https//tinyurl.com/y4okk2ud (accessed 7 March 2019)

Emergency Services Hindered by Language Barriers. 2010. https//tinyurl.com/yycgxxtn (accessed 7 March 2019)

Ratner T. Beyond the language barrier. Nurs Spectr. 2001; 2:(6)20-23

Saldana J. The Coding Manual for Qualitative Researchers.: SAGE Publications Asia-Pacific Pte Ltd; 2009

Understanding language barrier: nurses' and patients' perspectives. 2004. https//tinyurl.com/y35x255t (accessed 7 March 2019)

Schlemmer A, Mash B. The Effects of Language Barrier in South African District Hospital. SAMJ. 2006; 96:(10)

Schyve P. Language Differences as a Barrier to Quality and Safety in Health Care: The Joint Commission Perspective. J Gen Intern. 2007; 22:(2)360-361

Tate RC. The need for more prehospital research on language barriers: a narrative review. West J Emerg Med. 2015; 16:(7)1094-1105

Timmins C. The impact of language barriers on the health care of Latinos in the United States: A review of the literature and guidelines for practice. J Midwifery Women's Health. 2002; 47:(2)80-96

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. United States. 1979. https//tinyurl.com/y54ty5kh (accessed 4 March 2019)

Vissandjée B, Ntetu A, Courville F, Breton ÉR, Bourdeau M. The Interpreter in an Intercultural Clinical Milieu. Can Nurs. 1998; 94:(5)36-42

Weiss NR, Weiss SJ, Tate R, Oglesbee S. Language disparities in patients transported by emergency medical services. Am J Emerg Med. 2015; 33:(12)1737-1741

Hospital, language, and culture: a snapshot of the nation. 2007. https//tinyurl.com/y2oaxqul (accessed 4 March 2019)

Włoszczak-Szubzda A, Jarosz M, Goniewicz M. Professional communication competences of paramedics—practical and educational perspectives. Ann Agricult Environm Med. 2013; 20:(2)366-372

Zolnierek K, DiMatteo MR. Physician Communication and Patient Adherence to Treatment: A Meta-analysis. Med Care. 2009; 47:(8)826-834

Language barrier and its implications for practice in Kuwait prehospital settings

02 March 2019
Volume 9 · Issue 1

Abstract

Objectives:

The purpose of this research was to explore the implications of language barrier among emergency medical technicians (EMTs) and paramedics in a prehospital setting in Kuwait.

Methods:

A small-scale exploratory case study was carried out using a qualitative method. Focus group interviews were conducted with prehospital providers in Kuwait. An inductive thematic analysis was performed whereby themes and sub-themes emerged from within the data.

Results:

The data revealed that language barrier has a direct effect on healthcare delivery with implications for an unpleasant patient experience, time delay and misdiagnosis; professional implications which include the need to enhance learning through communication and training to improve practice and support with translation; and personal implications including declining efficiency level, negative socio-emotional impact and physiologic response.

Conclusion:

This study contributes to the scarcity of available research determining the effects and implications of language barrier for EMTs and paramedics in a prehospital setting in Kuwait. It brings the deficiencies of the Kuwait emergency medical services (EMS) to light, as language disparities affect prehospital providers and their quality of work. Strategies for overcoming the language barrier, implemented by the respondents in this study, form a basis for the Kuwait EMS to address unexplored issues that could potentially improve prehospital practice. While the findings may not be generalisable, they may be transferable to other areas of practice with comparable situations where healthcare providers face challenges when communicating with their patients.

Effective communication is important in healthcare given that health professionals deal directly with patients (Divi et al, 2007; Houle 2010). Patient care is compromised when healthcare providers face direct communication failures with patients because of language discord (Schyve, 2007).

Kuwait is home to approximately 2 million expatriates, making up 70% of its population. This includes Arab and Asian expatriates: Arabs (Egyptian, Lebanese, Syrian, Jordanian, Iraqi, Yemeni); South Asians (Indian, Bangladeshi, Pakistani, Nepali and Sri Lankan); and others (Filipino, Ethiopian, Indonesian, American, Iranian and Europeans) (Central Intelligence Agency, 2019). The rapid migration of multicultural people into the State of Kuwait could lead to communication difficulties for many migrants who do not share a common language.

The emergency medical services (EMS) of Kuwait, within the State's national ambulance service, employs diverse nationalities who work in the paramedical field. These include Arabs and Asians from a variety of backgrounds in education, culture and language. The English language is widely spoken; however it is the second language after Arabic. These challenges therefore have an impact on patients as well as prehospital care providers, namely the emergency medical technicians (EMTs) and paramedics. These issues are crucial in the prehospital setting where the delivery of care is time-limited, especially in emergency situations and where communication is a matter of life or death, or safety versus risk (Pyke, 2010).

Subscribe to get full access to International Paramedic Practice

Thank you for visiting International Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed