As pediatric hospitalists, it is important that we recognize barriers to effective communication with the families that we serve. It has been well established that families who speak a language other than English (LOE) have worse health outcomes compared to English speaking families. The authors of the Hospital Pediatrics article “The Experiences of Families of Hospitalized Children Who Use Languages Other Than English” aimed to explore the lived-in experience of families who spoke an LOE and the knowledge the caregivers gained from their child’s hospitalization to identify any potential gaps in care and areas for improvement in communication (10.1542/hpeds.2024-008100).
Based at an inpatient unit in Toronto, Canada, the authors conducted a qualitative study interviewing 20 families that spoke 16 different languages, 1-2 weeks after discharge. They used established thematic analysis of transcribed English portions to identify emerging concepts.
The authors highlighted 3 major concepts. First, families who spoke an LOE shared they felt communication uncertainty. Most families appreciated interpreters used during rounds and longer conversations, but inconsistent use left them with uncertainty that compounded throughout their stay. Another theme was the lack of belonging, with many noting they did not have expectations to feel welcomed as they know "they are different" or may be seen as "others." The last theme was difficulty navigating a healthcare system in a new country and having to rely on a system that was often the opposite of what they were used to in their home country.
Regardless of where you practice, many of us care for patients and families who speak a language other than English. This is a reminder of what still needs to be done at the systemic and personal levels for us as physicians to “do no harm or injustice” as we serve these patients and their families. The results of this study highlight that cultural humility extends beyond interpretation services; it includes fostering a relationship of trust and belonging with families who speak an LOE. This study sheds light on the impact of having seemingly “small conversations” without interpreters and the uncertainty it propagates, as well as opportunities for medical professionals and our institutions to make our families feel welcomed. The authors warn against using “language barriers” as a justification for difference in care between English and non-English speaking families. What changes are you and your institution doing to improve the experience of patients and families who speak a language other than English?
