According to Jacobs, Shepard, and Stone those whose primary language is not English are less likely to use a source of primary care and less likely to receive preventative care (Jacobs, Shepard, Stone, 2004). One study found that infants of parents whose primary language was not English were half as likely to receive all recommended preventive care visits compared with infants of parents whose primary language was English (Cohen & Christakis, 2006). Language barriers have been demonstrated to result in lower participation in cancer screening programs: breast cancer screening, cervical cancer screening, and colorectal cancer screening (Alexandraki & Mooradian, 2010; Ayanian et al, 2005; Fang & Baker, 2013).
Mental health care relies heavily on language to appropriate treat mental health diseases. Older generations of immigrants with limited English-speaking skills present with high rates of mental health disorders but are also less likely to seek help. (Kim et al., 2011). Managing a patient’s pain is also an area effected by language barrier. Patients who unable to effectively communicate the amount of pain they are in are less likely to have it managed effectively. Jimenez reported obstetrical patients who receive interpreter services are more likely to report better pain control and treatment than those who did not receive an interpreter (Jimenez et al., 2014).
One area of concern with language barriers is chronic illness management because the patient will experience symptoms either longer term or for the rest of their life. Leaving them unmanaged can further exacerbate the disease and possible lead to preventable worsening health conditions or death. Using diabetes as an example, there is a lot of important information involved with managing this chronic illness. Knowledge of diabetes management includes knowledge of diet and exercise, both of which aid in lowering blood sugars. A diabetic patient must also know how to check their blood sugars as well as how often to monitor for elevated or low blood sugars that could lead to more health care issues or life-threatening situations. According to studies about language barriers and diabetes, all of these areas are shown to be deficient when compared with English speaking patients (Detz et al., 2014; Fernandez et al., 2011; Karter et al., 2000).
Informed consent for care or a procedure is very important in health care. The provider needs permission from the patient who fully comprehends all aspects of the care or procedure they are receiving. A procedure such as surgery requires that the surgeon explains the reason for the surgery, the steps of the surgery, medications being used, as well as the post-operative symptoms and potential risks. A patient with a language barrier cannot give informed consent if they do not understand everything the surgeon is saying. A study by Schenker showed non English-speaking patients were less likely to have documentation of informed consent for invasive procedures such as surgery (Schenker et al., 2007). Another study showed it was unknown if patients with limited English skills who were not provided an interpreter received adequate information for them to be considered informed (Hunt & de Voogd, 20070).
A safety concern for patients with a language barrier involves medication errors. Patients without interpreter services are at risk for misunderstanding medication administration instructions, will less likely take their medications consistently as directed, will have inadequate symptom management, and are at risk for further complications (Dilworth et al., 2009). In one study conducted, evidence showed Spanish speaking patients were more likely to experience a dosing error than English speaking patients (Samuels-Kalow et al., 2013). ?
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