Enhancing Communication and Advocacy in Primary Care

Abstract

Background: Language barriers in healthcare present significant challenges, leading to miscommunication, increased errors, and decreased quality of care. The introduction of a professional language interpretation service (LIS) at McMaster Family Practice (MFP) in Hamilton aims to address these issues. This study explores how physicians use LIS, the challenges they face, their teaching and learning practices, and the role of health advocacy for patients with limited English proficiency (LEP).

Aim: This study aims to understand the experiences of physicians and residents using LIS in primary care, identify barriers to effective use, and provide recommendations for clinical, educational, and policy improvements. Additionally, the study examines how health advocacy can be leveraged to improve care for patients with LEP.

Methods: A qualitative descriptive design was employed, utilizing semi-structured interviews with 14 participants, including staff physicians and residents at MFP. Data was analyzed using directed content analysis to identify key themes and patterns in LIS use and perceptions.

Findings: Participants reported using various LIS, with family members and Google Translate being the most common. They used these services to collect patient information, communicate diagnoses and health information, and engage in health promotion and disease prevention. Significant barriers identified included time constraints, organizational challenges, and others. Many contextual factors influenced providers perception and use of LIS, such as race and power dynamics. Providers demonstrated health advocacy actions at the individual level, but not at the community or systems level. The theme of ‘getting by’ was prevalent in this study, where participants decided to continue a visit without appropriate LIS, even when necessary.

Conclusions: The study highlights the need for better integrating LIS in clinical practice through organizational support and targeted educational interventions. Addressing these barriers can enhance the quality of care for patients with language barriers and support health advocacy efforts within the primary care setting.