Language barriers in nursing care

Abstract: Nurses today are faced with the challenges of caring in a multicultural environment. One of these challenges is the inability to communicate with the patient due to differences in language. Communication plays a key role in the nurse-patient relationship and determines the outcome of the care provided. The theory of transcultural nursing aims to educate nurses in providing person-centred culturally competent care and is a suggested strategy to overcome the barriers. Previous research from mixed healthcare professionals’ perceptions identify some effects and strategies, however without providing specific in depth insights into nursing. The aim of this study was to examine the effects of language barriers due to cultural differences on nursing care. An integrative literature review was conducted. Inclusion and exclusion criteria guided the selection. A literature search originating from the databases CINAHL and PubMed resulted in 15 included articles; 12 qualitative, two quantitative and one mixed-methods study. The analysis of the results gave rise to two major themes; effects on nursing and strategies. The results showed that nurses became aware of the effects both culture and language have on caring. Despite the time-consuming efforts of bridging the barrier, patients felt that the nurses’ attempts were inadequate. Non-verbal gestures and the use of familiar language were appreciated in providing safety and trust but insufficient when providing information. The most preferred strategy of using a formal interpreter was thwarted by lack of organisation and education. In order to ensure culturally competent care, nurses need more education as well as access to resources. Further research with quantitative approaches are required in order to generalise and impact the subject area. Patient- and clinicfocused methods could potentially highlight the current environment as experienced by patients accessing health care despite language barriers.