Language Discordance and Patient-Centered Care in Occupational Therapy: A Case Study

OTJR (Thorofare N J), 2015 · DOI: 10.1177/1539449215575265 · Published: April 1, 2015

Patient Experience Rehabilitation Public Health

Simple Explanation

This study explores how language differences between occupational therapists and patients affect the quality of care. It looks at the experiences of a Spanish-speaking patient, his wife, an English-speaking student therapist, and her supervisor. The research found that communication barriers made it difficult to set goals, build trust, and provide effective treatment. Using untrained interpreters also created safety concerns and ethical issues. The study suggests that occupational therapy programs need to better prepare students to work with diverse populations and that healthcare facilities should provide more support for language access services.

Study Duration

6 Weeks

Participants

A patient, his wife, a Level II Fieldwork student, and the student’s fieldwork educator

Evidence Level

Level IV, Case Study

Key Findings

1
Language discordance negatively impacts the ability to establish treatment goals and educate patients about occupational therapy, leading to frustration and a lack of understanding of the importance of therapy.
2
Communication barriers impede the development of strong therapeutic relationships, limiting patient engagement and shared decision-making, and impacting practitioner confidence.
3
The use of untrained interpreters can compromise patient safety, treatment fidelity, and ethical standards, highlighting the need for trained language access services and awareness of clinical boundaries.

Research Summary

This case study explores the impact of language discordance on patient-centered care in occupational therapy, focusing on the perspectives of a patient-provider-caregiver triad. The study identifies communication barriers as a primary obstacle to effective care, affecting goal setting, therapeutic relationships, and patient safety. The findings highlight the need for improved training, institutional support, and access to qualified interpreters to ensure equitable and patient-centered care for diverse populations.

Practical Implications

Enhance Training Programs

Incorporate comprehensive training on cultural competence and working with interpreters into occupational therapy curricula.

Improve Language Access

Increase the availability of trained interpreters and language access services in healthcare facilities.

Promote Patient-Centered Communication

Encourage practitioners to develop strategies for effective communication with patients who have limited English proficiency.

Study Limitations

1
Purposeful sampling of one patient-provider-caregiver triad
2
Enrollment of a patient-caregiver dyad that self-identified as Hispanic/Latino
3
Six week study period

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