Language Adaptation in Health Care and Health Services: Issues and Strategies
For the 20% of Québec's population whose mother tongue is not French, communication in this language can create difficulties when dealing with the health and social services system. The presence of linguistic barriers in available services can have major negative repercussions on the health of patients. To ensure that anglophones and other linguistic minorities have access to services in their mother tongue, Québec health care facilities may use bilingual or translated documents, hire bilingual employees, offer second language courses to health professionals, or use interpretation services.
While bilingual or translated documents can make it easier to ask questions in another language, they do not ensure that the answers will necessarily be understood. Moreover, in Québec, documents translated into English may not be relevant in communications with allophone or aboriginal clienteles.
The use of bilingual employees has many benefits in terms of communication quality. However, the second language skills of these employees are rarely formally assessed. Furthermore, studies have shown that using bilingual employees as interpreters can negatively affect their productivity and cause human resource management problems. In Québec, hiring bilingual English-French employees seems to be a common practice for adapting services.
Second language courses for health professionals may help such professionals establish a relationship of trust with minority language patients. However, if their second language skills are not assessed and they do not use interpreters, use of the second language may lead to communication errors that can have negative consequences on the health of patients. Assuming that language proficiency is closely related to the frequency of language use, the appropriateness of this measure may be limited in situations where the second language is rarely used by professionals in their work. In Québec, English second language (ESL) courses offered to health professionals could be beneficial for facilities with a high percentage of patients whose mother tongue is English.
Use of professional interpretation services for patients with a limited knowledge of French would be the most beneficial solution for optimizing the quality of communication and care. It is therefore important to make professionals and managers aware of the benefits, while ensuring that interpretation services are available and interpreters are properly trained. In Québec, where resources are limited, especially in facilities with a low percentage of minority language patients, access to a central bank of interpreters would be one avenue to explore for both the anglophone minority and other linguistic groups.