Linguistic and cultural barriers to health care among Chinese patients at the Toronto Western Hospital

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Eunice Lam
EJ Heathcote


Linguistic barriers to health care, cultural barriers, Chinese patients


Objective: Patient satisfaction surveys are primarily conducted in English and thus exclude respondents who cannot read or are not proficient in the English language. This study used a language and culture-specific questionnaire to explore potential barriers to health care among Chinese patients and to determine their satisfaction with health care services received at their visit to the Toronto Western Hospital (TWH), University Health Network.
Methods: A cross-sectional survey design was used. Patients were recruited from the General Internal Medicine inpatient ward and Tuberculosis, Liver and Angiography ambulatory care clinics at TWH. A questionnaire was administered by an interviewer to patients who self-identified as Chinese. The interviewer administered the questionnaire in English, Cantonese and Mandarin. The questionnaire explored three main topics which included language barriers, cultural barriers and patient satisfaction.
Results: A total of 138 patients were approached to participate in the study over a six week period. There was a 97.1% response rate. Of the 134 patients who participated in the study, 52% reported having difficulty speaking English but only 24% utilized the hospital’s interpretation and translation service.
Barriers to health care identified by patients included: limited discussion of use of Chinese medical therapies with physicians, difficulty understanding explanations provided by physicians and nurses, and difficulty finding a hospital staff member who could talk with them about their illness in their preferred language.
Conclusion: Language and culture-specific questionnaires can reveal barriers to health care in patients with limited English proficiency. These barriers need to be addressed to ensure delivery of quality health care in a culturally responsive manner.