Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses' perspectives

J Clin Nurs. 2018 Mar;27(5-6):e1152-e1160. doi: 10.1111/jocn.14204.


Aim and objective: To explore nurses' perspectives of language barriers and their impact on the provision of care to patients with limited English proficiency from diverse linguistic background.

Design and methods: A qualitative descriptive approach was used. Using individual interviews and focus group discussions, data were collected from 59 nurses working in tertiary care hospitals in England. A thematic analysis was used to analyse the data.

Findings: Three themes, "multi-ethnicities and language barriers," "the impact of language barriers" and "communicating via interpreters," were identified. Communication was identified as the most important aspect of care provision and an essential component of a nurse's professional role regardless of the clinical area or speciality. Language barriers were identified as the biggest obstacles in providing adequate, appropriate, effective and timely care to patients with limited English proficiency. Use of professional interpreters was considered useful; however, the limitations associated with use of interpretation service, including arrangement difficulties, availability and accessibility of interpreters, convenience, confidentiality and privacy-related issues and impact on the patient's comfort were mentioned.

Conclusions: Language barriers, in any country or setting, can negatively affect nurses' ability to communicate effectively with their patients and thereby have a negative impact on the provision of appropriate, timely, safe and effective care to meet patient's needs.

Relevance to clinical practice: An understanding of language barriers can help nurses find appropriate strategies to overcome such barriers and, consequently, enhance the provision of effective care to patients affected by language barriers in any clinical setting in any healthcare system. The findings of the study have international relevance as language barriers affect healthcare provision in any country or setting.

Keywords: communication issues; interpreters; language barriers; limited English proficiency.

MeSH terms

  • Adult
  • Communication Barriers*
  • Culturally Competent Care
  • Female
  • Focus Groups
  • Health Services Accessibility / organization & administration*
  • Humans
  • Nurse-Patient Relations*
  • Patient-Centered Care / organization & administration
  • Qualitative Research
  • United Kingdom