SSHRC
2007-2009

Talking about pain: Healthcare communication in a second language

Segalowitz, N. (Concordia University), Gatbonton, E. (Concordia University), Kehayia, E. (McGill), & Turner, C.E. (McGill)

This research looks at issues related to communication between patients and health professionals who do not share the same first language and where at least one of them has to use a second language. In Canada, this is the situation for many linguistic minority groups, especially Francophone communities outside Québec and Anglophone communities in some parts of Québec. It is also true for many members of First Nations communities and many immigrant groups. The proposed research aims to understand how encounters between patients and health professionals may be compromised when communication involves at least one person speaking nonfluently in his or her second language. The research also aims to address how language training for health professionals can be improved.

The particular focus of this research proposal is communication between English and French speakers in situations where a health professional uses a second language nonfluently while discussing a person's experience of pain with them. There are four 4 specific questions that will be addressed:

• How does communication unfold differently when a health professional uses second language English or French nonfluently compared to using the first language fluently?
• What is the impact on people who are talking about their pain experiences when the health professionals use a nonfluent second language, compared to the impact when they use the first language fluently?
• What are the linguistic needs of health professionals who want to communicate better in their second language?
• Can the answers to the above questions be used to develop and evaluate a 6-hour second-language training module in English and French for health professionals?

In the long-term, the goal of this research is to contribute toward ensuring that patients from linguistic minorities will have access to health professionals able to communicate fully with them.

This three-year research program will comprise four studies. All the studies focus on issues regarding patient-health professional communication about pain. The participant health professionals will be Anglophone and Francophone medical students and the "patients" will be Anglophones and Francophones from the general population. Study 1 looks at differences in the linguistic characteristics of exchanges about pain with a health professional when that person uses a nonfluent second language versus a fluent first language. Study 2 examines whether the people having a medical conversation about pain are affected by the fact that the health professional is speaking to them nonfluently in a second language, compared to speaking fluently in a first language. Study 3 looks at this question further by asking whether people listening to a conversation between a patient and a health professional will judge the health professional's competence and personality differently as a function of whether he or she is speaking a nonfluent second language or a fluent first language. Finally, Study 4 will use the insights from the previous studies to develop an innovative second-language training module for improving health professionals' ability to converse with patients about pain and will also evaluate that module.

The proposed research is original because it will use a variety of qualitative and quantitative methods, generally used by others to study first language communication in healthcare contexts, and apply them to the study of second language communication in healthcare contexts. An interdisciplinary team of four investigators with expertise in communication analysis and assessment, psycholinguistics, second language pedagogy, applied linguistics, linguistics, cognitive psychology, and qualitative and quantitative research methods, plus 3-4 graduate and several undergraduate Honours students will work on the project. The research will have an impact on language training for health professionals, on health access for linguistic minorities and will contribute to our understanding of healthcare communication in contexts that are frequently encountered in Canada.