The impact of language discordance between provider and patient on perioperative anesthetic care: A scoping review

Abstract

Objectives: Language discordance between patient and provider may impede effective communication, leading to difficult clinical decision-making, worse health outcomes, and decreased quality of care for underrepresented populations across multiple settings. These concerns extend to the perioperative setting, but the extent to which they impact anesthetic care is unclear. This scoping review aimed to identify the relevant literature and examine the effects of language discordance on the anesthetic and analgesic care across the perioperative setting.

Methods: Our search screened 3 large databases (MEDLINE, Embase, and Scopus) and identified 86 relevant primary sources related to preoperative care and consent, intraoperative management, and postoperative management.

Results: Eighty-six manuscripts met inclusion criteria. We found that language discordance hinders the patient education and consent process in the preoperative setting. In the intraoperative setting, language discordance often altered the anesthetic plan, leading to lower usage of regional anesthesia, and complicated communication with patients during intubation and emergence. In the postoperative setting, language discordance led to inconsistent opioid usage and pain scoring. While the use of interpreters and smartphone translation applications were shown to improve communication and reduce disparities for underrepresented populations in all settings, they were underutilized due to logistical barriers.

Practice implications: These findings emphasize the need for increased interpreter availability and utilization, as well as expanded written and video resources to ensure equitable care.

Conclusions: Language discordance impacts patient-provider communication in perioperative settings. Future studies should evaluate the quality and availability of medical translations and interpreter reliability to improve anesthetic care during language discordance.

Keywords: Analgesia; Anesthesia; Language; Language barrier; Language discordance.