Communication Strategies in Language-Discordant Consultations Perspectives of Migrant Patients and Informal Caregivers

The Netherlands is experiencing an increase in language-discordant healthcare consultations. Without proper use of communication strategies, migrant patients with limited Dutch proficiency (LLP) are at risk of facing ineffective communication. While healthcare providers' views on these strategies have been examined, insights from migrant patients and informal caregivers are lacking. Using purposive and snowball sampling, we recruited 51 LLP migrant patients and informal caregivers (i.e., patients’ family members) for semi-structured interviews. The interviews were conducted in the interviewees’ preferred languages and analysed using the Thematic Analysis Method using both deductive and inductive approaches. Six key themes emerged: Healthcare providers often (1) diffused the responsibility for overcoming language barriers to informal caregivers or (2) ‘got-by’ with instrumental communication strategies. When these proved inadequate, and patients attended alone, providers (3) involved others (e.g., bilingual staff) as interpreters or (4) utilised digital translation tools. Some providers (5) implemented affective communication strategies to build rapport or address patients' emotions. However, there was an overall (6) insufficient usage of communication strategies. The overreliance on informal caregivers and limited communication strategy usage indicates ongoing issues in communication with migrant patients. Future research should develop tools to address language barriers and enhance healthcare communication.