# The impact of language barriers on patients’ perception of their physician’s involvement in shared decision-making

## TL;DR

Language barriers in healthcare reduce patients' satisfaction with their involvement in treatment decisions, especially in multilingual settings like Saudi Arabia.

## Contribution

This study identifies the impact of language barriers on shared decision-making perceptions in Jeddah, Saudi Arabia.

## Key findings

- Patients with language barriers rated physician involvement as 'Very Good' only 17% of the time, compared to 72% without barriers.
- Saudi nationals were more likely to rate involvement as 'Very Good' than non-Saudis (43.5% vs. 23.3%).
- Positive ratings were strongly linked to physician listening, politeness, and clear explanations.

## Abstract

Effective communication is essential in healthcare, particularly when involving patients in treatment decisions. In multilingual settings like Saudi Arabia, language barriers may influence patients’ perceptions of their involvement in shared decision-making. This study explores how language barriers affect patients’ perceptions of their physician’s involvement in treatment decisions in Jeddah.

To assess how language barriers affect patients’ satisfaction with their physician’s involvement in shared decision-making and to identify key communication-related factors influencing these ratings.

This cross-sectional study was conducted in Jeddah, Saudi Arabia, from July to October 2024. Adult patients from diverse linguistic backgrounds receiving care at multiple hospitals were included. A total of 410 responses were collected via an online questionnaire, with 399 included in the final analysis. The survey assessed language barriers, patients’ ratings of physician behaviors related to involvement in decision-making, and satisfaction with involvement in care decisions. Descriptive statistics were used, and associations were analyzed using Chi-square (χ2) tests.

Language barriers were significantly associated with lower ratings of physician involvement in decision-making according to rh patient (p < 0.001). Only 17% of patients with communication difficulties rated involvement as “Very Good,” compared to 72% without barriers. Among patients who never felt understood, 74.3% gave poor ratings. Positive ratings were strongly associated with physician listening, politeness, and clear explanations (p < 0.001). Saudi nationals were more likely than non-Saudis to rate involvement as “Very Good” (43.5% vs. 23.3%; p < 0.001).

Language barriers significantly impact patients’ satisfaction with their physician’s involvement in shared decision-making. Enhancing communication through training and interpretation services can improve patient engagement and overall care quality.