# Healthcare Providers’ Perspectives on Patient–Healthcare Worker Communication in the Emergency Department: A Cross-Sectional Survey Study in Riyadh, Saudi Arabia

## TL;DR

This study explores communication challenges between healthcare workers and patients in a Saudi Arabian emergency department, finding that nurses face more difficulties and barriers than physicians.

## Contribution

The study provides insights into communication barriers in a Saudi ED and highlights differences in experiences between physicians and nurses.

## Key findings

- Nurses reported greater communication difficulty and higher perceived language and cultural barriers compared to physicians.
- Nurses had lower access to interpreters and higher participation in cross-cultural and empathy training.
- Language and cultural barriers showed a moderate positive correlation, and cumulative barriers were linked to increased communication difficulty.

## Abstract

Background: Effective communication between healthcare providers (HCPs) and patients is fundamental to quality emergency care. However, emergency department (ED) settings pose particular challenges due to time constraints, high patient volumes, and linguistic and cultural diversity. This study aimed to assess how physicians and nurses experience these communication barriers in a Saudi Arabian tertiary hospital ED and to identify factors associated with perceived communication difficulty.
Methods: This cross-sectional survey was executed at King Abdulaziz Medical City, Riyadh, Saudi Arabia, from November to December 2024. A convenience sample of ED physicians and nurses was invited to complete a structured, self-administered questionnaire assessing communication barriers, empathy behaviors, and discharge practices. Data were analyzed using chi-square and Fisher’s exact tests for categorical variables, and Mann-Whitney U tests for ordinal variables. Statistical significance was set at p<0.05.
Results: Among 157 respondents (78 physicians and 79 nurses), nurses reported greater communication difficulty (p<0.001) and higher perceived language and cultural barriers (both p<0.001). Interpreter access was lower among nurses (p<0.001). Although empathy behaviors were comparable, nurses reported higher participation in cross-cultural (51.9% vs. 10.3%) and empathy (48.1% vs. 28.2%) training. Language and cultural barriers demonstrated a moderate positive correlation (r=0.55, p<0.001), indicating a meaningful but not strong association. Furthermore, cumulative barrier exposure was associated with increased difficulty (p=0.008). Most providers (87.2%) delivered discharge instructions verbally.
Conclusion: Communication experiences differed significantly between physicians and nurses, with nurses reporting greater difficulty and barrier exposure. These findings point out the need for targeted, evidence-based interventions such as improved interpreter access and communication training while recognizing that conclusions are limited by the study’s cross-sectional, single-center design.