Language barrier challenges in multi-lingual radiography setting : impact on effective patient communication

Abstract

Introduction Malta’s health-care system now serves a highly multicultural population, with a 2023 net migration of 20,960 predominantly non-EU newcomers. This linguistic diversity challenges radiographers, who must obtain accurate histories, give precise procedural instructions, and secure informed consent within very brief patient encounters. The present dissertation investigated the primary language-barrier challenges faced by radiographers in a large public hospital, assessed their perceived impact on communication, and explored demographic and organisational factors that shape these experiences. Methods A validated, cross-sectional questionnaire was distributed to 28 qualified radiographers. The sample was chiefly young (21-30 years) and female, mirroring the department’s workforce profile. Respondents reported strong proficiency in Maltese and English but limited competence in other languages. Results The most salient barrier was time pressure during patient encounters (mean = 3.96), indicating that workflow constraints frequently curtail thorough explanations. Systemic shortcomings followed: under-utilization of multilingual staff (mean = 3.11) and limited availability of professional interpreter services (mean = 3.00). Participants indicated that language barriers markedly reduced patient comprehension (mean = 4.57) and the ability to address patient concerns (mean = 4.39). Open-ended comments revealed reliance on ad-hoc interpreters, family members or bilingual colleagues, raising concerns about confidentiality, accuracy, and increased repeat imaging. Younger radiographers perceived time constraints more acutely; gender differences were modest and not statistically significant. These findings align with broader European literature that attributes communication breakdowns primarily to organizational, rather than individual, language deficits. Conclusions Language barriers in Maltese radiography are fundamentally systemic. Heavy workloads, insufficient interpreter infrastructure, and the lack of formal mechanisms to mobilize existing multilingual staff erode effective radiographer-patient dialogue, compromising safety, increasing repeat examinations, and elevating radiation exposure. Implications for Practice 1. Centralized interpreter service: Implement an on-demand, professional medical interpreter platform integrated into radiology workflows. 2. Curricular and CPD integration: Embed mandatory cross-cultural communication and interpreter-use training in undergraduate radiography programs and continuing professional development. 3. Scheduling redesign: Adjust appointment-booking protocols to allocate additional time for patients requiring interpretation, ensuring comprehensive explanations without sacrificing departmental efficiency.