title: Language difficulties in outpatients and their impact on a chronic pain unit in Northwest Switzerland.
abstract: BACKGROUND
  Many foreign patients attending our pain clinic are unable to understand one of the four Swiss national languages and are also unable to speak English. Therefore, communication with these patients can be very difficult or even impossible. Consequently, diagnosis and treatment may also prove difficult. Recognizing that language barriers can have deleterious effects, the use of an interpreter is at times the only way to communicate, however, the financial responsibility becomes that of the health care provider.
  
  
  METHODS
  The aim of this paper was to study the aspects of communication with immigrants and to discuss the effect of language difficulties on the organizational structure of a pain clinic. In our analysis, we prospectively included all patients attending our pain clinic between January 1st and December 31st, 2006 and 2008. The mother tongue, rather than the nationality, of the patients and their ability to communicate was registered.
  
  
  RESULTS
  In 2006, the communication of 92% of the patients was "good" or "very good". Communication was extremely difficult or impossible in 6% to 7%. No statistically significant difference was found between the number of consultations per patient per mother tongue, irrespective of the patient's ability to communicate. Additionally, the consultation times were significantly shorter in patients with a poor ability to communicate.
  
  
  CONCLUSIONS
  In 6% to 7% of our pain patients, communication was impossible or extremely difficult. Language barriers can be problematic in all cultures and consultation situations. The average consultation length may be associated with better outcomes in chronic pain patients.
authors.affiliation: Department of Anesthesia and Intensive Care Medecine, Universtiy Hospital, Basel, Switzerland. wruppen@gmail.com
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Ruppen
authors.forename: Oliver
authors.initials: O
authors.lastname: Bandschapp
authors.forename: Albert
authors.initials: A
authors.lastname: Urwyler
mesh_terms: D002908:Chronic Disease; D003144:Communication Barriers; D016001:Confidence Intervals; D054242:Emigrants and Immigrants; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D010045:Outpatients; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy; D018710:Pain Clinics; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012017:Referral and Consultation; D013557:Switzerland; D013997:Time Factors