Lost in translation: exploring therapists’ experiences of providing stroke rehabilitation across a language barrier

Purpose: This study sought to explore English-speaking therapists' experiences of providing stroke rehabilitation to non-English speaking individuals in an urban area. Methods: This was a qualitative study using focus groups. Two focus groups were conducted. Participants included physiotherapists, occupational therapists, speech and language therapists and a psychotherapist (n=13). A grounded theory approach was used to analyse data. Results: Factors affecting rehabilitation were categorised under themes of engagement, practicalities and social context. Subtle communication was identified as a core category that ran through all themes, illustrating therapists' use and interpretation of subtleties and nuances which a language barrier impeded. Providing rehabilitation across a language barrier was found to present significant challenges. Therapists perceived that assessment and treatment are likely to be delayed and limited in scope, especially regarding cognition and neurological communication disorders. A conceptual model of factors involved in rehabilitation across a language barrier was generated. Conclusions: Therapists perceive that rehabilitation is affected by a language barrier. The conceptual model illustrates the interrelationship between factors affecting rehabilitation provision when there is a language barrier. Subtle communication was found to be an important therapeutic tool which was lost across a language barrier, and may have broader relevance to therapeutic relationships in the field of rehabilitation. Further research is needed to gain insights into experiences of individuals receiving rehabilitation across a language barrier and to identify how to enhance the efficacy of rehabilitation for them.Implications for RehabilitationAs it appears rehabilitation is affected by a language barrier, this is likely to impact on the outcome of an individual's rehabilitation.The concept of "subtle communication" should be recognised as a vital component of therapeutic skills.Improving access to formal interpreters, extending their role and introducing training could reduce practical barriers.The conceptual model could be utilised by clinicians as a tool for reflection or education.