The Power of the Tongue: A Systematic Review on Inclusive Language Practices in Patient-Centered Healthcare Settings Restricted; Files Only

Abstract

Background: Communication of health-related information is a crucial aspect of the professional work taking place in healthcare settings. Many studies have shown that language used in the delivery of health information and healthcare interactions can both positively and negatively impact patient health outcomes. A systematic review of the literature was conducted to identify best practices for decreasing harmful and biased language. 

Goal: To systematically identify and summarize evidence-based best practices for decreasing biased language usage by health sciences professionals working in healthcare and research.

Methods: A systematic search and review was conducted to locate peer-reviewed literature. An initial literature search was performed using ProQuest Sociological Abstracts, PubMed, and ScienceDirect databases. Covidence, a systematic literature review tool, was used by two reviewers to perform screening and data extraction of studies and to mitigate the risk of bias and poor reporting quality. PRISMA guidelines were used for the reporting process. A total of 128 full-text articles were deemed relevant for the review.

Results: A total of 128 papers were identified and title and abstract screened. After initial screening, 33 articles were deemed relevant for a full-text screen. This resulted in 12 articles meeting all eligibility requirements. Findings indicate a need for the use of inclusive language in healthcare settings and the challenges in implementing inclusive language in these settings.

Conclusion: Healthcare providers must be trained in inclusive language to enhance patient care quality, as advocated by organizations such as the American Medical Association and World Health Organization. Implementations such as inclusive language workshops and trainings are necessary to ensure the next generation of healthcare providers adopts these practices. Implementing these practices is a crucial step toward addressing systemic biases in the healthcare system, patient-centered care and improving health outcomes for all populations.

Keywords: Bias, Inclusive Language, Stigma, Healthcare workers, Infectious Diseases, Public Health, Patient-centered Care 

Table of Contents

LIST OF ABBREVIATIONS...................................................................

I.      INTRODUCTION..........................................................................1

Problem Statement.................................................................................4

Purpose Statement.................................................................................5

Research Objectives...............................................................................5

II.      BACKGROUND LITERATURE REVIEW.......................................5

a.      Terminology Usage:........................................................................6

i.      Person-Centered Care vs. Patient-Centered Care...............................7

ii.     People-first language......................................................................8

b.      Inclusive Language Research in a Limited Number of Health Issues.....9

c.     Lack of Action-oriented Inclusive Language Research........................11

III.     METHODOLOGY.......................................................................12

a.     Inclusion and Exclusion Criteria......................................................13

b.     Literature Search Strategy..............................................................14

c.     Screening, Extraction, and Review of Identified Literature..................14

i.      Covidence platform........................................................................14

ii.     Management of Literature..............................................................15

iii.    Screening Process..........................................................................16

iv.     Data Extraction............................................................................17

d.     Data Management.........................................................................18

e.      Data Synthesis and Analysis...........................................................18

f.      Ethical Considerations....................................................................19

IV.       RESULTS...................................................................................19

a.      Recruitment and Data Collection of Included Studies.........................21

b.      Study Participant Characteristics of Included Studies........................22

c.     Inclusion and Exclusion Criteria of Included Studies...........................22

d.     Measures and Outcomes of Studies...................................................23

e.      Key Conclusions of Included Studies.................................................24

V.       DISCUSSION & LIMITATIONS....................................................25

Discussion..............................................................................................25

a. More research & training on inclusive language.....................................26

b. Effects of racial bias on language usage.................................................27

Limitations.............................................................................................28

VI. CONCLUSION..................................................................................28

VII. PUBLIC HEALTH IMPLICATIONS AND RECOMMENDATIONS......29

VIII.     REFERENCES............................................................................31

IX.       APPENDICES.............................................................................43

a.     Appendix 1: Data Search..................................................................43

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	Patient-Centered Care Bias Public Health Infectious Diseases Stigma Inclusive Language Healthcare workers
Committee Chair / Thesis Advisor	Claudia Ordóñez, Emory University

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