Table 2.

Disconnected experiences impeding interactions, communication and decision-making

Sub-theme	Quote
Patient experience related to language barrier
Patients unable to express themselves to the healthcare team	PT 1 expressed: “I’m talking, but they’re not understanding. You make an effort to enunciate better. Sometimes you are not using the correct tone of a word, so that generates a block from people that, if they didn’t understand you the first time, let you go—they abandon you.” CL 2 recalled: “After [surgeons] applied a mesh, due to this incident, the young man was complaining that something was wrong and that what they had done was not right. We didn’t know what was going on, so we encouraged him and told him, ‘You have to wait. Healing takes time’ (…) he was not able to explain the level of pain he was in. He couldn’t express himself, so there were complications, and he needed a second surgery.”
Language barrier impedes patients understanding of healthcare team	PT 2 said: “[Communication] was somewhat difficult. As a Spanish-speaker, if they would speak English too fast, I couldn’t catch all of it.”
Language barrier affects patient level of confidence in medical decision-making	CG 3 noted:  “To be able to explain what is going on at the moment, such as the seriousness and the consequences, is tense because often (…) you have to be aware of, ‘Well, if I make this decision, where is this going to lead me?’”
Language barrier prevents patients from expressing themselves regarding medical decision-making	PT 11 said: “There are moments of a lot of stress, a lot of hard decisions, a lot of mental instability, so you can’t express your decision because you don’t speak the required language that is spoken at the hospital.”
Workarounds
Drawings	PT 2 said: “We had to make the decision about me getting a tube that went from my stomach to my liver (…) I was afraid (…) The doctors explained thoroughly, even with a drawing.”
Translation App	CG 1 noted: “I just got on the phone a translation app from English to Spanish.”
Body movements and gestures	PT 3 noted: “We would try to exchange information with each other (…) I would talk with my body movements, and [the medical care team] would respond with body movements (…) That made it easier.”