Communication Accommodation Between Nurses and Patients at a Private Tertiary Hospital: A Protocol Paper

Effective communication between nurses and patients is essential for delivering safe and high-quality healthcare. In Malaysia, although English is the official working language in many private hospitals, many nurses are more comfortable using Malay. This often creates communication challenges when interacting with English-speaking patients, including expatriates, medical tourists, and long-term foreign residents who may not understand local expressions or cultural norms. This barrier can lead to misunderstandings, reduced patient satisfaction, and potentially adverse health outcomes. This study applies Communication Accommodation Theory (CAT) to examine the English language challenges faced by Malaysian nurses and how they adapt their communication when engaging with patients at a private tertiary hospital. CAT offers a useful lens for understanding how individuals adjust their speech and behaviour to foster understanding and connection. The study investigates the use of accommodation strategies, convergence, divergence, overaccommodation, and underaccommodation, and their impact on patient trust and communication effectiveness. A mixed-methods approach will be used, combining quantitative data from nurse questionnaires with qualitative data from interviews with both nurses and patients. Where permitted, non-participant observations of nurse-patient interactions will also be conducted to gain deeper insights into real-world communication practices. The findings are expected to inform the development of targeted communication training and support for Malaysian nurses, enhancing their ability to interact effectively across linguistic and cultural boundaries. This research also contributes to the limited literature on nurse-patient communication in Malaysia, particularly in multilingual and multicultural healthcare settings.