Patient-First Language Can Affect Patient Care

September 29th, 2021

By Jill Drachenberg, Editor, Relias Media

In recent years, clinicians have been shifting toward person-first language in patient care. Using terms such as “person with epilepsy” instead of “epileptic” (identity-first language) and “person with alcohol use disorder” instead of the more stigmatized “alcoholic” defines the patient as a person rather than a disorder.

Recent research shows that person-first language can affect the care of patients seeking mental healthcare. A survey was sent to 251 counselors and student counselors, with half receiving a version that used “schizophrenic” and the other half received “person with schizophrenia.” Those who received materials with “schizophrenic” scored lower in benevolence and higher in authoritarian views than those who received “person with schizophrenia.” The authors did not study whether these views affected counselors’ daily practice.

“Language matters. The words we use can either reduce stigma and improve the quality of care that our clients receive, or our words can make counselors less likely to treat their clients with basic human dignity and respect,” said lead author Darcy Haag Granello, PhD, of The Ohio State University. “The take-home message is clear — all people, even mental health professionals, are affected by the words and labels that we use. We now have empirical evidence that taking the time to utter a few more syllables and include the word ‘person’ has real potential to make a difference in the lives of our clients.”

The push for person-first language began in 1974. While it is taught in medical school curricula, it is not the norm in all practice settings. “When practitioners do not use person-first language, they may place a barrier between themselves and the person in their care,” the authors of a 2019 paper noted. “This barrier enables the practitioner to view the diagnosis or injury independently from the individual, distancing them from the person and shielding them from having to consider the person as a whole and all the complexities that entails. … While there are many possible reasons why person-first language has not been adopted into practice by all health care providers, the possibility that some providers may need the psychological distance that is provided by the disuse of person-first language is the most intriguing. The notion that providers may not be able to take on the burden of treating every patient as a person and may need to solely focus on the impairment or disease warrants further investigation and could provide greater insight into both provider burnout and the role language plays in patient care.”

Another reason identity-first language might be used is a patient’s personal preference. For instance, many members of the deaf community prefer identity-first language and capitalization of “Deaf,” rather than the term “hearing-impaired,” as many consider it an identity or culture rather than a disability.

“The extent to which individuals with disabilities identify with disability culture is affected by the development of their own identity in relation to their disability, and the choice of whether to use identity-first or person-first language may be impacted by the stage of the individual’s disability identity development and whether or not the disability is congenital or acquired, and whether the condition is temporary or one with long-term or lasting effects,” the paper authors noted. “While use of person-first language is a step in the right direction, it is by no means a perfect solution and should be practiced with the full understanding that it may not be accepted by all individuals.”