Abstract
The language used to present an argument has long been argued to influence people’s reaction to that argument. This study examined how language and grammatical structure influenced response to health-related dilemmas. We investigated whether medical students’ willingness to receive a medical treatment or to take an action (regarding advancing one’s own health or other people’s health) was influenced by the language (first versus foreign) and the grammatical structures (modifiers and quantifiers) used. Saudi medical students (N = 368) read health-related dilemmas using different adverbial modifiers and quantifiers in Arabic or in English. The participants were randomly assigned to one of four conditions: Arabic with high certainty (i.e., very-modifier and all-quantifier), Arabic with low certainty (no very-modifier and some-quantifier), English with high certainty, and English with low certainty. The results showed that the participants were susceptible to a foreign language effect, but not to a grammatical structure effect. We discuss the implications of these results in relation to how different health-scenarios may affect decision making for health professionals.
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Dr. Reem Alkhammash would like to acknowledge Taif University Researchers Supporting Project number (TURSP-2020/173) Taif University, Taif, Saudi Arabia.
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Appendices
Appendix A
Health scenarios.
Situation | English version | Arabic version |
|---|---|---|
Fasting while sick | You are very ill and need to take medication during the day after meals. Ramadan comes, and you start thinking about whether to postpone your medication until after breakfast to see how much you can tolerate, or to break your fast and follow the pharmacist’s instructions that those in the same situation should take the medicine in time and fast later What would you do? 1. Definitely fast 2. Fast 3. Not sure 4. Not fast 5. Definitely not fast |
|
Medicine interaction | You are getting older and you have heard about hormonal treatment that will make you look so much younger and stronger. You ask your doctor about whether he can do it. The doctor says that people with your health conditions should not take the treatment. As you are taking other medications, it will cause very serious health complications What would you do? 1. Definitely take the treatment 2. Take the treatment 3. Not sure 4. Not take the treatment 5. Definitely not take the treatment |
|
Receiving treatment during Ramadan | You have a medical appointment during Ramadan and you have prior knowledge that your doctor will place nasal drops because you have inflammation of the nose. The doctor tells you that all patients in the same condition should take the nasal drop. You start thinking that if you go to the appointment, you are going to break the fast. Also, if you don’t go, you’ll have to reschedule your appointment and there may not be a date soon What would you do? 1. Definitely go to the appointment 2. Go to the appointment 3. Not sure 4. Not go to the appointment 5. Definitely not go to the appointment |
|
Consuming food for medical reason during Ramadan | You have a stomachache that is very painful during Ramadan. You think about eating a small amount of food to lower your pain. But you will break your fast What would you do? 1. Definitely eat food 2. Eat food 3. Not sure 4. Not eat food 5. Definitely not eat food |
|
Consuming food for urgent medical reason during Ramadan | While you are fasting, you feel like you are about to faint. According to your doctor’s advice, all patients in the same condition must eat something. You look at the watch and you find that there is only a little while left for breakfast What would you do? 1. Definitely eat food 2. Eat food 3. Not sure 4. Not eat food 5. Definitely not eat food |
|
Serious illness | You are a pharmacist. A person comes to you with a prescription to ask what this medication is for. It looks like the person does not have any idea what his/her illness is. You are inclined to tell the person as all people in his/her case should take the medication regularly. You also think it is not your duty to disclose any information to this person What would you do? 1. Definitely tell about the illness 2. Tell about the illness 3. Not sure 4. Not tell about the illness 5. Definitely not tell about the illness |
|
Potential harm | You work as a doctor. A person who does not have any condition requests hormone therapy for a cosmetic purpose. You know that all people should avoid this treatment because of its complications. But the person insists that he/she is aware of the risks and wants to go ahead with hormone therapy What would you do? 1. Definitely give the treatment 2. Give the treatment 3. Not sure 4. Not tell about the illness 5. Definitely not tell about the illness |
|
Refusing medications for side-effects/ patient’s adherence to medicines | You are a pharmacist. A person comes to the pharmacy with a prescription. You explain that this medicine has very serious side-effects. The person decides not to take the medication. You think you could convince the person by explaining further that if medication is not taken, his/her medical condition will worsen What would you do? 1. Definitely convince the person of the bad outcome 2. Convince the person of the bad outcome 3. Not sure 4. Not convince the person of the bad outcome 5. Definitely not convince the person of the bad outcome |
|
Stopping medication when experiencing no symptoms | You are a pharmacist. A person comes to the pharmacy to tell you that they have stopped taking their medication because they feel better. You check their prescription and see that they still need to take their medication for three more days. You explain that this medicine should be taken for three more days, but the person decides not to take the medication. You think you could persuade the person to take the medication by telling them that people who do not take their medication regularly could get very sick What would you do? 1. Definitely convince the person to take medication 2. Convince the person to take medication 3. Not sure 4. Not convince the person to take medication 5. Definitely not convince the person to take medication |
|
Removing something harmful from the road | You are driving on the highway when you see a branch of tree laid in the middle of the road. You think this branch can harm all people who crash into it. At the same time, you are driving fast, and it is hard to stop the car in the middle of the highway What would you do? 1. Definitely remove the tree 2. Remove the tree 3. Not sure 4. Not remove the tree 5. Definitely not remove the tree |
|
Donating organs after death | You go to a shopping center and you are stopped by a group of Ministry of Health employees to let you know about the benefits of donating organs after death. They tell you about the importance of registering as an organ donor, and that it is a very important step. You also do not want to think about what would happen to your body after death What would you do? 1. Definitely register as an organ donor 2. Register as an organ donor 3. Not sure 4. Not register as an organ doner 5. Definitely not register as an organ donor |
|
Donating blood | You receive a WhatsApp message asking you to donate blood to one of your acquaintances. You want to help. However, your doctor advises you not to donate blood as all people with your medical case should not What would you do? 1. Definitely donate blood 2. Donate blood 3. Not sure 4. Not donate blood 5. Definitely not donate blood |
|
Donating organs alive | You attend a workshop about the importance of donating organs to other people. You can still live a satisfying life, but your health is not great. You know that by donating you save the lives of all people who use your organs. The purpose of the workshop is to recruit people as potential doners What would you do? 1. Definitely register as an organ donor 2. Register as an organ donor 3. Not sure 4. Not register as an organ doner 5. Definitely not register as an organ donor |
|
Helping a sick person | You are walking on the street, and you see an old person falling in front of you. The person seems to be very sick and at the same time you think this person does not wear a mask. He/she might pose a potential danger to you by not wearing a mask. You think this person can be unconscious and his/her case will be worsening. At the same time, you care about social distancing and taking all the precautionary health measures What would you do? 1. Definitely help the person 2. Help the person 3. Not sure 4. Not help the person 5. Definitely not help the person |
|
Appendix B
Means and standard deviations for all groups in all dilemma scenarios.
Dilemma Scenario | Group | M | SD |
|---|---|---|---|
Fasting while sick | L1 no very | 2.59 | 1.54 |
L1 very | 2.61 | 1.42 | |
L2 no very | 3.33 | 1.30 | |
L2 very | 3.39 | 1.25 | |
Taking treatment with possible interactions | L1 no very | 1.28 | 0.95 |
L1 very | 1.59 | 1.07 | |
L2 no very | 2.52 | 1.64 | |
L2 very | 2.29 | 1.40 | |
Breaking fast due to pain | L1 no very | 3.67 | 1.31 |
L1 very | 3.65 | 1.23 | |
L2 no very | 3.35 | 1.13 | |
L2 very | 3.51 | 1.15 | |
Pharmacist convincing patient to take medication despite possible side-effects | L1 no very | 4.17 | 1.00 |
L1 very | 3.98 | 1.10 | |
L2 no very | 3.85 | 1.09 | |
L2 very | 3.80 | 1.07 | |
Pharmacist convincing patient not to stop medication despite feeling well | L1 no very | 4.36 | 0.89 |
L1 very | 4.05 | 1.16 | |
L2 no very | 4.11 | 0.98 | |
L2 very | 3.95 | 1.14 | |
Organ donation after death | L1 no very | 3.61 | 1.41 |
L1 very | 3.24 | 1.38 | |
L2 no very | 3.40 | 1.13 | |
L2 very | 3.54 | 1.16 | |
Helping sick old man who is not wearing mask | L1 no very | 4.68 | 0.58 |
L1 very | 4.20 | 0.98 | |
L2 no very | 3.94 | 0.99 | |
L2 very | 3.89 | 1.10 | |
Breaking fast due to medical treatment | L1 some | 3.77 | 1.25 |
L1 all | 3.71 | 1.21 | |
L2 some | 3.38 | 1.08 | |
L2 all | 3.29 | 1.25 | |
Breaking fast due to passing out | L1 some | 3.04 | 1.58 |
L1 all | 3.26 | 1.33 | |
L2 some | 2.91 | 1.36 | |
L2 all | 3.09 | 1.32 | |
Pharmacist disclosing medical condition | L1 some | 3.91 | 1.16 |
L1 all | 3.94 | 1.20 | |
L2 some | 3.60 | 1.24 | |
L2 all | 3.69 | 1.08 | |
Doctor performing procedure despite possible complications | L1 some | 2.87 | 1.40 |
L1 all | 2.76 | 1.31 | |
L2 some | 3.28 | 1.04 | |
L2 all | 3.43 | 1.16 | |
Removing tree from highway | L1 some | 4.09 | 1.01 |
L1 all | 3.61 | 1.26 | |
L2 some | 3.52 | 1.15 | |
L2 all | 3.41 | 1.09 | |
Blood donation despite medical condition | L1 some | 2.38 | 1.64 |
L1 all | 2.33 | 1.30 | |
L2 some | 2.51 | 1.28 | |
L2 all | 2.76 | 1.32 | |
Organ donation while alive | L1 some | 3.19 | 1.42 |
L1 all | 2.80 | 1.28 | |
L2 some | 2.98 | 1.00 | |
L2 all | 3.26 | 1.21 |
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Alkhammash, R., Asiri, Y.A., Alqarni, I.R. et al. Can Language Influence Health Decisions? The Role of Foreign Language and Grammatical Structure. J Psycholinguist Res 52, 957–974 (2023). https://doi.org/10.1007/s10936-022-09918-z
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DOI: https://doi.org/10.1007/s10936-022-09918-z