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Chauhan A, Newman B, Manias E, Joseph K, Leone D, Walpola RL, Seale H, Smith AB, Harrison R. Creating safer cancer care with ethnic minority patients: A qualitative analysis of the experiences of cancer service staff. Health Expect 2024; 27:e13979. [PMID: 39102700 PMCID: PMC10825879 DOI: 10.1111/hex.13979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/12/2023] [Accepted: 01/12/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Effective consumer engagement practices can enhance patient safety. This is important for consumers from ethnic minority backgrounds who are exposed to increased risk of patient safety events. Using the Systems Engineering Initiative for Patient Safety model, this study explored staff experiences of creating opportunities for engagement with consumers from ethnic minority backgrounds to contribute to their cancer care safety. METHOD A qualitative study was conducted using semistructured interviews with cancer service staff from four cancer services across two states in Australia. Purposive sampling was used to recruit healthcare staff from a diverse range of professions. Data were analysed using the Framework Analysis method. RESULTS Fifty-four interviews were conducted with healthcare staff. Analysis of the qualitative interview data identified enablers and associated challenges that contributed to creating a shared understanding between consumers and staff of the information, processes, expectations and problems arising in care. Enablers and challenges are reported in relation to four themes: (1) co-creating safety through shared understanding of care processes; (2) tools and technologies support planned communication; (3) organisational policy levers exist but lack implementation in direct care and (4) formal tasks incorporate consumer engagement more readily than informal interactions. CONCLUSION The availability of infrastructure and resources to support communication with consumers from ethnic minority backgrounds was limited to specific tasks across the cancer care continuum. Strategies implemented by health services to foster effective communication during formal interactions now require expansion to support and create conditions for effective consumer engagement during informal and everyday care tasks. The use of innovative language support tools and cultural considerations are required at the service and system level to support consumer engagement in all types of care interactions. PUBLIC AND PATIENT INVOLVEMENT The study was embedded within a larger project that included a consumer investigator and was guided by a consumer advisory group (CAG). These consumer team members have lived experience of cancer and are from diverse ethnic backgrounds. CAG members provided feedback on the draft interview guide and participant information for this study.
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Affiliation(s)
- Ashfaq Chauhan
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Bronwyn Newman
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Elizabeth Manias
- School of Nursing and MidwiferyMonash UniversityClaytonVictoriaAustralia
| | - Kathryn Joseph
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Desiree Leone
- Multicultural Health ServicesWestern Sydney Local Health DistrictNorth ParramattaNew South WalesAustralia
| | - Ramesh L. Walpola
- School of Health SciencesUNSW SydneyKensingtonNew South WalesAustralia
| | - Holly Seale
- School of Population HealthUNSW SydneyKensingtonNew South WalesAustralia
| | - Allen Ben Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSWCamperdownNew South WalesAustralia
- Ingham Institute for Applied Medical ResearchLiverpoolUK
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
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2
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Tang C, Camp P. Supporting the Respiratory Health of Migrants and Refugees. Clin Chest Med 2023; 44:605-612. [PMID: 37517838 DOI: 10.1016/j.ccm.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Migrants and refugees are at risk of developing acute and chronic respiratory diseases at their destination countries. Yet, people from these populations are also least likely to access care within the current health care system across the world. Although biological, psychological, and social factors play a role in influencing risk of respiratory diseases among these populations, the influences from cultural differences on health behaviors cannot be ignored. Cultural differences are influential in affecting an individual's level of health literacy. Health professionals can contribute to the provision of equitable care to diverse communities through addressing issues related to linguistic and cultural differences.
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Affiliation(s)
- Clarice Tang
- Physiotherapy, Western Sydney University, Sydney, Australia; Allied Health, South Western Sydney Local Health District, Sydney, Australia.
| | - Pat Camp
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
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3
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Gabay G, Gere A, Zemel G, Moskowitz H. Personalized Communication with Patients at the Emergency Department—An Experimental Design Study. J Pers Med 2022; 12:jpm12101542. [PMID: 36294684 PMCID: PMC9605307 DOI: 10.3390/jpm12101542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Communication of clinicians at the emergency department is a barrier to patient satisfaction due to lack of human connection, lack of control over the situation, low health literacy, deficient information, poor support at a time of uncertainty all affecting perceived quality of care. This explorative study tests drivers of patient satisfaction with communication of clinicians at the emergency department. The sample comprises 112 Americans from the New York greater area, who visited an emergency department in the past year. A conjoint-based experimental design was performed testing six messages in six categories. The categories encompass acknowledged aspects of communication with health providers enabling to compare among them when exploring communication at the ED by patient preferences. Respondents rated messages by the extent to which it drives their satisfaction with communication of clinicians at the emergency department. Based on the similarity of patients’ response patterns to each message, three significantly distinct mindsets of patient preferences regarding communication exchanges with clinicians at the emergency department emerged. Different conduct and communication messages drive the satisfaction of members of each mindset with the communication of clinicians at the emergency department. The strong performing messages for one mindset are irrelevant for members of other mindsets. Clinicians may identify the patient-belonging to a mindset and communicate using mindset-tailored messages. This novel strategy may enable clinicians to implement patient-centered communication, by mindset, promoting patient satisfaction and enabling clinicians to better cope with patients in the chaotic emergency department environment.
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Affiliation(s)
| | - Attila Gere
- Institute of Food Science and Technology, Department of Postharvest, Supply Chain, Commerce and Sensory Science, Hungarian University of Agriculture and Life Sciences, 1118 Budapest, Hungary
- Correspondence:
| | - Glenn Zemel
- Dupage Valley Anesthesiologists, Inc., Naperville, IL 60101, USA
| | - Howard Moskowitz
- Mind-Genomics Associates, White Plains, White Plains, NY 10617, USA
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4
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Hwang K, Williams S, Zucchi E, Chong TWH, Mascitti-Meuter M, LoGiudice D, Goh AMY, Panayiotou A, Batchelor F. Testing the use of translation apps to overcome everyday healthcare communication in Australian aged-care hospital wards-An exploratory study. Nurs Open 2021; 9:578-585. [PMID: 34704379 PMCID: PMC8685780 DOI: 10.1002/nop2.1099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 11/08/2022] Open
Abstract
Aims and objectives To trial three mobile translation apps in the healthcare setting to address language barriers in everyday care between healthcare staff and older people with limited English proficiency (LEP). Design A mixed‐methods exploratory study. Methods A two‐month trial of three translation apps was conducted across four aged‐care hospital wards. Observed interactions during use of translation apps were recorded, and staff surveys regarding the use of translation apps were collected at the end of the trial. Data were analysed using descriptive statistics and thematic content analysis of open‐ended responses in the surveys and observations. Findings from the thematic content analysis are reported using the Standards for Reporting of Qualitative Research (SRQR) checklist. Results Translation apps were mostly used for identifying pain and assisting with activities of daily living. Qualitative findings revealed that translation apps aided staff in providing care and improved rapport; however, practical shortcomings were identified.
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Affiliation(s)
- Kerry Hwang
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Sue Williams
- National Ageing Research Institute, Parkville, Victoria, Australia
| | | | - Terence W H Chong
- University of Melbourne, Parkville, Victoria, Australia.,St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | | | - Dina LoGiudice
- University of Melbourne, Parkville, Victoria, Australia.,Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anita M Y Goh
- National Ageing Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
| | - Anita Panayiotou
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Frances Batchelor
- National Ageing Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
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5
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A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 3:100038. [PMID: 35480607 PMCID: PMC9030275 DOI: 10.1016/j.rcsop.2021.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Objectives Methods Results Conclusion
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6
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Silvera-Tawil D, Pocock C, Bradford D, Donnell A, Freyne J, Harrap K, Brinkmann S. Enabling Nurse-Patient Communication With a Mobile App: Controlled Pretest-Posttest Study With Nurses and Non-English-Speaking Patients. JMIR Nurs 2021; 4:e19709. [PMID: 34406964 PMCID: PMC8373371 DOI: 10.2196/19709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 12/17/2020] [Accepted: 06/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is growing concern regarding the implications of miscommunication in health care settings, the results of which can have serious detrimental impacts on patient safety and health outcomes. Effective communication between nurses and patients is integral in the delivery of timely, competent, and safe care. In a hospital environment where care is delivered 24 hours a day, interpreters are not always available. In 2014, we developed a communication app to support patients' interactions with allied health clinicians when interpreters are not present. In 2017, we expanded this app to meet the needs of the nursing workforce. The app contains a fixed set of phrases translated into common languages, and communication is supported by text, images, audio content, and video content. OBJECTIVE This study aims to evaluate the efficacy of the communication app to support nursing staff during the provision of standard care to patients from non-English-speaking backgrounds when an interpreter is not available. METHODS This study used a one-group pretest-posttest sequential explanatory mixed methods research design, with quantitative data analyzed using inferential statistics and qualitative data analyzed via thematic content analysis. A total of 134 observation sessions (82 pretest and 52 posttest) of everyday nurse-patient interactions and 396 app use sessions were recorded. In addition, a total of 134 surveys (82 pretest and 52 posttest) with nursing staff, 7 interviews with patients, and 3 focus groups with a total of 9 nursing staff participants were held between January and November 2017. RESULTS In the absence of the app, baseline interactions with patients from English-speaking backgrounds were rated as more successful (t80=5.69; P<.001) than interactions with patients from non-English-speaking backgrounds. When staff used the app during the live trial, interactions with patients from non-English-speaking backgrounds were rated as more successful than interactions without the app (F2,119=8.17; P<.001; η2=0.37). In addition, the level of staff frustration was rated lower when the app was used to communicate (t80=2.71; P=.008; r=0.29). Most participants indicated that the app assisted them in communicating. CONCLUSIONS Through the use of the app, a number of patients from non-English-speaking backgrounds experienced better provision of standard care, similar to their English-speaking peers. Thus, the app can be seen as contributing to the delivery of equitable health care.
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Affiliation(s)
- David Silvera-Tawil
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Marsfield, Australia
| | | | - DanaKai Bradford
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Pullenvale, Australia
| | | | - Jill Freyne
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Marsfield, Australia
| | - Karen Harrap
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Australia
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7
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Thonon F, Perrot S, Yergolkar AV, Rousset-Torrente O, Griffith JW, Chassany O, Duracinsky M. Electronic Tools to Bridge the Language Gap in Health Care for People Who Have Migrated: Systematic Review. J Med Internet Res 2021; 23:e25131. [PMID: 33955837 PMCID: PMC8138704 DOI: 10.2196/25131] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND People who have migrated or with a language barrier may face significant hurdles in accessing health care. Some apps have been specifically developed to facilitate the dialogue between health care professionals and people who have migrated who have low-level language proficiency or to promote health among people who have migrated. OBJECTIVE We conducted a systematic review to investigate development, acceptability, and effectiveness of these types of apps. METHODS We conducted a search of PubMed, Scopus, and Embase databases. We included all study designs (qualitative, quantitative, mixed) reporting development, evaluation of efficacy, or acceptability of apps facilitating dialogue with a health professional or promoting health for people who have migrated, minorities, or tourists with a language barrier, using any outcome. Two researchers selected the studies independently. We collected general information about the app, information about health literacy and cultural adaptation, information about the development of the app, evidence on acceptability or efficacy, and information on app use. Data were collected by 2 researchers independently and results were reviewed to verify agreement and reported according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis). RESULTS Positive results for translation apps included better communication, but with possible limitations, and reduced consultation time. Positive results for health promotion apps included improved quality of life and better management of chronic illnesses. CONCLUSIONS Overall, the apps had good levels of acceptability, though only half had their efficacy evaluated. In those evaluations, the endpoints were mostly related to reported behavior change and knowledge improvement, which is common for evaluations of health promotion programs. In the future, as more health apps are created, it is essential that apps that claim to have a public health objective undergo a rigorous evaluation of their acceptability, efficacy, and actual use. Indicators of outcomes beyond changes in behavior and knowledge should be reported; change in health status or access to care should also be reported. This systematic review has helped us note the characteristics associated with improved acceptability and efficacy, which can be helpful for the development of future apps.
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Affiliation(s)
- Frédérique Thonon
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Swati Perrot
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | | | - Olivia Rousset-Torrente
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - James W Griffith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, F94270, Le Kremlin Bicêtre, France
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8
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Gerchow L, Burka LR, Miner S, Squires A. Language barriers between nurses and patients: A scoping review. PATIENT EDUCATION AND COUNSELING 2021; 104:534-553. [PMID: 32994104 PMCID: PMC8011998 DOI: 10.1016/j.pec.2020.09.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/05/2020] [Accepted: 09/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers. METHODS A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists. RESULTS 48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions. CONCLUSION Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload. PRACTICE IMPLICATIONS This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.
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Affiliation(s)
- Lauren Gerchow
- New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY, USA.
| | - Larissa R Burka
- New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY, USA
| | - Sarah Miner
- St. John Fisher College Wegmans School of Nursing, 3690 East Ave, Rochester, NY, USA
| | - Allison Squires
- New York University Rory Meyers College of Nursing, 433 1st Ave, New York, NY, USA
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9
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Skaczkowski G, Pejoski N, Kaur J, White V, Livingston PM, Wilson C. Distress and problem assessment among people living with cancer from Culturally and Linguistically Diverse backgrounds. Psychooncology 2020; 29:1662-1669. [PMID: 32748467 DOI: 10.1002/pon.5503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/07/2020] [Accepted: 07/22/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine whether routine assessment of distress, recommended as part of comprehensive cancer care, is utilised equally with culturally and linguistically diverse (CALD) vs non-CALD people living with cancer. METHODS A medical records review of all patients attending cancer-specific treatment units at a single tertiary hospital in Melbourne, Australia between 2015-2018. Recording of administration of the Distress Thermometer and Problem Checklist (DT and PC) was extracted for all patients. Details regarding how the DT and PC (used together) was administered were extracted for a random sub-sample of 294 CALD patients and 294 matched non-CALD patients. RESULTS A total of 6977 patients were identified (12.0% CALD). Just over half of the CALD (54.7%) and non-CALD (58.2%) patients had a recorded DT and PC (P > 0.05). For the sub-sample analysis, CALD patients were less likely to complete the form themselves (14.8% vs 75.9% non-CALD) and were more likely to have a family member complete the form (55.1% vs 15.1% non-CALD). CALD patients reported a similar level of distress to non-CALD patients. Distress scores for CALD and non-CALD patients were higher when family members completed the form. Provision of discussion, written information, referral offers and rates of referral acceptance were similar between CALD and non-CALD patients. CONCLUSIONS Assessment of distress and associated problems, and the process following assessment, were similar for CALD and non-CALD patients. However, differences in how the form was completed highlight the need for further improvements to ensure that CALD patients are actively involved in their care.
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Affiliation(s)
- Gemma Skaczkowski
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia.,Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia.,Department of Rural Health, Allied Health and Human Performance, University of South Australia, Melbourne, Australia
| | - Natalie Pejoski
- Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia
| | - Jasmeen Kaur
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Victoria White
- School of Psychology, Deakin University, Melbourne, Australia
| | - Patricia M Livingston
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Melbourne, Australia
| | - Carlene Wilson
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia.,Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, Australia
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10
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Chauhan A, Walton M, Manias E, Walpola RL, Seale H, Latanik M, Leone D, Mears S, Harrison R. The safety of health care for ethnic minority patients: a systematic review. Int J Equity Health 2020; 19:118. [PMID: 32641040 PMCID: PMC7346414 DOI: 10.1186/s12939-020-01223-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/16/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the nature and rate of patient safety events occurring amongst ethnic minority consumers, which is critical for the development of relevant intervention approaches to enhance the safety of their care. OBJECTIVES To establish how ethnic minority populations are conceptualised in the international literature, and the implications of this in shaping of our findings; the evidence of patient safety events arising among ethnic minority healthcare consumers internationally; and the individual, service and system factors that contribute to unsafe care. METHOD A systematic review of five databases (MEDLINE, PUBMED, PsycINFO, EMBASE and CINAHL) were undertaken using subject headings (MeSH) and keywords to identify studies relevant to our objectives. Inclusion criteria were applied independently by two researchers. A narrative synthesis was undertaken due to heterogeneity of the study designs of included studies followed by a study appraisal process. RESULTS Forty-five studies were included in this review. Findings indicate that: (1) those from ethnic minority backgrounds were conceptualised variably; (2) people from ethnic minority backgrounds had higher rates of hospital acquired infections, complications, adverse drug events and dosing errors when compared to the wider population; and (3) factors including language proficiency, beliefs about illness and treatment, formal and informal interpreter use, consumer engagement, and interactions with health professionals contributed to increased risk of safety events amongst these populations. CONCLUSION Ethnic minority consumers may experience inequity in the safety of care and be at higher risk of patient safety events. Health services and systems must consider the individual, inter- and intra-ethnic variations in the nature of safety events to understand the where and how to invest resource to enhance equity in the safety of care. REVIEW REGISTRATION This systematic review is registered with Research Registry: reviewregistry761.
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Affiliation(s)
- Ashfaq Chauhan
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, NSW, Australia.
| | - Merrilyn Walton
- School of Public Health, University of Sydney, Sydney, 2006, NSW, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, 3025, VIC, Australia
| | - Ramesh Lahiru Walpola
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, NSW, Australia
| | - Holly Seale
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, NSW, Australia
| | - Monika Latanik
- Multicultural Health, Western Sydney Local Health District, Westmead, 2145, NSW, Australia
| | - Desiree Leone
- Multicultural Health, Western Sydney Local Health District, Westmead, 2145, NSW, Australia
| | - Stephen Mears
- Hunter New England Health Libraries, Hunter New England Local Health District, Tamworth, 2310, NSW, Australia
| | - Reema Harrison
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, NSW, Australia
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11
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Müller F, Chandra S, Furaijat G, Kruse S, Waligorski A, Simmenroth A, Kleinert E. A Digital Communication Assistance Tool (DCAT) toObtain Medical History from Foreign-LanguagePatients: Development and Pilot Testing in a PrimaryHealth Care Center for Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041368. [PMID: 32093286 PMCID: PMC7068523 DOI: 10.3390/ijerph17041368] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 11/18/2022]
Abstract
Background: Language barriers play a critical role in the treatment of migrant and refugee patients. In Germany, primary care interpreters are often not available especially in rural areas or if patients demand spontaneous or urgent consultations. Methods: In order to enable patients and their physicians to communicate effectively about the current illness history, we developed a digital communication assistance tool (DCAT) for 19 different languages and dialects. This paper reports the multidisciplinary process of the conceptual design and the iterative development of this cross-cultural user-centered application in an action-oriented approach. Results: We piloted our app with 36 refugee patients prior to a clinical study and used the results for further development. The acceptance and usability of the app by patients was high. Conclusion: Using digital tools for overcoming language barriers can be a feasible approach when providing health care to foreign-language patients.
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Affiliation(s)
- Frank Müller
- Department of General Practice, University Medical Center Göttingen/Georg-August-University, Humboldtallee 38, 37073 Göttingen, Germany or (S.K.); (E.K.)
- Correspondence:
| | - Shivani Chandra
- Institute for Health System Solutions and Virtual Care (WIHV), Women’s College Hospital, 76 Grenville St, Toronto, ON M5S 1B2, Canada;
- Crossroads Clinic, Women’s College Hospital, 76 Grenville St, Toronto, ON M5S 1B2, Canada
| | - Ghefar Furaijat
- Department of General Practice, University Medical Center Göttingen/Georg-August-University, Humboldtallee 38, 37073 Göttingen, Germany or (S.K.); (E.K.)
| | - Stefan Kruse
- Department of General Practice, University Medical Center Göttingen/Georg-August-University, Humboldtallee 38, 37073 Göttingen, Germany or (S.K.); (E.K.)
| | | | - Anne Simmenroth
- Department of General Practice, University Medical Center Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany;
| | - Evelyn Kleinert
- Department of General Practice, University Medical Center Göttingen/Georg-August-University, Humboldtallee 38, 37073 Göttingen, Germany or (S.K.); (E.K.)
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