Health risks among long-term immigrants in Norway with poor Norwegian language proficiency

Patient education in multilingual groups of cardiac patients: Mission (im)possible?

Objective

In Norway, cardiac rehabilitation with patient education is usually accessible only to patients who understand Norwegian. The Cardiac Care Class (CCC) in focus in this article is a unique healthcare service in that, via interpreting services, it provides patient education to patients with limited Norwegian proficiency (LNP). This article examines the adaptations carried out to make cardiac rehabilitation accessible to LNP patients.

Methods

The data stem from a qualitative study with participant observation during interpreter-mediated CCCs and from interviews with healthcare professionals, patients, and interpreters conducted by an interdisciplinary team. The collaborative data analysis focused on identifying various forms of adaptations.

Results

Providing interpreting in CCCs required organizational, logistical, and pedagogical adaptations, including having fewer class participants, engaging qualified interpreters, conducting pre-class meetings with the interpreters, and adjusting the course content and language. Communication was found to be satisfactory, although some critical issues (e.g., interpreters' working conditions) were raised.

Conclusion

This study showed that interpreter-mediated CCCs can reach multilingual groups provided that the necessary adaptations are made.

Innovation

This research is the first to show how a cardiac rehabilitation class in Norway is made accessible to multilingual patient groups by providing interpreting.

Norwegian "dugnad" as a rhetorical device in public health communication during the COVID-19 pandemic. A qualitative study from immigrant's perspectives

BACKGROUND

During the COVID-19 pandemic, the Norwegian government appealed to the term "national dugnad" in the communication of containment measures as a call for collective action to fight the spread of infection. "Dugnad" is traditionally associated with solidarity, social responsibility, and a communal spirit in the form of volunteer work carried out by a local community. Although the word "dugnad" is difficult to translate to other languages, it was used as a rhetorical device by the government to communicate health-related information during the pandemic. This study aims to explore how immigrants understood and related to the term "dugnad" as used in the context of the COVID-19 pandemic in Norway.

METHODS

We conducted 55 semi-structured interviews in 2020 with immigrants from Poland (10), Syria (15), Somalia (10), Sri Lanka (10), and Chile (10). Interviews were conducted in participants' mother-tongues. We used systematic text condensation following Malterud's four steps to analyze the data.

RESULTS

The results are organized into three themes corresponding to: (1) meaning making of the term "dugnad"; (2) attitudes towards the term "dugnad"; and (3) reactions to the use of "dugnad" in a public health context. Overall, participants were familiar with the term "dugnad" and positively associated it with volunteering, unity, and a sense of community. However, we found a variety of reactions towards using this term in a public health context, ranging from agreement to disagreement and irritation.

CONCLUSION

Health communication during pandemics is crucial for maximizing compliance and gaining control of disease spread. In multicultural societies, governments and authorities should be aware of the linguistic and cultural barriers to public health communication if they are to effectively reach the entire population. The use of culturally specific concepts in this context, specially as rhetorical devices, may hinder effective health communication and increase health inequalities.

Civic communicators' view of and approach to health promotion for newly arrived migrants in Sweden

For newly arrived migrants, integration is important in promoting health and decreasing health inequities. In a Swedish context, civic orientation is a program to promote integration and increase the chance of employment for newly arrived migrants. The aim of this project was to explore how civic communicators view and approach health promotion in their work with newly arrived migrants in the civic orientation program in Sweden. Data were collected through interviews with eight civic communicators working with newly arrived migrants in civic orientation in the north of Sweden. The interviews followed a semi-structured interview guide and were transcribed verbatim and analyzed using thematic analysis. The analysis resulted in the main theme “To dress the participants for a (healthy) life in Sweden,” with two sub-themes “Knowledge—a key to health” and “Being a guide for participants in a new context.” In their work with civic orientation for newly arrived migrants, civic communicators are involved in health promotion by preparing their participants for a life in Sweden. They work to empower their participants to be able to make informed decisions and live healthy lives by both providing information to enhance knowledge and skills. They also work to guide them through the complexity of being in a new situation and country.