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Köpsén S, Lilja M, Hellgren M, Sandlund J, Sjöström R. Midwives' and Diabetes Nurses' Experience of Screening and Care of Women with Gestational Diabetes Mellitus: A Qualitative Interview Study. Nurs Res Pract 2023; 2023:6386581. [PMID: 37546577 PMCID: PMC10404154 DOI: 10.1155/2023/6386581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies. Aim The aim of this study was to explore midwives' and diabetes nurses' experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines. Method Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman. Results The analysis of the interviews resulted in the overall theme "An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care." Difficulties in carrying out the important task of handling GDM while at the same time keeping the pregnancy in focus were central. Women were described as highly motivated to maintain a healthy lifestyle during pregnancy with the baby in mind, but it seemed difficult to maintain this after delivery, and compliance with long-term follow-up with the aim of reducing the risk of T2DM was low. The women came to the first follow-up but did not continue with later contact. This was at a time when the women felt healthy and were focusing on the baby and not themselves. A lack of cooperation and easy access to a dietician and physiotherapist were pointed out as well as a wish for resources such as group activities and multiprofessional teams.
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Affiliation(s)
- Sofia Köpsén
- Department of Community Medicine and Rehabilitation, Unit of Research, Education and Development-Östersund, Umeå University, Umeå, Sweden
| | - Mikael Lilja
- Department of Public Health and Clinical Medicine, Unit of Research, Education and Development-Östersund, Umeå University, Umeå, Sweden
| | - Margareta Hellgren
- The Skaraborg Institute, Sweden. Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Jonas Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Rita Sjöström
- Department of Community Medicine and Rehabilitation, Unit of Research, Education and Development-Östersund, Umeå University, Umeå, Sweden
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Dominicé Dao M, Gerosa D, Pélieu I, Haller G. Allophone immigrant women's knowledge and perceptions of epidural analgesia for labour pain: a qualitative study. BMJ Open 2022; 12:e057125. [PMID: 35428638 PMCID: PMC9014067 DOI: 10.1136/bmjopen-2021-057125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To explore allophone immigrant women's knowledge and perceptions of epidural analgesia for labour pain, in order to identify their information needs prior to the procedure. DESIGN We conducted focus groups interviews with allophone women from five different linguistic immigrant communities, with the aid of professional interpreters. Thematic analysis of focus group transcripts was carried out by all authors. SETTING Women were recruited at two non-profit associations offering French language and cultural integration training to non-French speaking immigrant women in Geneva. PARTICIPANTS Forty women from 10 countries who spoke either Albanian, Arabic, Farsi/Dari, Tamil or Tigrigna took part in the five focus groups. Four participants were nulliparous, but all others had previous experience of labour and delivery, often in European countries. A single focus group was conducted for each of the five language groups. RESULTS We identified five main themes: (1) Women's partial knowledge of epidural analgesia procedures; (2) Strong fears of short-term and long-term negative consequences of epidural analgesia during childbirth; (3) Reliance on multiple sources of information regarding epidural analgesia for childbirth; (4) Presentation of salient narratives of labour pain to justify their attitudes toward epidural analgesia; and (5) Complex community positioning of pro-epidural women. CONCLUSIONS Women in our study had partial knowledge of epidural analgesia for labour pain and held perceptions of a high risk-to-benefits ratio for this procedure. Diverse and sometimes conflicting information about epidural analgesia can interfere with women's decisions regarding this treatment option for labour pain. Our study suggests that women need comprehensive but also tailored information in their own language to support their decision-making regarding epidural labour analgesia.
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Affiliation(s)
- Melissa Dominicé Dao
- Primary Care, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Désirée Gerosa
- Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Iris Pélieu
- Acute Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Guy Haller
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Acute Care Medicine, Geneva University Hospitals, Geneva, Switzerland
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Bischoff A. The evolution of a healthcare interpreting service mapped against the bilingual health communication model: a historical qualitative case study. Public Health Rev 2020; 41:19. [PMID: 32774991 PMCID: PMC7401237 DOI: 10.1186/s40985-020-00123-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/07/2020] [Indexed: 11/20/2022] Open
Abstract
Background Twenty-five years ago, the need for health care interpreting in Switzerland increased due to the sharp influx of asylum seekers from war zones and countries of political unrest. Due to complex health needs, there was a need to move away from using volunteers as interpreters towards qualified interpreter services. Methods A historical qualitative case study design was used to describe the evolution of the language assistance programmes at Geneva University Hospitals, between 1992 and 2017. The aim was to map the evolution of the interpreter services against the Bilingual Health Communication Model with the constructs—Communicative Goals, Individual Agency, System Norms and Quality and Equality of Care—while identifying key factors to optimise interpreter service and patient care. Results and discussion Five phases were identified during the 25 years of service evolution studied: (1) Service initiation—the interpreter services were first used in a small service that cared for refugees and asylum seekers. (2) Growth and formalisation—due to the arrival of high numbers of Albanian-speaking asylum seekers, Albanian-speaking interpreters were provided to all departments of the Geneva University Hospitals. This helped roll out the use of interpreters among doctors and nurses. (3) Ensuring quality—the care for all patients, whether foreign-language speaking or not, became an issue and led to research into the quality of patient-provider communication. (4) Institutionalisation—this phase dealt with challenges including the lack of interpreter financing regulation and the clarification of interpreter roles. (5) Equity—healthcare interpreter services were put in an overall framework of equity standards. The Bilingual Health Communication Model was applied and showed that some items were not implemented: clear shifts (i) towards a culturally sensitive focus, (ii) towards community interpreting, (iii) towards triadic communication, (iv) towards spelling out the right to have an interpreter and (v) towards the involvement of insurance companies. Finally, the inclusion of healthcare interpreting as an essential ingredient in healthcare provision, including chronic disease management, is incomplete or missing. Conclusions Healthcare interpreting at Geneva University Hospitals has evolved from a ‘muddling-through’ approach towards an institutional approach by addressing quality of care, by focussing on the mental health of asylum seekers, training of both interpreters and users of interpreters and institutional policy based on equity.
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Affiliation(s)
- Alexander Bischoff
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Route des Cliniques 15, CH-1700 Fribourg, Switzerland.,Institute of Global Health, Faculty of Medicine, University of Geneva, 24 rue du Général-Dufour, 1211 Genève 4, Switzerland
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Rajpoot A, Rehman S, Ali P. Emotional and Psychological Impact of Interpreting for Clients with Traumatic Histories on interpreters: a review of qualitative articles. WIKIJOURNAL OF MEDICINE 2020. [DOI: 10.15347/wjm/2020.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
PURPOSE This study explored nursing experiences using interpreters in primary healthcare settings. METHODS Eight nurses in southern Sweden were subjected to semistructured interviews. The responses were divided into three categories using content analysis: interpreter influence, challenges, and strategies. RESULTS Despite using an interpreter to minimize language barriers, nurses do not achieve the same level of person-centered care as those who speak the same language as their patients, but translation services remain a useful communication tool for patient care. CONCLUSION Communication through an interpreter is an inevitability for healthcare professionals, and formal education is recommended to improve nurses' utilization of these services.
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Affiliation(s)
- Darya Salavati
- At Skåne University Hospital in Lund, Sweden, Darya Salavati is a nurse in the oncology clinic and Fanny Lindholm is a nurse in the medicine clinic. Eva Drevenhorn is a senior lecturer at Lund University in Lund, Sweden
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Ault R, Morales A, Ault R, Spitale A, Martinez GA. Communication pitfalls in interpreted genetic counseling sessions. J Genet Couns 2019; 28:897-907. [PMID: 31112366 DOI: 10.1002/jgc4.1132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 04/19/2019] [Indexed: 01/20/2023]
Abstract
The impact of language interpretation on interactive communication in genetic counseling sessions is not well studied. We sought to determine whether interpretation affects communication in genetic counseling sessions using communication analysis. With a sample of pregnant patients of advanced maternal age, we audiotaped, analyzed, and compared seven Spanish-speaking patients with limited-English proficiency to seven English-speaking patients on length of session, English words spoken, and number of questions asked. An analysis of verbal listening cues, including back-channels and questions asked was performed to evaluate the level of engagement by both provider and patient. Session length did not differ between groups (p > 0.05), however, English-speaking sessions involved significantly more words (mean: 4,798 vs. 2,524) exchanged over the course of the conversation than interpreter-mediated sessions (p < 0.001). The number of back-channeling responses was significantly greater in English-speaking compared to Spanish-speaking sessions. We found the same information was covered, but there was less provider-patient interaction when the session was interpreter-mediated. The patient asked fewer questions and the genetic counselor spoke in condensed ideas. Overall, our observations suggest diminished levels of interactive communication in interpreter-mediated sessions. Our work highlights the need for further evaluation in how genetic counselors communicate during interpreter-mediated sessions.
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Affiliation(s)
- Rachel Ault
- Department of Human Genetics, The Ohio State University, Columbus, Ohio
| | - Ana Morales
- Department of Human Genetics, The Ohio State University, Columbus, Ohio
| | - Russell Ault
- Medical Scientist Training Program, The Ohio State University, Columbus, Ohio
| | - Allison Spitale
- Department of Maternal Fetal Medicine, The Ohio State University, Columbus, Ohio
| | - Glenn A Martinez
- Department of Spanish and Portuguese, The Ohio State University, Columbus, Ohio
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Ali PA, Watson R. Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses' perspectives. J Clin Nurs 2018; 27:e1152-e1160. [DOI: 10.1111/jocn.14204] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Parveen Azam Ali
- School of Nursing and Midwifery; University of Sheffield; Sheffield UK
| | - Roger Watson
- Faculty of Social Sciences; University of Hull; Hull UK
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Vincent B, Thakur V, Thakur A. Patient-satisfaction in an outpatient vein surgery office: A comparison of English- and Spanish-speaking patients. Phlebology 2018; 33:672-677. [PMID: 29368534 DOI: 10.1177/0268355517754172] [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: 11/16/2022]
Abstract
BACKGROUND In spite of an increasing Latino population and accompanying rise in demand for health care, not much is known about patient-satisfaction in Spanish-speaking patients and how to improve patient-satisfaction when using interpreters. We sought to compare patient-satisfaction with vein surgery office visits between English-speaking and Spanish-speaking patients. METHODS Directly before and after the office visit, 126 patients completed a socio-demographic survey, a five-point ordinal rating survey of physician and interpreter satisfaction with the encounter. Measures were satisfaction with the provider's friendliness, respectfulness, concern, ability to make the patient comfortable, and time spent for the exam. RESULTS When the provider was fluent in the language that the patient spoke, patients ( M = 4.954, SD = 0.21) were significantly more satisfied with their visit at VVHC than patients who required an interpreter ( M = 4.762, SD = 0.71), z = 2.230, p = 0.012. Spanish speaking patients were more likely to be satisfied with the visit when they felt their interpreter was friendly ( n = 58, p = 0.049). There was no difference found with regard to the provider being thoughtful and comforting. CONCLUSION Spanish-speaking patients are less satisfied with the care provided in a vein surgery office. Patients who communicated through an interpreter were less satisfied with the patient-provider relationship. In light of the growing diversity of the US population and the fact that patient-satisfaction is increasingly tied to reimbursement, additional research might identify potential areas of improvement for the surgeon, interpreter, and patient perspectives.
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Cramer E. The Impact of Professional Language Interpreting in Midwifery Care: A Review of the Evidence. INTERNATIONAL JOURNAL OF CHILDBIRTH 2017. [DOI: 10.1891/2156-5287.7.1.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND: Patients’ limited proficiency in the language of health care providers is known to be associated with health care disparities. Reluctance to use professional interpreting is documented across a wide range of health care professionals. Most of the literature on the effect of interpreting practices has focused on non-midwifery contexts.OBJECTIVE: To review the evidence regarding how using professional interpreters impacts the midwifery care of women with limited dominant language proficiency (LDLP).METHODS: Eligible studies were identified using searches of MEDLINE, CINAHL, and Maternity and Infant Care, then analyzed and assessed for applicability to midwifery.RESULTS: 40 eligible papers, and two systematic reviews containing 48 additional papers, were included. The use of professional interpreters was found to support all aspects of the midwife’s direct role, with some complex findings on woman-centered communication during interpreted encounters. The use of ad hoc interpreters, or no interpreting, undermines all aspects of midwifery care for women with LDLP.IMPLICATIONS: Midwifery care should be enhanced by increasing midwives’ use of professional interpreters; future research should consider how best to achieve this or investigate the comparative efficacy of more complex interventions, such as interpreter-doulas.
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Pope CA, Escobar-Gomez M, Davis BH, Roberts JR, O'Brien ES, Hinton E, Darden PM. The challenge of tetradic relationships in medically interpreted pediatric primary care visits: A descriptive study of communication practices. PATIENT EDUCATION AND COUNSELING 2016; 99:542-548. [PMID: 26796067 DOI: 10.1016/j.pec.2015.10.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 10/17/2015] [Accepted: 10/31/2015] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To examine spoken interactions between pediatricians and community-based interpreters speaking with adolescents and parents with Limited English proficiency (LEP) in primary care to identify the challenges of interpreting in a four-person or tetradic visit, its sources of co-constructed errors, and specific practices for educational intervention. METHODS As part of a larger study of vaccine decision-making at six clinical sites in two states, this descriptive study used discourse analysis to examine 20 routine primary care visits in a Latino Clinic in interactions between adolescents, parents, community-based interpreters, and pediatricians. Specific patterns of communication practices were identified that contributed to inaccuracies in medical interpretation RESULTS Practices needing improvement were tallied for simple frequencies and included: omissions; false fluency; substitutions; editorializing; added clarification, information, or questions; medical terminology; extra explanation to mother; and, cultural additions. Of these speaking practices, omissions were the most common (123 out of 292 total) and the most affected by pediatricians. CONCLUSION The dynamics of both pediatricians and interpreters contributed to identification of areas for improvement, with more adolescent participation in bilingual than monolingual visits. PRACTICE IMPLICATIONS These observations provide opportunities for mapping a communication skills training intervention based on observations for future testing of an evidence-based curriculum.
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Affiliation(s)
- C A Pope
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street SN511, MSC 160, Charleston, SC 29425-1600, USA; Ralph H. Johnson Veterans Affairs (VA) Medical Center, 109 Bee Street, Charleston, SC 29401, USA.
| | | | - B H Davis
- Department of English, University of North Carolina at Charlotte, 9201 University City Boulevard, Fretwell 255A, Charlotte, NC 28223, USA.
| | - J R Roberts
- Department of Pediatrics, Medical University of South Carolina College of Medicine, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA.
| | - E S O'Brien
- Department of Pediatrics, Medical University of South Carolina College of Medicine, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA.
| | - E Hinton
- Department of Pediatrics, Medical University of South Carolina College of Medicine, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA.
| | - P M Darden
- General & Community Pediatrics, Oklahoma University Health Sciences Center, 1200 Children's Avenue, Suite 12400, Oklahoma City, OK 73104-4637, USA.
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Krupic F, Hellström M, Biscevic M, Sadic S, Fatahi N. Difficulties in using interpreters in clinical encounters as experienced by immigrants living in Sweden. J Clin Nurs 2016; 25:1721-8. [PMID: 26879885 DOI: 10.1111/jocn.13226] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To study a group of immigrants' experiences regarding interactions with primary health care through an interpreter. BACKGROUND Approximately, 230 million people are resettled outside of their own home country. Thus, more than 3% of the world's population are migrants. It is a major challenge for health care providers to satisfy immigrants' needs for individualised health care services. DESIGN Qualitative study. METHODS Focus group interviews were conducted with four groups of immigrants (n = 24) from Bosnia and Herzegovina, Croatia, Kosovo and Somalia. The group interviews were audio recorded, transcribed and analysed, and the text was categorised using the content analysis method. RESULTS Participants' expectations of the interpreter-mediated consultations were high, but not always fulfilled. Interpreters being late, lacking professionalism or lacking knowledge in medical terminology and the use of health care professionals or relatives as interpreters were some of the problems raised. CONCLUSION A well-organised, disciplined interpreter service with professional and competent interpreters is needed to overcome problems regarding clinical consultations involving interpreters. A satisfactory language bridge has a significant impact on the quality of communications. CLINICAL IMPLICATION Interpreter services should be well organised, and interpreters should be linguistically, culturally and socially competent, as these factors may have a significant impact on consultation outcomes. Using relatives or staff as interpreters can sometimes be a solution but often results in an unsatisfactory clinical consultation.
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Affiliation(s)
- Ferid Krupic
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Hellström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mirza Biscevic
- Department of Orthopaedics and Traumatology, Clinical Centre, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sahmir Sadic
- Orthopaedic and Traumatology Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Nabi Fatahi
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Kishimoto M, Noda M. Factors complicating the diabetes management of visitors to Japan: advices from a Japanese National Center for overseas medical staff. THE JOURNAL OF MEDICAL INVESTIGATION 2016; 63:15-8. [DOI: 10.2152/jmi.63.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Miyako Kishimoto
- Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine
- Diabetes and Metabolism Information Center, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine
- Department of Internal Medicine, Sanno Hospital
| | - Mitsuhiko Noda
- Diabetes and Metabolism Information Center, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine
- Department of Endocrinology and Diabetes, Saitama Medical University
- Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine
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Hadziabdic E, Lundin C, Hjelm K. Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare. BMC Health Serv Res 2015; 15:458. [PMID: 26444009 PMCID: PMC4595314 DOI: 10.1186/s12913-015-1124-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 09/30/2015] [Indexed: 11/10/2022] Open
Abstract
Background Elderly migrants who do not speak the official language of their host country have increased due to extensive international migration, and will further increase in the future. This entails major challenges to ensure good communication and avoid communication barriers that can be overcome by the use of adequate interpreter services. To our knowledge, there are no previous investigations on interpreting practices in multilingual elderly healthcare from different healthcare professionals’ perspectives. This study examines issues concerning communication and healthcare through a particular focus on interpretation between health professionals and patients of different ethnic and linguistic backgrounds. The central aim of the project is to explore interpretation practices in multilingual elderly healthcare. Methods A purposive sample of 33 healthcare professionals with experience of using interpreters in community multilingual elderly healthcare. Data were collected between October 2013 and March 2014 by 18 individual and four focus group interviews and analysed with qualitative content analysis. Results The main results showed that interpreting practice in multilingual elderly healthcare was closely linked to institutional, interpersonal and individual levels. On the organizational level, however, guidelines for arranging the use of interpreters at workplaces were lacking. Professional interpreters were used on predictable occasions planned long in advance, and bilingual healthcare staff and family members acting as interpreters were used at short notice in everyday caring situations on unpredictable occasions. The professional interpreter was perceived as a person who should interpret spoken language word-for-word and who should translate written information. Furthermore, the use of a professional interpreter was not adapted to the context of multilingual elderly healthcare. Conclusion This study found that interpreter practice in multilingual elderly healthcare is embedded in the organizational environment and closely related to the individual’s language skills, cultural beliefs and socio-economic factors. In order to formulate interpreter practice in the context of multilingual elderly healthcare it is important to consider organizational framework and cultural competence, cultural health knowledge, beliefs and customs.
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Affiliation(s)
- Emina Hadziabdic
- Department of Social and Welfare Studies, Linköping University, SE-581 83, Linköping, Sweden. .,Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, SE- 351 95, Växjö, Sweden.
| | - Christina Lundin
- Department of Social and Welfare Studies, Linköping University, SE-581 83, Linköping, Sweden.
| | - Katarina Hjelm
- Department of Social and Welfare Studies, Linköping University, SE-581 83, Linköping, Sweden.
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Abstract
Objective. Previous studies have shown that receiving diabetes self-management education (DSME) is associated with increased care utilization. However, the relationship between DSME duration and care utilization patterns remains largely unexamined. Our purpose is to characterize DSME duration and examine the relationship between DSME duration and clinical- and self-care utilization patterns. Methods. The study sample included 1,446 adults who were ≥18 years of age, had diabetes, and had participated in the 2008 Florida Behavioral Risk Factor Surveillance System survey. Clinical- and self-care outcomes were derived using responses to the survey's diabetes module and were based on minimum standards of care established by the American Diabetes Association. The outcomes examined included self-monitoring of blood glucose at least once per day; receiving at least one eye exam, one foot exam, A1C tests, and an influenza vaccination in the past year; and ever receiving a pneumococcal vaccination. DSME duration was categorized as no DSME, >0 to <4 hours, 4-10 hours, and >10 hours. Results. After adjusting for sociodemographic variables, compared to those who did not receive DSME, those who had 4-10 or 10+ hours of DSME were more likely to receive two A1C tests (odds ratio [95% CI] 2.69 [1.30-5.58] and 2.63 [1.10-6.31], respectively) and have a pneumococcal vaccination (1.98 [1.03-3.80] and 1.92 [1.01-3.64], respectively). Those receiving 10+ hours of DSME were 2.2 times (95% CI 1.18-4.09) as likely to have an influenza vaccination. Conclusion. These data reveal a positive relationship between DSME duration and utilization of some diabetes clinical care services.
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Affiliation(s)
- Tammie M. Johnson
- University of North Florida, Department of Public Health, Brooks College of Health, Jacksonville, FL
| | - Jennifer Richards
- University of North Florida, Department of Public Health, Brooks College of Health, Jacksonville, FL
| | - James R. Churilla
- University of North Florida, Department of Clinical and Applied Movement Science, Brooks College of Health, Jacksonville, FL
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Hadziabdic E, Hjelm K. Arabic-speaking migrants' experiences of the use of interpreters in healthcare: a qualitative explorative study. Int J Equity Health 2014; 13:49. [PMID: 24934755 PMCID: PMC4071792 DOI: 10.1186/1475-9276-13-49] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 06/10/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Arabic-speaking migrants have constituted a growing population in recent years. This entails major challenges to ensure good communication in the healthcare encounter in order to provide individual and holistic healthcare. One of the solutions to ensure good communication between patient and healthcare staff who do not share the same language is to use a professional interpreter. To our knowledge, no previous qualitative studies have been found concerning Arabic-speaking migrants and the use of interpreters. This study aims to ascertain their individual experiences which can help extend our understanding of the studied area. METHOD A purposive sample of 13 Arabic-speaking persons with experience of using interpreters in healthcare encounters. Data were collected between November 2012 and March 2013 by four focus-group interviews and analysed with qualitative analysis according to a method described for focus groups. RESULTS Four categories appeared from the analysis: 1) The professional interpreter as spokesperson; 2) Different types of interpreters and modes of interpretation adapting to the healthcare encounter; 3) The professional interpreter's task and personal properties affected the use of professional interpreters in a healthcare encounter; 4) Future planning of the use of professional interpreters in a healthcare encounter. The main findings were that the use of interpreters was experienced both as a possibility and as a problem. The preferred type of interpreters depended on the interpreter's dialect and ability to interpret correctly. Besides the professional interpreter's qualities of good skill in language and medical terminology, translation ability, neutrality and objectivity, Arabic-speaking participants stated that professional interpreters need to share the same origin, religion, dialect, gender and political views as the patient in order to facilitate the interpreter use and avoid inappropriate treatment. CONCLUSION The study showed that the personal qualities of a good interpreter not only cover language ability but also origin, religion, dialect, gender and political views. Thus, there is need to develop strategies for personalized healthcare in order to avoid inappropriate communication, to satisfy the preferences of the person in need of interpreters and improve the impact of interpretation on the quality of healthcare.
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Affiliation(s)
- Emina Hadziabdic
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences Linnaeus University, Växjö, SE-351 95, Sweden
| | - Katarina Hjelm
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences Linnaeus University, Växjö, SE-351 95, Sweden
- Department of Social and Welfare Studies, Linkoping University, Linköping, Sweden
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