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Partyka O, Pajewska M, Czerw A, Sygit K, Lyubinets O, Banaś T, Małecki K, Grochans E, Grochans S, Cybulska A, Schneider-Matyka D, Cipora E, Kaczmarski M, Sośnicki K, Dykowska G, Sienkiewicz Z, Strzępek Ł, Bandurska E, Ciećko W, Drobnik J, Pobrotyn P, Sierocka A, Marczak M, Kozlowski R. Migration Challenges and Their Impact on the Primary Healthcare System-A Qualitative Research. Healthcare (Basel) 2024; 12:1607. [PMID: 39201167 PMCID: PMC11353464 DOI: 10.3390/healthcare12161607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024] Open
Abstract
In 2020 it is estimated that 281 million people were international migrants. Migrants constitute a potentially vulnerable population in terms of facing discrimination, poor living and housing conditions, and insufficient access to healthcare services. Due to the armed conflict in Ukraine in 2022, almost 10 million people crossed the Polish border within a year of the outbreak of the conflict. The objective of this paper is to present the use of primary healthcare services by people migrating from Ukraine to Poland and identify the barriers in access to healthcare by this group of persons. This study used a qualitative research technique in the form of an expert interview using individual in-depth interviews (IDI). The study group consisted of professionally active primary healthcare providers (doctors, nurses, and facility managers) in Poland. Research was carried out in the areas regarding the availability of healthcare, the potential threats and challenges, and possible system solutions. The results showed that the most common cause for doctor's appointments among migrants are respiratory infections, including COVID-19. Many cases were related to back pain, mainly resulting from the physical work of the patients. Additionally, some barriers to access and the provision of healthcare services for patients from Ukraine were identified. The majority (75%) of respondents indicated language as a significant barrier when providing services. Based on the study results, we recommend creating a dedicated website and telephone hotline for this group of persons as well as the use of traditional media to distribute information about access to healthcare services. It is also essential to focus on assistance for older people, since they may experience more difficulties with language and navigating the healthcare system.
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Affiliation(s)
- Olga Partyka
- Department of Health Economics and Medical Law, Medical University of Warsaw, 01-445 Warsaw, Poland
- Department of Economic and System Analyses, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | - Monika Pajewska
- Department of Health Economics and Medical Law, Medical University of Warsaw, 01-445 Warsaw, Poland
- Department of Economic and System Analyses, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | - Aleksandra Czerw
- Department of Health Economics and Medical Law, Medical University of Warsaw, 01-445 Warsaw, Poland
- Department of Economic and System Analyses, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | - Katarzyna Sygit
- Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland
| | - Oleh Lyubinets
- Department of Public Health, Danylo Halytsky Lviv National Medical University, 79010 Lviv, Ukraine
| | - Tomasz Banaś
- Department of Radiotherapy, Maria Sklodowska-Curie Institute-Oncology Center, 31-115 Cracow, Poland
| | - Krzysztof Małecki
- Department of Radiotherapy for Children and Adults, University Children’s Hospital of Cracow, 30-663 Cracow, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Szymon Grochans
- Department of Pediatric and Oncological Surgery, Urology and Hand Surgery, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
| | - Anna Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Daria Schneider-Matyka
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Elżbieta Cipora
- Medical Institute, Jan Grodek State University in Sanok, 38-500 Sanok, Poland
| | - Mateusz Kaczmarski
- Medical Institute, Jan Grodek State University in Sanok, 38-500 Sanok, Poland
| | - Krzysztof Sośnicki
- Medical Institute, Jan Grodek State University in Sanok, 38-500 Sanok, Poland
| | - Grażyna Dykowska
- Department of Health Economics and Medical Law, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Zofia Sienkiewicz
- Department of Nursing, Social and Medical Development, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Łukasz Strzępek
- Department of Surgery, Andrzej Frycz Modrzewski Cracow University, 30-705 Cracow, Poland
| | - Ewa Bandurska
- Center for Competence Development, Integrated Care and e-Health, Medical University of Gdansk, 80-204 Gdansk, Poland
| | - Weronika Ciećko
- Center for Competence Development, Integrated Care and e-Health, Medical University of Gdansk, 80-204 Gdansk, Poland
| | - Jarosław Drobnik
- Department of Family Medicine, Faculty of Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland
| | - Piotr Pobrotyn
- Pulsantis Specialist and Rehabilitation Clinic Ltd., 53-238 Wroclaw, Poland
| | - Aleksandra Sierocka
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Michał Marczak
- Department of Innovation, Merito University in Poznan, 61-895, Poznan, Poland
| | - Remigiusz Kozlowski
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
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Chen WT, Sun W, Huang F, Shiu CS, Kim B, Candelario J, Toma L, Wu G, Ah-Yune J. Lost in Translation: Impact of Language Barriers and Facilitators on the Health Care of Asian Americans Living with HIV. J Racial Ethn Health Disparities 2024; 11:2064-2072. [PMID: 37306920 PMCID: PMC10713860 DOI: 10.1007/s40615-023-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
Language barriers are major obstacles that Asian American immigrants face when accessing health care in the USA. This study was conducted to explore the impact of language barriers and facilitators on the health care of Asian Americans. Qualitative, in-depth interviews and quantitative surveys were conducted with 69 Asian Americans (Chinese, Filipino, Japanese, Malaysian, Indonesian, Vietnamese, and mixed Asian backgrounds) living with HIV (AALWH) in three urban areas (New York, San Francisco, and Los Angeles) in 2013 and from 2017 to 2020. The quantitative data indicate that language ability is negatively associated with stigma. Major themes emerged related to communication, including the impact of language barriers on HIV care and the positive impact of language facilitators-family members/friends, case managers, or interpreters-who can communicate with healthcare providers in the AALWH's native language. Language barriers negatively impact access to HIV-related services and thus result in decreased adherence to antiretroviral therapy, increased unmet healthcare needs, and increased HIV-related stigma. Language facilitators enhanced the connection between AALWH and the healthcare system by facilitating their engagement with health care providers. Language barriers experienced by AALWH not only impact their healthcare decisions and treatment choices but also increase levels of external stigma which may influence the process of acculturation to the host country. Language facilitators and barriers to health services for AALWH represent a target for future interventions in this population.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Cheng-Shi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Boram Kim
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jury Candelario
- APAIT- A division of Special Service for Groups, Inc., Los Angeles, CA, USA
| | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
| | - Gilbert Wu
- Chinese-American Planning Council, Inc., New York, NY, USA
| | - Judy Ah-Yune
- Chinese-American Planning Council, Inc., New York, NY, USA
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Indrayathi PA, Ulandari LPS, Pradnyani PE, Dhamanti I, Kirshbaum MN, Szepesi CI, Horvath N, Kolozsvari LR. Understanding International Students' Perspective of Health Service Quality: A Cross-Sectional Study in a Hungarian University. Risk Manag Healthc Policy 2024; 17:1757-1769. [PMID: 38974389 PMCID: PMC11227865 DOI: 10.2147/rmhp.s460534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/18/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose Understanding patient's preferences is important to delivering good quality services. Patients' feedback provides healthcare providers with valuable information about the services provided. The increasing number of international students enrolling in Hungarian Universities raises the need to ensure the quality of services meets international students' requirements, which includes healthcare. This study aimed to assess service quality in the University Health Center (UHC) from the international student's point of view to be used to improve the quality of services. Methods This cross-sectional study was conducted at the university health center. We used a mixed methods approach to collect both quantitative and qualitative data. We used the importance-performance analysis (IPA) for quantitative analysis to understand expectations and perceptions in service research. The qualitative analysis was conducted from responses to reflection questions. The qualitative data were then analyzed using thematic analysis. Results 437 international students participated in the study, but only 402 (91.99%) were analysed. The gaps between the importance and performance of service quality were negative in all dimensions (P-value < 0.001). This suggests that there is an unmet need for student expectations and university health center performance. From the Importance factor, the highest and lowest were related to safety (4.54 ± 0.56) and efficiency (4.31 ± 0.66) dimensions. The Performance factor's highest and lowest mean scores were also related to safety (4.22 ± 0.72) and efficiency (3.91 ± 0.87), respectively. From qualitative analysis, there are two major themes several secondary themes from the thematic analysis of free-text responses were identified. Conclusion The importance and performance analysis could provide useful information to university policymakers about university health center service quality. There is a need for improvement and obviating the importance-performance gaps, especially in the efficiency dimension. Decision-makers can use the IPA analysis results to allocate limited resources more effectively, giving special attention to possible organizational weaknesses for further direction.
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Affiliation(s)
- Putu Ayu Indrayathi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Public Health and Preventive Medicine, Udayana University, Denpasar, Bali, Indonesia
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Inge Dhamanti
- Center of Excellence for Patient Safety Research and Quality, Universitas Airlangga, Surabaya, Indonesia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | | | - Csongor Istvan Szepesi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Nora Horvath
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Laszlo Robert Kolozsvari
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
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Forray AI, Oltean O, Hanft-Robert S, Madzamba R, Liem A, Schouten B, Anthonissen C, Swartz L, Cherecheș RM, Higgen S, Hall BJ, Mösko M. Uncovering multi-level mental healthcare barriers for migrants: a qualitative analysis across China, Germany, Netherlands, Romania, and South Africa. BMC Public Health 2024; 24:1593. [PMID: 38877460 PMCID: PMC11177472 DOI: 10.1186/s12889-024-19046-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population. METHODS Adhering to a qualitative research paradigm, the study centers on stakeholders' perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach. RESULTS The study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants. CONCLUSIONS This research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers' capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.
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Affiliation(s)
- Alina Ioana Forray
- Faculty of Political, Administrative and Communication Sciences, Center for Health Innovation, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Community Medicine, Discipline of Public Health and Management, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ovidiu Oltean
- Faculty of Political, Administrative and Communication Sciences, Center for Health Innovation, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Saskia Hanft-Robert
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Rowan Madzamba
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Andrian Liem
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia
| | - Barbara Schouten
- Department of Communication Science, Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Center for Urban Mental Health, Amsterdam, The Netherlands
| | - Christine Anthonissen
- Department of General Linguistics, Stellenbosch University, Stellenbosch, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Răzvan Mircea Cherecheș
- Faculty of Political, Administrative and Communication Sciences, Center for Health Innovation, Babeș-Bolyai University, Cluj-Napoca, Romania
- Postgraduate Program for Bio-Behavioral Integrative Medicine (UBBMed), Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Sanna Higgen
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Brian J Hall
- Center for Global Health Equity, NYU Shanghai, Shanghai, China
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
- Department of Applied Human Sciences, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany.
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Ando K, Sato M, Wakatsuki S, Nagai R, Chino K, Kai H, Sasaki T, Kato R, Nguyen TP, Guo N, Sultan P. A comparative study of English and Japanese ChatGPT responses to anaesthesia-related medical questions. BJA OPEN 2024; 10:100296. [PMID: 38975242 PMCID: PMC11225650 DOI: 10.1016/j.bjao.2024.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/06/2024] [Accepted: 05/24/2024] [Indexed: 07/09/2024]
Abstract
Background The expansion of artificial intelligence (AI) within large language models (LLMs) has the potential to streamline healthcare delivery. Despite the increased use of LLMs, disparities in their performance particularly in different languages, remain underexplored. This study examines the quality of ChatGPT responses in English and Japanese, specifically to questions related to anaesthesiology. Methods Anaesthesiologists proficient in both languages were recruited as experts in this study. Ten frequently asked questions in anaesthesia were selected and translated for evaluation. Three non-sequential responses from ChatGPT were assessed for content quality (accuracy, comprehensiveness, and safety) and communication quality (understanding, empathy/tone, and ethics) by expert evaluators. Results Eight anaesthesiologists evaluated English and Japanese LLM responses. The overall quality for all questions combined was higher in English compared with Japanese responses. Content and communication quality were significantly higher in English compared with Japanese LLMs responses (both P<0.001) in all three responses. Comprehensiveness, safety, and understanding were higher scores in English LLM responses. In all three responses, more than half of the evaluators marked overall English responses as better than Japanese responses. Conclusions English LLM responses to anaesthesia-related frequently asked questions were superior in quality to Japanese responses when assessed by bilingual anaesthesia experts in this report. This study highlights the potential for language-related disparities in healthcare information and the need to improve the quality of AI responses in underrepresented languages. Future studies are needed to explore these disparities in other commonly spoken languages and to compare the performance of different LLMs.
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Affiliation(s)
- Kazuo Ando
- Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - Masaki Sato
- Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - Shin Wakatsuki
- Private Practice Group, Pacific Anesthesia Inc., Honolulu, HI, USA
| | - Ryotaro Nagai
- Private Practice Group, Pacific Anesthesia Inc., Honolulu, HI, USA
| | - Kumiko Chino
- University of Pittsburgh Medical Center, Magee-Women's Hospital, PA, USA
| | - Hinata Kai
- Department of Anesthesiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tomomi Sasaki
- Department of Anesthesiology, Showa University School of Medicine, Tokyo, Japan
| | - Rie Kato
- Department of Anesthesiology, Showa University School of Medicine, Tokyo, Japan
| | - Teresa Phuongtram Nguyen
- Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - Nan Guo
- Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
| | - Pervez Sultan
- Department of Anesthesiology, Perioperative and Pain Medicine. Stanford University School of Medicine, Stanford, CA, USA
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Bakhsh NM, Fatani OA, Melybari RZ, Alabdullah R, Bahakeem RF, Alsharif SH, Alharbi JK, Fatani OA. Language and Communication Barriers in Emergency Departments in Makkah: Physicians' Perspective. Cureus 2024; 16:e58987. [PMID: 38800163 PMCID: PMC11127613 DOI: 10.7759/cureus.58987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/29/2024] Open
Abstract
Background Communication is essential in the medical sector, particularly in the emergency departments (ED), to provide appropriate patient care. Lack of patient history and large patient numbers, cultural variations, inadequate health literacy, and language difficulties can impact effective communication. Aim This study aims to examine language and communication barriers experienced by ED physicians in Makkah, Saudi Arabia, as well as to determine the effect of language barriers on patient care and explore possible methods to deal with language and communication barriers. Methods This cross-sectional study was conducted from April 8 to June 6, 2023. A total of 136 responses were collected from ED physicians at the six Ministry of Health Hospitals (MOH) in Makkah through a validated online survey. The data analysis was implemented using RStudio (R version 4.1.1). Result In this study, 136 participants' data were examined. Of note, one-quarter of ED physicians (25%; n=34) under study stated that they always experienced language barriers, whereas 64.7% (n=88) of them sometimes experienced these difficulties. More than half of the ED physicians (54.4%; n=74) stated that their patients had poor outcomes because of poor communication. Among those who responded positively to poor outcomes, ED physicians' suggestions to improve communication with patients included providing labels of the common scientific terminologies in different languages (59.6%; n=81) and providing courses to communicate in foreign languages (48.5%; n=66). Conclusion Exposure to language barriers among ED physicians in Makkah was slightly high. This may impact the patient's outcomes. Therefore, strategies to improve patient-physician communication are needed.
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Affiliation(s)
- Noura M Bakhsh
- Emergency Medicine, King Fahad General Hospital, Makkah, SAU
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Colman L, Delaruelle K, Bracke P, Ceuterick M. Trends in the use of benzodiazepine receptor agonists among working-age adults in Belgium from 2004 to 2018. Front Public Health 2023; 11:1191151. [PMID: 37397739 PMCID: PMC10311493 DOI: 10.3389/fpubh.2023.1191151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The use of psychotropics, such as benzodiazepine receptor agonists (BzRAs), among working-age adults in Belgium has shown educational differences. However, it is unclear how work status plays a role in this relationship. Therefore, this research aims to investigate whether work status explains observed educational differences in BzRA use. In addition, considering medicalisation processes, where non-medical factors, such as work status, are increasingly associated with medical mental health care-seeking behavior, this research also aims to investigate whether work status explains observed educational differences in BzRA use, regardless of mental health status. Methods Data are obtained from the Belgian Health Interview Survey (BHIS). Four successive waves are covered: 2004, 2008, 2013, and 2018. The weighted data represent a sample of 18,547 Belgian respondents aged 18 to 65 years old. Poisson regression models are used to analyze the research aims. Time evolutions are plotted using marginal means postestimation. Results The average use of BzRAs shows a slight decline over the waves studied (2004 = 5.99, 2008 = 5.88, 2013 = 5.33, 2018 = 4.31). Educational and work status differences in BzRA use are observed, regardless of mental health status. Individuals with longer education report lower use compared to individuals with shorter education, and individuals who are unemployed, (pre-)retired, or sick or disabled report higher use compared to employed individuals. Furthermore, work status acts as a mediator, partially explaining educational differences in BzRA use, regardless of mental health status. Discussion Work-related uncertainty leads to increased prescribing and medication use, regardless of mental health. Medicalisation and pharmaceuticalisation processes detach social problems from their social roots and treat them as personal failures. The marginalization of the social roots of unemployment, sick leave and involuntary (pre-)retirement has led to a personalization of responsibility. Negative feelings arising from such work statuses may cause isolated, non-specific symptoms for which medical treatment is sought.
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Bonakdar Tehrani M, Baird K, Trajkovski S, Kaplun C, Bruce T, Kemp L. Interpreter use in sustained nurse home visiting: interpreter experience and support. BMC Health Serv Res 2023; 23:143. [PMID: 36765326 PMCID: PMC9911949 DOI: 10.1186/s12913-023-09117-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/27/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND The aim of this study was to explore the experiences of healthcare interpreters working with child and family health nurses (CFHNs) in providing child and family health nursing (CFHN) services and sustained nurse home visiting (SNHV) programs to culturally and linguistically diverse (CALD) families with limited English proficiency. METHODS A mixed methods longitudinal research design was conducted to develop, implement and evaluate a training and practice support model for healthcare interpreters working with nurses and CALD families in providing CFHN services and SNHV programs in three major local health services in Sydney, Australia. One pre-training survey with 24 healthcare interpreters was conducted; field notes were recorded during training and implementation; and a post-implementation focus group with six healthcare interpreters was conducted. Quantitative survey data were analysed descriptively using Alchemer. The focus group was audio-recorded for transcription purposes, and this and the field notes were thematically analysed applying a socioecological framework. RESULTS Three themes were identified from the initial, pre-training survey: facilitate communication and delivery accurately; a bridge linking the clients and the healthcare practitioners; and make everybody feel comfortable. Practice support implementation was negatively impact by system and COVID-19 related barriers. Four themes were developed from evaluative phase of the study including: system-related issues; interpreters' challenges; working with nurses; and client session related issues. CONCLUSION Quality interpreting was favourably influenced by adequate time for interpreting the session including a pre- and post-briefing session with CFHNs, an appropriate mode of interpretation, allocation of female interpreters and the same interpreters with CALD mothers and clarity about interpreter role and cultural comfort. These strategies support the quality of communication and relationships in delivery of CFHN services and SNHV programs to CALD mothers with limited English proficiency.
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Affiliation(s)
- Mehrnoush Bonakdar Tehrani
- Translational Research and Social Innovation (TReSI), Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia. .,School of Nursing and Midwifery, Western Sydney University, Sydney, Australia. .,Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia.
| | - Kelly Baird
- Translational Research and Social Innovation (TReSI), Level 3, 1 Campbell Street, Liverpool, NSW 2170 Australia ,grid.1029.a0000 0000 9939 5719School of Nursing and Midwifery, Western Sydney University, Sydney, Australia ,grid.429098.eIngham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW 2170 Australia
| | - Suza Trajkovski
- grid.1029.a0000 0000 9939 5719School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Catherine Kaplun
- grid.429098.eIngham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW 2170 Australia ,Transforming early Education And Child Health (TeEACH) Research Centre, Westmead Innovation Quarter, Westmead, NSW 2145 Australia
| | - Tracey Bruce
- Translational Research and Social Innovation (TReSI), Level 3, 1 Campbell Street, Liverpool, NSW 2170 Australia ,grid.1029.a0000 0000 9939 5719School of Nursing and Midwifery, Western Sydney University, Sydney, Australia ,grid.429098.eIngham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW 2170 Australia
| | - Lynn Kemp
- Translational Research and Social Innovation (TReSI), Level 3, 1 Campbell Street, Liverpool, NSW 2170 Australia ,grid.1029.a0000 0000 9939 5719School of Nursing and Midwifery, Western Sydney University, Sydney, Australia ,grid.429098.eIngham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW 2170 Australia
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Increasing Language Interpreter Services Use and Documentation: A Quality Improvement Project. J Healthc Qual 2023; 45:19-26. [PMID: 36584115 DOI: 10.1097/jhq.0000000000000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND/PURPOSE Based on the Civil Rights Act of 1964, hospitals receiving funding from the Department of Human and Health Services must ensure adequate language assistance via a qualified interpreter for Limited English Proficiency (LEP) patients. Despite availability at our institution, official interpreter services were underutilized with inconsistent documentation of use. Baseline data over a 6-week period revealed a median of 43% of LEP parents reported use of official interpreter services, with a median of 0% documentation of use. We aimed to improve both over a 3-month period. METHODS This quality improvement project was conducted at a children's hospital between April and August 2020. Surveys were provided to inpatient LEP families. Four intervention periods were implemented with ongoing data collection for 12 weeks. Interventions included developing best practices, incorporating language identification into daily workflow, empowering families, and standardizing documentation. Data were analyzed by run chart and descriptive statistics. RESULTS After interventions and several plan-do-study-act cycles, a median of 73% reported use of official interpreter services, and a median of 59% were documented. CONCLUSIONS After multiple interventions, specifically noted after intervention period #2, improvement of official interpreter service use and documentation were identified in all inpatient units.
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Sina B, Noemi G, Myriam G, Ursula F, Anne J, Jabeen F, Kristina K, Julia B. The use of intercultural interpreter services at a pediatric emergency department in Switzerland. BMC Health Serv Res 2022; 22:1365. [DOI: 10.1186/s12913-022-08771-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
AbstractThe aim of our study was to analyze the use of interpreter services and improve communication during health encounters with families with limited language proficiency (LLP) at the pediatric emergency department (ED) of the University Hospital of Bern.This study is a pre- and post-intervention study analyzing the use of interpreter services for LLP families. All families originating from a country with a native language other than German, English or French presenting to the ED were eligible to participate in the study. If they agreed to participate, the language proficiency of the caregiver present during the health encounter was systematically assessed during a phone interview within a few days after the consultation, using a standardized screening tool. If screened positive (relevant LLP), a second phone interview with an interpreter was conducted. Further variables were extracted including nationality, age, gender and date of visit using administrative health records. To increase the use of interpreter services, a package of interventions was implemented at the department during 3 months. It consisted of: i) in person and online transcultural teaching ii) awareness raising through the regular information channels and iii) the introduction of a pathway to systematically identify and manage LLP families.The proportion of LLP families who received an interpreter was 11.0% (14/127) in the pre-intervention period compared to 14.8% (20/135) in the post-intervention period. The interpreter use was therefore increased by 3.8% (95% CI − 0.43 to 0.21; p = 0.36).The assessed level of language proficiency of caregivers differed from the self-reported level of language proficiency. Of the study participants in the interview whose language proficiency was screened as limited, 77.1% estimated their language proficiency level as intermediate. More than half of the LLP families who did not receive an interpreter and participated in the interview reported, that they would have liked an interpreter during the consultation.Conclusions: Interpreter services are largely underused during health encounters with LLP families. Relying on caregivers´ self-assessed language proficiency and their active request for an interpreter is not sufficient to ensure safe communication during health encounters. Systematic screening of language proficiency and standardized management of LLP families is feasible and needed at health care facilities to ensure equitable care. Further studies are needed to analyze personal and institutional barriers to interpreter use and find interventions to sustainably increase the use of interpreter services for LLP families.
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Crawshaw AF, Farah Y, Deal A, Rustage K, Hayward SE, Carter J, Knights F, Goldsmith LP, Campos-Matos I, Wurie F, Majeed A, Bedford H, Forster AS, Hargreaves S. Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review. THE LANCET. INFECTIOUS DISEASES 2022; 22:e254-e266. [PMID: 35429463 DOI: 10.1101/2021.11.08.21266058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 05/18/2023]
Abstract
Understanding why some migrants in Europe are at risk of underimmunisation and show lower vaccination uptake for routine and COVID-19 vaccines is critical if we are to address vaccination inequities and meet the goals of WHO's new Immunisation Agenda 2030. We did a systematic review (PROSPERO: CRD42020219214) exploring barriers and facilitators of vaccine uptake (categorised using the 5As taxonomy: access, awareness, affordability, acceptance, activation) and sociodemographic determinants of undervaccination among migrants in the EU and European Economic Area, the UK, and Switzerland. We searched MEDLINE, CINAHL, and PsycINFO from 2000 to 2021 for primary research, with no restrictions on language. 5259 data sources were screened, with 67 studies included from 16 countries, representing 366 529 migrants. We identified multiple access barriers-including language, literacy, and communication barriers, practical and legal barriers to accessing and delivering vaccination services, and service barriers such as lack of specific guidelines and knowledge of health-care professionals-for key vaccines including measles-mumps-rubella, diphtheria-pertussis-tetanus, human papillomavirus, influenza, polio, and COVID-19 vaccines. Acceptance barriers were mostly reported in eastern European and Muslim migrants for human papillomavirus, measles, and influenza vaccines. We identified 23 significant determinants of undervaccination in migrants (p<0·05), including African origin, recent migration, and being a refugee or asylum seeker. We did not identify a strong overall association with gender or age. Tailored vaccination messaging, community outreach, and behavioural nudges facilitated uptake. Migrants' barriers to accessing health care are already well documented, and this Review confirms their role in limiting vaccine uptake. These findings hold immediate relevance to strengthening vaccination programmes in high-income countries, including for COVID-19, and suggest that tailored, culturally sensitive, and evidence-informed strategies, unambiguous public health messaging, and health system strengthening are needed to address access and acceptance barriers to vaccination in migrants and create opportunities and pathways for offering catch-up vaccinations to migrants.
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Affiliation(s)
- Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Yasmin Farah
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Kieran Rustage
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Sally E Hayward
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Lucy P Goldsmith
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Ines Campos-Matos
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK; UK Health Security Agency, London, UK
| | - Fatima Wurie
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK; UK Health Security Agency, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Helen Bedford
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
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Crawshaw AF, Farah Y, Deal A, Rustage K, Hayward SE, Carter J, Knights F, Goldsmith LP, Campos-Matos I, Wurie F, Majeed A, Bedford H, Forster AS, Hargreaves S. Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review. THE LANCET. INFECTIOUS DISEASES 2022; 22:e254-e266. [PMID: 35429463 PMCID: PMC9007555 DOI: 10.1016/s1473-3099(22)00066-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 12/13/2022]
Abstract
Understanding why some migrants in Europe are at risk of underimmunisation and show lower vaccination uptake for routine and COVID-19 vaccines is critical if we are to address vaccination inequities and meet the goals of WHO's new Immunisation Agenda 2030. We did a systematic review (PROSPERO: CRD42020219214) exploring barriers and facilitators of vaccine uptake (categorised using the 5As taxonomy: access, awareness, affordability, acceptance, activation) and sociodemographic determinants of undervaccination among migrants in the EU and European Economic Area, the UK, and Switzerland. We searched MEDLINE, CINAHL, and PsycINFO from 2000 to 2021 for primary research, with no restrictions on language. 5259 data sources were screened, with 67 studies included from 16 countries, representing 366 529 migrants. We identified multiple access barriers-including language, literacy, and communication barriers, practical and legal barriers to accessing and delivering vaccination services, and service barriers such as lack of specific guidelines and knowledge of health-care professionals-for key vaccines including measles-mumps-rubella, diphtheria-pertussis-tetanus, human papillomavirus, influenza, polio, and COVID-19 vaccines. Acceptance barriers were mostly reported in eastern European and Muslim migrants for human papillomavirus, measles, and influenza vaccines. We identified 23 significant determinants of undervaccination in migrants (p<0·05), including African origin, recent migration, and being a refugee or asylum seeker. We did not identify a strong overall association with gender or age. Tailored vaccination messaging, community outreach, and behavioural nudges facilitated uptake. Migrants' barriers to accessing health care are already well documented, and this Review confirms their role in limiting vaccine uptake. These findings hold immediate relevance to strengthening vaccination programmes in high-income countries, including for COVID-19, and suggest that tailored, culturally sensitive, and evidence-informed strategies, unambiguous public health messaging, and health system strengthening are needed to address access and acceptance barriers to vaccination in migrants and create opportunities and pathways for offering catch-up vaccinations to migrants.
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Affiliation(s)
- Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Yasmin Farah
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Kieran Rustage
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Sally E Hayward
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Lucy P Goldsmith
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Ines Campos-Matos
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK; UK Health Security Agency, London, UK
| | - Fatima Wurie
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK; UK Health Security Agency, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Helen Bedford
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
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Loer AKM, Koschollek C, Hövener C. Investigating associated factors of primary and specialist health care utilization among people with selected nationalities: results of a multilingual survey in two German federal states. BMC Health Serv Res 2022; 22:1050. [PMID: 35978356 PMCID: PMC9382615 DOI: 10.1186/s12913-022-08419-y] [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] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximately every fourth person in Germany has a migration background. Health research on the use of primary and specialist health care in this group is still scarce. Few studies have suggested a difference in the use of primary and specialist health care among people with a migration background. Potential resources and barriers to health care access should be investigated as they are critical to health equity. This study investigates associated sociodemographic, migration-sensitive, and health-related factors of primary and specialist health care utilization among people with a migration background as defined by nationality. METHODS Analyses are based on data from a feasibility study of the project "Improving Health Monitoring in Migrant Populations" (IMIRA), conducted by the Robert Koch Institute. The sample (n = 1055) included persons with Croatian, Polish, Romanian, Syrian, and Turkish nationalities living in the federal states of Berlin and Brandenburg, Germany. Descriptive and bivariate analyses as well as multiple binary logistic regression analyses were carried out to assess sociodemographic (sex, age, socioeconomic position), health-related (self-rated health), and migration-sensitive factors (duration of residence in Germany, residence status, German language proficiency) associated with the use of primary and specialist health care services in the past 12 months. RESULTS Of the total study population, 79.62% visited a general practitioner and 59.53% a specialized physician in the past 12 months. Participants who were female sex, aged 65 and older, and with moderate/poor/very poor self-rated health had higher odds of visiting a general practitioner and a specialized physician, with the strongest impact from self-rated health. After controlling for sociodemographic and health-related factors, duration of residence in Germany and residence status were associated with primary but not with specialist health care utilization. CONCLUSIONS Our results suggest that migration-sensitive characteristics, such as duration of residence, should be considered in a differentiated manner in health services research to gain detailed insights into health care utilization and its potential barriers among the heterogenous group of people with a migration background. Further research needs to be done to evaluate how to get people into contact with a general practitioner.
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Affiliation(s)
- Anne-Kathrin M. Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany
| | - Carmen Koschollek
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany
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George R, Utunen H, Ndiaye N, Tokar A, Mattar L, Piroux C, Gamhewage G. Ensuring equity in access to online courses: Perspectives from the WHO health emergency learning response. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Richelle George
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
| | - Heini Utunen
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
| | - Ngouille Ndiaye
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
| | - Anna Tokar
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
| | - Lama Mattar
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
| | - Corentin Piroux
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
| | - Gaya Gamhewage
- Learning and Capacity Development Unit, WHO Health Emergencies Programme World Health Organization Genève Switzerland
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15
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Greene M, Nasir SL. Care of the Refugee. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Lor M, Badenoch N, Yang MJ. Technical Meets Traditional: Language, Culture, and the Challenges Faced by Hmong Medical Interpreters. J Transcult Nurs 2022; 33:96-104. [PMID: 34404302 PMCID: PMC10711740 DOI: 10.1177/10436596211039553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Ineffective intercultural communication can occur due to inaccurate medical interpreting for limited English proficiency (LEP) patients. Research shows that Hmong patients experience poorer quality interpreter services than other LEP populations. This study's purpose is to understand Hmong medical interpreters' perceptions of the factors that affect their ability to make accurate medical interpretations during clinical encounters. METHOD A qualitative study was conducted with Hmong-speaking medical interpreters. The interviews were semistructured, audio recorded, and analyzed using conventional content analysis. RESULTS 13 interpreters aged 29 to 49 years participated in the study. Three factors affected the interpreters' ability to make accurate medical interpretations for Hmong-speaking patients: (a) matched gender between the interpreter and patient, (b) culturally taboo topics in communicating about reproductive body parts and sexual health/activity, and (c) culture and generational language differences between interpreters and Hmong patients. DISCUSSION Clinical encounters that match patient-interpreter ages, gender, and/or local culture may reduce communication barriers.
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Affiliation(s)
- Maichou Lor
- University of Wisconsin–Madison, Madison, WI, USA
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17
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Julien J, Wang X, Meng H, Qian Z, Wang D, Zhang X. The Influence of Transaction Process With Doctors on Patient Satisfaction, Self-Rating Anxiety and Self-Efficacy Among International Students in China. Front Public Health 2021; 9:737278. [PMID: 34631650 PMCID: PMC8496449 DOI: 10.3389/fpubh.2021.737278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: To investigate the communication mechanism between international students and Chinese physicians by evaluating the influence of the transaction process on patient satisfaction, self-rating anxiety and self-efficacy. Methods: A cross-sectional survey was conducted among international students living in Central, Northern and Eastern China; enrolled at Chinese universities and experienced outpatient and inpatient healthcare services. Guided by the elements of King's transaction process: IR, Initiating and Responding; IP, Identifying Problems; MGS, Mutual Goal Setting; and EM, Exploring means and agreeing on means to achieve goals. We used spearman correlation analysis to calculate the correlation of the variables: patient satisfaction, self-efficacy, transaction process, IR, IP, MGS, and EM and regression analysis to measure the influence of transaction process on patient satisfaction, self-rating anxiety and self-efficacy. Results: Four hundred and four (404) participants were investigated for this study. The results of correlation analysis showed that there was a significant positive correlation among patient satisfaction, self-efficacy, transaction process, IR, IP, MGS, and EM (p < 0.05). Regression analysis showed that the higher scores of IR (β = 0.176, p = 0.003) and MGS (β = 0.249, p = 0.002) was associated with the higher score of patient satisfaction; the higher the score of IR and IP was associated with the higher self-efficacy score (β = 0.148,0.225; p = 0.016,0.001); and higher the MGS score was associated the lower the self-rating anxiety (β = -0.220, p = 0.022). Conclusion: The influence of transaction process on patient satisfaction, self-rating anxiety and self-efficacy between Chinese physicians and international students (Patients) was established. Findings support the urgent implementation of tools at healthcare facilities to improve the communication between Chinese doctors and international students, therefore improving patient satisfaction and self-efficacy, and reducing anxiety.
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Affiliation(s)
- Janelle Julien
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xuemei Wang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Han Meng
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zhou Qian
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Dan Wang
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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18
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Saito S, Harris MF, Long KM, Lewis V, Casey S, Hogg W, Cheng IH, Advocat J, Marsh G, Gunatillaka N, Russell G. Response to language barriers with patients from refugee background in general practice in Australia: findings from the OPTIMISE study. BMC Health Serv Res 2021; 21:921. [PMID: 34488719 PMCID: PMC8419978 DOI: 10.1186/s12913-021-06884-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022] Open
Abstract
Background Language is a barrier to many patients from refugee backgrounds accessing and receiving quality primary health care. This paper examines the way general practices address these barriers and how this changed following a practice facilitation intervention. Methods The OPTIMISE study was a stepped wedge cluster randomised trial set within 31 general practices in three urban regions in Australia with high refugee settlement. It involved a practice facilitation intervention addressing interpreter engagement as one of four core intervention areas. This paper analysed quantitative and qualitative data from the practices and 55 general practitioners from these, collected at baseline and after 6 months during which only those assigned to the early group received the intervention. Results Many practices (71 %) had at least one GP who spoke a language spoken by recent humanitarian entrants. At baseline, 48 % of practices reported using the government funded Translating and Interpreting Service (TIS). The role of reception staff in assessing and recording the language and interpreter needs of patients was well defined. However, they lacked effective systems to share the information with clinicians. After the intervention, the number of practices using the TIS increased. However, family members and friends continued to be used to interpret with GPs reporting patients preferred this approach. The extra time required to arrange and use interpreting services remained a major barrier. Conclusions In this study a whole of practice facilitation intervention resulted in improvements in procedures for and engagement of interpreters. However, there were barriers such as the extra time required, and family members continued to be used. Based on these findings, further effort is needed to reduce the administrative burden and GP’s opportunity cost needed to engage interpreters, to provide training for all staff on when and how to work with interpreters and discuss and respond to patient concerns about interpreting services. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06884-5.
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Affiliation(s)
- Shoko Saito
- Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, New South Wales, Kensington, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, New South Wales, Kensington, Australia. .,UNSW Sydney, NSW, 2052, Sydney, Australia.
| | - Katrina M Long
- Department of General Practice, School of Primary & Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne, Australia
| | - Virginia Lewis
- Centre for Health Systems Development, Australian Institute for Primary Care and Ageing, La Trobe University, Victoria, Melbourne, Australia
| | - Sue Casey
- Victorian Foundation for Survivors of Torture, Brunswick, Australia
| | - William Hogg
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - I-Hao Cheng
- Department of General Practice, School of Primary & Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne, Australia
| | - Jenny Advocat
- Department of General Practice, School of Primary & Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne, Australia
| | - Geraldine Marsh
- Centre for Health Systems Development, Australian Institute for Primary Care and Ageing, La Trobe University, Victoria, Melbourne, Australia
| | - Nilakshi Gunatillaka
- Department of General Practice, School of Primary & Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne, Australia
| | - Grant Russell
- Department of General Practice, School of Primary & Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne, Australia
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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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20
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Gil-Salmerón A, Katsas K, Riza E, Karnaki P, Linos A. Access to Healthcare for Migrant Patients in Europe: Healthcare Discrimination and Translation Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157901. [PMID: 34360197 PMCID: PMC8345338 DOI: 10.3390/ijerph18157901] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022]
Abstract
Background: Discrimination based on ethnicity and the lack of translation services in healthcare have been identified as main barriers to healthcare access. However, the actual experiences of migrant patients in Europe are rarely present in the literature. Objectives: The aim of this study was to assess healthcare discrimination as perceived by migrants themselves and the availability of translation services in the healthcare systems of Europe. Methods: A total of 1407 migrants in 10 European Union countries (consortium members of the Mig-HealthCare project) were surveyed concerning healthcare discrimination, access to healthcare services, and need of translation services using an interviewer-administered questionnaire. Migrants in three countries were excluded from the analysis, due to small sample size, and the new sample consisted of N = 1294 migrants. Descriptive statistics and multivariable regression analyses were conducted to investigate the risk factors on perceived healthcare discrimination for migrants and refugees in the EU. Results: Mean age was 32 (±11) years and 816 (63.26%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Older migrants reported better treatment experience. Migrants in Italy (0.191; 95% CI [0.029, 0.352]) and Austria (0.167; 95% CI [0.012, 0.323]) scored higher in the Discrimination Scale to Medical Settings (DMS) compared with Spain. Additionally, migrants with better mental health scored lower in the DMS scale (0.994; 95% CI [0.993, 0.996]), while those with no legal permission in Greece tended to perceive more healthcare discrimination compared with migrants with some kind of permission (1.384; 95% CI [1.189, 1.611]), as opposed to Austria (0.763; 95% CI [0.632, 0.922]). Female migrants had higher odds of needing healthcare assistance but not being able to access them compared with males (1.613; 95% CI [1.183, 2.199]). Finally, migrants with chronic problems had the highest odds of needing and not having access to healthcare services compared with migrants who had other health problems (3.292; 95% CI [1.585, 6.837]). Conclusions: Development of culturally sensitive and linguistically diverse healthcare services should be one of the main aims of relevant health policies and strategies at the European level in order to respond to the unmet needs of the migrant population.
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Affiliation(s)
- Alejandro Gil-Salmerón
- Polibienestar Research Institute, University of Valencia, 46010 Valencia, Spain
- International Foundation for Integrated Care, Oxford OX2 6UD, UK
- Correspondence:
| | - Konstantinos Katsas
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Marousi, Greece; (K.K.); (P.K.); (A.L.)
| | - Elena Riza
- Department of Hygiene Epidemiology, Medical Statistics Medical School National, Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Pania Karnaki
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Marousi, Greece; (K.K.); (P.K.); (A.L.)
| | - Athena Linos
- Institute of Preventive Medicine Environmental and Occupational Health Prolepsis, 15125 Marousi, Greece; (K.K.); (P.K.); (A.L.)
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21
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Baumeister A, Chakraverty D, Aldin A, Seven ÜS, Skoetz N, Kalbe E, Woopen C. "The system has to be health literate, too" - perspectives among healthcare professionals on health literacy in transcultural treatment settings. BMC Health Serv Res 2021; 21:716. [PMID: 34289853 PMCID: PMC8293586 DOI: 10.1186/s12913-021-06614-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/08/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Effective communication is a central aspect of organizational health literacy. Healthcare professionals are expected to ensure an effective and satisfactory flow of information and to support their patients in accessing, understanding, appraising, and applying health information. This qualitative study aimed to examine the health literacy-related challenges, needs, and applied solutions of healthcare professionals when engaging with persons with a migrant background. Based on the integrated model of health literacy (Sørensen et al., BMC Public Health 12:80, 2012), we focused on environmental, personal, and situational factors that shape health literacy in transcultural treatment settings. METHODS We conducted five focus group discussions with healthcare professionals (N = 31) who are in regular contact with persons with a migrant background. Discussions were transcribed verbatim and analyzed using qualitative content analysis by applying a deductive-inductive categorization procedure. Deductive categories were derived from the integrated model of health literacy. RESULTS Challenges included a mismatch in the provision and use of health services. Participants regarded easily accessible services and outreach counselling as helpful solutions. Further challenges were the migrant patients' distrust in healthcare professionals and the German healthcare system, the participants' uncertainty in dealing with patients' expectations and needs, and the patients' non-compliance with appointments. Environmental factors included systemic lack of time and economic pressure. Both were reported as impeding the flow of information in all treatment settings. Participants with a migrant background themselves (n = 16) regarded this personal factor as an opportunity that increased patients' trust in them. They also reported challenges such as high levels of responsibility felt when ad hoc interpreting for colleagues. CONCLUSIONS Known issues observed in the delivery of healthcare for the majority population (i.e., systemic lack of time, economic pressure) appear to be intensified in the context of migration. An increasingly diverse patient clientele indicates a growing need for culture-sensitive, health-literate healthcare organizations. A corresponding diversity of the health workforce is desirable and should be strengthened by national finance and educational programs. Healthcare professionals who interpret for colleagues should be given the necessary time. Further studies are needed to develop appropriate interventions for improving health literacy at individual and organizational levels. Funding for interpreting services should be expanded.
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Affiliation(s)
- Annika Baumeister
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and Research Unit Ethics, Faculty of Medicine and University Hospital Cologne, 50931, Cologne, Germany.
| | - Digo Chakraverty
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Angela Aldin
- Evidence-Based Internal Medicine, Department I of Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935, Cologne, Germany
| | - Ümran Sema Seven
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Nicole Skoetz
- Evidence-Based Internal Medicine, Department I of Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and Research Unit Ethics, Faculty of Medicine and University Hospital Cologne, 50931, Cologne, Germany
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Poon Z, Lee ECW, Ang LP, Tan NC. Experiences of primary care physicians managing postpartum care: a qualitative research study. BMC FAMILY PRACTICE 2021; 22:139. [PMID: 34193053 PMCID: PMC8244666 DOI: 10.1186/s12875-021-01494-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The postpartum period is redefined as 12 weeks following childbirth. Primary care physicians (PCP) often manage postpartum women in the community after uneventful childbirths. Postpartum care significantly impacts on the maternal and neonatal physical and mental health. However, evidence has revealed unmet needs in postpartum maternal care. AIM The study aimed to explore the experiences of PCPs in managing postpartum mothers. METHODS Four focus group discussions and eleven in-depth interviews with twenty-nine PCPs were conducted in this qualitative research study in urban Singapore. PCPs of both gender and variable postgraduate training background were purposively enrolled. Audited transcripts were independently coded by two investigators. Thematic content analysis was performed using the codes to identify issues in the "clinician", "mother", "postpartum care" and "healthcare system & policy" domains stipulated in "The Generalists' Wheel of Knowledge, Understanding and Inquiry" framework. FINDINGS PCPs' personal attributes such as gender and knowledge influenced their postpartum care delivery. Prior training, child caring experience and access to resource materials contributed to their information mastery of postpartum care. Their professional relationship with local multi-ethic and multi-lingual Asian mothers was impacted by their mutual communication, language compatibility and understanding of local confinement practices. Consultation time constraint, awareness of community postnatal services and inadequate handover of care from the specialists hindered PCPs in the healthcare system. DISCUSSION Personal, maternal and healthcare system barriers currently prevent PCPs from delivering optimal postpartum care. CONCLUSION Interventions to overcome the barriers to improve postpartum care will likely be multi-faceted across domains discussed.
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Affiliation(s)
- Zhimin Poon
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Connection One, Tower 5, #15-10, Singapore, 150167, Singapore.
| | - Esther Cui Wei Lee
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Connection One, Tower 5, #15-10, Singapore, 150167, Singapore
| | - Li Ping Ang
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Connection One, Tower 5, #15-10, Singapore, 150167, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Connection One, Tower 5, #15-10, Singapore, 150167, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Singapore, Singapore
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Suarez NRE, Urtecho M, Jubran S, Yeow ME, Wilson ME, Boehmer KR, Barwise AK. The Roles of medical interpreters in intensive care unit communication: A qualitative study. PATIENT EDUCATION AND COUNSELING 2021; 104:1100-1108. [PMID: 33168459 PMCID: PMC8068732 DOI: 10.1016/j.pec.2020.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To understand healthcare team perceptions of the role of professional interpreters and interpretation modalities during end of life and critical illness discussions with patients and families who have limited English proficiency in the intensive care unit (ICU). METHODS We did a secondary analysis of data from a qualitative study with semi-structured interviews of 16 physicians, 12 nurses, and 12 professional interpreters from 3 ICUs at Mayo Clinic, Rochester. RESULTS We identified 3 main role descriptions for professional interpreters: 1) Verbatim interpretation; interpreters use literal interpretation; 2) Health Literacy Guardian; interpreters integrate advocacy into their role; 3) Cultural Brokers; interpreters transmit information incorporating cultural nuances. Clinicians expressed advantages and disadvantages of different interpretation modalities on the professional interpreter's role in the ICU. CONCLUSION Our study illuminates different professional interpreters' roles. Furthermore, we describe the perceived relationship between interpretation modalities and the interpreter's roles and influence on communication dynamics in the ICU for patients with LEP. PRACTICE IMPLICATIONS Patients benefit from having an interpreter, who can function as a cultural broker or literacy guardian during communication in the ICU setting where care is especially complex, good communication is vital, and decision making is challenging.
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Affiliation(s)
| | - Meritxell Urtecho
- Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, Minnesota, USA.
| | - Samira Jubran
- Language Services, Mayo Clinic, Rochester, Minnesota, USA.
| | - Mei-Ean Yeow
- Center For Palliative Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Michael E Wilson
- Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, Minnesota, USA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Kasey R Boehmer
- Knowledge and Evaluation Research Unit (KER), Mayo Clinic, Rochester, Minnesota, USA.
| | - Amelia K Barwise
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, USA.
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Masai AN, Güçiz-Doğan B, Ouma PN, Nyadera IN, Ruto VK. Healthcare services utilization among international students in Ankara, Turkey: a cross-sectional study. BMC Health Serv Res 2021; 21:311. [PMID: 33827556 PMCID: PMC8025898 DOI: 10.1186/s12913-021-06301-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background While international students form an increasing population of higher education students in Turkey, there is limited empirical evidence about their health services utilization. The study aim was to investigate healthcare access among a group of international students studying in Ankara city and identify potential barriers that affect full healthcare utilization. Method A total of 535 international students from 83 countries completed an online-based questionnaire. The survey was conducted from September until October 2020. Variables between groups within the study sample were compared using ANOVA and Chi-square tests (with Fisher’s exact test). Logistic regression analysis was used to evaluate the relationships between variables related to access to health services. Results Of the study population, 80.6% accessed the general practitioner (GP), 40% accessed the student health centres, and 11.4% were admitted to the hospital at least once. About 80% of international students reported changing their views to access healthcare more because of the COVID-19 pandemic. Conclusion Lack of awareness of healthcare support systems, perceived stigma associated with mental health services, and language barriers were the main barriers affecting healthcare access by international students. Implications Study findings indicate the need for education of international students on available healthcare, targeted health promotion, and training of health providers on effective communication.
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Affiliation(s)
- Abednego Nzyuko Masai
- Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Bahar Güçiz-Doğan
- Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Israel Nyaburi Nyadera
- Department of Political Science and Public Administration, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Government and Public Administration, University of Macau, Macau, China
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Care of the Refugee. Fam Med 2021. [DOI: 10.1007/978-1-4939-0779-3_137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kasodekar S, Tilak A. Enigma of valid consent continues in 2021……. JOURNAL OF OBSTETRIC ANAESTHESIA AND CRITICAL CARE 2021. [DOI: 10.4103/joacc.joacc_22_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Feiring E, Westdahl S. Factors influencing the use of video interpretation compared to in-person interpretation in hospitals: a qualitative study. BMC Health Serv Res 2020; 20:856. [PMID: 32917206 PMCID: PMC7488494 DOI: 10.1186/s12913-020-05720-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Facilitating access to professional interpretation services is key to equitable hospital care for migrants with limited language proficiency; however, interpreter underuse has been documented. The factors that potentially enable or hinder professional interpreter use are not well understood. We aimed to compare perceptions held by hospital managers and healthcare practitioners of the factors influencing the use of remote video interpretation and in-person interpretation. METHODS This study employed a retrospective qualitative design. Two hospitals, located in Austria and Norway, with adequately similar baseline characteristics were purposively selected. Both hospitals used in-person interpreters, and the Austrian hospital had recently introduced remote video interpretation as an alternative and supplement. Fifteen managers and healthcare practitioners participated in focus groups and individual interviews. Data were thematically analysed with the aid of behavioural system theory. RESULTS Across sites, the facilitators of interpreter use included individual factors (knowledge about interpreter services, skills to assess when/how to use an interpreter, beliefs about favourable consequences), as well as organisational factors (soft budget constraints). Barriers were identified at the individual level (lack of interpersonal skills to handle difficult provider-interpreter situations, lack of skills to persuade patients to accept interpreter use, lack of trust in service professionalism), and at the organisational level (limited interpreter availability, time constraints). The introduction of remote video interpretation services seemed to counteract the organisational barriers. Video interpretation was further perceived to enable patient confidentiality, which was regarded as a facilitator. However, video interpretation introduced specific barriers, including perceived communication deficiencies. CONCLUSION This study has identified a range of factors that are perceived to influence the use of interpreters in hospitals. The research suggests that-implementing remote video interpretation services lessens the barriers to use and that such services should be introduced in hospital settings as an alternative or supplement to in-person interpreters. Further intervention functions should be considered to bring about change in the use of interpretation services, including developing guidelines for interpreter use, educating staff in the appropriate use of video technology, and training staff in communicating with interpreter and patients with limited language proficiency.
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Affiliation(s)
- Eli Feiring
- Department of Health Management and Health Economics, University of Oslo, PO Box 1089, Blindern, 0317, Oslo, Norway.
| | - Stine Westdahl
- Department of Health Management and Health Economics, University of Oslo, PO Box 1089, Blindern, 0317, Oslo, Norway
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Is language disability a risk factor for complicated appendicitis? A retrospective cohort study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.770774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Bhandari D, Ozaki A, Kobashi Y, Higuchi A, Shakya P, Tanimoto T. Cancer information seeking and scanning behavior among Nepalese migrants in Japan and its association with preventive behavior. PLoS One 2020; 15:e0235275. [PMID: 32598343 PMCID: PMC7347024 DOI: 10.1371/journal.pone.0235275] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 06/11/2020] [Indexed: 01/24/2023] Open
Abstract
Background Increasing attention is being paid to cancer information seeking (CISE) (active searching for cancer-related health information) and information scanning (CISC) (passive collection of cancer-related health information) among migrants. However, information is lacking with respect to the extent and distribution of CISE and CISC among migrants, particularly in Japan. This study aimed to evaluate the prevalence of both CISE and CISC, to clarify factors associated with CISE and CISC, and to elucidate the association of CISE and CISC with basic cancer knowledge and preventive behavior among Nepalese migrants living in Tokyo, Japan. Methods Nepalese migrants living in Tokyo were recruited from March to August 2019, with snowball sampling. We collected data on CISE, CISC, sociodemographic components, health-related factors, knowledge about risk factors for cancer, and cancer-prevention behavior using a structured questionnaire. We employed several regression approaches to fulfill our study objectives. Results Out of the total 200 participants, 53 (27%) were actively involved in CISE and 176 (88%) in CISC. Internet was the most common information source. High education level and Japanese language skills were positively associated with both CISE and CISC. Migrants with low perceived health status were more likely to perform CISC, while those who had been ill last year and who perceived proper access to doctors were more likely to undertake CISE. Migrants with high CISE (B = 0.10, 95% CI: 0.01, 0.19) and high CISC (B = 0.16, 95% CI: 0.08, 0.23) were more likely to have better knowledge on risk factors of cancer. Furthermore, migrants with high CISE were more likely to eat fruits (B = 0.17, 95%CI: 0.01, 0.32), undergo pap smear test (OR = 1.72, 95%CI: 1.12, 2.65), and colonoscopy (OR = 6.02, 95%CI: 1.63, 22.13). Conclusion In this study, the proportion of Nepalese migrants who deliberately undertook CISE was low, while the practice of CISC was relatively common. Given that the CISE was associated with cancer-prevention behavior, proper strategies should be implemented to alleviate barriers for CISE and improve its impact on providing reliable evidence about cancer to migrants in Japan.
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Affiliation(s)
- Divya Bhandari
- Medical Governance Research Institute, Tokyo, Japan
- * E-mail:
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan
- Department of Breast Cancer, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Yurie Kobashi
- Medical Governance Research Institute, Tokyo, Japan
- Department of Public Health, Fukushima Medical University, Fukushima, Japan
| | | | - Prakash Shakya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Chen LK. Better migrant health services with glocal context. J Chin Med Assoc 2020; 83:520. [PMID: 32243273 DOI: 10.1097/jcma.0000000000000316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
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Jaeger FN, Pellaud N, Laville B, Klauser P. Barriers to and solutions for addressing insufficient professional interpreter use in primary healthcare. BMC Health Serv Res 2019; 19:753. [PMID: 31653211 PMCID: PMC6815061 DOI: 10.1186/s12913-019-4628-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/11/2019] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this nationwide study was to investigate barriers to adequate professional interpreter use and to describe existing initiatives and identify key factors for successful interpreter policies in primary care, using Switzerland as a case study. Methods Adult and paediatric primary care providers were invited to participate in an online cross-sectional questionnaire-based study. All accredited regional interpreter agencies were contacted first by email and, in the absence of a reply, by mail and then by phone. Local as well as the national health authorities were asked about existing policies. Results 599 primary care physicians participated. Among other reasons, physicians identified cumbersome organization (58.7%), absent financial coverage (53.7%) and lack of knowledge on how to arrange interpreter interventions (44%) as main barriers. The odds of organising professional interpreters were 6.6-times higher with full financial coverage. Some agencies confirmed difficulties providing professional interpreters for certain languages at a timely manner. Degrees of coverage of professional interpreter costs (full coverage to none) and organization varied between regions resulting in different levels of unmet needs. Conclusions Professional interpreter use can be improved through the following points: increase awareness and knowledge of primary care providers on interpreter use and organization, ensure financial coverage, as well as address organizational aspects. Examples of successful interventions exist.
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Affiliation(s)
- Fabienne N Jaeger
- Kollegium für Hausarztmedizin, Rue de l'Hôpital 15, CH-1701, Berne, Fribourg, Switzerland. .,Swiss Tropical and Public Health Institut, Socinstrasse 57, CH-4002, Basel, Switzerland. .,University of Basel, CH-4003, Basel, Switzerland.
| | - Nicole Pellaud
- Kollegium für Hausarztmedizin, Rue de l'Hôpital 15, CH-1701, Berne, Fribourg, Switzerland.,Swiss Society of Paediatrics, Rue de l'Hôpital 15, CH-1700, Fribourg, Switzerland
| | - Bénédicte Laville
- Kollegium für Hausarztmedizin, Rue de l'Hôpital 15, CH-1701, Berne, Fribourg, Switzerland
| | - Pierre Klauser
- Kollegium für Hausarztmedizin, Rue de l'Hôpital 15, CH-1701, Berne, Fribourg, Switzerland
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