Patient Perspectives on the Need for and Barriers to Professional Medical Interpretation.

BACKGROUND: Individuals with limited English proficiency (LEP) constitute an increasing share of the patient population in American healthcare settings. Few studies have described the patient's perspective on barriers to medical interpretation and experiences in the clinical setting. METHODS: We conducted focus groups with 22 LEP Spanish-speaking adults. Focus groups were transcribed and analyzed in their original Spanish. RESULTS: LEP patients face significant challenges when accessing health care services due to inadequate or insufficient access to professional interpreters. Predominant themes include: lack of interpreter availability, fear of disclosing limited English skills, and language discordant providers overestimating LEP patients' understanding of English. Many participants felt they had received poorer quality care. CONCLUSIONS: LEP patients face multiple barriers to accessing adequate interpretation leading to a perceived worsening in the quality of care. In order to improve health outcomes for LEP patients, routine provision of adequate interpretation is essential.

Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: stigma and misperceptions.

Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were "bad food," digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening.

Attitudes toward the physical examination: a comparison of U.S. and Dominican medical students.

BACKGROUND: Little information exists regarding whether medical students learning in relatively resource-scarce countries develop greater confidence in their physical examination skills or whether, compared to U.S. medical students, they have more positive attitudes regarding the utility of the physical examination. PURPOSE: To compare U.S. And Dominican medical students' attitudes toward the physical examination. METHODS: We surveyed final-year students at 1 medical school in the United States and 1 in the Dominican Republic regarding self-confidence in and perceived utility of the physical examination. Using 5-point Likert-type scales with response choices ranging from 1 (not at all confident) to 5 (very confident) and 1 (not at all useful) to 5 (very useful), respondents reported their attitudes toward the physical examination overall and toward 14 specific physical examination skills. RESULTS: The survey response rate was 117/164 (71%). Students at the Dominican school, compared to students at the U.S. school, reported significantly greater confidence in their overall physical examination skill (mean response 4.27 vs. 3.79, respectively, p < .001) and more positive views about the utility of the physical examination overall for providing diagnostically useful information (mean response 4.78 vs. 4.42, respectively, p < .001). Results for the specific skills also showed more positive attitudes in the students from the Dominican medical school. CONCLUSIONS: Students at a Dominican medical school reported more positive attitudes toward the physical examination than students at a U.S. medical school.

Salud psicosocial en un desastre complej: El efecto del huracán Mitch en Nicaragua / Psychosocial Health in a Complex Disaster: Effects of the Hurricane Mitch in Nicaragua

Recopilación resumida de las ponencias efectuadas durante el encuentro sobre los efectos psicológicos de los desastres en la población nicaragüense, en sucesos como el huracán Mitch en 1998

Salud psicosocial en un desastre complejo: El efecto del huracan Mitch en Nicaragua

Presenta la teoría de salud psicosocial en desatres. Rewitt Díaz y Escorcia Delgadillo discuten las diferentes fases de un desastre y la respuesta psicológica de la comunidad. Presentan la sintomatología que resulta como efectos del desatre y presenta una breve discusión sobre los grupos que son más afectados por desastres. Concluyen con una discusión sobre las intervenciones en el período de recuperación

Salud psicosocial en un desastre complejo: El efecto del huracán Mitch en Nicaragua

Trabajo realizado en Estelí, Chinandega y Matagalpa. El trabajo consiste en identificar los efectos de el desastre después del desastre. El trabajo consistió en ayudar a los miembros de la comunidad a redefinir su identidad y sentido de la pertenencia después del Huracán Mitch. Concluye el trabajo con la identificación de las variables que enaltecen la presencia de problemas emocionales en la población estudiada