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1.
East Mediterr Health J ; 26(2): 233-238, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141602

RESUMO

Background: English is the language of instructions in many medical schools in the Arab world. Its use may create a language barrier and adversely affect an individual's learning and later professional life. Aims: This study examined the views of final-year Arab medical students of a language barrier and its effect on their learning and academic performance, and their language preference for medial education. Methods: All final-year medical students (n = 142, 62% females) at the Arabian Gulf University, Bahrain, were invited to respond to a self-completed questionnaire. Differences in responses according to English proficiency and sex were assessed. Results: Of the 142 students, 99 (70%) responded. Most students did not feel a language barrier irrespective of their proficiency in English (P = 0.088). Most respondents did not think that language issues made studying more difficult, although there was a significant difference in responses between students considered proficient in English and those less proficient (P = 0.005). Most students (82%) were not aware or were not sure of medical terms in Arabic, but 66% were confident that they would be able to communicate with patients in Arabic. About half of the students (51%) supported medicine being taught only in English and 36% supported teaching in Arabic and English. Conclusions: Most students thought that learning in English did not affect their academic learning and performance. However, a good proportion supported being taught medicine in Arabic and English.


Assuntos
Barreiras de Comunicação , Educação Médica/métodos , Estudantes de Medicina/psicologia , Adulto , Barein , Competência Clínica , Compreensão , Educação Médica/normas , Feminino , Humanos , Linguagem , Masculino , Multilinguismo , Faculdades de Medicina , Inquéritos e Questionários , Universidades , Adulto Jovem
5.
Gesundheitswesen ; 82(2): 151-156, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31770778

RESUMO

AIM OF THE STUDY: Medicine has been criticized for over-emphasizing biological aspects of health and disease while neglecting social determinants. However, the last decades witnessed the rise of a strand of medical theorizing that proposed a biopsychosocial perspective on health and disease. This article investigates from ethnographic perspectives the extent to which contemporary biopsychosocial medicine succeeds in providing medical care to asylum-seekers in order to grasp societal influences on health and illness. METHODS: A mix of ethnographic methods including narrative interviews, semi-structured interviews and participant observation was used. RESULTS: Using examples of legal restrictions in patients' access to care and language barriers, the ethnographic material showed that physicians regularly failed to take asylum seekers' health-related life-world scientifically into account. Instead, they routinely improvised solutions or deferred responsibility for finding solutions to other agents. CONCLUSIONS: Approaches employed in the social sciences - especially in medical anthropology - could help alleviate these difficulties that result in sub-standard care, and should therefore be integrated into medical teaching and postgraduate education. Concurrently, theoretical and methodological gaps that might also concern other groups of patients might be closed.


Assuntos
Acesso aos Serviços de Saúde , Refugiados , Barreiras de Comunicação , Alemanha , Humanos , Narração
7.
Nursing ; 49(12): 60-63, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31764877

RESUMO

PURPOSE: This study explored nursing experiences using interpreters in primary healthcare settings. METHODS: Eight nurses in southern Sweden were subjected to semistructured interviews. The responses were divided into three categories using content analysis: interpreter influence, challenges, and strategies. RESULTS: Despite using an interpreter to minimize language barriers, nurses do not achieve the same level of person-centered care as those who speak the same language as their patients, but translation services remain a useful communication tool for patient care. CONCLUSION: Communication through an interpreter is an inevitability for healthcare professionals, and formal education is recommended to improve nurses' utilization of these services.


Assuntos
Atitude do Pessoal de Saúde , Barreiras de Comunicação , Recursos Humanos de Enfermagem/psicologia , Tradução , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem/estatística & dados numéricos , Atenção Primária à Saúde , Pesquisa Qualitativa , Suécia
9.
BMC Health Serv Res ; 19(1): 722, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638984

RESUMO

BACKGROUND: Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo. METHODS: Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access. RESULTS: Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband's limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad. CONCLUSIONS: Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants' knowledge and ability to navigate the Norwegian healthcare system.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Emigrantes e Imigrantes , Acesso aos Serviços de Saúde/estatística & dados numéricos , Massagem , Ocupações , Adulto , Barreiras de Comunicação , Feminino , Humanos , Noruega/epidemiologia , Direitos do Paciente , Pesquisa Qualitativa , Tailândia
10.
J Bone Joint Surg Am ; 101(18): e95, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31567810

RESUMO

BACKGROUND: Communication is the foundation of any patient-doctor relationship. Patients who are unable to communicate effectively with physicians because of language barriers may face disparities in accessing orthopaedic care and in the evaluation and treatment of musculoskeletal symptoms. We evaluated whether Spanish-speaking patients face disparities scheduling appointments with orthopaedists via the telephone. METHODS: From the American Academy of Orthopaedic Surgeons (AAOS) web site, we randomly selected 50 orthopaedic surgeons' offices in California specializing in knee surgery. The investigator called eligible offices using a script to request an appointment for a hypothetical Spanish-speaking or English-speaking 65-year-old man with knee pain. The caller randomly selected the patient's primary language for this first call. A second call was placed a week later requesting an appointment for an identical patient who spoke the alternate language. RESULTS: There was no significant difference between Spanish-speaking and English-speaking patients' access to appointments with an orthopaedic surgeon (p = 0.8256). Thirty-six English-speaking patients and 35 Spanish-speaking patients were offered an appointment. Twenty-eight Spanish-speaking patients were instructed to bring a friend or family member who could translate for them, 3 were told that the provider spoke sufficient Spanish to communicate without the need for an interpreter, and 4 were told that an interpreter would be made available. CONCLUSIONS: We did not detect a disparity between Spanish-speaking and English-speaking patients' access to appointments with an orthopaedic surgeon. However, 80% of Spanish-speaking patients were asked to rely on nonqualified interpreters for their orthopaedic appointment. This study suggests that orthopaedic offices in California depend heavily on ad hoc interpreters rather than professional interpretation services. It also highlights potential barriers to the provision of qualified interpreters. Additional study is warranted to assess how this lack of adequate utilization of medical interpreters affects the patient-doctor relationship, the quality of care received, and the financial burden on the health system. CLINICAL RELEVANCE: Optimizing the care that we provide to our patients is a goal of every orthopaedic surgeon. We highlight the importance of utilizing professional interpreters as a means to reduce health-care disparities and overall health-care costs, as well as the importance of improving reimbursement and infrastructure for physicians to utilize qualified interpreters in caring for their limited-English-proficient patients.


Assuntos
Agendamento de Consultas , Barreiras de Comunicação , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Linguagem , Cirurgiões Ortopédicos , Relações Médico-Paciente , Idoso , California , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos , Humanos , Masculino , Procedimentos Ortopédicos , Telefone , Tradução
11.
Artigo em Inglês | MEDLINE | ID: mdl-31581616

RESUMO

OBJECTIVE: To evaluate how patients' primary spoken language influences the understanding of their disorder and their subsequent sun-related behaviors. METHODS: This was a cross-sectional study conducted between February 2015 and July 2016 in two outpatient dermatology clinics among 419 adults with a sun-exacerbated dermatosis. The primary outcome was a successful match between the patient-reported diagnosis on a survey and the dermatologist-determined diagnosis. RESULTS: Of participants, 42% were native English speakers, and 68% did not know their diagnosis. Fewer non-native English speakers identified one risk factor for their condition (46% versus 54%, p < 0.01). A greater number of non-native English speakers were less familiar with medical terminology. Native English speakers were 2.5 times more likely to know their diagnosis compared to non-native speakers (adjusted odds (aOR) 2.5, 95% confidence interval, 1.32 to 4.5; p = 0.005). Additional factors associated with higher odds of knowing the diagnosis included: Higher education, sunscreen use, female gender, symptoms for 1-5 years, and diagnosis of melasma and postinflammatory hyperpigmentation (PIH). CONCLUSIONS: Knowledge of the diagnosis and understanding of factors that may influence skin disease may promote conscious sun behavior. Patients who knew that their diagnosis was sun-exacerbated had higher odds of wearing sunscreen.


Assuntos
Barreiras de Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Pacientes Ambulatoriais/psicologia , Queimadura Solar/diagnóstico , Queimadura Solar/tratamento farmacológico , Queimadura Solar/psicologia , Protetores Solares/uso terapêutico , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
12.
Hand Clin ; 35(4): 421-427, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31585602

RESUMO

As the population increases in the world's poorest countries, the need for surgical interventions will increase. Short-term surgical missions can play an important role in increasing access to solve this disparity by providing much-needed surgical services to vulnerable populations in low-income and middle-income countries. As short-term surgical missions increase, it is important that basic ethical principles are a foundation in service delivery. By following ethical principles outlined in this article, abiding by common moral language, and establishing long-term relationships, a significant contribution can be made to global surgery to increase access and deliver high-quality surgery.


Assuntos
Ética Médica , Saúde Global , Missões Médicas , Beneficência , Competência Clínica , Barreiras de Comunicação , Cultura , Países em Desenvolvimento , Humanos , Autonomia Pessoal
13.
BMC Health Serv Res ; 19(1): 727, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640714

RESUMO

BACKGROUND: Due to increasing international migration, Sweden has become a multicultural and multilingual society, with about 19% of the population born abroad, which imposes high demands on the healthcare sector and interpreting services. The aim was to investigate problems in the use of interpreters as recorded by healthcare staff and the interpreter service in a region in Sweden. METHODS: Cross-sectional register-based study. The study focused on a geographically well-defined region in Sweden including (a) specialized care at three hospitals; (b) local healthcare, including out-patient clinics at hospital and emergency healthcare and primary healthcare; and (c) dental care. The study was based on 726 existing incident reports on the interpreting service and information from the interpreter agency from 2012 and the first quarter of 2016 during a period of a massive influx of refugees. RESULTS: The highest number of adverse advents was reported in local healthcare and mainly concerned the absence of an interpreter at the appointed time. Non-authorized in-person interpreters performed most interpretation assignments and Arabic was the most requested language. CONCLUSIONS: This study highlights the significance of good cooperation between healthcare and the interpreter service in order to guarantee safe and high-quality healthcare for patients in need of interpreters to be able to communicate in healthcare.


Assuntos
Prestação Integrada de Cuidados de Saúde/normas , Emigração e Imigração/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Tradução , Barreiras de Comunicação , Estudos Transversais , Humanos , Qualidade da Assistência à Saúde , Suécia
14.
Rev Gaucha Enferm ; 40: e20190017, 2019 Sep 16.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31531595

RESUMO

OBJECTIVE: To identify aspects that hinder or facilitate the work of nurses in primary health care when disclosing difficult news. METHOD: Qualitative, descriptive and exploratory study addressing 15 nurses from ten primary health care units located in the south of Brazil. Data were collected from February to April 2017, using a semi-structured interview. Interviews were audio-recorded and analyzed based on discourse analysis. RESULTS: The aspects that hinder communication include the demand for services; work organization; the characteristics of patients; and personal aspects. Facilitating aspects include privacy and being in the community. Also hindering or facilitating communication: the way the network functions and the staff; academic training; professional experience; personal aspects. CONCLUSION: This topic is seldom addressed during academic training and this lack of preparedness is one of the main barriers hindering the disclosure of difficult news. Hence, it is essential that teaching institutions establish a discussion regarding this topic.


Assuntos
Atitude do Pessoal de Saúde , Comunicação , Enfermeiras e Enfermeiros/psicologia , Atenção Primária à Saúde , Revelação da Verdade , Barreiras de Comunicação , Confidencialidade , Educação em Enfermagem , Ética em Enfermagem , Humanos , Atenção Primária à Saúde/ética , Privacidade , Pesquisa Qualitativa , Revelação da Verdade/ética
16.
Artigo em Inglês | MEDLINE | ID: mdl-31398850

RESUMO

In Taiwan, migrants come mostly for marriage and work. Several researchers have conducted health-related studies of marital migrants and migrant workers, but the access of the two groups to healthcare has not been studied. Therefore, our study investigated the factors associated with migrants' access to healthcare, with the main foci being marital migrants and migrant workers in Taiwan. A structured and cross-sectional questionnaire was anonymously self-administered by migrants recruited to participate in this survey on a voluntary basis from 11 medical centers and 11 migrant-helping associations in Taiwan between May 1st and September 21st, 2018. A total of 753 questionnaires were analyzed. The majority of marital migrants (n = 243) and migrant workers (n = 449) surveyed were enrolled in Taiwan's National Health Insurance system (92.7 vs. 93.5%, p = 0.68). More of the migrant workers (n = 205) than the marital migrants (n = 42) encountered language barriers while seeking medical services (48.0 vs. 17.1%, p < 0.001). A professional interpreter at the point of care was considered important by more of the migrant workers (n = 316) than the marital migrants (n = 89) (70.2 vs. 39.6%, p < 0.001). Although more than 90% of the surveyed migrants were enrolled in the health insurance system in Taiwan, many, especially among the migrant workers, still faced language barriers while seeking medical services.


Assuntos
Barreiras de Comunicação , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Cônjuges/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Taiwan , Adulto Jovem
17.
G Ital Nefrol ; 36(4)2019 Jul 24.
Artigo em Italiano | MEDLINE | ID: mdl-31373463

RESUMO

People with a chronic kidney condition can live with their disease for several years, during which the illness becomes "an integral aspect of life" and requires "an arduous and continuous process of adaptation at multiple levels: cognitive, emotional and physical". Often, communicating with doctors is not helpful to these patients in understanding what is happening and reorganizing their lives, as ineffective communication strategies are employed. It is in fact necessary to overcome obstacles such as the use of incomprehensible technical language, ambiguity, the lack of communication training and the abundance of stressful situations. Chronically ill patients have the right to be informed in a simple, clear and impartial way about their condition and its possible treatments; this information will help them manage their kidney disease, "accept" it and find the motivation to adhere to medical prescriptions over time.


Assuntos
Barreiras de Comunicação , Nefrologia , Relações Enfermeiro-Paciente , Relações Médico-Paciente , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Esgotamento Profissional , Comunicação , Humanos , Acontecimentos que Mudam a Vida , Educação de Pacientes como Assunto , Insuficiência Renal Crônica/terapia
18.
BMC Public Health ; 19(1): 1096, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409317

RESUMO

BACKGROUND: Culturally competent health care service delivery can improve health outcomes, increasing the efficiency of clinical staff, and greater patient satisfaction. We aimed to explore the experience of patients with limited English proficiency and professional interpreters in an acute hospital setting. METHODS: In-depth interviews explored the experiences of four culturally and linguistically diverse communities with regards to their recent hospitalisation and access to interpreters. We also conducted focus group with professional interpreters working. Data were analysed using an inductive thematic approach with constant comparison. RESULTS: Individual interviews were conducted with 12 patients from Greek, Chinese, Dari and Vietnamese backgrounds. Focus groups were conducted with 11 professional interpreters. Key themes emerged highlighting challenges to the delivery of health care due distress and lack of advocacy in patients. Interpreters struggled due to a reliance on family to act as interpreters and hospital staff proficiency in working with them. CONCLUSIONS: In an era of growing ethnic diversity this study confirms the complexity of providing a therapeutic relationships in contemporary health practice. This can be enhanced by training towards the effective use of professional interpreters in a hospital setting. Such efforts should be multidisciplinary and collective in order to ensure patients don't fall through the gaps with regards to the provision of culturally competent care.


Assuntos
Barreiras de Comunicação , Assistência à Saúde Culturalmente Competente , Necessidades e Demandas de Serviços de Saúde , Linguagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Pessoal Técnico de Saúde/psicologia , Pessoal Técnico de Saúde/estatística & dados numéricos , Austrália , Diversidade Cultural , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/psicologia , Pacientes/estatística & dados numéricos , Pesquisa Qualitativa , Tradução
19.
BMC Health Serv Res ; 19(1): 597, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31443655

RESUMO

BACKGROUND: Language barriers in doctor-patient interactions are still an understudied phenomenon. This is particularly true concerning interactions with immigrant physicians who are learners of the patient's language; there is a lack of research even though labour migration is increasing internationally. This conversation analytical study focusses on language errors in one specific type of doctor-patient interaction, namely pre-anaesthesia evaluations with immigrant anaesthetists. METHODS: The study combines the research field of language acquisition with that of medical interaction. It is a qualitative study with an ethnomethodological framework which addresses the following research question: How do language errors, produced by immigrant anaesthetists, impact pre-anaesthesia evaluations? The primary data comes from naturally occurring pre-anaesthesia evaluations carried out by immigrant anaesthetists. The analysis method is a combination of conversation and error analysis. RESULTS: The study shows that the anaesthetists produced a considerable number of unintelligible utterances, due to various language errors. Despite the lack of understanding, hardly any negotiation of meaning occurred and both sides (anaesthetists and patients) claimed to be satisfied. CONCLUSIONS: The findings appear to be contradictory. An explanation for this can be found in the effect of the roles and scripts that are given in pre-anaesthesia evaluations. Since no negotiation of meaning is initiated during the interactions, the anaesthetists' insufficient language competence leads to a considerable impairment of informed consent, which is the main goal of the pre-anaesthesia evaluations. Based on these findings, the study reveals an urgent need for action regarding immigrant anaesthetists' language skills.


Assuntos
Anestesiologistas/normas , Barreiras de Comunicação , Emigrantes e Imigrantes , Consentimento Livre e Esclarecido , Relações Médico-Paciente , Anestesia/normas , Comunicação , Humanos , Motivação , Cuidados Pré-Operatórios , Pesquisa Qualitativa
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