背景:全球移民导致医疗保健中语言不一致的咨询(LDC)数量急剧增加。缺乏关于医疗保健提供者(HCPs)如何在减轻语言障碍的同时满足移民患者需求的证据。
方法:使用目的性和雪球采样,我们招募了27名荷兰HCPs(Mage=45.07,SD=11.46),并进行了半结构化访谈,以收集定性,用于确定最不发达国家移民患者使用的沟通策略的开放式数据。我们使用演绎和归纳法分析了转录本(例如,来自扎根理论的常数比较法)。最终图案代码(即,关键主题)在研究团队中进行了讨论,直到双方达成共识。
结果:从分析中得出了五个关键主题:HCP通常具有(1)工具和(2)在语言协调咨询中使用的情感交流策略来开始医疗咨询。当一些工具性沟通策略被认为无效时(例如,linguafranca,打手势,等。)弥合语言障碍,HCP转向(3)采用数字工具(例如,谷歌翻译)。当HCP完全无法与移民患者沟通时,(4)非正式、临时和专业口译员参与其中。最后,HCP通常(5)涉及额外的支持,以吸引移民患者参与与治疗相关的行为。
结论:我们的结果强调了提高HCP对使用不同策略的各种组合的认识的重要性。制定指示针对不同医疗咨询目标的沟通策略的最佳组合的指南可能有助于重塑最不发达国家HCP的当前沟通行为。
■HCP是这项定性研究中涉及的研究人群。难民健康顾问,全科医生和语言专家(即,Right2Health联盟的成员)在整个研究过程中都参与了荷兰医疗保健系统的经验。这包括对研究问题的回顾,参与者信息表和访谈主题指南,以及提供数据的解释和对本手稿的反馈。
BACKGROUND: Global migration has led to a sharp increase in the number of language-discordant consultations (LDCs) in healthcare. Evidence on how healthcare providers (HCPs) meet migrant patients\' needs while mitigating language barriers is lacking.
METHODS: Using purposive and snowball sampling, we recruited twenty-seven Dutch HCPs (Mage = 45.07, SD = 11.46) and conducted semi-structured interviews to collect qualitative, open-ended data for identifying the communication strategies used with migrant patients in LDCs. We analysed the transcripts using deductive and inductive approaches (e.g., constant comparative method from Grounded Theory). Final pattern codes (i.e., key themes) were discussed among the research team until mutual agreement had been achieved.
RESULTS: Five key themes emerged from the analyses: HCPs often \'got-by\' with (1) instrumental and (2) affective communication strategies used in language-concordant consultations to start medical consultations. When some instrumental communication strategies were deemed ineffective (e.g., lingua franca, gesturing, etc.) to bridge language barriers, HCPs turned to (3) incorporating digital tools (e.g., Google Translate). When HCPs were unable to communicate with migrant patients at all, (4) informal, ad-hoc and professional interpreters were involved. Finally, HCPs often (5) involved additional support to engage migrant patients to engage in treatment-related behaviours.
CONCLUSIONS: Our results highlight the importance of raising awareness among HCPs about using various combinations of different strategies. The development of a guideline indicating the optimal combination of communication strategies for different medical consultation goals may be useful in reshaping the current communication behaviour of HCPs in LDCs.
UNASSIGNED: HCPs were the study population involved in this qualitative study. Refugee health advisors, general practitioners and linguistic specialists (i.e., members of the Right2Health consortium) with experience with the Dutch healthcare system were involved throughout the development of this research. This includes a review of the research question, participant information sheet and interview topic guide as well as providing interpretations of the data and feedback to this manuscript.