Kocken Paul L, Zwanenburg Evelien Joosten-van, de Hoop Tine
TNO Quality of Life, Health Promotion Department, P.O. Box 2215, 2301 CE Leiden, The Netherlands.
Patient Educ Couns. 2008 Jan;70(1):25-30. doi: 10.1016/j.pec.2007.09.016. Epub 2007 Nov 19.
The effectiveness of use of migrant health educators in the general practitioners' care for female migrants with psychosomatic problems was evaluated to contribute to the improvement of the care for these patients.
A randomised controlled trial (RCT) design was used. A total of 104 patients (75%) agreed to take part in the intervention study. The patients were from Turkish and Moroccan immigrant groups living in The Netherlands. The intervention group received counselling and education from the migrant health educators as adjuncts to the GPs' care. Special attention was given to the patient's cultural background, supporting the communication between GP and patient. The control group received regular treatment from their GPs.
A significant improvement of perceived general health, psychological health and reported ability to cope with pain was observed among the intervention group. No effects were found for social support and the perceived burden of stressful life-events.
The patients' perceived health and coping abilities improved through the intervention as a whole. Not all outcome measures had been affected due to among others the diversity of physical and psychological complaints the patients suffered from, non-compliance and a perceived decrease of disability over time.
The intervention methods should be integrated in the patient care delivery for migrants in general practice. Further development of intervention methods to address the patients' social support is recommended.
评估在全科医生对患有心身问题的女性移民的护理中使用移民健康教育工作者的有效性，以促进对这些患者护理的改善。
采用随机对照试验（RCT）设计。共有104名患者（75%）同意参与干预研究。这些患者来自生活在荷兰的土耳其和摩洛哥移民群体。干预组接受移民健康教育工作者的咨询和教育，作为全科医生护理的辅助。特别关注患者的文化背景，以支持全科医生与患者之间的沟通。对照组接受全科医生的常规治疗。
干预组在总体健康感知、心理健康以及应对疼痛的能力方面有显著改善。在社会支持和感知到的压力性生活事件负担方面未发现影响。
通过整体干预，患者的健康感知和应对能力得到改善。并非所有结果指标都受到影响，原因包括患者所患身体和心理问题的多样性、不依从以及随着时间推移残疾感知的下降等。
干预方法应纳入全科医疗中对移民患者的护理服务。建议进一步开发干预方法以解决患者的社会支持问题。
