Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia.
BMC Health Serv Res. 2012 Sep 18;12:322. doi: 10.1186/1472-6963-12-322.
Australia is a culturally diverse nation with one in seven Australians born in a non-English speaking country. Culturally and Linguistically Diverse (CALD) populations are at a high risk of developing preventable chronic diseases such as cardiovascular disease, type 2 diabetes mellitus, renal disease, and chronic respiratory disease, especially communities from the Pacific Islands, the Middle East, North Africa, the Indian subcontinent and China. Previous studies have shown that access to services may be a contributing factor. This study explores the experiences, attitudes and opinions of immigrants from different cultural and linguistic backgrounds and their health care providers with regard to chronic disease care.
Five focus groups were conducted comprising participants from an Arabic speaking background, or born in Sudan, China, Vietnam or Tonga. A total of 50 members participated. All focus groups were conducted in the participants' language and facilitated by a trained multicultural health worker. In addition, 14 health care providers were interviewed by telephone. Interviews were digitally recorded and transcribed. All qualitative data were analysed with the assistance of QSR NVivo 8 software.
Participants were generally positive about the quality and accessibility of health services, but the costs of health care and waiting times to receive treatment presented significant barriers. They expressed a need for greater access to interpreters and culturally appropriate communication and education. They mentioned experiencing racism and discriminatory practices. Health professionals recommended recruiting health workers from CALD communities to assist them to adequately elicit and address the needs of patients from CALD backgrounds.
CALD patients, carers and community members as well as health professionals all highlighted the need for establishing culturally tailored programs for chronic disease prevention and management in CALD populations. Better health care can be achieved by ensuring that further investment in culturally specific programs and workforce development is in line with the number of CALD communities and their needs.
澳大利亚是一个文化多元化的国家,每七个澳大利亚人中就有一个人出生在非英语国家。文化和语言多样化(CALD)人群患可预防的慢性疾病的风险很高,如心血管疾病、2 型糖尿病、肾脏疾病和慢性呼吸道疾病,特别是来自太平洋岛屿、中东、北非、印度次大陆和中国的社区。先前的研究表明,获得服务可能是一个促成因素。本研究探讨了来自不同文化和语言背景的移民及其医疗保健提供者在慢性病护理方面的经验、态度和意见。
进行了五次焦点小组讨论,参与者来自阿拉伯语背景或出生于苏丹、中国、越南或汤加。共有 50 人参加。所有焦点小组都用参与者的语言进行,并由一名受过培训的多元文化卫生工作者主持。此外,还通过电话采访了 14 名医疗保健提供者。采访被数字化记录并转录。在 QSR NVivo 8 软件的协助下,对所有定性数据进行了分析。
参与者普遍对医疗服务的质量和可及性表示满意,但医疗保健费用和接受治疗的等待时间是显著的障碍。他们表示需要更多的口译员和文化上合适的沟通和教育。他们提到了经历种族主义和歧视性做法。卫生专业人员建议从 CALD 社区招聘卫生工作者,以帮助他们充分了解和满足来自 CALD 背景的患者的需求。
CALD 患者、照顾者和社区成员以及卫生专业人员都强调需要为 CALD 人群制定针对慢性病预防和管理的文化定制计划。通过确保进一步投资于文化特定的项目和劳动力发展与 CALD 社区的数量及其需求保持一致,可以实现更好的医疗保健。