van den Muijsenbergh Maria, van Weel-Baumgarten Evelyn, Burns Nicola, O'Donnell Catherine, Mair Frances, Spiegel Wolfgang, Lionis Christos, Dowrick Chris, O'Reilly-de Brún Mary, de Brun Tomas, MacFarlane Anne
1 Department of Primary and Community Care, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, The Netherlands.
2 Department of General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
Prim Health Care Res Dev. 2014 Apr;15(2):122-33. doi: 10.1017/S1463423613000157. Epub 2013 Apr 22.
The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions.
本文的目的是证实关于欧洲基层医疗环境中跨文化交流支持措施实施的障碍和促进因素研究的重要性。在概述移民健康问题后，重点关注基层医疗中跨文化咨询中的交流以及语言障碍的重要性，我们强调了这样一个事实，即在日常实践中存在一些长期存在且在不同欧洲环境中都存在的严重问题。语言和文化障碍阻碍了医生与移民之间咨询中的交流，产生了一系列负面影响，包括较差的依从性以及更倾向于寻求急诊服务。众所周知，需要熟练的口译员和具备文化能力的专业人员来解决这个问题。存在一系列专业指南和培训举措来支持基层医疗中跨文化咨询的交流。然而，这些举措在日常实践中通常并未得到实施。目前尚不清楚为什么专业人员不接受或实施这些指南和干预措施，以及在何种情况下他们会这样做。一项涉及六个欧洲国家的新研究，即RESTORE（在欧洲各种基层医疗环境中支持不同出身和语言背景患者的实施策略研究），旨在填补这些知识空白。它采用了当代社会理论、正常化过程理论（NPT）和参与式学习与行动（PLA）研究的独特组合。这应该会增强对实施的促进因素和障碍的理解，同时也为利益相关者提供机会，以创造性地解决实施此类干预措施时遇到的问题。
