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新到移民患者在加泰罗尼亚初级保健中心就诊时的痛苦程度、躯体化和对健康-疾病的信念,以及为实现其最有效管理而定义的专业能力:PROMISE 项目。

Level of distress, somatisation and beliefs on health-disease in newly arrived immigrant patients attended in primary care centres in Catalonia and definition of professional competences for their most effective management: PROMISE Project.

机构信息

Primary Healthcare Research Support Unit Metropolitana Nord, IDIAP Jordi Gol, Carrer Major 49-53, 08921 Santa Coloma de Gramenet, Spain.

出版信息

BMC Fam Pract. 2013 May 4;14:54. doi: 10.1186/1471-2296-14-54.

Abstract

BACKGROUND

Newly arrived immigrant patients who frequently use primary health care resources have difficulties in verbal communication. Also, they have a system of beliefs related to health and disease that makes difficult for health care professionals to comprehend their reasons for consultation, especially when consulting for somatic manifestations. Consequently, this is an important barrier to achieve optimum care to these groups. The current project has two main objectives: 1. To define the different stressors, the level of distress perceived, and its impact in terms of discomfort and somatisation affecting the main communities of immigrants in our area, and 2. To identify the characteristics of cross-cultural competence of primary health care professionals to best approach these reasons for consultation.

METHODS/DESIGN: It will be a transversal, observational, multicentre, qualitative-quantitative study in a sample of 980 people from the five main non-European Union immigrant communities residing in Catalonia: Maghrebis, Sub-Saharans, Andean South Americans, Hindustanis, and Chinese. Sociodemographic data, level of distress, information on the different stressors and their somatic manifestations will be collected in specific questionnaires. Through a semi-structured interview and qualitative methodology, it will be studied the relation between somatic manifestations and particular beliefs of each group and how these are associated with the processes of disease and seeking for care. A qualitative methodology based on individual interviews centred on critical incidents, focal groups and in situ questionnaires will be used to study the cross-cultural competences of the professionals.

DISCUSSION

It is expected a high level of chronic stress associated with the level of somatisations in the different non-European Union immigrant communities. The results will provide better knowledge of these populations and will improve the comprehension and the efficacy of the health care providers in prevention, communication, care management and management of resources.

摘要

背景

经常使用初级卫生保健资源的新移民患者在语言交流方面存在困难。此外,他们的健康和疾病观念与医疗保健专业人员的理解相去甚远,这使得医疗保健专业人员难以理解他们的就诊原因,尤其是在出现躯体症状时。因此,这是为这些群体提供最佳护理的一个重要障碍。本项目有两个主要目标:1. 定义不同的压力源、感知到的困扰程度及其对不适和躯体化的影响,这些影响影响我们地区的主要移民群体;2. 确定初级卫生保健专业人员的跨文化能力特征,以最好地了解这些就诊原因。

方法/设计:这将是一项横断面、观察性、多中心、定性-定量研究,样本为居住在加泰罗尼亚的五个主要非欧盟移民群体中的 980 人:马格里布人、撒哈拉以南非洲人、南美洲安第斯人、印度斯坦人和中国人。将收集社会人口统计学数据、困扰程度、关于不同压力源及其躯体表现的信息。通过半结构化访谈和定性方法,研究躯体表现与每个群体的特定信仰之间的关系,以及这些信仰如何与疾病和寻求护理的过程相关。将使用基于个体访谈的定性方法,重点是关键事件、焦点小组和现场问卷,研究专业人员的跨文化能力。

讨论

预计不同非欧盟移民群体的慢性压力水平与躯体化程度相关。研究结果将提供对这些人群的更好了解,并提高卫生保健提供者在预防、沟通、护理管理和资源管理方面的理解和效果。

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