Håkonsen Helle, Lees Karine, Toverud Else-Lydia
Department of Social Pharmacy, School of Pharmacy, University of Oslo, Blindern, P.O. Box 1068, 0316, Oslo, Norway,
Int J Clin Pharm. 2014 Dec;36(6):1144-51. doi: 10.1007/s11096-014-0005-z. Epub 2014 Sep 4.
Western societies' need for knowledge about how to meet the challenges in health care following increased immigration has emerged as studies have showed that non-Western immigrants tend to experience more obstacles to drug use and poorer communication with health professionals.
To identify the cultural barriers encountered by Norwegian community pharmacists in providing service to non-Western immigrant patients and to outline how they are being addressed.
Community pharmacies in Oslo, Norway.
A qualitative study consisting of four focus groups was conducted. In total 19 ethnic Norwegian pharmacists (17 female and 2 male; mean age: 40.6 years) participated. They were recruited from 13 pharmacies situated in areas of Oslo densely populated by non-Western immigrants. The audio-records of the focus group discussions were transcribed verbatim. A thematic content analysis was conducted. Main outcome measure Cultural barriers identified by Norwegian community pharmacists in the encounter with non-Western immigrants.
All the pharmacists were in contact with non-Western immigrant patients on a daily basis. They said that they found it challenging to provide adequate service to these patients, and that the presence of language as well as other cultural barriers not only affected what the patients got out of the available information, but also to a great extent what kind of and how much information was provided. Although the pharmacists felt that immigrant patients were in great need of drug counselling, there were large disparities in how much effort was exerted in order to provide this service. They were all uncomfortable with situations where family or friends acted as interpreters, especially children. Otherwise, cultural barriers were related to differences in body language and clothing which they thought distracted the communication. All the pharmacists stated that they had patients asking about the content of pork gelatin in medicines, but few said that they habitually notified the patients of this unless they were asked directly. Ramadan fasting was not identified as a subject during drug counselling.
This focus group study shows that language and other cultural barriers, including differences in body language, non-Western gender roles, and all-covering garments, are of great concern for ethnic Norwegian community pharmacists in the encounter with non-Western immigrant patients. Although the pharmacists recognise their role as drug information providers for immigrant patients, large disparities were detected with respect to kind of and amount of information provided to these patients.
随着研究表明非西方移民在用药方面往往面临更多障碍，且与医疗专业人员的沟通较差，西方社会对于如何应对移民增加后医疗保健方面的挑战的知识需求日益凸显。
确定挪威社区药剂师在为非西方移民患者提供服务时遇到的文化障碍，并概述如何应对这些障碍。
挪威奥斯陆的社区药房。
开展了一项包含四个焦点小组的定性研究。共有19名挪威族药剂师（17名女性和2名男性；平均年龄：40.6岁）参与。他们来自奥斯陆非西方移民聚居区的13家药房。焦点小组讨论的音频记录被逐字转录。进行了主题内容分析。主要结局指标为挪威社区药剂师在与非西方移民接触时识别出的文化障碍。
所有药剂师每天都与非西方移民患者接触。他们表示，为这些患者提供充分服务具有挑战性，语言以及其他文化障碍的存在不仅影响患者从现有信息中获取的内容，还在很大程度上影响提供何种信息以及提供多少信息。尽管药剂师认为移民患者非常需要药物咨询，但在提供这项服务时所付出的努力程度存在很大差异。他们都对家人或朋友，尤其是儿童充当口译员的情况感到不安。此外，文化障碍与肢体语言和着装差异有关，他们认为这些会干扰沟通。所有药剂师都表示有患者询问药品中猪明胶的成分，但很少有人说他们会习惯性地告知患者这一点，除非患者直接询问。斋月禁食在药物咨询期间未被视为一个主题。
这项焦点小组研究表明，语言和其他文化障碍，包括肢体语言差异、非西方性别角色和全身覆盖式服装，是挪威族社区药剂师在与非西方移民患者接触时极为关注的问题。尽管药剂师认识到自己作为移民患者药物信息提供者的角色，但在向这些患者提供的信息种类和数量方面存在很大差异。
