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专业人员和跨文化调解员对在捷克医疗保健系统中与乌克兰难民进行沟通的看法。

Professionals' and Intercultural Mediators' Perspectives on Communication With Ukrainian Refugees in the Czech Healthcare System.

机构信息

Institute of Public Health and Medical Law, First Faculty of Medicine, Charles University, Prague, Czech Republic.

Institute of Social Sciences, Faculty of Social Sciences, Charles University, Prague, Czech Republic.

出版信息

Health Expect. 2024 Aug;27(4):e14171. doi: 10.1111/hex.14171.

Abstract

INTRODUCTION

A growing body of research is examining how healthcare systems are responding to the increasing numbers of migrants and the resulting superdiversity of patients. The aim of this article is to identify and explain communication barriers in the provision of healthcare to Ukrainian war refugees in the Czech Republic from the perspectives of healthcare professionals and intercultural mediators.

METHODS

The exploratory case study is based on a qualitative analysis of semi-structured interviews with frontline health professionals: 20 with doctors and 10 with nurses. The second source of data is two focus groups aimed at capturing communication problems from the perspective of intercultural mediators who accompany refugees to health facilities. The interview transcripts and FGs were analysed using six-stage thematic coding.

RESULTS

The survey identified five main themes related to barriers to communication: (1) language barriers and interpreting, (2) cultural barriers, (3) differing expectations of health and the healthcare systems in the Czech Republic and Ukraine, (4) prejudices and negative attitudes and unethical behaviour towards refugees and migrants and (5) lack of awareness of patient rights.

CONCLUSIONS

The arrival of large numbers of migrants has highlighted deficiencies in the system that may affect other vulnerable groups and the general population. These include the lack of general communication skills and legal awareness among many health professionals, which are barriers to the development of patient-centred care. The involvement of intercultural mediators fundamentally improves communication between health professionals and (not only) migrant patients. Nevertheless, it is necessary to legally anchor and define the position of intercultural mediators within the healthcare system.

PATIENT OR PUBLIC CONTRIBUTION

Collaboration with intercultural mediators who interpreted the extensive experiences of Ukrainian refugee patients and also have personal experience as migrant or migrant-origin patients contributed to shaping research questions, facilitating study participation and enriching evidence interpretation. Researchers with multicultural backgrounds and experience with working with people from refugee backgrounds were involved in the study design and analysis.

摘要

介绍

越来越多的研究正在探讨医疗保健系统如何应对移民人数的增加以及由此产生的患者超级多样性。本文的目的是从医疗保健专业人员和跨文化调解员的角度确定并解释向在捷克共和国的乌克兰战争难民提供医疗保健时存在的沟通障碍。

方法

这项探索性案例研究基于对一线医疗保健专业人员的半结构化访谈的定性分析:20 名医生和 10 名护士。第二个数据源是两个焦点小组,旨在从陪同难民前往医疗机构的跨文化调解员的角度捕捉沟通问题。使用六步主题编码分析采访记录和 FGs。

结果

调查确定了与沟通障碍相关的五个主要主题:(1)语言障碍和口译,(2)文化障碍,(3)在捷克共和国和乌克兰对健康和医疗保健系统的期望不同,(4)对难民和移民的偏见和消极态度以及不道德行为,(5)缺乏对患者权利的认识。

结论

大量移民的到来凸显了系统中的缺陷,这可能会影响其他弱势群体和普通民众。其中包括许多医疗保健专业人员缺乏一般沟通技巧和法律意识,这是发展以患者为中心的护理的障碍。跨文化调解员的参与从根本上改善了医疗保健专业人员与(不仅是)移民患者之间的沟通。然而,有必要在法律上确定并定义跨文化调解员在医疗保健系统中的地位。

患者或公众贡献

与跨文化调解员合作,他们解释了乌克兰难民患者的丰富经验,并且作为移民或移民出身的患者也有个人经验,这有助于塑造研究问题,促进研究参与并丰富证据解释。具有多元文化背景和与难民背景的人合作经验的研究人员参与了研究设计和分析。

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