Migrant Health Clinic

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Migrant Health Clinic

  1. 1. Migrant Health Clinic Dorthe Nielsen RN, MHS, Ph.D.
  2. 2. Language barriers are associated with • • • • • • • • • • Less awareness of health care access and rights Longer consultations Less frequent health visits More visits to emergency departments Less understanding of health information given by doctor More and more expensive tests Less patient satisfaction Less uptake of preventive measures Some examinations and treatment takes longer time More complications, medical errors, side effects, and more severe outcome (Feinberg et al., 2002), Kravitz et al., 2000, Derose & Baker, 2000, David & Rhee, 1998; Gerrish, 2001, David & Rhee, 1998; Gerrish Hampers et al., 1999, Meredith et al., 2001; Morales, Cunningham, Brown, Liu, & Hays, 1999, Levy et al, 2005, Jacobs et al 2004, Bischoff et al, 2010, Australian council for safety and quality in health care (2005)
  3. 3. Migrant Health Clinic • • • • • • • • Have existed in 5 years 650 patients followed in 6-36 months Chronically ill patients Post traumatic stress syndrome - PTSD Special approach, special nursing and treatment Multidisciplinary and cross-sectorial cooperation 70% of all consultations are with interpreters Nurses, social worker and doctors
  4. 4. Migrant Health Clinic • • • • • • • • Have existed in 5 years 650 patients followed in 6-36 months Chronically ill patients Post traumatic stress syndrome - PTSD Special approach, special nursing and treatment Multidisciplinary and cross-sectorial cooperation 70% of all consultations are with interpreters Nurses, social worker and doctors
  5. 5. The approach to patients • • • • • • • • • • • Time is the magic word Trust Emphatic approach Eye contact Listening Communication Interpreters Supportive Never blaming the patients Focusing on resources not on limitations Phone calls and text messages
  6. 6. The approach to the patient • • • • • • • • • • • Time is the magic word Trust Emphatic approach Eye contact Listening Communication Interpreters Supportive Never blaming the patients Focusing on resources not on limitations Phone calls and text messages
  7. 7. When you don't speak proper Danish You get treated as a child 42 year old woman
  8. 8. “I need an interpreter when I speak about my feelings”
  9. 9. ”Is it something I shall remember? …..then I would like to have an interpreter” 35 year old woman, employed, lived in DK for 20 years
  10. 10. It would be very nice to get an interpreter just once – I don´t understand what my doctor is saying to me 42 year old woman
  11. 11. A male patient and his partner were told that the man's HIV test was positive – the couple understood this as being a positive result – and did not understand the duality of the information
  12. 12. In the old days • The competent interpreters chose the easy conversations • The competent interpreters did not drive 100 km to interpret a conversation • The interpreter came late • No parking • Patients got a new time for consultation • Longer waiting lists • The interpreter was in the waiting room with patients
  13. 13. In the old days Finger language and guessing when the interpreter didn't show up
  14. 14. Video interpretation
  15. 15. Ugeskrift for læger 22.10.10 &Nyhedsinformation, 23.10.2009
  16. 16. Video Interpretation  20 % shorter conversations  More professional conversations  Patients experience a better conversation
  17. 17. The interpreter is a part of the team
  18. 18. The advantages • • • • • • • • • • It is easy! Few interpreters Better relation between the professionals Knows each other well Easy to book (outlook calendar) Conversations from 10 seconds to 10 hours Medical, surgery, emergency ward, out patient clinics Solves acute problems The interpreter comes from another area in the country Avoid families to interpret – No children – stays in school
  19. 19. Video technology accommodate different needs
  20. 20. The interpreter is there without being there
  21. 21. The interpreter is standby Invisible until 20 minutes later when one word is missing
  22. 22. Video reduces stress at patients suffering of war traumas Competent interpreters improve the relationship to the health professionals and patients trust to doctors
  23. 23. Documents can be translated by the video interpreter
  24. 24. ”The interpreter don't know my body”
  25. 25. The hidden advantages for the interpreter No stress Gender becomes less important Don’t get personnel with patients Feel more professional and competent Can take notes, use internet, and other support • Can be invisible when intimate examinations • • • • •
  26. 26. The conversation and the content is in focus
  27. 27. Reducing CO2!
  28. 28. Price for equality in health Batool video interpreter
  29. 29. In the future? • Ambulance • Prisons
  30. 30. Thank you for your attention

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