Presentation of self and symptoms in primary care consultations involving patients from non-English speaking backgrounds

2004 ◽  
Vol 1 (2) ◽  
pp. 159-169 ◽  
Author(s):  
Celia Roberts ◽  
Srikant Sarangi ◽  
Becky Moss
Keyword(s):  
Primary Care ◽  
Presentation Of Self ◽  
English Speaking

scholarly journals Addressing the Social Needs of Spanish- and English-Speaking Families in Pediatric Primary Care

2020 ◽  
Vol 20 (8) ◽  
pp. 1170-1176
Author(s):  
Sarah Polk ◽  
Kathryn M. Leifheit ◽  
Rachel Thornton ◽  
Barry S. Solomon ◽  
Lisa Ross DeCamp
Keyword(s):  
Primary Care ◽  
Social Needs ◽  
Pediatric Primary Care ◽  
The Social ◽  
English Speaking

scholarly journals Language Co-Construction and Collaboration in Interpreter-Mediated Primary Care Encounters With Hispanic Adults

2017 ◽  
Vol 29 (6) ◽  
pp. 498-505 ◽  
Author(s):  
Robin Dawson Estrada ◽  
DeAnne K. Hilfinger Messias
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Clinical Encounter ◽  
Situational Analysis ◽  
Mediated Communication ◽  
Multiple Systems ◽  
Clinical Encounters ◽  
Communication Processes ◽  
English Speaking ◽  
Intraprofessional Collaboration

Purpose: Language asymmetry between patients and providers may influence the context, content, and quality of health care communication, affecting patient outcomes and contributing to health disparities. This research examined interpreter-mediated, primary care encounters between English-speaking nurse practitioners and Spanish-speaking adult patients. Method: Situational analysis guided the collection, analysis, and interpretation of audio-recorded clinical encounter data. Results: Interpreter-mediated communication was situated within intersecting social, economic, political, and health systems contexts. Three modes of collaborative knowledge generations were Constructing Connections, Constructing Mutual Understanding, and Constructing Effective Systems Navigation Strategies. Discussion: These findings illustrate how interactants contributed individual and collective knowledge across multiple systems to address patient concerns. Conclusion: The analysis revealed ways in which communication processes may influence both providers’ diagnostic and interventional decision-making and patients’ understanding and potential compliance. Ongoing preparation and support for intraprofessional collaboration is needed to ensure effective communication and mitigate untoward effects of language asymmetries in clinical encounters.

scholarly journals Validity of UK electronic health records to study migrant health: a population-based cohort study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Pathak ◽  
P Patel ◽  
R Mathur ◽  
R Burns ◽  
A Gonzalez-Izquierdo ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Electronic Health Records ◽  
Barriers To Care ◽  
Population Based ◽  
Health Records ◽  
Migration Status ◽  
English Speaking ◽  
International Migrants ◽  
The Uk

Abstract Background An estimated 14.3% (9.4 million people) of people living in the UK in 2019 were international migrants. Despite this, little is known about how migrants access and use healthcare services. To use electronic healthcare records (EHRs) to study migration health, a valid migration phenotype is necessary: a transparent reproducible algorithm using clinical terminology codes to determine migration status. We have previously described the validity of a migration phenotype in CALIBER data using the Clinical Practice Research Datalink (CPRD), the largest UK primary care EHR. This study further evaluates the phenotype by examining certainty of migration status. Methods This is a population-based cohort study of individuals in CPRD Gold (1997-2018) with a Read term indicating migration to the UK. We describe completeness of recording of migration over time: percentage of individuals recorded as migrants. We also describe cohort size based on certainty of migration status: “definite” (country of birth or visa status terms), “probable” (non-English first/main language terms), and “possible” (non-UK origin terms). Results Overall, 2.5% (403,768/16,071,111) of CPRD had ≥1 of 434 terms indicating migration to the UK. The percentage of recorded migrants per year increased from 0.2% (4,417/2,210,551) in 1997 to 3.64% (100,626/2,761,397) in 2018, following a similar trend to national migration data. 44.27% (178,749/403,768) were “definite” migrants and 53.68% (216,731/403,768) were “probable” migrants. Only 2.05%(8,288/16,071,111) were “possible” migrants. Conclusions We have created a large cohort of international migrants in the UK and certainty of migration status is high. This cohort can be used to study migration health in UK primary care EHR. The large contribution of language terms make this phenotype particularly suitable for understanding healthcare access and use by non-English speaking migrants who may face additional barriers to care. Key messages We have developed a way to study migration health in UK primary care electronic health records. Our method is particularly useful to study healthcare for non-English speaking migrants who may face additional barriers to care.

Adaptation of a Diabetes Self-Management Education and Support Intervention to Inform a Randomized Control Trial in Rural Populations (Preprint)

2021 ◽  
Author(s):  
Tamara Oser ◽  
Linda Zittleman ◽  
Kristen Curcija ◽  
Bethany Kwan ◽  
Shawnecca Burke ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Communities ◽  
Management Education ◽  
Advisory Council ◽  
Research Network ◽  
Rural Populations ◽  
Self Management ◽  
Community Members ◽  
Spanish Speaking ◽  
English Speaking

BACKGROUND Over 34 million people in the United States have diabetes, with 1.5 million diagnosed every year. Diabetes self-management education and support (DSMES) is a crucial component of treatment to delay or prevent complications. Rural communities face many unique challenges in accessing DSMES, including geographic barriers and availability of DSMES programs that are culturally adapted to rural context. OBJECTIVE Boot camp translation (BCT) is an established approach to community-based participatory research used to translate complex clinical and scientific information into concepts, messages, and materials that are understandable, meaningful, and relevant to community members and patients. This study aimed to utilize BCT to adapt an existing DSMES program for delivery in rural primary care for English- and Spanish-speaking people with diabetes. METHODS The High Plains Research network (HPRN) Community Advisory Council (C.A.C.) partnered with researchers at the University of Colorado and University of Utah to use BCT to aid in translating medical jargon and materials from an existing DSMES program, called “Diabetes One-Day (D1D).” BCT consisted of 10 virtual meetings over a 6-month period between the C.A.C., which included 15 diverse community stakeholders. Both English-speaking and bilingual Spanish-English speaking CAC members were recruited to reflect the diversity of the rural communities in which the adapted program would be delivered. RESULTS The BCT process guided adaptations to D1D for use in rural settings (R-D1D). R-D1D adaptations reflect both content and delivery to assure that the intervention is appropriate and likely to be accepted by rural English- and Spanish-speaking people with diabetes. Additionally, BCT informed design of recruitment and program materials and identification of recruitment venues. During the BCT process the importance of tailoring materials to reflect culture differences in English- and Spanish-speaking patients was identified. CONCLUSIONS BCT was an effective strategy for academic researchers to partner with rural community members to adapt an existing DSMES intervention for delivery in rural areas to both English- and Spanish-speaking patients with diabetes. Through BCT, adaptations to recruitment materials and methods, program content and delivery, and supplemental materials were developed. The need to culturally adapt Spanish materials with input from stakeholders rather than simply translate materials into Spanish was highlighted. The importance of increasing awareness of the connection between diabetes and depression/diabetes distress, adaptations to include local foods, and the importance of the relationship between people with diabetes and their primary care practices were identified. CLINICALTRIAL Official Title: Adapting and Assessing the Feasibility of a Diabetes Self-management Education and Support Telehealth Intervention for Rural Populations to Reduce Disparities in Diabetes Care ClinicalTrials.gov Identifier: NCT04600622 URL: https://clinicaltrials.gov/ct2/show/NCT04600622?term=oser&cond=diabetes&draw=2&rank=1

scholarly journals Satisfaction With Communication in Primary Care for Spanish-Speaking and English-Speaking Parents

2017 ◽  
Vol 17 (4) ◽  
pp. 416-423 ◽  
Author(s):  
Kori B. Flower ◽  
Asheley C. Skinner ◽  
H. Shonna Yin ◽  
Russell L. Rothman ◽  
Lee M. Sanders ◽  
...  
Keyword(s):  
Primary Care ◽  
Spanish Speaking ◽  
English Speaking

scholarly journals Influence of Language and Culture in the Primary Care of Spanish-Speaking Latino Adults with Poorly Controlled Diabetes: A Qualitative Study

2017 ◽  
Vol 27 (4) ◽  
pp. 379 ◽  
Author(s):  
Cindy D. Zamudio ◽  
Gabriela Sanchez ◽  
Andrea Altschuler ◽  
Richard W. Grant
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Language And Culture ◽  
Cultural Constructs ◽  
Spanish Speaking ◽  
English Speaking ◽  
Culturally Influenced

<p><strong>Background: </strong>We examined the role of language and culture in the interactions between Spanish-speaking Latino patients with poorly controlled diabetes – a fast-growing population in the United States - and their primary care providers. </p><p><strong>Methods: </strong>We conducted four focus groups with 36 non-US born Spanish-speaking patients with elevated HbA1c. Participants were insured health plan members with either English-speaking (2 groups) or Spanish-speaking (2 groups) primary care providers. Moderated discussions focused on visit preparation, communication during visit, and role of other care team members. Key themes derived from these discussions were then linked to corresponding Latino cultural constructs. </p><p><strong>Results: </strong>Patients had a mean age of 57.9 (±11.2) years and last measured HbA1c was 8.6% (1.5%). Two communication-related themes (reluctance to switch providers and use of intermediaries) and two visit-related themes (provider-driven visit agendas and problem-based visits) emerged from our analyses. These themes reflected the cultural constructs of confianza (trust), familismo (family), respeto (deference), and simpatía (harmonious relationship). Trust in the patient-provider relationship led many participants to remain with English-speaking providers who treated them well. Patients with either language concordant and discordant providers reported reliance on family or other intermediaries to close communication gaps. Deference to physician expertise and authority led to visit expectations that it is the doctor’s job to know what to ask and that visits were intended to address specific, often symptom-driven problems. </p><p><strong>Conclusions: </strong>Spanish-speaking Latino patients’ cultural expectations play an important role in framing their primary care interactions. Recognizing culturally influenced visit expectations is an important step toward improving patient-provider communication. <em></em></p><p><em>Ethn Dis. </em>2017;27(4):379- 386; doi:10.18865/ed.27.4.379. </p>

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