Alle Publikationen
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2017
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(2017): Kultursensible Aspekte während der Diagnostik von psychischen Belastungen bei Flüchtlingen – Zwei kommentierte Fallberichte. In: Psychotherapie, Psychosomatik, medizinische Psychologie 67 (3-04), S. 109-118. DOI: 10.1055/s-0042-107802
DOI: http://www.ncbi.nlm.nih.gov/pubmed/27706544 Abstract: High levels of mental disorders, especially PTSD, are commonly known among groups of people forced to leave their homeland as a consequence of war-related experiences (e. g. armed conflict, torture or persecution). Depending on the cultural background the perceptions of illnesses vary, different symptom presentation and thereupon different coping strategies respectively expectations towards health care services exist. To minimize the danger of misdiagnosis by different experts working with refugees in the host countries, a culture-sensitive diagnostic approach is needed from the beginning. This article describes important aspects of culture-sensitive diagnostics by means of 2 commented case reports. Special focus is set on the aspect of linguistic and in a broader sense cultural comprehension between therapist, client and if necessary language mediator.
Keywords: Adult, Communication Barriers, Culturally Competent Care, Culture, culture sensitive, Disziplin, Female, Germany, Humans, Kultur, Kulturtheorie, Life Change Events, Linguistik, Male, Mental Disorders/diagnosis/ethnology/psychology, Observablen/Kriterien für sozial angemessenes Verhalten und dessen Bewertung, Pathologie, Physician-Patient Relations, PREJUDICE, Psychologie, Refugees/psychology, Social Identification, Somatoform Disorders/diagnosis/ethnology/psychology, Stress Disorders, Post-Traumatic/diagnosis/ethnology/psychology, Suicidal Ideation, Translating 2016
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(2016): Effects of culture-sensitive adaptation of patient information material on usefulness in migrants. A multicentre, blinded randomised controlled trial. In: BMJ open 6 (11). DOI: 10.1136/bmjopen-2016-012008
DOI: http://www.ncbi.nlm.nih.gov/pubmed/27881523 Abstract: OBJECTIVES To evaluate the usefulness of culture-sensitive patient information material compared with standard translated material. DESIGN Multicentre, double-blind randomised controlled trial. SETTING 37 primary care practices. PARTICIPANTS 435 adult primary care patients with a migration background with unipolar depressive disorder or non-specific chronic low back pain were randomised. Patients who were unable to read in the language of their respective migration background were excluded. Sufficient data were obtained from 203 women and 106 men. The largest group was of Russian origin (202 patients), followed by those of Turkish (52), Polish (30) and Italian (25) origin. INTERVENTIONS Intervention group: provision of culture-sensitive adapted material. CONTROL GROUP provision of standard translated material. MAIN OUTCOME MEASURES Primary outcome: patient-rated usefulness (USE) assessed immediately after patients received the material. SECONDARY OUTCOMES patient-rated usefulness after 8 weeks and 6 months, symptoms of depression (PHQ-9), back pain (Back Pain Core Set) and quality of life (WHO-5) assessed at all time points. RESULTS Usefulness was found to be significantly higher (t=1.708, one-sided p=0.04) in the intervention group (USE-score=65.08, SE=1.43), compared with the control group (61.43, SE=1.63), immediately after patients received the material, in the intention-to-treat analysis, with a mean difference of 3.65 (one-sided 95% lower confidence limit=0.13). No significant differences were found for usefulness at follow-up (p=0.16, p=0.71). No significant effect was found for symptom severity in depression (p=0.95, p=0.66, p=0.58), back pain (p=0.40, p=0.45, p=0.32) or quality of life (p=0.76, p=0.86, p=0.21), either immediately after receiving the material, or at follow-up (8 weeks; 6 months). Patients with a lower level of dominant society immersion benefited substantially and significantly more from the intervention than patients with a high level of immersion (p=0.005). CONCLUSION Cultural adaptation of patient information material provides benefits over high quality translations. Clinicians are encouraged to use culture-sensitive material in their consultations, particularly with low-acculturated patients. TRIAL REGISTRATION NUMBER German Register for Clinical Trials: DRKS00004241, Universal Trial Number: U1111-1135-8043, Results.
Keywords: Adult, Aged, Cultural Competency, culture sensitive, Depressive Disorder, Major/therapy, Disziplin, Double-Blind Method, Female, Focus Groups, Health Literacy, Humans, Italy, Kultur, Kulturtheorie, Language, Low Back Pain/therapy, Male, Medizin, Middle Aged, Pamphlets, Patient Education as Topic/methods, Patient Participation, Poland, Psychologie, Quality of Life, Rolle (Beruf), Russia, Transients and Migrants, Translating, Turkey
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