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Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral

Author

Listed:
  • Bischoff, Alexander
  • Bovier, Patrick A.
  • Isah, Rrustemi
  • Francoise, Gariazzo
  • Ariel, Eytan
  • Louis, Loutan

Abstract

The objective of this study was to determine whether language barriers during the screening interview affected the reporting of asylum seekers' health problems and their referral to further health care. Seven hundred and twenty-three standard screening questionnaires, administered by nurses to asylum-seekers at the time of entry into Geneva/Switzerland between June and December 1998, were reviewed, as well as information pertaining to language use during the interview. Language concordance between nurses and asylum seekers was assessed by considering the presence/absence of an interpreter, the type of interpreter present (trained, untrained), and the nurse's self-assessed proficiency in the language used during the medical interview. Nurses also recorded their own subjective assessment of the overall quality of communication during the interview. More than half of the asylum seekers came from Europe, mainly the Balkan regions, and a third of them from Africa. Most asylum seekers were men (72%). The median age was 26.5 years, and 50% were younger than 25 years. Severe physical and psychological symptoms were reported by 19% and traumatic events prior to migration were reported by 63%. The nurses referred 36% of all refugees to further medical care and 6% to psychological care. Professional interpreters were used in 8% of the interviews and ad hoc interpreters in 16%. Adequate, partial and inadequate language concordance was reported for 54%, 27% and 18% of the consultations respectively. Adequate language concordance was significantly associated with higher reporting of past experience of traumatic events and of severe psychological symptoms, contrasting with much fewer referrals to psychological care when language concordance was inadequate. These results suggest the importance of addressing language barriers in primary care centres in order to adequately detect and refer traumatised refugees. To address this problem, the use of professional interpreters is recommended.

Suggested Citation

  • Bischoff, Alexander & Bovier, Patrick A. & Isah, Rrustemi & Francoise, Gariazzo & Ariel, Eytan & Louis, Loutan, 2003. "Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral," Social Science & Medicine, Elsevier, vol. 57(3), pages 503-512, August.
    • Handle: RePEc:eee:socmed:v:57:y:2003:i:3:p:503-512
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    Citations

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    Cited by:

    1. Gagnon, A.J. & Zimbeck, M. & Zeitlin, J., 2009. "Migration to western industrialised countries and perinatal health: A systematic review," Social Science & Medicine, Elsevier, vol. 69(6), pages 934-946, September.
    2. Janevic, T. & Savitz, D.A. & Janevic, M., 2011. "Maternal education and adverse birth outcomes among immigrant women to the United States from Eastern Europe: A test of the healthy migrant hypothesis," Social Science & Medicine, Elsevier, vol. 73(3), pages 429-435, August.
    3. Frank Müller & Shivani Chandra & Ghefar Furaijat & Stefan Kruse & Alexandra Waligorski & Anne Simmenroth & Evelyn Kleinert, 2020. "A Digital Communication Assistance Tool (DCAT) to Obtain Medical History from Foreign-Language Patients: Development and Pilot Testing in a Primary Health Care Center for Refugees," IJERPH, MDPI, vol. 17(4), pages 1-8, February.
    4. Kohlenberger, Judith & Buber-Ennser, Isabella & Rengs, Bernhard & Leitner, Sebastian & Landesmann, Michael, 2019. "Barriers to health care access and service utilization of refugees in Austria: Evidence from a cross-sectional survey," Health Policy, Elsevier, vol. 123(9), pages 833-839.
    5. Ferdinand Garoff & Natalia Skogberg & Antti Klemettilä & Eero Lilja & Awa Ahmed Haji Omar & Olli Snellman & Anu E. Castaneda, 2021. "Mental Health and Traumatization of Newly Arrived Asylum Seeker Adults in Finland: A Population-Based Study," IJERPH, MDPI, vol. 18(13), pages 1-12, July.
    6. Wang, Haining & Cheng, Zhiming & Smyth, Russell, 2019. "Health outcomes, health inequality and Mandarin proficiency in urban China," China Economic Review, Elsevier, vol. 56(C), pages 1-1.
    7. Leu, A. & Wepf, H. & Elger, B. & Wangmo, T., 2018. "Experts’ perspectives on SwissDRG: Second class care for vulnerable patient groups?," Health Policy, Elsevier, vol. 122(6), pages 577-582.
    8. Deumert, Ana, 2010. "'It would be nice if they could give us more language' - Serving South Africa's multilingual patient base," Social Science & Medicine, Elsevier, vol. 71(1), pages 53-61, July.
    9. Karsten Klingberg & Adrian Stoller & Martin Müller & Sabrina Jegerlehner & Adam D. Brown & Aristomenis Exadaktylos & Anne Jachmann & David Srivastava, 2020. "Asylum Seekers and Swiss Nationals with Low-Acuity Complaints: Disparities in the Perceived level of Urgency, Health Literacy and Ability to Communicate—A Cross-Sectional Survey at a Tertiary Emergenc," IJERPH, MDPI, vol. 17(8), pages 1-11, April.
    10. Ramin Asgary, 2016. "Graduate public health training in healthcare of refugee asylum seekers and clinical human rights: evaluation of an innovative curriculum," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(3), pages 279-287, April.
    11. Jaschke, Philipp & Kosyakova, Yuliya, 2020. "Does facilitated access to the health system improve asylum-seekers' health outcomes? : Evidence from a quasi-experiment," IAB-Discussion Paper 201907, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    12. Anna Christina Nowak & Yudit Namer & Claudia Hornberg, 2022. "Health Care for Refugees in Europe: A Scoping Review," IJERPH, MDPI, vol. 19(3), pages 1-10, January.

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