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Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study

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dc.contributor.author Teunissen, Erik
dc.contributor.author Gravenhorst, Katja
dc.contributor.author Dowrick, Christopher
dc.contributor.author van Weel-Baumgarten, Evelyn
dc.contributor.author van den Driessen Mareeuw, Francine
dc.contributor.author de Brún, Tomas
dc.contributor.author Burns, Nicola
dc.contributor.author Lionis, Christos
dc.contributor.author Mair, Frances
dc.contributor.author O'Donnell, C.
dc.contributor.author O'Reilly-de Brún, Mary
dc.contributor.author Papadakaki, Maria
dc.contributor.author Saridaki, Aristoula
dc.contributor.author Spiegel, Wolfgang
dc.contributor.author van Weel, Chris
dc.contributor.author van den Muijsenbergh, Maria
dc.contributor.author MacFarlane, Anne E.
dc.date.accessioned 2017-07-17T08:15:48Z
dc.date.available 2017-07-17T08:15:48Z
dc.date.issued 2017
dc.identifier.uri http://hdl.handle.net/10344/5894
dc.description peer-reviewed en_US
dc.description.abstract Background: Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice.Methods: We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers' fieldwork reports, were coded and thematically analysed by each team using NPT.Results: In all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants' needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP's diagnoses and GPs reported a clearer understanding of migrants' symptoms.Conclusions: Migrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients. en_US
dc.language.iso eng en_US
dc.publisher BioMed Central en_US
dc.relation.ispartofseries International Journal for Equity in Health;16: 32
dc.subject primary health care en_US
dc.subject transients and migrants en_US
dc.subject general practice en_US
dc.subject community-based participatory research en_US
dc.subject cross-cultural communication en_US
dc.title Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.date.updated 2017-07-17T07:58:45Z
dc.description.version PUBLISHED
dc.identifier.doi 10.1186/s12939-017-0525-y
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 2704805
dc.internal.copyrightchecked Yes
dc.identifier.journaltitle International Journal For Equity In Health
dc.description.status peer-reviewed


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