"language Barriers And Medical Emergencies: The Role Of Travel Insurance In Europe"

 "language Barriers And Medical Emergencies: The Role Of Travel Insurance In Europe" - “This is the first barrier”: the lack of a common language remains a major barrier to accessing/providing healthcare services across Europe

International migration shapes and transforms urban areas and also affects access to and delivery of healthcare in Europe. To investigate how residents of highly diverse neighborhoods design their care, we conducted qualitative interviews with 76 caregivers and 160 residents in four European cities: Bremen, Germany; Birmingham, England; Lisbon, Portugal and Uppsala, Sweden, between September 2015 and April 2017. A common theme emerging from the data is language and communication barriers, with both healthcare providers and users experiencing language difficulties , although all four countries have interpretation policies or guidelines that language problems have to deal with. barriers to health services. Official translation services are considered unreliable and sometimes of poor quality, leading to reliance on informal translation. Various coping strategies used by service providers and users result in successful communication even when there is no common language. When communication fails, it causes feelings of dissatisfaction and frustration among users and providers. Language difficulties existed in all participating countries, although not attributable to the interview questions, highlighting the pervasive nature of language and communication barriers and the need to overcome them to promote equal access to health services. quality.

"language Barriers And Medical Emergencies: The Role Of Travel Insurance In Europe"

Despite the extensive literature on how the lack of a common language hinders access to quality healthcare (Flores, 2005; Bauer & Alegria, 2010), ongoing global migration makes this topic worth revisiting. Language skills and the ability to articulate problems in the office are critical to accessing medical care (Dixon-Woods et al., 2005). Without these skills, people will not have access to necessary services and therefore will not be able to receive appropriate care (Ahmad & Walker, 1997).

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To meet the language needs of different populations, European national health services have taken various measures, including translation services, multilingual health information, translation training, and recording staff language skills (Huddleston et al., 2015; McGarry et al., 2015). al., 2018). The standard measures implemented in the United Kingdom (UK), Portugal, Sweden and Germany, the four countries where this study was carried out, are described below.

The National Health Service (NHS) Trust in England has a duty to ensure that ethnic minorities understand health information and that patients and doctors can communicate effectively. According to NHS guidelines, rather than relying on family or friends, healthcare professionals are required to provide professional interpreters (Public Health England, 2014).

In Portugal, public authorities have to inform immigrants and professionals about their rights and obligations, and mediate when there are problems, for example, when there is a language barrier between professionals and users (Equinet – Network of European Equality Agencies, 2016).

In Sweden, anyone who does not speak sufficient Swedish has a formal right to an interpreter when seeking medical and dental care (Migrationsverket, 2017). However, the availability of qualified interpreters varies widely.

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In Germany, every patient has the right to receive adequate information and advice about all procedures in a language that she understands, but it is not specified who should bear the costs (Bundesministerium der Justiz und für Verbraucherschutz, 2013; Bühring, 2015). Similar to Sweden, healthcare in Germany is decentralized with different models to overcome language barriers, even within the same federal state.

Although the described steps are effective in some cases, they are insufficient in others (Greenhalgh et al., 2007; Priebe et al., 2011; Mangrio and Sjögren Forss, 2017). Furthermore, the influx of refugees into Europe in 2015-2016 further stretched the capacity of the health system in the host country, especially where refugees lacked pre-existing social networks.

In this article, we report how language emerged as one of the main barriers to healthcare access and delivery in our research: a qualitative content analysis of semi-structured interviews with healthcare users and providers in a study conducted in four cities. very diverse European communities during and after the refugee crisis of 2015/16. We not only explain how language has shaped the carer and user experience, but also describe coping strategies to indicate where service needs to be improved.

The term 'super diversity' describes the formation of a new and complex social constellation in urban areas characterized by the dynamic interaction of different characteristics, including age, sex, educational level, country of origin, mode of migration, legal status and length of stay. in the area/area. new country (Vertovec, 2007). Such settings serve as arrival zones for new immigrants, who often settle in areas where people they know or are familiar with live, to access networks that help them navigate their new country of residence, thereby reducing pressure to move. (McKenzie and Rapoport, 2007; Zaiceva and Zimmermann, 2014).

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The data used was collected within the framework of the Understanding the Practice and Development of Wellness DIY (UPWEB) project, which aims to further develop the concept of wellness DIY to better understand how residents of super-diverse neighborhoods in four European cities healthcare (Phillimore et al., 2015). UPWEB incorporates mixed methods including qualitative approaches (semi-structured interviews, roadmaps, and ethnography) and surveys based on qualitative findings. Fieldwork was carried out in two different neighborhoods in Bremen, Germany, Birmingham, England, Lisbon, Portugal, and Uppsala, Sweden.

UPWEB adopts a broad and innovative operationalization of who is a health provider, covering a spectrum of people who work in public or private health facilities, or with organizations involved in the community that provide health-related services, support and mediation for the access to health services. What is meant by, among other things, medical personnel, social welfare workers, community employees or non-governmental organizations (NGOs) and mediators, hereinafter referred to as "providers". By residents we mean people living in the study area at the time the study was conducted.

Between September 2015 and April 2017, a total of 236 semi-structured qualitative interviews were conducted with caregivers (n = 76) and residents (n = 160) of 8 highly diverse neighborhoods, as part of a larger study on how residents of Super-diverse environments make your care. Interview questions focused on the ease of access and accessibility of local services for local residents and how service providers and service users overcome the barriers they face. Each participating country has a different type of welfare state (Rice, 2013) and the selected cities have a long history of migration and each is home to people from more than 100 different backgrounds. The two selected neighborhoods in each city are characterized by their super diversity, with one showing high levels of economic and social deprivation and the other showing signs of rebuilding (see Supplementary Table 1 for the characteristics of the selected neighborhoods).

This study was approved by the relevant bodies in each project setting: the ethics review committee of the Universities of Birmingham and Bremen, the Lisbon and Tagus regional health authorities in Lisbon, and the Uppsala region (Etiknämnden, journal issue 2015 /112).

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The sampling technique aims for maximum variation in the selection of participants. To assist with environmental mapping, identification of potential human resources, and joint interviews, multilingual individuals who are familiar with their respective environments and involved in various community social activities are recruited and trained as community investigators. Community researchers undergo a registration and selection process at each participating study center and collaborate with academic researchers (Phillimore et al., 2019a, b). The age, gender, and language spoken by researchers in the community are provided in Supplementary Table 2.

Service providers were identified through ethnographic mapping and during resident interviews. All interviewees, both residents and providers, were interviewed once and briefed on the study objectives and procedures during recruitment and again prior to the actual interview. They were also informed that the interviews would be recorded and the transcribed data would be anonymous. Participants sign a consent form, which is available in multiple languages.

Residents were asked how they have coped with the health problems they have experienced since living in the neighborhood: what they do, their sources of support to access health services, the resources they use, and the problems or obstacles they face. health (Phillimore et al., 2019a).

Providers were asked about the challenges they face in performing their work in the environment, as well as the challenges their patients/clients face in accessing services.

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In some cases, community researchers also acted as interpreters during interviews with residents, and some of them also transcribed and translated transcripts of interviews conducted in languages ​​other than the primary language of the country.

The main issues raised by informants were identified using a systematic thematic analysis approach (Phillimore et al., 2019a, b). For this, a shared codebook was developed in collaboration with the research team, both for interviews with residents and caregivers. During the inductive process, the codebook was tested in at least two interviews in each country and the coders' comments and suggestions were incorporated into further development, moderating the process in all four countries.

The 160 residents interviewed varied in terms of age, gender, country of birth, nationality, length of stay in their country/neighborhood, and local language proficiency.

Language barriers of communication, travel insurance for medical emergencies, language barriers in schools, medical emergencies in the workplace, barriers of language, language barriers in the workplace, overcoming language barriers in the workplace, emergencies in the medical office, language and cultural barriers in healthcare, language barriers in education, impact of language barriers in healthcare, language barriers in business communication

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