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Published in: BMC Health Services Research 1/2012

Open Access 01-12-2012 | Research article

Two sides of the coin: patient and provider perceptions of health care delivery to patients from culturally and linguistically diverse backgrounds

Authors: Nera Komaric, Suzanne Bedford, Mieke L van Driel

Published in: BMC Health Services Research | Issue 1/2012

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Abstract

Background

Australia is a culturally diverse nation with one in seven Australians born in a non-English speaking country. Culturally and Linguistically Diverse (CALD) populations are at a high risk of developing preventable chronic diseases such as cardiovascular disease, type 2 diabetes mellitus, renal disease, and chronic respiratory disease, especially communities from the Pacific Islands, the Middle East, North Africa, the Indian subcontinent and China. Previous studies have shown that access to services may be a contributing factor. This study explores the experiences, attitudes and opinions of immigrants from different cultural and linguistic backgrounds and their health care providers with regard to chronic disease care.

Methods

Five focus groups were conducted comprising participants from an Arabic speaking background, or born in Sudan, China, Vietnam or Tonga. A total of 50 members participated. All focus groups were conducted in the participants’ language and facilitated by a trained multicultural health worker. In addition, 14 health care providers were interviewed by telephone. Interviews were digitally recorded and transcribed. All qualitative data were analysed with the assistance of QSR NVivo 8 software.

Results

Participants were generally positive about the quality and accessibility of health services, but the costs of health care and waiting times to receive treatment presented significant barriers. They expressed a need for greater access to interpreters and culturally appropriate communication and education. They mentioned experiencing racism and discriminatory practices. Health professionals recommended recruiting health workers from CALD communities to assist them to adequately elicit and address the needs of patients from CALD backgrounds.

Conclusions

CALD patients, carers and community members as well as health professionals all highlighted the need for establishing culturally tailored programs for chronic disease prevention and management in CALD populations. Better health care can be achieved by ensuring that further investment in culturally specific programs and workforce development is in line with the number of CALD communities and their needs.
Literature
1.
go back to reference World Health Organization: Preventing chronic diseases: a vital investment. 2005, Geneva: WHO Global Report World Health Organization: Preventing chronic diseases: a vital investment. 2005, Geneva: WHO Global Report
2.
go back to reference Health Q: Queensland Strategy for Chronic Disease 2005–2015. 2005, Brisbane: Queensland Health Health Q: Queensland Strategy for Chronic Disease 2005–2015. 2005, Brisbane: Queensland Health
3.
go back to reference Australian Institute of Health and Welfare: Australia’s Health 2008. 2008, Canberra: Australian Institute of Health and Welfare Australian Institute of Health and Welfare: Australia’s Health 2008. 2008, Canberra: Australian Institute of Health and Welfare
4.
go back to reference Biddle N, Kennedy S, McDonald JT: Health assimilation patterns amongst Australian immigrants. Econ Rec. 2007, 83: 16-30. 10.1111/j.1475-4932.2007.00373.x.CrossRef Biddle N, Kennedy S, McDonald JT: Health assimilation patterns amongst Australian immigrants. Econ Rec. 2007, 83: 16-30. 10.1111/j.1475-4932.2007.00373.x.CrossRef
5.
go back to reference Queensland Health: Chapter 1. Whole of Population. Health Determinants. 2004, Brisbane; Queensland Health Queensland Health: Chapter 1. Whole of Population. Health Determinants. 2004, Brisbane; Queensland Health
6.
go back to reference Gorman D, Brough M, Elvia R: How young people from culturally and linguistically diverse backgrounds experience mental health: some insights for mental health nurses. Int J Ment Health Nurs. 2003, 12: 194-202. 10.1046/j.1440-0979.2003.00289.x.CrossRefPubMed Gorman D, Brough M, Elvia R: How young people from culturally and linguistically diverse backgrounds experience mental health: some insights for mental health nurses. Int J Ment Health Nurs. 2003, 12: 194-202. 10.1046/j.1440-0979.2003.00289.x.CrossRefPubMed
8.
go back to reference Goris , et al: Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review. Australian Journal of Primary Health. 2012, http://dx.doi.org/10.1071/PY11130. Goris , et al: Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review. Australian Journal of Primary Health. 2012, http://​dx.​doi.​org/​10.​1071/​PY11130.
9.
go back to reference Nutbeam D: The evolving concept of health literacy. Social Science & Medicine. 2008, 67: 2072-2078. 10.1016/j.socscimed.2008.09.050.CrossRef Nutbeam D: The evolving concept of health literacy. Social Science & Medicine. 2008, 67: 2072-2078. 10.1016/j.socscimed.2008.09.050.CrossRef
10.
go back to reference Keleher H, Hagger V: Health literacy in primary health care. Australian Journal of Primary Health. 2007, 13: 24-30. 10.1071/PY07020.CrossRef Keleher H, Hagger V: Health literacy in primary health care. Australian Journal of Primary Health. 2007, 13: 24-30. 10.1071/PY07020.CrossRef
11.
go back to reference Keleher H, Thomacos N: Health literacy and CALD populations in Australia. Australian Mosaic. 2009, 22: 27-28. Keleher H, Thomacos N: Health literacy and CALD populations in Australia. Australian Mosaic. 2009, 22: 27-28.
12.
go back to reference Health Q: Health Statistics Centre Publications. 2009, Brisbane: Queensland Government Health Q: Health Statistics Centre Publications. 2009, Brisbane: Queensland Government
13.
go back to reference National Health and Medical Research Council: National statement on ethical conduct in human research (2007). 2007, Canberra: Australian Government National Health and Medical Research Council: National statement on ethical conduct in human research (2007). 2007, Canberra: Australian Government
14.
go back to reference Chan B, Ritchie J: Perceptions of Chinese Australians on seeking help for mental health problems: a qualitative study. Int J Ment Heal Promot. 2011, 13: 36-45. 10.1080/14623730.2011.9715667.CrossRef Chan B, Ritchie J: Perceptions of Chinese Australians on seeking help for mental health problems: a qualitative study. Int J Ment Heal Promot. 2011, 13: 36-45. 10.1080/14623730.2011.9715667.CrossRef
15.
go back to reference Caperchione , et al: Physical activity behaviours of culturally and linguistically diverse (CALD) women living in Australia: a qualitative study of socio-cultural influences. BMC Publ Health. 2011, 11: 11-26. 10.1186/1471-2458-11-11.CrossRef Caperchione , et al: Physical activity behaviours of culturally and linguistically diverse (CALD) women living in Australia: a qualitative study of socio-cultural influences. BMC Publ Health. 2011, 11: 11-26. 10.1186/1471-2458-11-11.CrossRef
16.
go back to reference Australian Inclusion Board: Breaking Cycles of Disadvantage. 2011, Canberra: Australian Government Australian Inclusion Board: Breaking Cycles of Disadvantage. 2011, Canberra: Australian Government
17.
go back to reference Rasanathan K, Montesinos EV, Matheson D, et al: Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health. J Epidemiology Community Health. 2011, 65: 656-660. 10.1136/jech.2009.093914.CrossRef Rasanathan K, Montesinos EV, Matheson D, et al: Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health. J Epidemiology Community Health. 2011, 65: 656-660. 10.1136/jech.2009.093914.CrossRef
18.
go back to reference van der Veen YJJ, de Zwart O, Mackenbach J, Richardus JH: Cultural tailoring for the promotion of Hepatitis B screening in Turkish Dutch: a protocol for a randomized controlled trial. BMC Public Health. 2010, 10: 674-10.1186/1471-2458-10-674.CrossRefPubMedPubMedCentral van der Veen YJJ, de Zwart O, Mackenbach J, Richardus JH: Cultural tailoring for the promotion of Hepatitis B screening in Turkish Dutch: a protocol for a randomized controlled trial. BMC Public Health. 2010, 10: 674-10.1186/1471-2458-10-674.CrossRefPubMedPubMedCentral
19.
go back to reference Queensland Health: Multicultural Policy Statement. 2000, Brisbane: Queensland Health Queensland Health: Multicultural Policy Statement. 2000, Brisbane: Queensland Health
20.
go back to reference National Health and Medical Research Council: Cultural Competency in Health: A guide for policy, partnerships and participation. 2006, Canberra: Australian Government National Health and Medical Research Council: Cultural Competency in Health: A guide for policy, partnerships and participation. 2006, Canberra: Australian Government
21.
go back to reference Access Economics: Dementia prevalence and incidence amongst people who do not speak English at home. 2006, Canberra: Alzheimer’s Australia Access Economics: Dementia prevalence and incidence amongst people who do not speak English at home. 2006, Canberra: Alzheimer’s Australia
22.
go back to reference Colagiuri RTM, Buckley A: Preventing Type 2 Diabetes in Culturally and Linguistically Diverse Communities in NSW. 2007, Sydney: NSW Department of Health Colagiuri RTM, Buckley A: Preventing Type 2 Diabetes in Culturally and Linguistically Diverse Communities in NSW. 2007, Sydney: NSW Department of Health
23.
go back to reference Kokanovic R, Manderson L: Social support and self-management of type 2 diabetes among immigrant Australian women. Chronic Illn. 2006, 2: 291-301.CrossRefPubMed Kokanovic R, Manderson L: Social support and self-management of type 2 diabetes among immigrant Australian women. Chronic Illn. 2006, 2: 291-301.CrossRefPubMed
24.
go back to reference Kokanovic R, Dowrick C, Butler E, Herrman H, Gunn J: Lay accounts of depression amongst Anglo-Australian residents and East African refugees. Soc Sci Med. 2008, 66: 454-66. 10.1016/j.socscimed.2007.08.019.CrossRefPubMed Kokanovic R, Dowrick C, Butler E, Herrman H, Gunn J: Lay accounts of depression amongst Anglo-Australian residents and East African refugees. Soc Sci Med. 2008, 66: 454-66. 10.1016/j.socscimed.2007.08.019.CrossRefPubMed
25.
go back to reference National Rural Health Alliance Inc: Aboriginal and Torres Strait Islander Health Workers: Position Paper. 2006, Canberra: National Rural Health Alliance National Rural Health Alliance Inc: Aboriginal and Torres Strait Islander Health Workers: Position Paper. 2006, Canberra: National Rural Health Alliance
26.
go back to reference Kokanovic R, Furler J, May C, Dowrick C, Herrman H, Evert H, et al: The politics of conducting research on depression in a cross-cultural context. Qual Health Res. 2009, 18: 708-17.CrossRef Kokanovic R, Furler J, May C, Dowrick C, Herrman H, Evert H, et al: The politics of conducting research on depression in a cross-cultural context. Qual Health Res. 2009, 18: 708-17.CrossRef
27.
go back to reference Refugee Council of Australia: Annual report 2007–2008. 2008, Melbourne: Refugee Council of Australia Refugee Council of Australia: Annual report 2007–2008. 2008, Melbourne: Refugee Council of Australia
28.
go back to reference Fuller J: Multicultural health care: reconciling universalism and particularism. Nurs Inq. 1997, 4: 153-159. 10.1111/j.1440-1800.1997.tb00093.x.CrossRefPubMed Fuller J: Multicultural health care: reconciling universalism and particularism. Nurs Inq. 1997, 4: 153-159. 10.1111/j.1440-1800.1997.tb00093.x.CrossRefPubMed
29.
go back to reference Bryman A: Social Research Method. 2001, New York: Oxford University Press Bryman A: Social Research Method. 2001, New York: Oxford University Press
30.
go back to reference FECCA: The Quest for ‘a Level Playing Field. FECCA Access and Equity Report 2010–11. 2011, Canberra: FECCA FECCA: The Quest for ‘a Level Playing Field. FECCA Access and Equity Report 2010–11. 2011, Canberra: FECCA
Metadata
Title
Two sides of the coin: patient and provider perceptions of health care delivery to patients from culturally and linguistically diverse backgrounds
Authors
Nera Komaric
Suzanne Bedford
Mieke L van Driel
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2012
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-12-322

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