Communication difficulties in perioperative anesthesia management for immigrant and refugee patients

Healthcare providers who encounter different ethnic groups have been faced with serious communication problems with immigrant and refugee (I/R) patients. The perioperative period is very important for both anesthesiologists and patients. In this study, it was aimed to reveal anesthesiologists’ problems related to I/R patients and to propose solutions for determined problems. An online survey questionnaire about the quantity and quality of communication problems that anesthesiologists come across in the perioperative period was developed. 120 of the anesthesiologists (49.0%) were trying to communicate by using body language or dictionary. 65 (26.5%) of the anesthesiologists could not communicate with these patients at all. During the process of taking “Informed Consent Form” before the anesthesia practice, 125 of the anesthesiologists (51.2%) stated that used a form written in physician’s own language which was not understood by I/R patients. 76 anesthesiologists (31%) stated that they preferred general anesthesia instead of regional anesthesia because of language barriers. As a conclusion, the present study reveals that there are serious problems in the providing health care services regarding anesthesia to I/R patients especially due to the language barriers.

___

Devi S. Syria’s health crisis: 5 years on. Lancet. 2016;387:1042-3.

2016 migration report of Turkey. http://www.goc.gov.tr/files/files/2016_yiik_ goc_raporu_haziran.pdf

Patient rights regulation. http://www.mevzuat.gov.tr/Metin. Aspx?MevzuatKod=7.5.4847&sourceXmlSearch=&MevzuatIliski=0 access date 01.08.1998.

Law on foreigners and international protection. http://www.resmigazete.gov. tr/eskiler/2013/04/20130411-2.htm access date 01.11.2018

2017 Migration statistical report of Turkey. https://www.kizilay.org.tr/Upload/ Dokuman/Dosya/38492657_2017-yili-goc-istatistik-raporu-ocak-2018.pdf access date 03.11.2018

Field survey on demographic view, living conditions and future expectations of Syrians of Turkey. https://www.afad.gov.tr/upload/Node/25335/ xfiles/17b-Field_Survey_on_Demographic_View_Living_Conditions_and_ Future_Expectations_of_Syrians_in_Turkey_2017_English_1.pdf access date 05.11.2018

Priebe S, Sandhu S, Dias S et al. Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Public Health. 2011;11:1-12.

Dowsey MM, Broadhead ML, Stoney JD et al. Outcomes of total knee arthroplasty in English versus non–English-speaking patients. J Orthop Surg. 2009;17:305-9.

Akkoç S, Tok M, Hasiripi A. The problems encountered by healthcare workers while offering an medical care to refugees and asylum seekers. Health Care Acad J. 2017;4:23-7.

Ruppen W, Urwyler A, Bandschapp O. Language difficulties in outpatients and their impact on a chronic pain unit in Northwest Switzerland. Swiss Med Wkly. 2010;140:260-4.

Morris MD, Popper ST, Rodwell TC et al. healthcare barriers of refugees post-resettlement. J Community Health. 2009;34:529-38.

Ring DC, Herndon JH, Meyer GS. Case 34-2010 – a 65-year-old woman with an incorrect operation on the left hand. N Engl J Med 2010;363:1950-7.

Barash PG, Cullen BF, Stoelting RK. In: Clinical Anesthesia. 5th edition. Lippincott Williams and Wilkins Press, Philadelphia 2006, 257.

Shapeton A, O’Donoghue M, Vielen BV, Barnett SR. Anesthesia lost in translation: perspective and comprehension. JEPM. 2017;19:1-8.

Improving patient safety systems for patients with limited English proficiency: A guide for hospitals. https://www.ahrq.gov/sites/default/files/publications/ f iles/lepguide.pdf access date 01.11.2018

Asked questions on informed consent for procedures. American Society of Anesthesiologists Committee on ethics. http://www.asahq.org/~/media/sites/ asahq/files/public/resources/faq-anesthesia-consent-ver-1-5.pdf access date 23.11.2016

Jones JW, Mccullough LB, Richman BW. Informed Consent: It’s Not Just Signing a Form. Thoracic Surg Clin. 2005;15:451-60.

Soysal A, Yağar F. Assessment of the effectiveness of healthcare management about Syrian asylum seekers in Turkey. 2nd Middle East Conferences: Migration Issues in the Context of Conflict in the Middle East, 28-29 April, 2016. Kilis, Turkey, 441-52.

Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev. 2005;62:255-99.

Palinkas, LA, Pickwell SM. Acculturation as a risk factor for chronic disease among Cambodian refugees in the United States. Social Science & Medicine, 1995;40:1643-53.

Griswold K, Zayas LE, Kernan JB, Wagner CM. Cultural awareness through medical student and refugee patient encounters. J Immigrant Minority Health, 2007:9:55-60.

Pottie K, Greenaway C, Feightner J et al. Evidence-based clinical guidelines for immigrants and refugees. CMAJ. 2011;183:824-925.