Ankara’da iki hastaneye başvuran Suriyeli mültecilere göre algılanan dil engellerinin belirlenmesi

Abstract

Amaç: Bu çalışmanın amacı Suriyeli mültecilere göre sağlık hizmetlerine erişimde algılanan dil engellerini ve bununla başa çıkmak için kullandıkları yöntemleri belirlemektir.

Yöntem: Çalışma tanımlayıcı tipte bir çalışmadır. Ankara’da bulunan iki hastaneyi ziyaret eden Suriyeli yetişkinler arasında bir anket uygulanmıştır.

Bulgular: 221 katılımcının % 11.1’i Türkçe konuştuğunu, % 48.5’i hastanede tercümanlık hizmeti kullandığını, % 20.6’sı, % 17.6’sı ve % 13.2’si sırası ile, yardım almadığını, o an uygun olan Türkçe bilen bir kişinin tercümanınlık yardımını ve özel tercüman kullandığını belirtmiştir. Türkçe’nin öğrenilmesi ile istihdam durumu ve yerel halkla sosyal ilişkilere sahip olma istatistiksel olarak anlamlı ilişki göstermektedir. Evli, işsiz, okuma yazma bilmeyen, Türkçe konuşan akrabası olmayan veya hastalık deneyimi olan katılımcılar arasında dil engeli daha yaygındır. Dil engeli ile baş etmek için kullanılan yöntemler ve şu değişkenler arasında istatistiksel olarak anlamlı ilişki tespit edilmiştir: Cinsiyet, ekonomik durum, Türkçe konuşan akrabalara sahip olma ve hastalık deneyimi olma.

Sonuç: Sağlık hizmetlerine erişimde dilin bir bariyer olmaktan çıkmasını sağlamak için uygulanacak politikalarda ve çalışmalarda sosyoekonomik faktörler açısından daha dezavantajlı mültecilere öncelik verilmelidir. Ayrıca hem istihdam açısından hem de ev sahibi toplumla ilişkilerin kurulması açısından mültecilerin desteklenmesinin, dil bariyerinin sağlık hizmetlerine erişimde bir problem olmasın eliminasyonuna katkı sunacağı düşünülmektedir.

Keywords

• Dil engeli
• Sağlık hizmetleri
• Suriyeli mülteciler
• Göç
• Türkiye

Determination of perceived language barriers according to Syrian refugees visiting two hospitals in Ankara

Abstract

Objective: The aim of this study is to determine perceived language barriers in accessing healthcare services according to Syrian refugees and the methods they used to cope with this problem.

Methods: The study was a descriptive study. A survey was carried out among Syrian adults visiting two hospitals in Ankara.

Results: Of the 221 participants, 11.1% stated that they speak Turkish, 48.5% of them used hospital interpreters while 20.6%, 17.6% and 13.2% of them did not get any help, used ad hoc interpreters and used a private interpreter respectively. Employment status and having social relationships with locals had statistically significant relationships with learning the Turkish language. The language barrier was more common, among participants, who were married, unemployed, illiterate, had no Turkish-speaking relatives or had diseases. Gender, economic status, having Turkish-speaking relatives and having diseases were variables showing association with the method they used to cope with the language barrier.

Conclusion: More disadvantaged refugees in terms of socio-economic factors should be prioritized in policies and projects aiming to reduce language barrier in accessing health services. Additionally, supporting refugees regarding employment and social relationships with locals would contribute to eliminate language barrier in accessing healthcare services. 

Keywords

• Language barrier
• Healthcare services
• Syrian refugees
• migration
• Turkey

References

1. 1. Guha-Sapir D, Schluter B, RodriguezLlanes JM, Lillywhite L, Hicks MH. Patterns of civilian and child deaths due to war-related violence in Syria: a comparative analysis from the Violation Documentation Center dataset, 2011-16. The Lancet Global health. 2018;6(1):e103-e110.
2. 2. Mowafi H, Leaning J. Documenting deaths in the Syrian war. The Lancet Global health. 2017;6(1):e14-e15.
3. 3. Management DGoM. Migration Statistics. 2019; http://www.goc.gov.tr/icerik6/ gecici-koruma_363_378_4713_icerik. Accessed March 10, 2021.
4. 4. Torun P, Mucaz Karaaslan M, Sandikli B, et al. Health and health care access for Syrian refugees living in Istanbul. International journal of public health. 2018;63(5):601-608.
5. 5. Fassaert T, Hesselink AE, Verhoeff AP. Acculturation and use of health care services by Turkish and Moroccan migrants: a cross-sectional populationbased study. BMC public health. 2009;9(1):332.
6. 6. DeJong J, Ghattas H, Bashour H, Mourtada R, Akik C, Reese-Masterson A. Reproductive, maternal, neonatal and child health in conflict: a case study on Syria using Countdown indicators. BMJ global health. 2017;2(3):e000302.
7. 7. Green M. Language Barriers and Health of Syrian Refugees in Germany. American journal of public health. 2017;107(4):486.
8. 8. Beiser M, Hou F. Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10- year study. Social science & medicine (1982). 2001;53(10):1321-1334.

9. 9. C. M. R. Sulaiman-Hill SCT. “Thinking Too Much”: Psychological distress, sources of stress and coping strategies of resettled Afghan and Kurdish refugees. Muslim Mental Health. 2012;VI(2).
10. 10. Jacobs E, Chen AHM, Karliner LS, AggerGupta N, Mutha S. The Need for More Research on Language Barriers in Health Care: A Proposed Research Agenda. The Milbank Quarterly. 2006;84(1):111-133.
11. 11. Fox SA, Stein JA. The effect of physician-patient communication on mammography utilization by different ethnic groups. Medical care. 1991;29(11):1065-1082.
12. 12. Kirkman-Liff B, Mondragón D. Language of interview: relevance for research of southwest Hispanics. American journal of public health. 1991;81(11):1399-1404.
13. 13. Fiscella K, Franks P, Doescher MP, Saver BG. Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Medical care. 2002;40(1):52-59.
14. 14. Manson A. Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Medical care. 1988;26(12):1119-1128.
15. 15. Crane JA. Patient comprehension of doctor-patient communication on discharge from the emergency department. The Journal of emergency medicine. 1997;15(1):1-7.
16. 16. Gandhi TK, Burstin HR, Cook EF, et al. Drug complications in outpatients. J Gen Intern Med. 2000;15(3):149-154.
17. 17. Sarver J, Baker DW. Effect of Language Barriers on Follow-up Appointments After an Emergency Department Visit. Journal of General Internal Medicine. 2000;15(4):256-264.
18. 18. Perez-Stable EJ, Napoles-Springer A, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Medical care. 1997;35(12):1212-1219.
19. 19. Bellamy K, Ostini R, Martini N, Kairuz T. Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia. The International journal of pharmacy practice. 2016.
20. 20. Wangdahl J, Lytsy P, Martensson L, Westerling R. Health literacy and refugees’ experiences of the health examination for asylum seekers - a Swedish cross-sectional study. BMC public health. 2015;15:1162.
21. 21. Alderliesten ME, Vrijkotte TG, van der Wal MF, Bonsel GJ. Late start of antenatal care among ethnic minorities in a large cohort of pregnant women. BJOG : an international journal of obstetrics and gynaecology. 2007;114(10):1232-1239.
22. 22. Hemingway H, Saunders D, Parsons L. Social class, spoken language and pattern of care as determinants of continuity of carer in maternity services in east London. Journal of public health medicine. 1997;19(2):156-161.
23. 23. Hall JL. Welcoming Syrian refugees. Canadian Family Physician. 2016;62(3):269-269.
24. 24. Riddick S. Improving Access for Limited English-Speaking Consumers: A Review of Strategies in Health Care Settings. Health Care for the Poor and Underserved. 1998;9 Supplement:S40-S61.
25. Hornberger J, Itakura H, Wilson SR. Bridging language and cultural barriers between physicians and patients. Public health reports (Washington, DC : 1974). 1997;112(5):410-417.
26. Shah SM, Ayash C, Pharaon NA, Gany FM. Arab American immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. Journal of immigrant and minority health. 2008;10(5):429-436.
27. Asgary R, Segar N. Barriers to health care access among refugee asylum seekers. Journal of health care for the poor and underserved. 2011;22(2):506-522.
28. Palmer D, Ward K. ‘Lost’: listening to the voices and mental health needs of forced migrants in London. Medicine, conflict, and survival. 2007;23(3):198-212.
29. O’Donnell CA, Higgins M, Chauhan R, Mullen K. “They think we’re OK and we know we’re not”. A qualitative study of asylum seekers’ access, knowledge and views to health care in the UK. BMC health services research. 2007;7:75.
30. Carroll J, Epstein R, Fiscella K, Gipson T, Volpe E, Jean-Pierre P. Caring for Somali women: implications for clinician-patient communication. Patient education and counseling. 2007;66(3):337-345.
31. Kiselev N, Pfaltz M, Haas F, et al. Structural and socio-cultural barriers to accessing mental healthcare among Syrian refugees and asylum seekers in Switzerland. Eur J Psychotraumatol. 2020;11(1):1717825-1717825.
32. Bhatia R, Wallace P. Experiences of refugees and asylum seekers in general practice: a qualitative study. BMC Family Practice. 2007;8(1):48.
33. 2016 Yılı Değerlendirme Toplantısı [Internet]. 2017; https://www. saglik.gov.tr/TR,12813/2016-yilidegerlendirme-toplantisi.html. Accessed 06 June 2017.
34. Ekmekci PE. Syrian Refugees, Health and Migration Legislation in Turkey. Journal of immigrant and minority health. 2017;19(6):1434-1441.