Mike Mösko, Juliette Maggu, Kirstin Bührig & Holger Schulz Department of Medical Psychology Research Group on Migration and Psychosocial Health (MiPH) Multilingualism in hospital: demands, resources and practices – explorative study Mike Mösko, Juliette Maggu, Kirstin Bührig & Holger Schulz 18.05.2018, 1st World Congress on Migration, Ethnicity, Race & Health, Edinburgh

Research Group on Migration and Psychosocial Health (MiPH) www.uke.de/miph Research Group on Migration and Psychosocial Health (MiPH) Research Focus Relationship between migration and health/resilience Intercultural Health Care Research Multilingualism in healthcare Intercultural opening of the healthcare system Epidemiology, Evaluation and Quality Assurance Aktivitäten: (Versorgungs-)Epidemiologie Struktur-, Prozess- und Ergebnisqualität in der Gesundheitsversorgung Fragebogenentwicklung Lehre, Versorgung & Forschung Entwicklung, Durchführung & Evaluation von Interventionen (Inter-)nationale Vernetzung 2

Source: http://www. healthcarecommunication

Background Perspective: Health Care System Patients with limited language proficiency have less access to care and less understanding of physician’s explanation (Yeo 2004, Mösko et al. 2013, Lebrun 2012;) Non-native speakers with limited German proficiency are discharged earlier from inpatient mental health care treatment than German speakers (Bermejo et al 2009) Perspective: Population US internal medicine residency program: 10 % of patients with limited English skills (Cardinal et al., 2016) After 2 years 47% of refugees in Germany still have little to not any German language skills (Brücker, 2016)

Research questions How many limited-German-proficient patients are attending the hospital? Do staff members use their language competencies in daily clinical routine? Vorschlag von mir – aber gern noch Layout und Textfluss verbessern. Ich würd diese Forschungsfragen nehmen: Wie viele nicht-deutschsprachige Patient(inn)en werden versorgt und welche Sprachen sprechen diese Patient(inn)en? Wie wird mit Sprachbarrieren im Klinikalltag umgegangen? Welche Ressourcen haben die Mitarbeiter(inn)en, wie und in welchem Umfang werden diese eingebracht? Welche Unterstützung braucht es für die Mitarbeiter(inn)en in der Versorgung nicht- deutschsprachiger Personen?

Results - Sample Department of psychiatry & psychotherapy Department of oncology & hematology

Results - Sample Function group Total N Sample Response rate (%) Medical personal 105 41 39 Nursing staff 314 142 45 Psychological personal 46 29 63 Specialist therapists 43 28 65 Cleaning personal 23 12 52 Supply assistant 27 93 Unclear - 14 612 249 48 Department of psychiatry & psychotherapy Department of oncology & hematology

Results - Sample Function group Total N Sample Response rate (%) Medical personal 105 41 39 Nursing staff 314 142 45 Psychological personal 46 29 63 Specialist therapists 43 28 65 Cleaning personal 23 12 52 Supply assistant 27 93 Unclear - 14 612 249 48 Department of psychiatry & psychotherapy Department of oncology & hematology

Note: 1/3 of the cleaning personal has a university-entrance diploma Results – characteristics of the sample Note: 1/3 of the cleaning personal has a university-entrance diploma

Patients with Limited German Proficiency (LGP) I. Patients with limited German proficiency   Patients with Limited German Proficiency (LGP) Setting In-patient Out-patient n Mean Estimation of staff with migration background (MB) Respondants with MB 27 9.4% 54 10.9% Respondants without MB 74 9.8% 135 12.7% Estimations within the departments Department of Oncology 43 11.3% 92 14.9% Department of Psychiatry 51 8.7% 88 Estimations of Occupational groups Physicians 23 10.1% 34 8.6% Nurses 7.8% 97 14% Psychologists and therapists 24 3.8% 31 7.2% Supply chain and cleaning staff 21 18.3% Total 98 9,8% (s=13,8) 186 12,3% (s=15,3)

III. Language usage of supply assistants and cleaning staff Did it happen, that you support other persons at work with patients in the last month who do not speak sufficient German? while physicians (14.3%), psychologists and (psycho)therapists (15.4 %) as well as nurses (14.3%) were less likely help out with interpretation. No Yes No answer

III. Language usage of supply assistants and cleaning staff Did it happen, that you support other persons at work with patients who do not speak sufficient German? With, translating texts: 2,5% With communication with patients: 52,5% Appreciation of the language support (very much)? Patients: 50% Colleagues: 25% Head: 13% while physicians (14.3%), psychologists and (psycho)therapists (15.4 %) as well as nurses (14.3%) were less likely help out with interpretation.

Conclusion Substantial Number of Patients who come to the hospital do not speak German sufficiently Clinic staff as well as cleaning staff and food supply assistants have substantial language competencies These competencies are used in clinical setting Conflict appears between the professional role (duties) and clinical needs

Outlook Scientific: Replication studies for in- & outpatient settings Include patientst` perspective (and competencies?) Develop interventions to promote and use staff`s language competencies Health Care: Implementation of structures and gratifications for multilingual staff Implementation of structures and gratifications for qualified community interpreters (CI) Standards in qualification of CI

Welcome to Hamburg

Thank you for your attention! Dr. Mike Mösko University Medical Center Hamburg-Eppendorf Department of Medical Psychology Head of Research Group on Migration and Psychosocial Health (MiPH) Phone: +49 (0) 40 7410-59743 Telefax: +49 (0) 40 7410-54940 E-Mail: mmoesko@uke.de Website: www.uke.de/miph