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See detailArzt-Patienten-Kommunikation in einem mehrsprachigen Setting: Eine qualitative Studie
Bourkel, Elisabeth UL

Doctoral thesis (2014)

This dissertation addresses the view of general practitioners working in Luxembourg on possible language and culture barriers in their consultations. Furthermore the thesis deals with the doctors’ ... [more ▼]

This dissertation addresses the view of general practitioners working in Luxembourg on possible language and culture barriers in their consultations. Furthermore the thesis deals with the doctors’ perceptions of doctor-patient-communication in general, including further possible influencing factors (e.g., further doctor and patient factors or professional context). In addition the thesis focuses on the general practitioners’ ideas on intercultural competence, i.e. “the competence to act successfully in an intercultural encounter.” (Thomas & Simon, 2007, S. 136). The theoretical part of the thesis initially deals with the characteristics of the Luxembourg medical setting. Subsequently we present models concerning interpersonal communication and doctor-patient-communication in which the Communication Accommodation Theory (Giles et al., 1991) and the Three levels of doctor-patient-communication (Jain & Krieger, 2011) are considered in detail. Moreover, we explain the essential elements of doctor-patient-communication according to the Kalamazoo Consensus Statement (Makoul, 2001) and the Factors influencing doctor-patient-communication by Mead and Bower (2000). Furthermore, we discuss recent research on intercultural doctor-patient-communication. Finally, general concepts concerning intercultural competence in general and specific intercultural competence in the medical setting are presented. Through a synthesis of those models, we developed an integrative heuristic model of intercultural competence including its requirements and components (intercultural knowledge and skills). The objectives of the empirical study conducted in line with the present thesis, lead to research on (1) how general practitioners in Luxembourg describe the communication with their patients, (2) the awareness of Luxembourg general practitioners of cultural and language factors which may affect doctor-patient-communication and (3) the ideas of general practitioners in Luxembourg on intercultural competence. The research questions were analysed using a phenomenological approach. 16 general practitioners working in Luxembourg were interviewed. The interviews were analysed with a structuring resp. evaluative content analysis (Kuckartz, 2012; Mayring, 2010). The findings of the present study show that the doctors describe the elements of doctor-patient-communication in accordance with Makoul (2001). The model of influencing factors on doctor-patient-communication by Mead and Bower (2000) was almost entirely validated and new factors were added. Perceived as the three most relevant influencing factors in intercultural doctor-patient-communication with language barriers were: (1) patients with psychological problems (2) presence of translator in the consultation, (3) economic and time related components of consultations. Furthermore, the findings show that the majority of the interviewed doctors perceive a cultural influence on doctor-patient-communication in their Luxembourg practices. This influence can be described by the Model on influencing factors on intercultural communication by Schouten and Meeuweesen (2006). The greater portion of the interviewed doctors experienced language barriers in their professional daily routine. These language barriers can primarily be related to the patient’s medical condition, the doctor’s language proficiencies and migration background, the work content, as well as the language used in the consultation. Concerning intercultural competence, the practitioners described two kinds of intercultural skills: the skill to act proactively, e.g., which allows preventing misunderstandings, and the skill to react in intercultural conflict situations. Moreover, the findings show that the label “intercultural competence” is not known to all doctors. The relevance of the findings for the Luxemburg context as well as the differentiation between intercultural competence and professional resp. communication competencies in the medical consultation are discussed. The findings contribute to the development of existing models on intercultural doctor-patient-communication and intercultural competence which should be further explored in future studies. [less ▲]

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See detailDoctors' view on intercultural competence in the medical setting in Luxembourg
Bourkel, Elisabeth UL; Ferring, Dieter UL

in Psychology and Health (2013), 28(S1), 71

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See detailWahrgenommene Rechte von Menschen mit Alzheimer
Bourkel, Elisabeth UL

Article for general public (2012)

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See detailPerceived rights of and social distance to people with Alzheimer's disease
Bourkel, Elisabeth UL; Ferring, Dieter UL; Weber, Germain

in GeroPsych: Journal of Gerontopsychology and Geriatric Psychiatry (2012), 25(1), 25-32

The present study investigated how laypeople and professionals (N = 185) judge the rights of a person affected with Alzheimer’s disease (AD) and whether social distance exists towards this person ... [more ▼]

The present study investigated how laypeople and professionals (N = 185) judge the rights of a person affected with Alzheimer’s disease (AD) and whether social distance exists towards this person. Participants completed a questionnaire after reading a vignette describing a target person with an early stage of AD. Half of the participants responded to a female target, the other half responded to a male target. Results showed that rights and competencies of the persons are rated high and social distance is exhibited only to a lesser degree, although there was a significant difference between the male and female target. Furthermore, health professionals approved more rights than laypeople, which suggests that there is a need for more detailed information about this disease in the general population. [less ▲]

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See detailDoctor’s view on doctor-patient-communication in a multilingual and multicultural setting.
Bourkel, Elisabeth UL; Ferring, Dieter UL

in Psychology and Health (2012), 27(Sup1), 12-12

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See detailEmotions associated with Alzheimer’s disease in laypersons and health professionals
Bourkel, Elisabeth UL; Ferring, Dieter UL

Scientific Conference (2011, August)

This study starts with the notion that Alzheimer’s disease shows specific symptoms of cognitive decline as well as different affective-motivational symptoms. These range from increased irritability to a ... [more ▼]

This study starts with the notion that Alzheimer’s disease shows specific symptoms of cognitive decline as well as different affective-motivational symptoms. These range from increased irritability to a depressed mood, which may also characterize the main features of individual disease representations. The cause and the onset of AD may be perceived as uncontrollable and could increase the perceived threat associated with this disease. The aim of the present study was to investigate the intensity of emotions evoked by a vignette describing a person affected with AD using two groups each with different knowledge of the disease – namely a sample of lay persons (n=72) and a sample of health professionals working with persons with persons affected with AD (n=113). The vignette comprised two versions - one describing a woman, the other a man in an early stage of AD showing first specific symptoms - and it was followed by a list of k=16 emotions whose intensity was rated towards the target person. Analyses of variance showed that the intensity of “pro-social feelings” towards the person was significantly rated higher than the intensity of negative feelings. Interactions between the gender of the target person and the understanding of the disease emerged for some emotions. Cluster analysis identified three groups with differing emotion profiles: “Those with high pro-social feelings”, “Those with a low emotional profile” and “Those with mixed emotions”. Findings are discussed with respect to their implications for health care professionals and public perception of AD. [less ▲]

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See detailPerceived rights and stigmatisation of people with Alzheimer’s disease
Bourkel, Elisabeth UL; Ferring, Dieter UL; Weber, Germain

Scientific Conference (2010, October)

The estimation of the autonomy and the competencies of a person with Alzheimer’s disease (AD) is a complicated process, which may sometimes rely on socially shared stereotypes of this disease and may thus ... [more ▼]

The estimation of the autonomy and the competencies of a person with Alzheimer’s disease (AD) is a complicated process, which may sometimes rely on socially shared stereotypes of this disease and may thus lead to the stigmatization of people with AD. This becomes especially evident when it comes to rights and responsibilities of persons with AD given that there is no clear-cut definition of these. The aim of the empirical study presented here was to examine perceived rights of people with AD and their relation with indicators of stigmatization. This was analyzed in a sample of laypersons (n=72) and a sample of health professionals working with persons with AD (n=113). In particular, the study questionnaire presented a vignette describing in one version a female and in the other version a male person at an early stage of AD followed by a list of 26 rights which had to be rated with respect to the target person on a 5 point Likert-scale. The list showed a factorial structure differing between five domains of perceived rights, namely “right of privacy and information”, right of autonomous living”, “citizen rights”, “right of self-determination and self-responsibility”, and “decision making by significant others”. Moreover, k=16 emotions towards the target person were analysed as indicators of social distancing. In subsequent steps of analyses, we tested if rights were differently perceived depending on (a) target person’s gender, (b) professional contact with persons with AD and (c) perceived social distancing. Results showed that the rate of agreement to the five identified domains rights was in general quite high across groups; furthermore, participants expressed a low level of social distancing and high pro-social emotional reactions towards persons with AD. Professionals accorded more rights to people with AD than laypersons, showed less social distancing and less pro-social and unpleasant emotions towards the target person. Social distance was higher towards the male target person who elicited more unpleasant emotional reactions and was rated more dangerous than a woman with AD. Findings are discussed with respect to the necessity of creating and developing a culture concerning the rights to be accorded to persons affected with AD. [less ▲]

Detailed reference viewed: 94 (3 UL)