title: Communication in cross-cultural consultations in primary care in Europe: the case for improvement. The rationale for the RESTORE FP 7 project.
abstract: The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions.
authors.affiliation: 1 Department of Primary and Community Care, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: van den Muijsenbergh
authors.affiliation: 1 Department of Primary and Community Care, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, The Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: van Weel-Baumgarten
authors.affiliation: 2 Department of General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Burns
authors.affiliation: 2 Department of General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
authors.forename: Catherine
authors.initials: C
authors.lastname: O'Donnell
authors.affiliation: 2 Department of General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
authors.forename: Frances
authors.initials: F
authors.lastname: Mair
authors.affiliation: 3 Abteilung für Allgemeinmedizin, Zentrum für Public Health, Medizinische Universität Wien, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Spiegel
authors.affiliation: 4 Clinic of Social and Family Medicine, University of Crete Medical School, Crete, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.affiliation: 5 Primary Medical Care, University of Liverpool, Liverpool, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Dowrick
authors.affiliation: 6 Discipline of General Practice, National University of Ireland, Galway, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: O'Reilly-de Brún
authors.affiliation: 6 Discipline of General Practice, National University of Ireland, Galway, Ireland.
authors.forename: Tomas
authors.initials: T
authors.lastname: de Brun
authors.affiliation: 7 Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: MacFarlane
mesh_terms: D003144:Communication Barriers; D054521:Cultural Competency; D005060:Europe; D058006:General Practice; D006801:Humans; D010817:Physician-Patient Relations; D011320:Primary Health Care; D058996:Quality Improvement; D012017:Referral and Consultation; D014171:Transients and Migrants