Health-Care Access in a Rural Area: Perspectives from Russian-Speaking Immigrants, English-Speaking Doctors, and Volunteer Interpreters

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Autor/in	Brua, Charles R.
Titel	Health-Care Access in a Rural Area: Perspectives from Russian-Speaking Immigrants, English-Speaking Doctors, and Volunteer Interpreters
Quelle	(2009), (250 Seiten) PDF als Volltext Verfügbarkeit Ph.D. Dissertation, The Pennsylvania State University
Sprache	englisch
Dokumenttyp	gedruckt; online; Monographie
ISBN	978-1-1094-6853-3
Schlagwörter	Hochschulschrift; Dissertation; Medical Services; Socialization; Speech Communication; Access to Health Care; Language Role; Health Insurance; Interviews; Patients; Rural Areas; Content Analysis; Immigrants; English (Second Language); Second Language Learning; Cultural Differences; Language Minorities; Non English Speaking; Russian; Language Proficiency; Older Adults; Health Personnel; Intercultural Communication; Foreign Countries; Physicians; Volunteers; Translation; Pennsylvania + Suchen Sie Ihr Suchwort? Thesis; Dissertations; Academic thesis; Arzt; Socialisation; Sozialisation; Krankenversicherung; Interviewing; Interviewtechnik; Patient; Rural area; Ländlicher Raum; Inhaltsanalyse; Immigrant; Immigrantin; Immigranten; English as second language; English; Second Language; Englisch als Zweitsprache; Zweitsprachenerwerb; Kultureller Unterschied; Sprachminderheit; Russisch; Language skill; Language skills; Sprachkompetenz; Älterer Erwachsener; Medizinisches Personal; Interkulturelle Kommunikation; Ausland; Physician; Doctor; Freiwilliger
Abstract	Health-care access for immigrants in the United States is often problematic because of language barriers, lack of health insurance, or differing expectations based on divergent medical systems in the U.S. and the immigrants' home countries. Such difficulties are exacerbated when a linguistic-minority population lives in a rural community that has limited health-care-access resources for non-English-speakers. In the current project, I investigate an immigrant community in an area of Pennsylvania that has recently become a destination for Russian-speaking immigrants. Their numbers have been estimated at 2,000 people. Some have strong proficiency in English, but many do not, especially the elderly. In the study context, there are very few medical personnel with language skills in both English and Russian, few intermediaries trained in medical interpretation for those languages, and a scarcity of Russian-language print materials. Using a directed approach to content analysis, I analyze data from semi-structured interviews with three groups who have a significant stake in the issue of health-care access: recent Russian-speaking immigrants from the former Soviet Union (n=12); English-speaking staff members at a medical and social services facility where many of the immigrants seek help (n=5); and volunteer interpreters who act as go-betweens for Russian-speaking patients and English-speaking personnel (n=3). Based on the coding and analysis of the data, particularly salient issues included: (1) the role of language as an entry point or impediment to health-care access (language and language accommodation) and (2) the impact of immigrant and U.S. health-care beliefs on medical behavior (health-care socialization). Regarding "language and language accommodation", I consider the following questions using data from the stakeholders' interviews: (1) What kind of language accommodation is portrayed as desirable? (2) Who is responsible for providing the interpreter? (3) What roles do non-professional/non-naive interpreters take on? In regard to health-care socialization, I address the following issues using data from the stakeholders' interviews: (1) How are "good doctors" portrayed? (2) How are "good patients" portrayed? (3) How is use of medications portrayed? (4) What effects are associated with divergent logistics of the medical systems? (5) What attitudes surround prices, payments, and quality of care? In the three participant groups' discussion of these issues, there are areas of convergence. For instance, all share the sense that medical costs in the U.S. present a barrier to access, and all recognize the need for medical bilingualism in interpreters. There are also a number of potentially significant divergences, especially around attitudes toward medical compliance and use of medications, and the logistics of approach to medical care. In the conclusion, I synthesize the research literature and my own empirical findings to suggest ways of increasing the health-care access of the Russian-speaking community in the study context and, by extension, of other linguistic-minority groups in areas far from the resources available in large cities. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.] (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10