Bakgrund: I och med att globaliseringen växer har det medfört en ökning av mångfalden i samhället. Allt fler interkulturella samtal sker som kräver ett fungerande samspel mellan utrikesfödda patienter och sjukvårdspersonal. Bristande kommunikation i form av språkbarriärer utgör en risk för vårdandet samt försvårar möjligheten för god vård. Syfte: Syftet var att beskriva utrikesfödda patienters upplevelser av språkbarriärer inom hälso- och sjukvård. Metod: En litteraturöversikt genomfördes baserad på elva vetenskapliga artiklar.Resultat: Resultat presenterar tre huvudkategorier. Dessa är Konsekvenser av språkbarriärer, Vikten av fungerande kommunikation och Tolk i vården. Sammanfattning: Litteraturöversikten har påvisat att språkbarriärer försvårade patient- och sjukvårdspersonalens vårdrelation. En konsekvens av detta var att informationsöverföringen brast och patienter lämnades ovetande om sin hälso- och sjukvårdssituation. Andra svårigheter som lyftes fram var korrelerat till känslomässiga, negativa ochkulturella element. Även tolkanvändning för att stödjakommunikationen benämndes vilket upplevdes både positivt ochnegativt. Att visa omtanke till patienter som inte kan detgemensamma språket är nyckeln till en god vård. Respekten ochförståelse för patienters olika kulturer är en central del för enpersoncentrerad omvårdnad. / Background: As globalization around the world grows, it has led to an increase in the diversity of society. More and more intercultural conversations are taking place that require a functioning interaction between foreign-born patients and healthcare professionals. Lack of communication in the form of language barriers compose a risk for patient care and makes the possibility of quality care more difficult. Aim: The purpose of this study was to describe foreign-born patients ́ experiences of language barriers in health care. Method: A literature review based on eleven scientific articles. Results: The result presents three main categories. These are consequence of language barriers, the importance of effective communication and interpreters in healthcare. Summary: The literature review has shown that language barriers made it difficult for patients and healthcare professionals to have a caring relationship. One consequence of this was that the transfer of information broke down and patients were left unaware of their healthcare situation. Other difficulties highlighted were correlated with emotional, negative and cultural elements. The use of interpreters to support communication was also mentioned, which was experienced both positively and negatively. Showing care to patients who do not know the common language is the key to good care. Respect and understanding of patients' different cultures is a central part of person-centered nursing.

Bakgrund: Migration är vanligt förekommande i världen och i Sverige är invandring en stor anledning till folkökningen. När människor behöver söka sig till hälso- och sjukvården i ett nytt land så kan språkbarriärer uppstå, vilket påverkar kommunikationen. För att uppnå en god relation samt ett personcentrerat förhållningssätt i vården, så är kommunikation en betydelsefull aspekt. Ett sätt att kommunicera på vid språkbarriär är via tolk, vilket sjuksköterskor beskriver som värdefullt men ibland problematiskt. För att förbättra kommunikationen med patienter vid språkbarriärer så behöver patienters perspektiv undersökas, inte endast vårdpersonalens.  Syfte: Att undersöka patienters upplevelser av kommunikation vid språkbarriärer mellan patient och vårdpersonal inom hälso- och sjukvård.  Metod: En litteraturstudie baserad på tio kvalitativa originalartiklar. Datainsamling utfördes i databaserna PubMed och CINAHL. De artiklar som har valts ut till studien har uppfyllt inklusions- och exklusionskriterier, samt har bedömts vara av hög kvalitet i kvalitetsgranskning.  Resultat: Tre huvudkategorier lyftes fram under resultatanalysen; Hur språkbarriärer påverkar den personcentrerade vården, Missförstånd och konsekvenser samt Användning av tolk. Den första huvudkategorin delades in i tre underkategorier; Upplevd diskriminering, Känslor till följd av språkbarriärer och Preferenser gällande hälso- och sjukvårdspersonal. Även den sista huvudkategorin delades in i tre; Professionell tolk, Informell tolk och Andra sätt att kommunicera.  Slutsats: Språkbarriärer har stor påverkan på kommunikationen mellan patienter och vårdpersonal. Detta kan av flera anledningar få negativa följder i vården. För att säkerställa en personcentrerad vård, så är vårdpersonalens bemötande och utveckling av de kommunikationssätt som finns avgörande. / Background: Migration is common in a global perspective and immigration is an important reason for the population increase in Sweden. When individuals are in need of healthcare in a new country, language barriers can arise and affect the communication. To achieve patient-centered care and a good relationship in healthcare, communication is a crucial aspect. Use of interpreters is one way to overcome language barriers, which nurses describe as valuable but sometimes problematic. To improve the communication with patients when there are language barriers, patients’ perspectives needs to be explored in addition to healthcare professionals.  Aim: To investigate patients’ experiences of communication, when there are language barriers between patients and health care professionals in health care.  Method: A literature study based on ten qualitative original articles. The databases Pubmed and CINAHL were used for data collection. The articles chosen for the study met the criteria of inclusion and exclusion. Their quality was also assessed as high in the quality analysis.  Results: Three main categories were highlighted under the analysis of the results; How language barriers affect person-centered care, Misunderstandings and consequences and The use of interpreters. The first main category was divided into three sub-categories; Experienced discrimination, Feelings due to language barriers and Preferences regarding healthcare professionals. The last main category was also divided into three; Professional interpreter, Informal interpreter and Other ways to communicate.  Conclusion: Language barriers have a big impact on the communication between patients and healthcare professionals. This can affect healthcare negatively for many reasons. The behavior of healthcare professionals and development of existing means of communication, is crucial to ensure a patient-centered care.

São Paulo é uma cidade global que concentra os maiores fluxos migratórios que chegam ao Brasil. A ausência de uma política migratória inclusiva não facilita e, muitas vezes dificulta, o acesso à saúde, direito do imigrante. Dessa forma, o presente estudo busca identificar as características associadas às populações de imigrantes e de não imigrantes acometidas pela tuberculose, residentes na cidade de São Paulo, bem como mostrar a dificuldade para a obtenção de dados para análise. Trata-se de um estudo descritivo, tipo levantamento. A população do estudo foi constituída por todos os casos de TB notificados durante o ano 2016. Para o estudo, foram utilizadas variáveis sociodemográficas, clínicas, de diagnóstico e de tratamento, obtidas pelo banco dados TB-WEB. Na análise dos dados, foram utilizadas técnicas de análise descritiva e testes estatísticos qui-quadrado com análise de resíduo padronizado e Mann Whitney para identificar as características associadas às populações de imigrantes versus não imigrantes. Os resultados encontrados possibilitam a melhor compreensão de variáveis de diagnóstico, clínicas, sociodemográficas e, também, variáveis de tratamento para o grupo de imigrantes no ano 2016 através da análise e discussão das associações encontradas, de forma a contribuir para o melhor conhecimento da dinâmica da TB nesse grupo e para o desenvolvimento de políticas e programas de saúde mais adequados e voltados para essa população / São Paulo is a global city that concentrates the largest migratory flows coming to Brazil. The absence of a comprehensive migration policy does not help and often difficult, access to health care, immigrant right. Thus, this study seeks to identify the characteristics associated with populations of immigrants and non-immigrants affected by tuberculosis, in the city of São Paulo, as well as show the difficulty to obtain data for analysis. This is a descriptive, survey-type study. The study population consisted of all TB cases reported during the year 2016. For the study, sociodemographic, clinical, diagnostic and treatment variables obtained by the database TB-WEB were used. In the analysis of the data, descriptive analysis techniques and chi-square statistical tests with standardized residue analysis and Mann Whitney were used to identify the characteristics associated to the populations of immigrants versus non-immigrants. The results allow a better understanding of diagnostic, clinical, sociodemographic and treatment variables for the group of immigrants in the year 2016 through the analysis and discusion of the associations found, in order to contribute to a better understanding of the dynamics of TB in this group and to the development of health policies and programs that are more adequate and focused on this population

BACKGROUND: Latinos report higher food insecurity than the national average, and food insecurity has been associated with adverse health outcomes wherein Latinos experience disparities. This study quantified the independent effects of language-speaking proficiency and citizenship on increased food insecurity among a predominantly immigrant Caribbean Latino sample in Lawrence, Massachusetts. METHODS: The analytic sample comprised 574 participants aged 21-83 who visited a community health center in 2011-2013. Food insecurity was assessed via the 6-item US Household Food Security Survey. Multivariable logistic modeling (adjusted for self-reported age group, gender, education, and marital status) examined the independent associations between language proficiency and citizenship on increased food insecurity. RESULTS: One-third of participants were classified as food insecure. Most respondents were citizens (59.5%), foreign-born (92.4%; 70.3% from the Dominican Republic), and spoke monolingual Spanish (72.8%). Monolingual Spanish-speakers had marginally increased odds of food insecurity (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.00 to 2.26), compared to bilingual participants; however after adjustment this relationship was attenuated (OR = 1.25, 95% CI: 0.79 to 2.00). Non-citizenship was not associated with increased odds of food insecurity (OR=1.18, 95% CI: 0.82 to 1.68). CONCLUSION: Food insecurity in this predominantly immigrant Caribbean Latino sample was higher than the national average for Latinos. Future research on food insecurity among different Latino ethnicities is needed in order to inform targeted interventions that promote food security.

Objetivo: Evaluar si existe asociación entre el abandono con la falla terapéutica en inmigrantes venezolanos con infección por el virus de inmunodeficiencia humana (VIH) que reinicien tratamiento antirretroviral de gran actividad (TARGA). Métodos: Llevamos a cabo una cohorte retrospectiva en el Hospital Nacional Arzobispo Loayza. Incluimos pacientes que reiniciaron tratamiento TARGA. La variable de resultado fue la falla terapéutica (FT), compuesta por falla inmunológica (FI), virológica (FV) y clínica (FC). La variable de exposición fue el abandono terapéutico, aquellos que no recibieron tratamiento por 30 días, de 30 días a seis meses y de seis meses a más. Las variables control fueron el sexo, la orientación sexual, el nivel de instrucción, la edad y comorbilidades. Utilizamos modelos lineales generalizados de Poisson con errores estándar robustos para calcular riesgo relativo a nivel crudo (RR) y ajustado por criterio estadístico (RRa1) y epidemiológico (RRa2). Resultados: Incluimos 294 pacientes, 47,7% de ellos abandonaron TARGA, 32,7% abandono menos de seis meses, 15% abandonó mas de seis meses y el 27,9% tenían FT. Comparado con aquellos que no abandonaron, un abandono menor a 6 meses [RRa1: 1,98 (IC95%: 1,27 a 3,09);] y de seis meses a más [RRa1: 3,17 (IC95%: 2,02 a 4,95);] incrementó el riesgo de FT. El abandono de hasta seis meses [RRa1: 2,32 (IC95%: 1,40 a 3,84)] y de seis meses a más [RRa1: 3,93 (IC95%: 2,39 a 6,45)]; aumentó el riesgo de FV. En el caso de la FC [RRa1: 1,96 (IC95%: 0,67 a 5,79)] y la FI [RRa1: 2,99 (IC95%: 0,87 a 10,30)] no encontramos evidencia estadística de asociación con el abandono terapéutico. Conclusiones: El abandono del TARGA incrementa el riesgo de FT y FV en pacientes inmigrantes venezolanos. Dentro de la valoración integral que los pacientes con VIH debe explorarse el abandono como una variable de alta a importancia. / Objective: To evaluate the association between antiretroviral treatment interruption with the treatment failure in adults with human immunodeficiency virus (HIV) infection that reinitiates (HAART). Methods: We carried out a retrospective cohort study at the Hospital Nacional Arzobispo Loayza. We included immigrant patients who reinitiate HAART. The outcome was treatment failure (TF) may be immunological (IF), virological (VF), and clinical (CF) failure. The exposure variable was antiretroviral treatment interruption. The control variables measured were sex, sexual orientation, educational level, age, and comorbidities. We performed linear Poisson models with robust standard errors to calculate relative risk at the crude level (RR) and adjusted by statistical and epidemiological criteria. Results: We included 294 in the analysis. 47.7% of them defaulted treatment, 32.7% abandoned less than six months, 15% abandoned more than six months and 27.9% did TF; 24.6% VF; 6.8% IF, and 6.4% CF. A treatment interruption less than 6 months [aRR: 1.98 (95% CI: 1.27 to 3.09);] and from six months to more [aRR: 3.17 (95% CI: 2.02 to 4.95)] increased the risk of TF. Likewise, treatment interruption of up to six months [aRR: 2.85 2.32 (95% CI: 1.40 to 3.84)] and from six months to more [aRR: 3.93 (95% CI: 2.39 to 6,45)]; increased the risk of VF concerning patients who did not abandon treatment. In the CF [aRR: 1,96 (IC95%: 0,67 a 5,79)] and IF [aRR: 2,99 (IC95%: 0,87 a 10,30)] case, we did not find statistical evidence of an association with the abandonment time. Conclusions: The HAART treatment interruption is associated with the development of therapeutic and virologic failure. Treatment interruption should be explored as a variable of high importance in the assessment of patients with HIV. / Tesis

This study aims to draw on some of the ethical guidelines enshrined in the South African Press Code (SAPC 2007:10). This SAPC states that “the press shall be obliged to report news truthfully, accurately, fairly and in a balanced manner, without any intentional or negligent departure from the facts”. This insight is used in order to analyse the way in which the 2008 xenophobic attacks were reported in South Africa by the Sowetan and Daily Sun newspapers. Overall, the findings show that the two newspapers adhered to the South African Press Code (2007), and were ethical in their 2008 news reports. This specifically contradicts the dominant perception of most mainstream newspaper readers, who thought that, the Daily Sun is just a tabloid newspaper which “represents the lowest standard of journalism” (Wasserman 2012:1), because of its sensational crime and sex stories. / Communication Science / M.A. (Communication)

This study aims to draw on some of the ethical guidelines enshrined in the South African Press Code (SAPC 2007:10). This SAPC states that “the press shall be obliged to report news truthfully, accurately, fairly and in a balanced manner, without any intentional or negligent departure from the facts”. This insight is used in order to analyse the way in which the 2008 xenophobic attacks were reported in South Africa by the Sowetan and Daily Sun newspapers. Overall, the findings show that the two newspapers adhered to the South African Press Code (2007), and were ethical in their 2008 news reports. This specifically contradicts the dominant perception of most mainstream newspaper readers, who thought that, the Daily Sun is just a tabloid newspaper which “represents the lowest standard of journalism” (Wasserman 2012:1), because of its sensational crime and sex stories. / Communication Science / M.A. (Communication)