Documente Academic
Documente Profesional
Documente Cultură
Background Objectives
Identify the type of difficulties encountered by PCP caring for
Because of current geopolitical context and migratory
culturally diverse patients.
fluxes, primary care physicians (PCP) encounter an
Evaluate their relevance for cultural competence training of PCP.
increasing amount of culturally diverse patients in their
practice. If not addressed adequately, the issues
brought up by these cultural differences can adversely Methods
affect the quality of health care. Retrospective study of transcultural consultations requested by PCPs
between 2006 and 2015.
At the Geneva University Hospitals, a transcultural Data: consultation request intake forms and consultation reports
consultation (TC) is available since 2006 for issued to the PCP.
practitioners encountering difficulties with culturally Quantitative analysis: patient and provider characteristics.
diverse patients. Qualitative analysis: motives of consultation, issues identified by the
The CT consultants perform a cultural evaluation of the cultural evaluation and recommendations issued.
situation using the Cultural Formulation Outline1. They
provide feed-back through multidisciplinary meeting. Outline for Cultural Formulation:
Identified issues and subsequent recommendations are Cultural identity and history of migration
documented in a CT report in the patients medical file. Cultural explanations of illness
1 Lewis-Fernandez & Diaz, Psychiatry Quarterly, 2002. Mezzich, Carrachi, Fabrega & Cultural factors related to psychosocial environment
Kirmayer. Transcultural Psychiatry, 2009. Cultural elements of the patient-provider relationship
Results: analysis of 32 consultations requested by PCPs (75% HUG and 25% private practice), 50% done through an interpreter
Patients :
Aged from 18 to 86 years (median 46), 50% female. 50% originated from Africa, 41% were Muslim.
48% migrated because of political instability or war. 16% were naturalized Swiss, 22% had no legal permit.
22% suffered from a medically unexplained symptom, 16% from chronic pain, 19% from a neurological disease and 16% a
psychiatric condition.
Souleymane, 37 years old, suffers from tonic-clonic
Main reasons for TC request : epilepsy after undergoing surgery for cerebral arterioveinous
Understanding of patients socio-cultural context malformation. His lack of compliance to antiepileptic medication
Exploration of patients explanatory model of illness frequently leads him in the emergency room. His PCP questions whether
Improve patients non-adherence no treatment cultural factors contribute to this problem and wishes to learn
Feeling dead-ended and wanting a strategy to move on more about the patients context.
Website: www.hug-ge.ch/consultation-transculturelle-interpretariat