Data Collection Through the Eyes of the Newly Arrived

Deb Penney, MS, CNM, MPH

March 16, 2015

1

Exploring the Primary Health Care Encounter

Study Background

• Critical Ethnography• Postcolonial Feminism

-power, knowledge, subjugation, voice• 10 Primary Health Care Providers• 15 Iraqi Muslim Women• Semi-structured interviews in Arabic and

English

2

Limits to Data Quality

• Communication– Interpreter quality and training– Time limitations in the health encounter– Expectations (referenced in a prior social

context)– Differing cultural norms

3

Provider Perceptions

Knowledge about Iraqi women obtained directly from the Iraqi patients

PTSD, depression, insomnia

Demanding

Educated

Comparisons

Fusing identities

4

Iraqi Muslim Women’s Experiences

Not enough time

Limited conversation about concerns

Interpreter support and frustration

Lack of psychological comfort

Individual need for like-gender provider and interpreter

5

Types of Data Use

Computer use

For interpretation (Marti)

For gathering/storing patient data

Positive aspects

As resource information

Observed use by providers

6

Questions

“A good doctor is one that understands You don’t have to explain a lot to them… they understand where you come from and they know what you are talking about and don’t keep asking a lot of questions.”

7

Templates

Full medical, family, social history

Repetitive

Not consistent with the chief complaint

Culturally distressing

8

Comments

“…with my Dad being there, it’s not so good because I wouldn’t normally talk to him about that.”

“There are questions that may be acceptable by the American culture, but can be irritating or provocative to us.”

9

Being Understood

Restructuring the health encounter

Increased knowledge of the individual

Time to communicate

understand assess, diagnose

translate

10

Restructuring

• Critical reflection of the templates to gather data

• Use of Health guides/interpreters• Social workers, Case managers• Adjustable time based on patient/family

needs• Mental health and financial resources

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