(Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany.

OBJECTIVES: This study was designed to explore the utilization and non-utilization of pre-hospital emergency care by migrants and non-migrants, and the factors that influence this behaviour. METHODS: A cross-sectional representative German survey was conducted in a sample of 2.175 people, 295 of whom had a migration background. An additional sample of 50 people with Turkish migration background was conducted, partially in the Turkish language. Apart from socio-demographics, the utilization of emergency services and the reasons for non-utilization were assessed. RESULTS: Migrants had a higher utilization rate of pre-hospital emergency care (RR = 1.492) than non-migrants. Furthermore, migrants who were not born in Germany had a lower utilization rate (RR = 0.793) than migrants who were born in Germany. Regarding non-utilization, the most frequently stated reasons belonged to the categories initial misjudgment of the emergency situation and acting on one's own behalf, with the latter stated more frequently by migrants than by non-migrants. CONCLUSIONS: To prevent over-, under-, and lack of supply, it is necessary to transfer knowledge about the functioning of the medical emergency services, including first aid knowledge.

Migration background and overall satisfaction with pre-hospital emergency care.

OBJECTIVES: This study was designed to explore how sociodemographic factors of the patient/patient's relatives including migrant status and service-related aspects influence overall satisfaction with pre-hospital emergency care. METHODS: A descriptive-analytical study was conducted on 218 persons (57 migrants and 161 nonmigrants) who had received pre-hospital emergency care directly (as a patient) or indirectly (as a significant other) in Germany. Sociodemographic data and service-related aspects were entered into a hierarchical regression analysis in order to identify their influence on overall satisfaction. RESULTS: Altogether, 58.3% of the variance of the overall satisfaction with pre-hospital emergency care can be explained by the final model. Of this sum, only 9.8% is explained by sociodemographic factors and 47.3% by service-related aspects. Migrant status per se did not show any significant influence, whereas no or a basic level of German language skills is significantly negatively associated with overall satisfaction. Professional and emotional/social competencies of the emergency personnel are significantly positively associated with overall satisfaction with pre-hospital emergency care. CONCLUSIONS: Sociodemographic-related factors, excepted from language skills, seem to be largely unrelated to overall satisfaction with pre-hospital emergency care. Service-related factors such as the emergency personnel's professional and social/emotional competencies appear as the main factors determining overall satisfaction with pre-hospital emergency care.

Migrants' and professionals' views on culturally sensitive pre-hospital emergency care.

This study was designed to explore the views of migrants and professionals on culturally sensitive pre-hospital emergency care in order to adapt such care to migrants' needs. Interviews were conducted with 41 migrants who had received direct (as a patient) or indirect (as a significant other) pre-hospital emergency care. Furthermore, 20 professionals in the field of pre-hospital emergency care were interviewed. The content analysis showed five distinguishable categories based on the statements by the migrants and six categories based on the statements by the professionals. While migrants gave priority to basic proficiencies of first responders such as 'social/emotional competencies' and 'communication skills', the professionals considered '(basic) cultural knowledge', 'awareness' and 'attitude' the most important. Furthermore, migrants provided practical indications, e.g. regarding areas of cultural knowledge, whereas professionals seemed to view the issue of culturally pre-hospital emergency care from a more theoretical perspective. The issues of the culturally sensitive pre-hospital emergency care itself, as well as the varying points of view of the two groups interviewed, resulted in eight recommendations for culturally sensitive pre-hospital emergency care.

[The concept of culture from the perspective of emergency victims with migration background and experts in the context of emergency care]. / Der Kulturbegriff aus Sicht von Betroffenen mit Migrationshintergrund und Bevölkerungsschutzexperten im Kontext der Notfallversorgung.

OBJECTIVES: In the field of emergency care there is a lack of conceptual foundations of Intercultural Competence. This study aims to elaborate a practice relevant definition of the term culture in order to develop a qualification training. METHOD: Interviews were conducted with 43 emergency victims and 20 experts. The analysis was performed based on the statements concerning the individual interpretation of the term culture according to the principles of the qualitative content analysis. RESULTS: The content analysis showed 11 distinguishable categories. Socialisation was a factor frequently mentioned by all persons interviewed. Moreover, emergency victims often linked culture to the fields of behaviour and way of life whilst experts gave priority to functional aspects of culture. CONCLUSION: A single definition would not be suitable for a common understanding. Rather, several key aspects commonly associated with the term culture should be considered by taking into account complex life environments.