Emergency physician's perception of cultural and linguistic barriers in immigrant care: results of a multiple-choice questionnaire in a large Italian urban XXXX .

@entity1 @entity341
BACKGROUND: A poor communication with immigrants can lead to inappropriate use of healthcare services, greater risk of misdiagnosis, and lower compliance with treatment. As precise information about communication between emergency physicians (EPs) and immigrants is lacking, we analyzed difficulties in communicating with immigrants in the @entity341 ( @entity341 ) and their possible associations with demographic data, geographical origin and clinical characteristics. METHODS: In an @entity341 with approximately 85 000 visits per year, a multiple-choice questionnaire was given to the EPs 4 months after discharge of each immigrant in 2011. RESULTS: Linguistic comprehension was optimal or partial in the majority of @entity1 . Significant barriers were noted in nearly one fourth of @entity1 , for only half of them compatriots who were able to translate. Linguistic barriers were mainly found in older and sicker @entity1 ; they were also frequently seen in @entity1 coming from western Africa and southern Europe. Non-linguistic barriers were perceived by EPs in a minority of @entity1 , more frequently in the elderly and frequent attenders. Factors independently associated with a poor final comprehension led to linguistic barriers, non-linguistic obstacles, the absence of intermediaries, and the presence of @entity1 's fear and hostility. The latter probably is a consequence, not the cause, of a poor comprehension. CONCLUSION: Linguistic and non-linguistic barriers, although quite infrequent, are the main factors that compromise communication with immigrants in the @entity341 , with negative effects especially on elderly and more seriously ill @entity1 as well as on physician satisfaction and appropriateness in using services.
