Yüce Yilmaz-Aslan

Illness perceptions in Turkish migrants with diabetes: A qualitative study

Objectives Illness perceptions are usually conceptualized using the self-regulatory model of illness. Although a few examinations of illness perceptions among Turkish language populations exist, the validity of the self-regulatory model of illness has never been confirmed for this population group. The aim of our study was to explore the validity of the self-regulatory model of illness in chronically ill Turkish migrants residing in Germany using diabetes mellitus type 2 as an example. Methods Qualitative semi-structured interviews were conducted with 24 Turkish migrants with self-reported diabetes who were recruited through key persons. The core aspects of the qualitative data were extracted through a hermeneutic approach. Subsequently, a system of categories and sub-categories was developed by means of content analysis. Results Seven distinct core dimensions of illness perceptions, each with a different number of sub-domains, could be identified in the sample. They comprised the perceived timeline of diabetes, its consequences, its causes, its controllability as well as the identity/coherence and the emotional response with respect to the condition. Discussion As regards the conceptualization of illness perceptions, the dimensions identified are in line with the self-regulatory model of illness. Addressing illness perceptions through tailored interventions may contribute to improving health care and health outcomes in Turkish migrants.

The factor structure of the Turkish version of the Revised Illness Perception Questionnaire (IPQ-R) in patients with diabetes and cardiovascular disease.

BackgroundThe Revised Illness Perception Questionnaire (IPQ-R) has been used extensively in the study of illness perceptions across different populations. Only few confirmatory factor analytic (CFA) studies of the questionnaire are available. This study examines the construct and discriminant validity of the Turkish IPQ-R in patients with diabetes and cardiovascular disease focusing on the hypothesized seven dimensions of personal controllability, treatment controllability, timeline acute/chronic, timeline cyclical, coherence, consequences and emotional representations.Methods302 patients (60.6% women) with a medically confirmed diagnosis of diabetes or cardiovascular disease and a mean age of 53.9 years were recruited from out-patient clinics in Turkey and surveyed by means of standardized interviews. Direct maximum likelihood confirmatory factor analysis was conducted.ResultsSeveral areas of ill-fit were identified in the original measurement model of the IPQ-R. Four items (items 17, 19, 20, and 31) were deleted because of poor factor loadings. Also, two error covariances (between items 33 and 34 and between items 7 and 8) were added and item 6 respecified to obtain a good model fit. The modified 34-item model showed good reliability and discriminant validity.ConclusionIn accordance with studies on other language adaptations of the questionnaire, we identified certain items of the IPQ-R as potential sources of poor model fit. Their inclusion should be reconsidered in future applications of the questionnaire and researchers should examine whether our reduced set of items is stable across different populations. Our modified 34-item model showed a good reliability and discriminant validity and hence could be a valuable instrument in the assessment of illness perceptions in the Turkish health care setting, provided that the model is confirmed in subsequent research.

Determinants of mammography screening participation among Turkish immigrant women in Germany – a qualitative study reflecting key informants' and women's perspectives

Mammography screening programmes aiming to reduce mortality from breast cancer are implemented in most European countries. Immigrant women are less likely to participate than women of the respective autochthonous populations in several European countries but not in Germany. Qualitative, semi-structured interviews were conducted with 16 key informants and 10 Turkish immigrant women aged 50-69 years to analyse the factors influencing their screening participation in Germany. Interviews were analysed using summarising content analysis. The Theory of Planned Behaviour was used for structuring the results. Key informants stated poor German language skills and insufficient knowledge about breast cancer and screening as factors influencing screening participation. Immigrant women demonstrated basic knowledge about screening, but their attitudes towards screening varied. Information from the invitation letter of the screening programme was often filtered by family members. Key informants tended to emphasise barriers and system-related factors while the Turkish women focused more on factors on the individual level. Contrasting both perspectives is helpful for health professionals to critically assess their own views. Measures to improve screening participation need to address not only barriers but also take womens attitudes and norms into account, thus helping women to make an informed decision.

Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study

Objectives Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. Methods We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007–2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Results Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for ‘satisfaction with psychological care’ and 0.11 (99.5% CI 0.08 to 0.14) for ‘satisfaction with treatments during rehabilitation’. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Conclusions Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process.

Storytelling als Intervention

The number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.ZusammenfassungDie Zahl pflegebedürftiger Menschen in Deutschland nimmt stetig zu. Besonders Menschen mit Migrationshintergrund können aufgrund von Zugangsbarrieren wie Sprachschwierigkeiten und Informationsdefiziten die Einrichtungen und Angebote des Gesundheitssystems nicht adäquat nutzen. In dem vorliegenden Artikel wird die Umsetzung des Projekts saba beschrieben, in dem auf Basis des Storytellings ein selbsthilfeorientierter Interventionsansatz für türkische Pflegebedürftige und ihre pflegenden Angehörigen entwickelt und erprobt wurde. In Anwesenheit von speziell geschulten Gesundheitsmediator(inn)en mit Türkisch als Muttersprache fanden regelmäßige Treffen mit den pflegenden Angehörigen statt. Während der Treffen konnten die pflegenden Angehörigen durch gegenseitiges Erzählen ihre Pflegeerfahrungen und Informationen austauschen. Die Intervention diente zur Förderung des Selbstmanagements und Empowerments der türkischen Pflegebedürftigen und ihrer pflegenden Angehörigen. Informationsdefizite und Zugangsbarrieren können somit abgebaut und die Nutzung von Hilfen und Angeboten von Pflegemaßnahmen erleichtert werden.AbstractThe number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.

Krankheitsvorstellungen bei Diabetikern mit türkischem Migrationshintergrund

Zusammenfassung Diabetiker mit türkischem Migrationshintergrund haben komplexe Krankheitsvorstellungen, von denen einige vorteilhaft und einige nachteilig für eine optimale Behandlung und ein erfolgreiches Selbstmanagement von Diabetes mellitus sind. In der Versorgung dieser Patientengruppe sollten die vorteilhaften Krankheitsvorstellungen gefördert und die nachteiligen Krankheitsvorstellungen modifiziert werden.

Medizinische Rehabilitation und Leistungen zur Teilhabe am Arbeitsleben bei Menschen mit Migrationshintergrund

Mit insgesamt fast 16 Millionen Menschen hat ein groser Teil der Bevolkerung in Deutschland einen Migrationshintergrund. Die Gruppe der Menschen mit Migrationshintergrund umfasst Personen auslandischer Staatsangehorigkeit und deutsche Staatsangehorige, die selbst oder deren Eltern nach Deutschland zugewandert sind. Die beiden grosten Bevolkerungsgruppen mit Migrationhintergrund sind (Spat-)Aussiedlerinnen und (Spat-)Aussiedler sowie Menschen turkischer Herkunft. Zusammen machen sie knapp die Halfte der Bevolkerung mit Migrationshintergrund aus (vgl. Statistisches Bundesamt 2012).

Umgang mit Diversität in der Pflege und Palliativversorgung am Beispiel von Menschen mit Migrationshintergrund

Our society is characterized by increasing diversity. Immigrants greatly contribute to this diversification. Currently, one fifth of the population in Germany is considered to be of immigrant origin. Healthcare needs of immigrants are often not sufficiently taken into account by healthcare institutions. This may result in many barriers encountered by immigrants in the healthcare system, which may affect the utilization and quality of care. These barriers are particularly pronounced in nursing and palliative care. Current strategies aiming to reduce these barriers are limited as they often only focus on culture and religion, thereby neglecting the role of other diversity dimensions, such as sex and socioeconomic status. Diversity management is able to overcome these shortcomings by implementing conditions in healthcare institutions which promote awareness and openness towards the diversity of healthcare clients. This can improve the quality of care and can contribute to patient-oriented healthcare.ZusammenfassungUnsere Gesellschaft ist durch eine zunehmende Vielfalt geprägt. Menschen mit Migrationshintergrund tragen maßgeblich zu dieser Diversifizierung bei. Aktuell hat ein Fünftel der Bevölkerung Deutschlands einen Migrationshintergrund. Versorgungsbedürfnisse und -bedarfe dieser Bevölkerungsgruppe werden von vielen Versorgungsinstitutionen bisher nicht ausreichend aufgegriffen. Menschen mit Migrationshintergrund stoßen dadurch im Gesundheitssystem auf zahlreiche Barrieren, die die Inanspruchnahme und Qualität ihrer Versorgung nachteilig beeinflussen können. Die Pflege und Palliativversorgung sind Versorgungsbereiche, in denen Barrieren besonders stark ausgeprägt sein können. Bisherige Strategien zur Überwindung dieser Barrieren greifen durch ihren ausschließlichen Fokus auf Kultur und Religion häufig zu kurz, da sie die Bedeutung anderer Merkmale von Vielfalt wie Geschlecht und den sozioökonomischen Status vernachlässigen. Das geht mit unterschiedlichen Limitationen einher. Diversity Management erlaubt es, diese Limitationen zu überwinden und Rahmenbedingungen in Gesundheitsinstitutionen herzustellen, die die Offenheit gegenüber der Vielfalt aller NutzerInnen fördern. Dies kann zu einer Verbesserung der Qualität und Nutzerorientierung in der Versorgung beitragen.AbstractOur society is characterized by increasing diversity. Immigrants greatly contribute to this diversification. Currently, one fifth of the population in Germany is considered to be of immigrant origin. Healthcare needs of immigrants are often not sufficiently taken into account by healthcare institutions. This may result in many barriers encountered by immigrants in the healthcare system, which may affect the utilization and quality of care. These barriers are particularly pronounced in nursing and palliative care. Current strategies aiming to reduce these barriers are limited as they often only focus on culture and religion, thereby neglecting the role of other diversity dimensions, such as sex and socioeconomic status. Diversity management is able to overcome these shortcomings by implementing conditions in healthcare institutions which promote awareness and openness towards the diversity of healthcare clients. This can improve the quality of care and can contribute to patient-oriented healthcare.

Storytelling als InterventionStorytelling

The number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.ZusammenfassungDie Zahl pflegebedürftiger Menschen in Deutschland nimmt stetig zu. Besonders Menschen mit Migrationshintergrund können aufgrund von Zugangsbarrieren wie Sprachschwierigkeiten und Informationsdefiziten die Einrichtungen und Angebote des Gesundheitssystems nicht adäquat nutzen. In dem vorliegenden Artikel wird die Umsetzung des Projekts saba beschrieben, in dem auf Basis des Storytellings ein selbsthilfeorientierter Interventionsansatz für türkische Pflegebedürftige und ihre pflegenden Angehörigen entwickelt und erprobt wurde. In Anwesenheit von speziell geschulten Gesundheitsmediator(inn)en mit Türkisch als Muttersprache fanden regelmäßige Treffen mit den pflegenden Angehörigen statt. Während der Treffen konnten die pflegenden Angehörigen durch gegenseitiges Erzählen ihre Pflegeerfahrungen und Informationen austauschen. Die Intervention diente zur Förderung des Selbstmanagements und Empowerments der türkischen Pflegebedürftigen und ihrer pflegenden Angehörigen. Informationsdefizite und Zugangsbarrieren können somit abgebaut und die Nutzung von Hilfen und Angeboten von Pflegemaßnahmen erleichtert werden.AbstractThe number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.

[Storytelling: an intervention to improve home care of Turkish migrants].

The number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.ZusammenfassungDie Zahl pflegebedürftiger Menschen in Deutschland nimmt stetig zu. Besonders Menschen mit Migrationshintergrund können aufgrund von Zugangsbarrieren wie Sprachschwierigkeiten und Informationsdefiziten die Einrichtungen und Angebote des Gesundheitssystems nicht adäquat nutzen. In dem vorliegenden Artikel wird die Umsetzung des Projekts saba beschrieben, in dem auf Basis des Storytellings ein selbsthilfeorientierter Interventionsansatz für türkische Pflegebedürftige und ihre pflegenden Angehörigen entwickelt und erprobt wurde. In Anwesenheit von speziell geschulten Gesundheitsmediator(inn)en mit Türkisch als Muttersprache fanden regelmäßige Treffen mit den pflegenden Angehörigen statt. Während der Treffen konnten die pflegenden Angehörigen durch gegenseitiges Erzählen ihre Pflegeerfahrungen und Informationen austauschen. Die Intervention diente zur Förderung des Selbstmanagements und Empowerments der türkischen Pflegebedürftigen und ihrer pflegenden Angehörigen. Informationsdefizite und Zugangsbarrieren können somit abgebaut und die Nutzung von Hilfen und Angeboten von Pflegemaßnahmen erleichtert werden.AbstractThe number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.