RESPOND - Improving regional health system responses to the challenges of migration through tailored interventions for asylum-seekers and refugees (English Version)

Findings for Multi-Item Scale Recommendations for Multi-Item Scale

In this question it should be examined above all whether the introduction is understandable and whether the doctor's name is understood.

Serbian

Test persons SER01 and SER02 point out that the term "visit…for advice" in the question in the Serbian questionnaire was translated as "asking for advice" and that both would therefore have thought first of all whether they had sought psychological advice from a psychologist. Only through the items does the relevance of the question become clear. Otherwise the introduction to the question is understandable.

Test person SER01 is unfamiliar with several doctor's names and asks the interpreter for explanations (primary care physician, specialist, orthodontist). The term "orthodontist" is also unknown to test subject SER02.

Arabic

For the test persons AR01 and AR02 the introduction is understandable. They indicate that this is about the health care system in Germany. With the exception of "orthodontist", test person AR01 knows all the terms and can explain the differences between the doctors. Test person AR02 does not know the term "primary care physician", but equates it with general practitioner.

Farsi

Test subjects FAR01 and FAR02 correctly reproduce the introduction and find it understandable. They also know all the doctor's names and find it easy to answer the questions. Regarding the term "general practitioner", subject FAR01 notes that in Farsi one does not speak of a primary care physician but of a family doctor: "In Afghanistan, for example, a family doctor is someone to whom the whole family al-ways goes. The doctor knows all the family's problems and pre-existing conditions. He is therefore a specialist for this family." (FAR01). Test subject FAR02 and an interpreter also point out that the term "family doctor" has been translated incorrectly.

The interpreters in these interviews point out that the questionnaire on Farsi makes no reference to the "following doctors". Only the last medical treatment/examination is mentioned. One interpreter also notes that orthodontist was translated as "jaw and tooth surgeon".

Russian

Test person RUS01 cannot answer item c): "I know what it is, but I haven't used it." (RUS01). She has been to the dentist in her home country, but not yet in Germany. Therefore, she does not find any answer category appropriate and it is unclear to her whether the question refers only to Germany or also to her home country. However, she is aware of all the doctor's names.

Test person RUS02 can correctly repeat the introduction and all doctor's names are known to her.

English

ENG01 has no difficulty in understanding the introduction. She also knows all the terms in the question and had no difficulty in answering it. The interviewer notes that the translation of "specialist" is not ideal (medical or surgical specialist).

Question: As addressed by test subject RUS01, the introduction suggests that it is exclusively about visits to doctors in Germany. This is again not apparent from question 45. Should only doctor's visits in Germany be mentioned here or the general visit to a doctor (also in the home country). The test persons may find it difficult to tick "never" if they visited a doctor a few months ago but have since arrived in Germany.
Based on the comments of the test subjects in the pretest, we suggest changing the order of the verbs in the question to shift the focus from the consultation to the actual treatment. Furthermore, in order to keep translation problems to a minimum, a simpler choice of words should be used:
The following questions are about your medical care in Germany.
[In den folgenden Fragen geht es um Ihre medizinische Versorgung in Deutschland.]
If you have a health problem in Germany, you first go to a general practitioner who is called a primary care physician in Germany. The primary care physician organizes all further examinations or refers you to a specialist. A specialist has special knowledge and experience in a certain medical field (cardiovascular, dermatologist, ophthalmologist, psychiatrist).
[Wenn man in Deutschland ein gesundheitliches Problem hat, geht man zuerst zu einem Allgemeinmediziner, der in Deutschland Hausarzt heißt. Der Hausarzt organisiert alle weiteren Untersuchungen oder überweist zu einem Facharzt. Ein Facharzt hat besondere Kenntnisse und Erfahrungen in einem bestimmten medizinischen Bereich (Herz-Kreislauf, Haut- oder Augenarzt, Psychiater).]
When did you last visit one of the following doctors in Germany to be examined, treated or advised?
[Wann waren Sie zuletzt bei einem der folgenden Ärzte in Deutschland, um sich untersuchen, behandeln oder beraten zu lassen?]
Since the term orthodontist is unknown to many test persons, it should be explained in more detail or possibly deleted completely.
Answer options: In addition, we recommend that to reconsider the answer options in terms of the question and, if necessary, differentiate them more strongly, or even examine the standard examination on arrival in Germany.