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Stefan Bösnerr

Bio: Stefan Bösnerr is an academic researcher. The author has contributed to research in topics: Ethnic group. The author has an hindex of 1, co-authored 1 publications receiving 24 citations.
Topics: Ethnic group

Papers
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Journal ArticleDOI
TL;DR: Physicians in Germany should be more aware of the culturally based expectations of immigrant patients in order to understand their needs better, improve the physician-patient relationship, and ensure equal opportuities in health care.
Abstract: In the context of medical care migrants are often seen as difficult; this is the result of a lack of linguistic understanding, poorer compliance, and different disease concepts (1, 2). Primary care physicians report feeling uncertain, helpless, and even angry when working with migrants (2, 3). However, migration-specific health-care research almost always focuses on the point of view of medical professionals (4); little is known about immigrants’ own experiences. Whether they can report experiences similar to those of native-born citizens is an issue of interest. The participants in the study presented here were first-generation Russian-speaking immigrants from the former Soviet Union. This group is the second-largest immigrant population in Germany and consists mainly of ethnic Germans, including late emigres (“Russian-Germans”) and their relatives, Jewish immigrants, and migrants with other residency rights. For simplicity, Russian-speaking participants are referred to hereafter as “migrants,” and native-born citizens with no background of migration as “Germans,” even though most of the Russian-speaking participants are of German origin. No research has yet been conducted into the expectations or experiences of Russian-speaking immigrants in a medical context. There is therefore no existing information on whether migrants are as integrated into medical care, in terms of equality of opportunity, as native-born citizens are. Qualitative methods should be used both to develop a hypothesis for further substudies and to investigate the following questions: How do migrants and Germans experience primary care? Do the two groups have the same experiences? What expectations do immigrants and Germans have of their primary care physicians?

24 citations


Cited by
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Journal ArticleDOI
TL;DR: This issue centers around two topics: Access to healthcare and the commodation of diverse (presumably culturally formed) needs, be‐ liefs, and wishes in healthcare provision.
Abstract: Migration is not a new phenomenon and has always occurred throughout human history. The last two decades have seen a marked increase in international migration, however, in 2017 there were an estimated 258 million international migrants.1 Armed conflicts, for example in Syria, have spurred migratory movements, with about 66 million people being forcibly displaced worldwide in 2016.2 Other factors might also have impacted migration rates, for example the European Union (EU) regulations that grant EU citizens the right to move and choose their place of work freely in combination with the eastern enlargement of the EU in 2004 and 2007. Migration is ac‐ cordingly one of the defining features of our world today. As patients and healthcare providers, migrants interact with and shape healthcare systems. Migration thereby impacts healthcare provision and poses several ethical challenges. Societies receiving migrants3 will have to ask themselves how to conduct migration‐ sensitive health research and public health surveillance as the basis for effective health programs without promoting stereotypes.4 Another key issue is what level of healthcare should be granted to different migrant groups. It is also unclear how to deal with value differences, especially at the end of life: Migrant families might want to protect patients from bad news (and negative emotional reac‐ tions), for example, while physicians see it as their duty to inform patients fully.5 The above‐mentioned issues have an ethical dimension because they concern the well‐being and self‐determination of patients and providers, and pose questions concerning the just distribution of healthcare resources and how to deal with value conflicts in pluralis‐ tic healthcare contexts. Yet, while in other disciplines research on migration, culture, and health has increased in the last decade, bioethicists6 have only engaged with the topic to a very limited de‐ gree.7 Based on this observation, the authors organized a week‐long workshop on ethical challenges in the healthcare provision for mi‐ grants in March 2016.8 The workshop gave early‐career researchers and experts the opportunity to share and critically discuss their ideas and arguments. When the authors were asked to edit this special issue following from the workshop, the call was intentionally kept broad, allowing workshop participants to share their ideas with a wider audience and more researchers to join the debate. Accordingly, the articles in this issue explore a variety of questions and draw on different dis‐ courses. Some contributions ground their analyses on concepts from global health ethics such as cosmopolitanism,9 others make use of concepts from medical sociology such as health‐related deserving‐ ness,10 and still others draw on legal debates. At the same time, the articles center around two topics: Access to healthcare and the ac‐ commodation of diverse (presumably culturally formed) needs, be‐ liefs, and wishes in healthcare provision. Access to healthcare has so far received the most wide‐spread attention among bioethicists.11 This topic may have been of particu‐ lar interest because the exclusion of some migrant groups from healthcare is a political reality in many destination countries12—a re‐

33 citations

05 Nov 2016
TL;DR: Identifying preferred terms for migrants, seeking consensus on important migration-related variables for collection across health information systems and progressing towards universal access to health care across the WHO European Region are recommended as policy options.
Abstract: Variations in definitions used for “migrant” and for different groups of migrants in different areas can affect health system policies and migrant access to health care. This systematic review explored this issue using evidence from academic peer-reviewed and grey literature in 169 publications in English or Russian from 2010 to 2015 that focused on primary care or both primary and secondary care (including screening services and emergency departments). There is currently no universally accepted definition for migrant at an international level and the heterogeneity of definitions used limits comparability of routinely collected data. Legal status was one of the most significant factors determining access to affordable and adequate health services for migrants in a country. Identifying preferred terms for migrants, seeking consensus on important migration-related variables for collection across health information systems and progressing towards universal access to health care across the WHO European Region are recommended as policy options.

30 citations

Journal ArticleDOI
01 Nov 2016
TL;DR: In Deutschland berufen sich Kostentrager bei der Finanzierung von Psychotherapie auf eine Richtlinie des Gemeinsamen Bundesausschusses.
Abstract: In Deutschland berufen sich Kostentrager bei der Finanzierung von Psychotherapie auf eine Richtlinie des Gemeinsamen Bundesausschusses. Wie wirkt sich das auf die Versorgung komplex traumatisierter Menschen aus? Die vorgestellte Studie erfasst die Erfahrungswerte von 1334 Menschen, die mittels Online-Fragebogen an einer Befragung zur Versorgungsrealitat teilnahmen. Beteiligt haben sich Betroffene, Angehorige von Betroffenen, MitarbeiterInnen in Beratungsstellen, ambulant arbeitende TherapeutInnen und stationar mit Traumatisierten Arbeitende. Neben der Erhebung quantitativer Daten befasst sich ein Grosteil der Studie mit qualitativer Forschung zur Versorgungsrealitat. Die Daten belegen, dass die Versorgung komplex traumatisierter Menschen mit Psychotherapie nicht ausreichend ist, um Betroffene fur dauerhafte gesellschaftliche Teilhabe zu stabilisieren. Als eine der Ursachen hierfur kann die Orientierung der Kostentrager an der Psychotherapie-Richtlinie identifiziert werden. Kontinuierliche, kompetente Begleitung bei sinnvoller Vernetzung der professionellen HelferInnen kann Ruckfalle verhindern, Kosten reduzieren und die Chronifizierung von Komorbiditaten vermeiden. Die Ergebnisse bestatigen die Notwendigkeit, die Psychotherapie-Richtlinie zu erganzen.

17 citations

Journal ArticleDOI
TL;DR: Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.
Abstract: Among the world's 272 million international migrants, more than 25 million are from the former Soviet Union (FSU), yet there is a paucity of literature available about FSU immigrants' health literacy. Besides linguistic and cultural differences, FSU immigrants often come from a distinct healthcare system affecting their ability to find, evaluate, process, and use health information in the host countries. In this scoping review and commentary, we describe the health literacy issues of FSU immigrants and provide an overview of FSU immigrants' health literacy based on the integrated health literacy model. We purposefully consider the three most common locations where FSU immigrants have settled: the USA, Germany, and Israel. For context, we describe the healthcare systems of the three host countries and the two post-Soviet countries to illustrate the contribution of system-level factors on FSU immigrants' health literacy. We identify research gaps and set a future research agenda to help understand FSU immigrants' health literacy across countries. Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.

17 citations