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Uršula Lipovec Čebron VECˇJEZICˇNO ZDRAVJE: Komunikacijske Strategije in Vecˇkulturni Stiki S Tujejezicˇnimi Bolniki V Slovenskem Zdravstvenem Sistemu

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Uršula Lipovec Čebron VECˇJEZICˇNO ZDRAVJE: Komunikacijske Strategije in Vecˇkulturni Stiki S Tujejezicˇnimi Bolniki V Slovenskem Zdravstvenem Sistemu Uredili Nike K. Pokorn in Uršula Lipovec Čebron VECˇJEZICˇNO ZDRAVJE: KOMUNIKACIJSKE STRATEGIJE IN VECˇKULTURNI STIKI S TUJEJEZICˇNIMI BOLNIKI V SLOVENSKEM ZDRAVSTVENEM SISTEMU Zbirka Prevodoslovje in uporabno jezikoslovje Ljubljana 2019 Vecjezicno_zdravje_FINAL.indd 1 12.2.2019 9:19:49 VEČJEZIČNO ZDRAVJE: KOMUNIKACIJSKE STRATEGIJE IN VEČKULTURNI STIKI S TUJEJEZIČNIMI BOLNIKI V SLOVENSKEM ZDRAVSTVENEM SISTEMU ZBIRKA PREVODOSLOVJE IN UPORABNO JEZIKOSLOVJE ISSN 2335-335X Urednici: Nike K. Pokorn, Uršula Lipovec Čebron Recenzenta: Robert Grošelj, Jana Šimenc Lektor: Damjan Popič Založila: Znanstvena založba Filozofske fakultete Univerze v Ljubljani Izdal: Oddelek za prevajalstvo Za založbo: Roman Kuhar, dekan Filozofske fakultete Ljubljana, 2019 Prva izdaja Naklada: 300 izvodov Oblikovna zasnova: Kofein, d. o. o. Prelom: Aleš Cimprič Tisk: Birografika Bori, d. o. o. Cena: 20,00 EUR To delo je ponujeno pod licenco Creative Commons Priznanje avtorstva-Deljenje pod enakimi pogoji 4.0 Mednarodna licenca. / This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Knjiga je izšla s podporo Javne agencije za raziskovalno dejavnost Republike Slovenije. Raziskovalni projekt št. J6-6842 je sofinancirala Javna agencija za raziskovalno dejavnost Republike Slovenije iz državnega proračuna. Prva e-izdaja. Publikacija je v digitalni obliki prosto dostopna na https://e-knjige.ff.uni-lj.si/ DOI: 10.4312/9789610601364 Kataložna zapisa o publikaciji (CIP) pripravili v Narodni in univerzitetni knjižnici v Ljubljani Tiskana knjiga COBISS.SI-ID=298323968 ISBN 978-961-06-0151-7 E-knjiga COBISS.SI-ID=298311424 ISBN 978-961-06-0136-4 (pdf) 2 VECˇJEZICˇNO ZDRAVJE Vecjezicno_zdravje_FINAL.indd 2 12.2.2019 9:19:49 VECˇJEZICˇNO ZDRAVJE 3 Vecjezicno_zdravje_FINAL.indd 3 12.2.2019 9:19:49 KAZALO VSEBINE Kazalo vsebine 4 VECˇJEZICˇNO ZDRAVJE Vecjezicno_zdravje_FINAL.indd 4 12.2.2019 9:19:49 KAZALO VSEBINE KAZALO Uvod 8 STIKI ZDRAVSTVENIH DELAVCEV S TUJEJEZIČNIMI PACIENTI: OVIRE IN POTREBE Kdo dela z uporabniki zdravstvenega sistema, ki ne govorijo slovensko? 16 Tamara Mikolič Južnič Reševanje jezikovnih ovir v slovenskem zdravstvu: analiza stanja 30 Nike K. Pokorn Jezikovne kompetence zdravstvenih delavcev 48 Marija Milavec Kapun, Nike K. Pokorn Pravni statusi nedržavljanov in z njimi povezane ovire pri dostopu do zdravstvene obravnave 66 Sara Pistotnik Medkulturni (in drugi) nesporazumi v zdravstvu 78 Uršula Lipovec Čebron DVA KORAKA V SMER VEČJEZIČNEGA ZDRAVSTVA Izbor jezikov za Večjezični priročnik za lažje sporazumevanje v zdravstvu 94 Nike K. Pokorn Pot do Večjezičnega priročnika za lažje sporazumevanje v zdravstvu 106 Tamara Mikolič Južnič, Uršula Lipovec Čebron Usposabljanje zdravstvenih delavcev kot korak k bolj kakovostni zdravstveni obravnavi oseb iz drugih jezikovnih in kulturnih okolij 126 Uršula Lipovec Čebron, Simona Jazbinšek, Danica Rotar-Pavlič, Vesna Homar Študija uporabnosti Večjezičnega priročnika za lažje sporazumevanje v zdravstvu 146 Nike K. Pokorn, Nataša Hirci, Erika Zelko, Marija Milavec Kapun, Tanja Korošec, Simona Jazbinšek, Tamara Mikolič Južnič Priloga 1: Predlog napotkov za delo s tolmačem 170 Nike K. Pokorn Napotki za zdravstvene delavce ob obravnavi tujejezičnega uporabnika zdravstvenih storitev 173 Priporočeni koraki za delo s tolmačem, ki ne pozna bolnika 174 Priporočen položaj v prostoru tolmača v tolmačenem pogovoru v zdravstvenem okolju 175 VECˇJEZICˇNO ZDRAVJE 5 Vecjezicno_zdravje_FINAL.indd 5 12.2.2019 9:19:49 KAZALO VSEBINE Priporočeni koraki za delo z neprofesionalnim tolmačem laikom (npr. sorodnikom uporabnika zdravstvenih storitev) 177 Priloga 2: Vseslovenska anketa, namenjena zdravstvenim delavcem v slovenskih zdravstvenih ustanovah, o stikih s tujejezičnimi uporabniki zdravstvenih storitev. 180 Priloga 3: Evalvacija uporabe Večjezičnega priročnika za lažje sporazumevanje v zdravstvu 190 Povzetek v slovenščini 194 Abstract 200 Imensko kazalo 206 6 VECˇJEZICˇNO ZDRAVJE Vecjezicno_zdravje_FINAL.indd 6 12.2.2019 9:19:49 VECˇJEZICˇNO ZDRAVJE 7 Vecjezicno_zdravje_FINAL.indd 7 12.2.2019 9:19:49 UVOD Uvod 8 VECˇJEZICˇNO ZDRAVJE Vecjezicno_zdravje_FINAL.indd 8 12.2.2019 9:19:49 UVOD Učinkovita komunikacija med bolnikom1 in zdravnikom je osnova za uspešno zdravljenje in preprečevanje bolezni, vendar pa je ta pogosto otežkočena. Eden izmed najpogostejših razlogov za nezmožnost vzpostavitve komunikacije in na- stanek komunikacijskih šumov med uporabniki in ponudniki zdravstvenih sto- ritev je nepoznavanje oziroma slabo znanje jezika, ki ga uporablja zdravstveno osebje ali uporabniki zdravstvenih storitev. V slovenskem zdravstvenem sistemu se zdravniki, medicinske sestre in drugi zdravstveni delavci vedno pogosteje sre- čujejo z uporabniki zdravstvenih storitev, ki ne znajo slovensko in govorijo jezike, ki jih zdravstveni delavci ne razumejo. Ti s seboj prinašajo tudi značilnosti svo- jega družbeno-kulturnega okolja, vključno s predstavami in praksami o zdravju, bolezni in zdravljenju. Zdravstveni delavci pa kljub temu, da so v pogostih stikih s tujejezičnimi uporabniki zdravstvenih storitev, nimajo ne ustrezne podpore ne znanja, da bi se uspešno spopadli s temi novimi izzivi na svojem delovnem mestu. S tem v mislih smo se v okviru interdisciplinarne skupine, sestavljene iz prevo- doslovk, medicinskih antropologinj, zdravnic, medicinskih sester in sociologinje, odzvali na razpis in izoblikovali predlog projekta »Izdaja slovarja, namenjenega lažji komunikaciji migrantov z zdravstvenim osebjem«, ki ga je financiralo Mi- nistrstvo za notranje zadeve s podporo Evropske unije iz Sklada za azil, migracije in vključevanje.2 Preden smo se posvetili pripravi večjezičnega priročnika, na- menjenega zdravstvenim delavcem, smo najprej želeli bolje spoznati jezikovne izzive v slovenskem zdravstvu, zato smo oblikovali spletni anketni vprašalnik. V njem smo zdravstvene delavce spraševali o pogostosti stikov z uporabniki, ki ne razumejo slovenščine, o jezikovnih ovirah, s katerimi se srečujejo pri svojem delu, in o načinih, na katere se z njimi soočajo. Spletna anketa je potekala jeseni 2016, v njej je sodelovalo 564 zdravstvenikov oz. medicinskih sester, zdravnikov, zobo- zdravnikov in ostalega zdravstvenega osebja (fizioterapevti, defektologi, logopedi, socialni delavci, radiološki inženirji ipd.). Na osnovi rezultatov, ki smo jih prido- bili prek te ankete in ostalih sorodnih raziskav, smo izoblikovali osemjezični pri- ročnik in v različnih krajih Slovenije izvedli 14 usposabljanj, ki se jih je udeležilo 708 posameznikov in v katerih smo seznanili zdravstvene delavce s priročnikom in z različnimi strategijami reševanja medkulturnih, pravno-administrativnih in jezikovnih problemov, ki nastajajo ob stikih s tujejezičnimi uporabniki zdravstve- nih storitev. Pričujoča monografija podaja kritično analizo rezultatov te ankete, opisuje potek izoblikovanja priročnika in ponuja ovrednotenje priročnika in izo- braževanja, ki je potekalo po izdaji priročnika. 1 V monografiji je moška oblika uporabljena kot spolno nevtralna in velja za vse spole. 2 V projektu so sodelovali Filozofska fakulteta (Oddelek za etnologijo in kulturno antropologijo, Oddelek za prevajalstvo), Me- dicinska fakulteta in Zdravstvena fakulteta Univerze v Ljubljani ter Nacionalni inštitut za javno zdravje in Zdravniška zbornica Slovenije. Projekt je bil financiran iz Sklada za azil, migracije in vključevanje EU ter Ministrstva za notranje zadeve RS. Vodja projekta je bila izr. prof. dr. Uršula Lipovec Čebron, sodelavke pa: doc. dr. Nataša Hirci, asist. Vesna Homar, mag. Simona Jazbinšek, mag. Ajda Jelenc, red. prof. dr. Nike Kocijančič Pokorn, Tanja Korošec, doc. dr. Tamara Mikolič Južnič, mag. Marija Milavec Kapun, Sara Pistotnik, izr. prof. dr. Danica Rotar Pavlič, Mojca Vrečar, doc. dr. Erika Zelko in Tjaša Zidarič. VECˇJEZICˇNO ZDRAVJE 9 Vecjezicno_zdravje_FINAL.indd 9 12.2.2019 9:19:49 UVOD Monografija je razdeljena na dva večja sklopa:3 v prvem, ki smo ga naslovili Sti- ki zdravstvenih delavcev s tujejezičnimi pacienti: ovire in potrebe, smo podrobneje predstavili in analizirali rezultate vseslovenske ankete zdravstvenih delavcev. Ta sklop je sestavljen iz petih poglavij: v prvem poglavju Tamara Mikolič Južnič po- drobneje predstavi uporabljene metode anketne raziskave in populacijo, ki jo je zajela anketa, tj. različne skupine zdravstvenih delavcev v slovenskem zdravstvu, ki se srečujejo s tujejezičnimi uporabniki zdravstvenih storitev pri svojem delu; v drugem Nike K. Pokorn analizira odgovore na vprašanja, v katerih so zdrav- stveni delavci določili, katere tuje jezike govorijo in kako dobro jih obvladajo, katere jezike govorijo tujejezični uporabniki zdravstvenih storitev v slovenskem zdravstvenem sistemu in kateri izmed teh jezikov predstavljajo največje težave zdravstvenemu osebju v slovenskem zdravstvenem sistemu. V tem poglavju se tudi seznanimo z najpogostejšimi komunikacijskimi strategijami, tj. z načini, kako zdravstveni delavci rešujejo situacije, ko ne razumejo bolnikov in bolniki ne razumejo njih. Kot komentar rezultatom ankete so navedena tudi dognanja stroke in opozorila, kateri načini reševanja jezikovnih težav v zdravstveni oskrbi so potencialno problematični oziroma nesprejemljivi. V tretjem poglavju Marija Milavec Kapun in Nike K. Pokorn primerjata od- govore anketirancev glede na osnovni poklic v zdravstvu in doseženo stopnjo izobrazbe ter na posamezne statistične regije, v katerih delujejo. Iz rezultatov samoocen znanja tujih jezikov je razvidno, da je znanje tujih jezikov slabše pri medicinskih sestrah kot
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