Determinanţi ai calităţii vieţii pacienţilor de etnie romă, din perspectiva mediatorilor sanitari
Keywords:
Roma community, health mediator, health policy, physician-patient communication, exclusion, healthcareAbstract
The Roma represent an important ethnic minority in Romania, who often face inequalities in their access to health care. The policies and the strategies that focused on reducing this inequalities and a better inclusion of the Roma have lead to the establishment of a sanitary mediators network, that is currently operating in Roma communities, thus facilitating a better communication between this particular minority and the health care professionals, as well as an improved access to healthcare services. Our study – Determinants of the quality of life of the Roma patients, from the perspective of the health mediators – focuses on identifying the determinants of the quality of life of Roma patients, and it is based on three group interviews with sanitary mediators, in the counties of Iasi and Cluj. The results indicate that, when it comes to health care services, doctors should be familiar with and aware of the cultural background of the community, their values and traditions. Communication based on respect, the development of a partnership between doctors and patients, avoiding racial labeling and prejudices are the most important requirements of the Roma, because their dignity and quality of life should not be affected under the conditions of the interaction with healthcare professionals. The activity of health mediators, persons who are familiar with members of the community, with their customs and traditions, has a positive potential in assuring the quality of life.
Downloads
References
Astărăstoae, V., Gavrilovici, C., Vicol, M. C., Gergely, D., Ion, S., Etica şi non-discriminarea grupurilor vulnerabile în sistemul de sănătate, Iaşi, Editura Universităţii „Gr. T. Popa”, 2011.
Berevoescu, I., Cace, S., Costin Sima, D., Zamfir, C., Preda, M. (coord.), Romii în România, Bucureşti, Editura Expert, 2002.
Cristea, O., Lăţea, P., Chelcea, L., Stigmatul etnic la o comunitate de rromi, în „Rromathan”, nr. 1(1), 1997, pp. 61–68.
Dahlgren, G., Whitehead, M., Policies and strategies to promote social equity in health. Background document to WHO: strategy paper for Europe, Institute for Futures Studies, Stockholm, 1991, disponibil online la http://www.framtidsstudier.se/wp-content/uploads/2011/01/20080109110739filmZ8UVQv2wQFShMRF6cuT.pdf.
Duminică, G., Lupu, S., Rughiniş, C., Persoanele de etnie roma în situaţii de risc, în Preda M. (ed.). Riscuri şi inechităţi sociale în România, Iaşi, Editura Polirom, 2009, pp. 226–233.
Duminică, G., Preda, M., Accesul romilor pe piaţa muncii, Bucureşti, ECA – Editura Cărţii de Agribusiness, 2003, disponibil online la http://www.agentiaimpreuna.ro/files/publicatii/Accesul_romilor_pe_piata_muncii.pdf.
Emanuel, E. J., Fairclough, D. L., Slutsman, J., Alpert, H., Baldwin, D., Emanuel, L. L., Understanding economic and other burdens of terminal illness: the experience of patients and their caregivers, în “American Journal of Internal Medicine”, no. 132, 2000, pp. 451–459.
Fésüs, G., Effectiveness of Policies to Improve the Health and Social Situation of Roma Populations in the European Region, PhD thesis, supervisor: prof. R. Adany, Univeristy of Debrecen, Doctoral School of Health Sciences, Debrecen, 2012, disponibil online la http://ganymedes.lib.unideb.hu:8080/dea/bitstream/2437/124366/10/Fesus_Gabriella_ertekezes.pdf.
Fésüs, G., Östlin, P., McKee, M., Ádány, R., Policies to improve the health and well-being of Roma people: The European experience, în “Health Policy”, no. 105(1), 2012, pp. 25–32.
Given, B. A., Given, C. W., Kozachik, S., Family support in advanced cancer, în “CA: A Cancer Journal for Clinicians”, no. 51, 2001, pp. 213–231.
Hajioff, S., McKee, M., The health of the Roma people: a review of the published literature, în “Journal of Epidemiological Community Health”, no. 54, 2000, pp. 864–869, disponibil online la http://jech.bmj.com/content/54/11/864.long.
Hall, C. C. I., Cultural malpractice: The growing obsolescence of psychology with the changing U.S. Population, în “American Psychologist”, no. 52, 1997, pp. 642–651.
Hasdeu, I., Bori et r(R)omni. Réflexions sur les rapports sociaux de sexe chez les Roms căldărari de Roumanie, în «Etudes Tsiganes», no. 31–32, 2008, pp. 116–143.
Hasdeu, I., Corps et vêtements des femmes Rom en Roumanie. Un regard anthropologique, în «Etudes Tsiganes», 33–34, 2009, pp. 60–77.
Ionescu, M., Cace, S., Politici de ocupare pentru romi, Bucharest, Expert Publishing, 2006.
Ionescu, M., Cace, S., Politici publice pentru romi. Evoluţii şi perspective, Bucureşti, Expert Publishing, 2006.
Kitzinger, C. J., Qualitative research: Introducing focus groups, în «British Medical Journal», no. 311, 1995, pp. 299–302.
Krieger, N., Does racism harm health? Did child abuse exist before 1962? On explicit questions, critical science and current controversies: an ecological perspective, în “American Journal of Public Health”, no. 93(2), 2003, pp. 194–199.
Krieger, N., Smith, K., Naishadham, D., Hartman, C., Barbeau, E. M., Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health, în “Social Science and Medicine”, no. 61(7), 2005, pp. 1576–1596.
Kriegsman, D. M., Penninx, B. W., van Eijk, J. T., Chronic disease in the elderly and its impact on the family, în “Family Systems Medicine”, no. 12(3), 1994, pp. 249–267.
Leduc, N., Proulx, M., Patterns of health services utilization by recent immigrants, în “Journal of Immigrant Health”, no. 6(1), 2004, pp. 15–27.
Ma, G. X., Henderson, G., Rethinking ethnicity and health care: A sociocultural perspective, Springfield, Charles C. Thormas, 1999.
Molnár, Á., Ádány, R., Ádám, B., Gulis, G., Kása, K., Health impact assessment and evaluation of a Roma housing project in Hungary, în “Health and Place”, no. 16, 2010, pp. 1240–1247.
Morgan, D. L., Focus groups as qualitative research, London, Sage, 1997.
Nijober, C., Triemstra, M., Tempelaar, R., van der Bos, G. A., Patterns of caregiver experiences among partners of cancer patients, în “Gerontologist”, no. 40, 2000, pp. 738–746.
Parry, G., Van Cleemput, P., Peters, J., Walters, S., Thomas, K., Cooper, C., Health status of Gypsies and Travellers in England, în “Journal of Epidemiology and Community Health”, no. 61, 2007, pp. 198–204.
Pădurariu, M., Ciobîcă, A., Persson, C., Ştefănescu, C., Autostigmatizarea în psihiatrie: perspective etice şi biopsihosociale, în „Revista Română de Bioetică”, no. 9 (1), 2011, pp. 16–23.
Pfaller, A., How to design a good health-care system for South Eastern Europe, în „Revista Calitatea Vieţii”, nr. 17 (3–4), 2006, pp. 375–379.
Preda, M., Grupuri sociale excluse/ignorate de politicile sociale în România, în Zamfir, C. (coord.), Politici sociale în România ’90–’98, Bucureşti, Editura Expert, 1999.
Revenga, A., Ringold, D., Tracy, W. M., Poverty and Ethnicity: A Cross-Country Study of Roma Poverty in Central Europe, The World Bank Technical paper, no. 531, Washington DC, The World Bank, 2002, disponibil online la http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2003/01/07/.
Ringold D., Orenstein M. A., Wilkens E., Roma Expanding Europe: Breaking the Poverty Cycle, Washington DC, The World Bank, 2005, disponibil online la http://siteresources.worldbank.org/EXTROMA/Resources/roma_in_expanding_europe.pdf.
Rotaru, V., UMF Iaşi derulează un proiect pentru rromii din judeţ, în „Bună Ziua Iaşi”, 02.02.2012, disponibil online la http://www.bzi.ro/umf-iasi-deruleaza-un-proiect-pentru-rromii-dinjudet-267200.
Ruzicka, M., Continuity or rupture? Roma/Gypsy communities in rural and urban environments under postsocialism, în “Journal of Rural Studies”, no. 28(2), 2012, pp. 81–88.
Sales, E., Family burden and quality of life, în “Quality of Life Resources”, no. 12, 2003, pp. 33–41.
Smith, J. A., Beyond the divide between cognition and discourse: Using interpretative phenomenological analysis in health psychology, în “Psychology and Health”, no. 11, 1996, pp. 261–271.
Surdu, M., Educaţia şcolară a populaţiei de romi, în vol. Indicatori privind comunităţile de romi din România, Bucureşti, Editura Expert, 2002.
Surdu, M., Surdu, L., Căsătoria şi sarcina timpurie în comunităţile de romi, Bucureşti, Editura Ro Media, 2005.
Trif, A. B., Living wills, în “Clinica”, no 4(4), 1999, pp. 45–50.
Voko, Z., Csepe, P., Nemeth, R., Kosa, K., Kosa, Z., Szeles, G., Adany, R., Does socioeconomic status fully mediate the effect of ethnicity on the health of Roma people in Hungary?, în “Journal of Epidemiology and Community Health”, no. 63, 2009, pp. 455–460.
Wang, L., Immigration, ethnicity, and accessibility to culturally diverse family physicians, în “Health and Place”, no. 13(3), 2007, pp. 656–671, disponibil online la http://www.mendeley.com/research/immigration-ethnicity-accessibility-culturally-diverse-family-physicians/#page-1.
Wong, R. K., Franssen, E., Szumacher, E., What do patients living with advanced cancer and their carers want to know? A needs assessment, în “Support Care Cancer”, no. 10, 2002, pp. 408–415.
Zamfir, C., Zamfir, E. (coord.), Ţiganii între ignorare şi îngrijorare, Bucureşti, Editura Alternative, 1993.
Zamfir, C., Preda, M. (coord.), Romii din România, Bucureşti, Editura Expert, 2002.
Zhang, J., Verhoef, M. J., Illness Management Strategies Among Chinese Immigrants Living with Arthritis, în “Social Science and Medicine”, no. 55, 2002, pp. 1795–1802.
*** Ambulance Not on the Way: The Disgrace of Health Care for Roma in Europe, European Roma Rights Centre, ERRC, Budapest, 2006, disponibil online la http://www.soros.org/initiatives/health/focus/roma/articles_publications/publications/ambulance_20061004/ambulance_20061004.pdf.
*** Cercetare-evaluare a programului mediatorilor sanitari în comunităţile de rromi în România. Raport, ICF JSI (Institutul de cercetare şi formare JSI România, Centrul pentru Politici şi Servicii de Sănătate), 2006, disponibil online la http://www.anr.gov.ro/docs/Politici/Evaluarea_PMSR_raport_final.pdf.
*** Decade of Roma Inclusion. Minutes and Summary of the XII. International Steering Committee Meeting, 2008. Disponibil online la http://demo.itent.hu/roma/portal/downloads/Decade%20Documents/12th%20ISC%20Meeting%20Minutes%20February%2025-26%202008.pdf.
*** Decade Watch. Results of the 2009 survey, Budapest, 2010, disponibil online la http://www.romadecade.org/files/downloads/Decade%20Watch%202010/Decade%20Watch%20-%20Results%20of%20the%202009%20Survey%20-%20Revised.pdf.
*** Declaration of the Decade of Roma Inclusion, 2005, disponibil online la http://www.romadecade.org/index.php?content=77.
*** Employment, Social Policy, Health and Consumer Affairs Council Meeting, Conclusions on Inclusion of the Roma, Council of the European Union, Brussels, 2011, disponibil online la http://www.consilium.europa.eu/ueDocs/cms_Data/docs/pressData/en/lsa/122116.pdf.
*** European Network Sastipen. Annual Report 2005–2006, Madrid, Fundación Secretariado Gitano, 2007, disponibil online la http://ec.europa.eu/health/ph_projects/2004/action3/docs/2004_3_01_inter_en.pdf.
*** Legal şi ilegal pe piaţa muncii pentru comunităţile de romi. Diagnoza factorilor care influenţează nivelul de ocupare la populaţia de romi din România,ICCV (Institutul de Cercetare a Calităţii Vieţii), Bucharest, Expert Publishing, 2010.
*** Poverty and social exclusion in the WHO European region: health systems respond, World Health Organisation, Copenhagen, WHO Regional Office for Europe, 2010, disponibil online la http://www.euro.who.int/_data/assets/pdf_file/0006/115485/E94018.pdf.
Published
Versions
- 2012-09-30 (2)
- 2021-11-03 (1)
How to Cite
Issue
Section
Copyright (c) 2021 Romanian Academy Publishing House
This work is licensed under a Creative Commons Attribution 4.0 International License.
