Auswahl der wissenschaftlichen Literatur zum Thema „Community interpreting, healtcare interpreting, medical interpreting, hospital interpreting“

This article examines the ecology of language in an urban hospital in the U.S. Southwest. We seek to uncover how the incursion of the interpreting industry, and the ensuing language standardization that it has engendered, has affected the perception and use of Spanish among bilingual health care providers (HCPs), specifically nurses. Our findings show that the interpreting industry has not eliminated language exploitability (Alarcón & Heyman, 2013; Alarcón & Heyman, 2014) among bilingual HCPs but rather has made this exploitability more insidious. We argue that the interpreting industry has fomented a discourse of “risk” surrounding the use of Spanish in the hospital that affects bilingual HCPs’ perceptions of their own language skills by generating linguistic insecurities. We support our arguments by providing the results of a survey implemented to determine bilingual nurses’ use of certified medical interpreters (CMIs). These results are followed by excerpts from in-depth interviews conducted with bilingual nurses who participated in the aforementioned survey. Based on our findings, we determined that language the hospital’s language ecology classifies many bilingual nurses’ Spanish language skills as inadequate. We conclude by advocating for a more robust role for academic institutions in providing community education/trainings that recognize and advocate for the linguistic/cultural capital provided by bilingual HCPs.

Introduction. In some medical centers, LIOC are exclusively interpreted by surgeons. The degree of accuracy of surgeon’s interpretation compared to that of radiologist (gold standard) and its clinical significance are not well studied. Objective. study whether surgeons are accurate in interpreting IOC or not by comparing the interpretation of LIOC by surgeons to the postoperative interpretation of same cholangiograms by radiologists, and study its clinical significance. Methods. A retrospective study of 200 consecutive patients who underwent selective LIOC in Al-Khor community hospital in Qatar during the period from May 2005 till December 2011. A radiology senior consultant blindly reviewed the cholangiograms (Reading B) then we compared these findings (ductal dilatation, defects of filling and passage of contrast into duodenum) to LIOC results that were reported intraoperatively by surgeons for the same patients (Reading A). Results. Ductal dilatation was found in (27.5%) of Reading A compared to 19% in Reading B. filling defects were reported in (20.5%) of Reading A compared to 14.5% in Reading B. Conclusion. there is significant difference of LIOC interpretation between surgeons and radiologist specially in the detection of defects of fillings although this variability did not affect the clinical outcome.

Developing countries are facing numerous challenges in the process of providing adequate health care to often deprived and diminished social groups. Being a country made up of a mainland territory and five islands in Gulf of Guinea, al-most entirely covered by tropical rainforest, with poor road infrastructure, Equatorial Guinea is a showcase of various obstructions in developing effective health care system. The paper explores guidelines for creation of model regional hospital, commissioned by Ministry of Health and Social Welfare, with the aim of achieving high level of replicability through minor program and site-specific adjustments. The demonstrated strategies are applied on a local hospital designed to provide all basic types of health services while retaining a high level of technical independence. The architectural concept was formulated aiming to maximize the use of natural ventilation, daylight, and rainwater management, leaving the operation block, laboratory, and intensive care unit practically the only parts of the structure that would need mechanical air conditioning. The potential and effectiveness of use of photovoltaic units in enhancing hospital?s resilience through on-site energy production was explored. The structure was designed having in mind local climate, culture and customs, thus offering a possibility of strong integration with local community. The building technology was thought over to enable efficient and cost-effective construction and proper resilience for tropical rainforest environment. The result is a structure providing for contemporary, high quality medical service, interpreting local climatic and cultural con-textual premises through modern architectural expression.

IntroductionSkin and soft tissue infections of the eye can be classified based on anatomic location as either anterior to the orbital septum (ie, periorbital cellulitis) or posterior to the orbital septum (ie, orbital cellulitis). These two conditions are often considered together in hospitalised children as clinical differentiation is difficult, especially in young children. Prior studies have identified variation in management of hospitalised children with orbital cellulitis; however, they have been limited either as single centre studies or by the use of administrative data which lacks clinical details important for interpreting variation in care. We aim to describe the care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis.Method and analysisThis is a multisite retrospective cohort study including previously healthy children aged 2 months to 18 years admitted to hospital with periorbital or orbital cellulitis from 2009 to 2018. Clinical data from medical records from multiple Canadian hospitals will be collected, including community and academic centres. Demographic characteristics and study outcomes will be summarised using descriptive statistics, including diagnostic testing, antibiotic therapy, adjunctive therapy, surgical intervention and clinical outcomes. Variation will be described and evaluated using χ² test or Kruskal-Wallis test. Generalised linear mixed models will be used to identify predictors of surgical intervention and longer length of stay.Ethics and disseminationApproval of the study by the Research Ethics Board at each participating site has been obtained prior to data extraction. Study results will be disseminated by presentations at national and international meetings and by publications in high impact open access journals. By identifying important differences in management and outcomes by each hospital, the results will identify areas where care can be improved, practice standardised, unnecessary diagnostic imaging reduced, pharmacotherapy rationalised and where trials are needed.

Objectives Ankle brachial pressure index (ABPI) is an invaluable tool for assessing the severity of peripheral arterial disease. In addition, it can be used as an independent marker of cardiovascular risk, with a predictive ability similar to the Framingham criteria. Identification of an abnormal ABPI should therefore trigger aggressive cardiac risk factor modulation for a patient. Unfortunately, the significance of abnormal ABPIs is poorly understood within the general medical community. This is compounded by the influence of various comorbidities on accurate measurement of ABPI, potentially leading to a wide variability in readings that need to be considered before interpretation in these patient populations. We aim to address these issues by revealing several common misunderstandings and pitfalls in ABPI measurement, describing accurate methodology, and highlighting patient cohorts in whom additional or alternative approaches may be required. Methods We present a narrative review of the role of ABPI in both the community and hospital setting. We have performed a literature review, exploring the validity and reproducibility of methodology for obtaining ABPI, alongside the utility of ABPI in different clinical scenarios. Results The measurement of ABPI is often performed incorrectly. Common pitfalls include inadequate patient preparation, failure to obtain the blood pressure from the correct lower limb artery in patients with tibial disease, failure to account for differences in brachial blood pressure between the arms, inappropriately chosen equipment and patient factors such as highly calcified arteries. Standardisation of methodology greatly improves reliability of the test. Exercise ABPI can identify significant peripheral arterial disease in patients with normal resting ABPI. In addition to its role in peripheral arterial disease, ABPI measurement has a role in assessing venous ulcers, entrapment syndromes and injured extremities; conversely, it has a more limited utility in the diabetic population. Conclusions A thorough understanding of the correct technique and associated limitations of ABPI measurement is essential in accurately generating and interpreting the data it provides. With this knowledge, the ABPI is an invaluable tool to help manage patients with peripheral arterial disease. Perhaps more importantly, ABPI can be used to identify and risk stratify patients with asymptomatic peripheral arterial disease, itself a major indicator of significant underlying cardiovascular disease. With the emergence of best medical therapy, targeted pharmacotherapy and lifestyle changes can reduce the risk of major cardiovascular events in high-risk patients by approximately 30%, particularly in diabetic patients. Therefore, the utility of ABPI transgresses vascular surgery, with an essential role in general practice and public health.

Purpose The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia. Design/methodology/approach Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed. Findings Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data. Practical implications This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals. Originality/value This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.

SUMMARYAims - To examine earlier uses and abuses of artworks by individuals living with severe mental illnesses, and particularly schizophrenia by both the psychiatric and arts communities and prevailing stereotypes associated with such practices. Further, to explore alternative constructions of the artworks and roles of the artist with schizophrenia and other severe mental illnesses, which may be more consistent with amore contemporary recovery orientation, encompassing their potentials for empowerment, social inclusion as citizens and legitimacy of their cultural role in the community. Results - Earlier practices with regardto the artworks of captive patients of psychiatrists, psychotherapists, art therapists, occupational and diversional therapists, often emphasised diagnostic or interpretive purposes, or were used to gauge progress or exemplify particular syndromes. As artists and art historians began to take an interest in such artworks, they emphasised their expressive, communicative and aesthetic aspects, sometimes in relation to primitive art. These efforts to ascribe value to these works, while well-meaning, were sometimes patronising and vulnerable to perversion by totalitarian regimes, which portrayed them as degenerate art, often alongside the works of mainstream modernist artists. This has culminated in revelations that the most prominent European collection of psychiatric art still contains, and appears to have only started to acknowledge since these revelations, unattributed works by hospital patients who were exterminated in the so-called “euthanasia” program in the Nazi era. Conclusions - Terms like Psychiatric Art, Art Therapy, Art Brut and Outsider Art may be vulnerable to abuse and are a poor fit with the aspirations of artists living with severe mental illnesses, who are increasingly exercising their rights to live and work freely, without being captive, or having others controlling their lives, or mediating and interpreting their works. They sometimes do not mind living voluntarily marginal lives as artists, but they prefer to live as citizens, without being involuntarily marginalised by stigma. They also prefer to live with culturally valued roles which are recognised as legitimate in the community, where they are also more likely to heal and recover.Declaration of Interest: This paper was completed during a Visiting Fellowship, Department of Social Medicine, School of Public Health, & Department of Medical Anthropology, Faculty of Arts & Sciences, Harvard University, Cambridge, Mass, USA. A condensed version of this paper is published in “For Matthew & Others: Journeys with Schizophrenia”, Dysart, D, Fenner, F, Loxley, A, eds. Sydney, University of New South Wales Press in conjunction with Campbelltown Arts Centre & Joan Sutherland Performing Arts Centre, Penrith, 2006, to accompany with a large exhibition of the same name, with symposia & performances, atseveral public art galleries in Sydney & Melbourne, Australia. The author is also a printmaker, partly trained at Ruskin School, Oxford, Central St. Martin's School, London, and College of Fine Arts, University of New South Wales, Sydney.

Abstract Background: The process of integrating and interpreting information from multiple diagnostic tests, which may have been provided by multiple laboratories, can result in inaccurate diagnoses and treatment delays for patients with hematologic malignancies. A diagnostic process and decision support tool that integrates laboratory results and guides clinical diagnosis may improve diagnostic accuracy and targeted treatment. This study compares the completeness and actionability of bone marrow biopsy work-up results as well as follow-up health care costs for patients with suspected hematologic cancers whose diagnostic tests were managed by specialty hematology and other types of laboratories. Methods: Adult patients who had undergone a bone marrow biopsy (BMB) and had been diagnosed with a hematologic condition between January 2007 and March 2012 were identified from a large US commercial health insurance database affiliated with Optum. Patient cohorts were identified based upon laboratories performing marrow morphologic assessment/directing testing sequence: Genoptix (GX, a specialty hematology-testing laboratory) and large commercial laboratories and other laboratories such as community hospital laboratories (OL); academic labs were not included. Cohorts identified for medical chart review were matched for age, sex, geographic region, primary diagnosis on the bone marrow biopsy index date, comorbidity score, and all-cause health care costs. Medical charts were obtained from the BMB-referring physician. Independent oncologists and hematologists reviewed patients’ medical charts to determine the impact of BMB pathology reports on diagnosis and disease management. GX and OL reports were compared for completeness (diagnostic work-up in accordance with guidelines and no additional tests recommended) and actionability (enough information provided to make or rule out a diagnosis and to generate treatment recommendations). Administrative claims health care costs per patient per month (PPPM) for the period 30 days post-biopsy through 12 months were examined. Logistic regression assessed differences between cohorts for completeness, actionability and definitive diagnosis adjusted for age, gender, comorbidity and initial diagnosis on the index date. Generalized linear models assessed costs, adjusting for demographics, baseline clinical characteristics, initial diagnosis on the BMB date, definitive diagnosis, completeness and actionability on the BMB work-up report. Results: This analysis included 499 subjects with BMB results from GX (n=249) or OL (n=250). Overall, average age of patients was 52 (SD 12) with baseline Quan-Charlson score of 1.2 (SD 1.5). The majority of patients had a non-cancer hematological condition diagnosis on the index date (GX 64% and OL 56%) rather than a specific hematological cancer diagnosis. The GX BMB work-up reports were more likely to be complete (OR 2.2; p=0.001) and provide a definitive diagnosis (OR 2.1; p< 0.001) than the OL BMB work-up reports. The odds for GX reports to be actionable compared to OL reports for actionability were greater (OR 1.3) although not statistically significant. Follow-up PPPM overall health care costs for GX patients were 32% (p=0.04) lower than for the OL patients. Conclusions: Comprehensive integrated reports of complete bone marrow biopsy work-up results provide advantages over traditional lab reports by highlighting critical information and ensuring testing is completed according to both guidelines and clinical need. Disclosures Brenneman: Optum: Employment. Belland:Optum: Employment. Hulbert:Optum: Employment. Korrer:Optum: Employment, Equity Ownership.

Abstract In this article, we explore real-time translation work undertaken by frontline healthcare professionals as they interact with marginal tribal communities in Western India. Our 1-year ethnographic study of a healthcare organization delivering obstetric and gynaecological care to tribal communities helps us understand how obstetric counsellors translate allopathic medical expertise across epistemological boundaries to the tribal community they serve, in localized comprehensible forms. We identify four distinct mechanisms of translation work—Interpreting, Annotating, Norming, and Justifying—which differentially deploy and integrate elements of tribal vocabulary, symbols, knowledge, and imaginations of health and body with specific aspects of clinical diagnosis and prescription, making the latter meaningful and actionable in the process. Furthermore, we use configurational approach—Qualitative Comparative Analysis—to investigate how the type of space where the interaction between the counsellors and tribal women patients happens influences the translation work undertaken. We find that counsellors engage in spatially differentiated translation work. They predominantly use justifying and norming in clinical space (hospital); interpreting and annotating in community space (village or school); and interpreting and norming in the overlapping in-between space (outdoor patient department). Our study contributes to translation literature by showing how real-time translation is undertaken in practice, especially in a setting representing high-stakes institutional translation, and how translation work is influenced by the type of space in which interactions happen.

Clostridioides difficile is the leading cause of healthcare-associated infectious diarrhoea. However, it is increasingly appreciated that healthcare-associated infections derive from both community and healthcare environments, and that the primary sites of C. difficile transmission may be strain-dependent. We conducted a multisite genomic epidemiology study to assess differential genomic evidence of healthcare vs community spread for two of the most common C. difficile strains in the USA: sequence type (ST) 1 (associated with ribotype 027) and ST2 (associated with ribotype 014/020). We performed whole-genome sequencing and phylogenetic analyses on 382 ST1 and ST2 C. difficile isolates recovered from stool specimens collected during standard clinical care at 3 geographically distinct US medical centres between 2010 and 2017. ST1 and ST2 isolates both displayed some evidence of phylogenetic clustering by study site, but clustering was stronger and more apparent in ST1, consistent with our healthcare-based study more comprehensively sampling local transmission of ST1 compared to ST2 strains. Analyses of pairwise single-nucleotide variant (SNV) distance distributions were also consistent with more evidence of healthcare transmission of ST1 compared to ST2, with 44 % of ST1 isolates being within two SNVs of another isolate from the same geographical collection site compared to 5.5 % of ST2 isolates (P-value=<0.001). Conversely, ST2 isolates were more likely to have close genetic neighbours across disparate geographical sites compared to ST1 isolates, further supporting non-healthcare routes of spread for ST2 and highlighting the potential for misattributing genomic similarity among ST2 isolates to recent healthcare transmission. Finally, we estimated a lower evolutionary rate for the ST2 lineage compared to the ST1 lineage using Bayesian timed phylogenomic analyses, and hypothesize that this may contribute to observed differences in geographical concordance among closely related isolates. Together, these findings suggest that ST1 and ST2, while both common causes of C. difficile infection in hospitals, show differential reliance on community and hospital spread. This conclusion supports the need for strain-specific criteria for interpreting genomic linkages and emphasizes the importance of considering differences in the epidemiology of circulating strains when devising interventions to reduce the burden of C. difficile infections.

Viele der Geflüchteten und Asylsuchenden in Deutschland sprechen nur wenig oder kein Deutsch. Hinreichende Gesundheitsversorgung ist daher oft nur mithilfe von Sprachmittlung möglich. Die vorliegende Arbeit untersucht, wie ein Sprachmittlungsdienst im Gesundheitsbereich in Berlin aussehen kann und soll, damit die Regelversorgung für nicht deutschsprachige Menschen gewährleistet und Integration gefördert wird. Im theoretischen Teil wird der Forschungsstand zum Thema Sprachmittlung im Gesundheitsbereich sowie die aktuelle Situation in Deutschland und insbesondere in Berlin dargestellt. Im empirischen Teil werden die Bedarfe, der Status quo und bisherige Erfahrungen anhand des Sprachmittlungsangebotes durch SprInt Berlin, einer schriftlichen Umfrage unter Fachkräften (n = 66), welche mit Sprachmittler*innen arbeiten, sowie Interviews mit Sprachmittler*innen (n = 11) ermittelt. Die Ergebnisse zeigen den Bedarf an Sprachmittlung im Berliner Gesundheitsbereich. Um diesen zu decken, muss Sprachmittlung größtenteils aus öffentlichen Mitteln finanziert und transparent organisiert werden. Das Sprachangebot und die Anzahl der Sprachmittler*innen müssen vergrößert werden. Telefon- und Videodolmetschen sollte für einfach strukturierte Gespräche und Notfallsituationen vermehrt zum Einsatz kommen. Die Qualität muss durch einheitliche Qualifizierung und Weiterbildung der Sprachmittler*innen gewährleistet werden. Sprachliche, interkulturelle, berufsbezogene, translatorische und soziale Kompetenzen sind für die Sprachmittler*innen unerlässlich. Die Arbeit verdeutlicht, dass Gesundheit ein wichtiger Faktor für Integrationsprozesse ist und professionelle Sprachmittlung an der Entwicklung einer pluralistischen, gleichberechtigten Gesellschaft mitwirkt.:1 Einleitung 1 I. Theoretische Grundlagen: Sprachmittlung im Gesundheitsbereich 3 2 Forschungsstand: Dolmetschen im Gesundheitsbereich 3 2.1 Besonderheiten des Dolmetschens im Gesundheitsbereich 5 2.1.1 Wo und was wird gedolmetscht? Einsatzorte, Themengebiete und Gesprächstypen 5 2.1.2 Wie wird gedolmetscht? Kompetenzen für das Dolmetschen im Gesundheitsbereich 7 2.1.3 Die Rolle der Sprachmittler*innen 10 2.2 Wer dolmetscht? Nicht ausgebildete, geschulte und ausgebildete Sprachmittler*innen 13 2.2.1 Nicht ausgebildete Sprachmittler*innen 13 2.2.2 Geschultes medizinisches Personal und ausgebildete Sprachmittler*innen 16 2.3 Wege zum Beruf Sprachmittler*in 18 2.4 Telefonisches und videobasiertes Dolmetschen 21 2.5 Was dolmetscht? Alternativen zur Sprachmittlung durch eine Person 25 3 Sprachmittlung im Gesundheitsbereich in Deutschland 26 3.1 Menschen mit Migrationshintergrund in Deutschland 26 3.2 Migration und Gesundheit 28 3.2.1 Daten zum Gesundheitszustand von Menschen mit Migrationshintergrund 30 3.2.2 Daten zum Gesundheitsverhalten von Menschen mit Migrationshintergrund 31 3.2.3 Hintergründe und Einflussfaktoren 32 3.2.4 Migration, Gesundheit und Sprachmittlung 33 3.3 Das Recht auf Sprachmittlung 36 3.4 Finanzierung von Sprachmittlung 39 4 Sprachmittlung im Gesundheitsbereich in Berlin 42 4.1 Menschen mit Migrationshintergrund in Berlin 42 4.2 Gesundheitsversorgung in Berlin 44 4.3 Finanzierung von Sprachmittlung im Gesundheitsbereich in Berlin 45 4.4 Geschulte und ausgebildete Sprachmittler*innen in Berlin 46 5 Zwischenfazit: Warum sollten Sprachmittler*innen im Gesundheitsbereich eingesetzt werden? 49 II. Empirische Untersuchung: Sprachmittlung im Gesundheitsbereich am Beispiel SprInt Berlin 51 6 SprInt Berlin als Akteur für Sprachmittlung im Gesundheitsbereich 52 7 Quantitative Umfrage unter Fachkräften in der Gesundheitsversorgung 54 7.1 Methoden: Planung und Anwendung 54 7.2 Analyse und Auswertung 56 7.2.1 Rücklauf und Studienpopulation 56 7.2.2 Klient*innenfrequenz 58 7.2.3 Verständigung mit nicht deutschsprachigen Klient*innen 59 7.2.4 Termine mit Sprachmittlung 61 7.2.5 Wer benötigt Sprachmittlung? Personengruppen, Herkunftsländer und Sprachen 63 7.2.6 Bedeutung der gleichen Herkunft von Sprachmittler*in und Klient*in 65 7.2.7 Wer übernimmt die Sprachmittlung? 68 7.2.8 Erfahrungen mit Sprachmittler*innen 70 7.2.9 Was tun Sie, wenn kein*e Sprachmittler*in zur Verfügung steht? 74 7.2.10 Hinzuziehung von Sprachmittler*innen 76 7.2.11 Maßnahmen zur Verbesserung der Kommunikation mit nicht deutschsprachigen Klient*innen 76 7.2.12 Kompetenzen von Sprachmittler*innen 78 7.2.13 Kompetenzen der SprInt-Mittler*innen 79 7.2.14 Aufgaben der Sprachmittler*innen 80 7.2.15 Nutzen von Sprachmittlung 82 7.2.16 Telefonische Sprachmittlung 83 7.2.17 Videobasierte Sprachmittlung 86 7.2.18 Argumente für und gegen telefonische und videobasierte Sprachmittlung 87 7.2.19 Finanzierung von Sprachmittlung 88 7.2.20 Vermittlung der Einsätze und Verfügungszeiten 89 7.2.21 Weitere Serviceleistungen, Kritik und Verbesserungsvorschläge 90 7.3 Zusammenfassung und Beurteilung der Umfrageergebnisse 94 8 Leitfadengestützte Interviews mit SprInt-Mittler*innen 96 8.1 Methoden: Planung und Anwendung 96 8.2 Analyse und Auswertung 98 8.2.1 Studienpopulation 98 8.2.2 Einsätze: Anzahl, Einsatzorte und Themen 100 8.2.3 Klient*innen: Personengruppen und Herkunftsländer 102 8.2.4 Kompetenzen von Sprachmittler*innen 105 8.2.5 Aufgaben und Rolle von Sprachmittler*innen 110 8.2.6 Erfahrungen im Kontakt mit Fachkräften 112 8.2.7 Erfahrungen im Kontakt mit Klient*innen 113 8.2.8 Missverständnisse aufgrund kultureller Hintergründe 115 8.2.9 Psychische Belastung und Supervision zur Bewältigung 116 8.2.10 Telefonische und videobasierte Sprachmittlung 118 8.2.11 Die SprInt-Qualifizierung, Aufqualifizierung und Weiterbildungen 119 8.2.12 Der Weg zum Beruf Sprachmittler*in 121 8.2.13 Erfahrungen mit nicht ausgebildeten Sprachmittler*innen 123 8.2.14 Die Zusammenarbeit mit der Vermittlungszentrale 123 8.3 Zusammenfassung und Beurteilung der Auswertung der Interviews 124 9 Diskussion der Ergebnisse: Theoretische Grundlagen, Perspektive der Fachkräfte und der Sprachmittler*innen im Vergleich 127 10 Reflexion und Ausblick 133