Pazienti cronici immigrati e italiani a confronto: un modello di analisi neuropsicologica e psico-sociale

[Autom. eng. transl.] Recent social surveys show that chronic immigrant patients in Italy are strongly influenced by the numerous risk factors to which they are exposed, including the absence of adequate health information, a low socioeconomic status, language barriers and nutritional, social habits. and cultural differences. Thanks to new paths created ad hoc it is possible to assist chronic immigrant patients in the integration process, which is influenced by a condition of fragility and difficult psychosocial conditions, which can sometimes lead to cognitive and emotional deficits. The purpose of this work is to highlight the dynamics existing between psychosocial and neuropsychological needs of immigrant patients compared to Italian patients with chronic disease present on the Italian national territory. Specifically, it is intended to propose a new multidimensional approach to assess the neuropsychological and clinical conditions of chronic immigrant and Italian patients in parallel. To pursue this dual objective, a sample of 80 chronic patients was considered, of which 45% Italian and 55% immigrants. The investigation tool used consists of a battery of tests for the neuropsychological evaluation of global cognitive functioning and a series of psychosocial tests to investigate basic language skills, the state of health, the perceived social support and the degree of daily discrimination, as well as that the socio-economic status and the possible presence of comorbid diseases. Lastly, patients were offered a semi-structured interview aimed at collecting in-depth social and psychological data, including the representation of their health condition. From the results obtained it is observed that the chronic immigrant patients are significantly younger than the Italians, they score lower in the basic linguistic skills, in the scales that investigate mental health and social involvement; they perceive less social support, specifically from the family, while they obtain higher scores in relation to emotional problems compared to Italian patients. From a neuropsychological point of view, chronic immigrant patients are more vulnerable cognitively, in particular in abstract non-verbal reasoning. The qualitative and quantitative analysis of the semi-structured interviews revealed specific representations of patients on their chronic disease and overall health condition, highlighting the macro areas of differential content between Italian and foreign patients. In conclusion, we believe that this multi-level approach could be included in the National Health System to make the needs and demand for health of immigrant patients more readable, allowing to redefine new diagnostic, therapeutic, organizational and preventive proposals.