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Hutchings JL, Grey C, Brewer KM, Aspden TJ. How pharmacist-led health services are tailored to minoritized populations, their acceptability and effectiveness: A scoping literature review. Res Social Adm Pharm 2023:S1551-7411(23)00278-4. [PMID: 37301642 DOI: 10.1016/j.sapharm.2023.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/27/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Worldwide, minoritized populations experience inequitable health risks and outcomes. The importance of offering tailored services to meet the specific needs of target populations should be addressed during service development. Within healthcare systems, pharmacists play a crucial role in supporting patients to manage their medicines and health conditions. OBJECTIVES This scoping review aims to identify, collate and analyse literature describing pharmacist-led services tailored for minoritized populations in order to strengthen the knowledge base and support for achieving health equity. METHODS A scoping review was guided by the PRISMA-ScR checklist and the five-stage process outlined by Arksey and O'Malley. Medline, EMBASE, Scopus, CINAHL Plus, International Pharmaceutical Abstracts, and Google Scholar databases, plus grey literature were searched to identify relevant studies published up to October 2022. Texts were included if they reported on a pharmacist-led health service tailored to meet the needs of a minoritized population. The review protocol was registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/E8B7D). RESULTS Of the 566 records initially identified, 16 full-text articles were assessed for eligibility and 9 articles describing 6 unique services met the criteria and were included in the review. Three services were non-health-condition-specific, 2 targeted type two diabetes and 1 focussed on opioid dependency disorders. Service acceptability was consistently explored, and all services ensured that pharmacists' views were considered. However, only 4 consulted with the people from the group that the service targeted. Where reported, the effectiveness was not comprehensively evaluated. CONCLUSION There is limited literature in this area and a critical need for more evidence on the effectiveness of pharmacist-led services for minoritized populations. We need a better understanding of how pharmacists contribute to health equity pathways and how to expand this. Doing so will inform future services and contribute towards achieving equitable health outcomes.
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Affiliation(s)
- Jess Lagaluga Hutchings
- School of Pharmacy, The University of Auckland, Auckland, New Zealand; Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand.
| | - Corina Grey
- Pacific Health, Ministry of Health, Wellington, New Zealand
| | - Karen M Brewer
- Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Trudi J Aspden
- School of Pharmacy, The University of Auckland, Auckland, New Zealand; Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
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Filmer T, Ray R, Glass BD. Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review. Res Social Adm Pharm 2023; 19:977-988. [PMID: 36868911 DOI: 10.1016/j.sapharm.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 02/03/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction. OBJECTIVE The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries. METHODS A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria. RESULTS A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building. CONCLUSIONS While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..
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Affiliation(s)
- Tamara Filmer
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
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Suzuki S, Kato ET, Sato K, Konda M, Kuwabara Y, Yasuno S, Liu J, Masuda I, Ueshima K. The effect of the Original MethOd at pharmacy To ENhAnce Support for Health Improvement in the limited Japanese proficiency patients visiting local community pharmacy: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2022; 105:366-374. [PMID: 34059363 DOI: 10.1016/j.pec.2021.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/09/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES With an increase in globalization, the number of non-native-speaking citizens and tourists visiting local pharmacies is rapidly growing worldwide, creating linguistic and sociological problems. The aim of this study is to compare the effect of adding our original method, Original MethOd at pharmacy To ENhAnce Support for Health Improvement (OMOTENASHI), to the conventional medication counselling method (CMC) when counselling non-Japanese patients at the pharmacy. METHODS The OMOTENASHI consists of tools written in multiple languages and illustrations to clarify the effects and side effects, and to confirm patients' understanding. 71 non-Japanese patients were recruited and randomly assigned to the OMOTENASHI or to the CMC in a 1:1 ratio. Comprehension and satisfaction level were evaluated. RESULTS The overall comprehension level was significantly higher in the OMOTENASHI than in the CMC (75% vs 38%, p = 0.002), with a prominent difference in the recognition of the name, effects, side effects, precautions, and how to deal with side effects of the prescribed medication. CONCLUSION The OMOTENASHI to be a helpful tool in providing essential information to non-native-speaking patients. PRACTICE IMPLICATION The study highlighted the need to ensure every patient's safety and interests, and to avoid disadvantages caused by limited language proficiency in the globalization era.
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Affiliation(s)
- Shota Suzuki
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan; Institute for Clinical and Translational Science, Nara Medical University Hospital, Nara, Japan.
| | - Eri Toda Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiko Sato
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Manako Konda
- Department of Preventive Services, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yoshihiro Kuwabara
- Center for Accessing Early Promising Treatment, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Yasuno
- Clinical Research Support Center, The Jikei University School of Medicine, Tokyo, Japan
| | - Jinliang Liu
- Department of Infectious Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Izuru Masuda
- Medical Examination Center, Takeda Hospital, Kyoto, Japan
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital, Kyoto, Japan
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Qureshi SA, Kjøllesdal M, Gele A. Health disparities, and health behaviours of older immigrants & native population in Norway. PLoS One 2022; 17:e0263242. [PMID: 35100306 PMCID: PMC8803195 DOI: 10.1371/journal.pone.0263242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Abstract
We aimed to investigate and compare activities of daily living (ADL), instrumental ADL (IADL), poor self-rated health and the health behaviours among immigrants and the native population in Norway. We present results from analysis of two Norwegian surveys, (Living Conditions Survey on Health from 2015, Living Conditions Survey among Immigrants 2016). Using logistic regression models, odds ratios were estimated for functional ability, self-reported health, and health behavior among immigrants, with Norwegian born being the reference category. The first model was controlled for age and gender and the second model was additionally adjusted for educational level. Our analysis included 5343 participants, 2853 men (913 immigrants), and 2481 women (603 immigrants), aged 45–79 years. The age-group 45–66 years includes n = 4187 (immigrants n = 1431, men n = 856; women n = 575) and 67–79 years n = 1147 (immigrants n = 85, men n = 57; women n = 28). The percentage of Norwegians having ≥ 14 years of education was 86%, as compared to 56% among immigrants. The percentage of immigrants with no education at all was 11%. The employment rate among the Norwegian eldest age group was nearly double (14%) as compared to the immigrant group. Adjusted for age, gender and education, immigrants had higher odds than Norwegian of ADL and IADL, chronic diseases and overweight. There were no differences between immigrants and Norwegians in prevalence of poor self-reported health and smoking. Overall elderly immigrants are worse-off than Norwegians in parameters of health and functioning. Knowledge about health and functioning of elderly immigrants can provide a basis for evidence-based policies and interventions to ensure the best possible health for a growing number of elderly immigrants. Furthermore, for a better surveillance, planning of programs, making policies, decisions and improved assessment and implementation, ADL and IADLs limitations should be included as a variable in public health studies.
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Affiliation(s)
- Samera Azeem Qureshi
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- Institute of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
- * E-mail:
| | - Marte Kjøllesdal
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- Institute of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
| | - Abdi Gele
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- Institute of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
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Amin MEK, Qudah BA, Kaur A, Rawy M, Chewning B. Construction and evaluation of an online module addressing counseling patients with diabetes observing religious fasting. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1602-1610. [PMID: 34895669 DOI: 10.1016/j.cptl.2021.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/30/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Little research has been conducted on training students of different health professions to deliver culturally appropriate care to patients observing religious fasting. This study aimed to formulate an online educational module on caring for patients with diabetes observing religious fasting and evaluate the module's impact. METHODS Third-year doctor of pharmacy students participated in an online module at the end of their core pharmacist-patient communication class. The module involved discussions and case scenarios addressing Muslim, Jewish, and Hindu patients with diabetes considering fasting. Students were provided with Ramadan Communication (RAMCOM), a tool designed to facilitate counseling of patients on religious fasting and were encouraged to use principles of motivational interviewing in addressing cases. A 13-item questionnaire was administered before and after the module. Answers provided on an open-ended item addressing students' experiences with the module were analyzed qualitatively using conventional content analysis. RESULTS Of 140 students taking the class, all students completed the module and 135 completed both questionnaires. The module elicited a statistically significant improvement in confidence across all 13 survey items. The computed aggregate score increased from 2.65 (0.56) to 3.66 (0.50) (P < .001), with 71% of students finding the module to be useful or extremely useful. Qualitative analysis provided insight into students' experiences, including how the module produced an improvement in student confidence as well as opportunities for module improvement. CONCLUSIONS A brief online module significantly improved pharmacy students' confidence in working with patients from different cultures and religions considering religious fasting.
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Affiliation(s)
- Mohamed Ezzat Khamis Amin
- Beirut Arab University, Faculty of Pharmacy, P.O. Box: 11, 5020 Beirut, Lebanon; AlAlamein International University, Faculty of Pharmacy, AlAlamein City Main Road, Matrouh, Egypt.
| | - Bonyan A Qudah
- University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705-2222, United States.
| | - Arveen Kaur
- University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705-2222, United States.
| | - Marwa Rawy
- University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705-2222, United States.
| | - Betty Chewning
- University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705-2222, United States.
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Plombon M, Religioni U, Neumann-Podczaska A, Merks P. Challenges for Polish Community Pharmacists in Provision of Services to Immigrants and Non-Polish-Speakers in 2018. Med Sci Monit 2021; 27:e933678. [PMID: 34743170 PMCID: PMC8588709 DOI: 10.12659/msm.933678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background International patient services in community pharmacies are becoming increasingly common. The growing number of immigrants, as well as the developing trend of medical tourism, make it necessary to provide these people with access to healthcare services, including pharmaceutical services in generally accessible pharmacies. Serving non-Polish-speaking patients, however, requires both fluent specialist knowledge of a foreign language and interpersonal skills. These skills can greatly influence the proper use of medications by patients. This study aimed to investigate the reported challenges for Polish community pharmacists in the provision of services to immigrants and non-Polish-speakers in 2018. Material/Methods The study included 98 pharmacists and pharmaceutical technicians from community pharmacies in Poland. The research tool was a questionnaire sent to pharmacy staff in cooperation with pharmacy councils in 2018. Results Analysis of the data gathered using a 5-point Likert scale showed that the participants rated the preparedness for international patient services in pharmacies as medium (mean 2.76±1.33). The mean foreign language knowledge score was 2.99±1.29. The participants indicated a low possibility of acquiring these language skills (mean 2.53±0.91), and emphasized that patients from abroad rarely asked about the use of the medications (mean=2.20±1.06). Conclusions This study showed that in 2018, pharmacy staff in Poland did not feel adequately prepared to provide comprehensive pharmacy services for immigrants and non-Polish-speakers, with concerns of non-compliance with medications due to poor communication.
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Affiliation(s)
- Marcin Plombon
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Urszula Religioni
- Collegium of Business Administration, Warsaw School of Economics, Warsaw, Poland
| | | | - Piotr Merks
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.,Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
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Sletvold H, Nguyen T. Experiences and perceptions of foreign-language customers on medication information received in the pharmacy - a focus group study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:330-335. [PMID: 33963846 DOI: 10.1093/ijpp/riab021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 04/13/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND In pharmacies, communication is essential for providing information about medicine and counselling customers on the correct use of medications. Previous studies have described pharmacists experiencing language and cultural barriers in communication with foreign-language (FL) customers. OBJECTIVE This study aimed to explore FL customer experiences and perceptions of medication information received in the pharmacy. METHODS A qualitative method was used, including interviews in five focus groups. Study participants (N = 18) spoke Arabic or Kurdish but lived in Norway and had the experience of purchasing medicine over the counter and/or prescription medicines in a Norwegian pharmacy. A descriptive thematic content analysis was conducted. KEY FINDINGS Overall, the FL customers were satisfied with the pharmacy service. However, they were divided in their views of the pharmacy role, which could affect how they received medication information. Communication barriers were prominent, and FL customers related language and cultural barriers to negative health outcomes. Their preferences on medication information were not met. Several communication facilitators that could support medication information were mentioned: simplified prescription labels, written information, pictograms, mobile apps, interpretators and bilingual staff. CONCLUSIONS The FL pharmacy customers' experience of communication barriers and unfulfilled needs for medical information can be a threat to patient safety. To overcome the barriers and ensure the correct use of medicines, health-care personnel in pharmacies must apply an array of communication aids, adapted to the diversity in language, culture and health literacy in the heterogenous population.
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Affiliation(s)
- Hege Sletvold
- Faculty of Nursing and Health Sciences, Nord University, Stjordal, Norway
| | - Thianna Nguyen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Qudah B, Thakur T, Chewning B. Factors influencing patient participation in medication counseling at the community pharmacy: A systematic review. Res Social Adm Pharm 2021; 17:1863-1876. [PMID: 33766505 DOI: 10.1016/j.sapharm.2021.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Findings document that patient participation in pharmacy encounters is associated with favorable outcomes. However, there is a need to understand factors that may enhance or hinder patient engagement and pharmacist counseling behaviors during their medication discussions. This review aims to: (1) identify barriers and facilitators for patient engagement in pharmacy consultations, (2) explore the relationship between patient factors (such as demographics and communication behavior) and subsequent pharmacist counseling behavior. METHODS A systematic review of literature using PRISMA guidelines examined studies published in English addressing influences on patient participation and the relationship between patient factors and pharmacist counseling behavior. Four databases were used - PubMed, CINAHL, PsycINFO, and Scopus. Findings were framed thematically within the constructs of Street's Linguistic Model of Patient Participation in Care (LM). FINDINGS Fifty studies from 1983 to 2019, including 37 using self-reported data, were identified. Patient involvement in patient-pharmacist communication was influenced by enabling factors such as patient knowledge, communication skills, and pharmacy environment. Predisposing factors for participation ranged from patients' beliefs and past experiences to demographic characteristics such as gender and age. Pharmacists' participative behavior with patients was positively associated with patients' engagement and perceived patient cues in the conversation. CONCLUSION This systematic review identified predictors of patients' engagement in pharmacy encounters drawing on LM framework. Various predisposing factors, enabling factors, and pharmacist' responses impacted patients' willingness to actively participate in medication counseling at community pharmacies. Equally important, studies documented considerable impact by patients on pharmacists' counseling behavior. Pharmacy encounters should no longer be viewed as controlled simply by pharmacists' expertise and agendas. Patient characteristics and factors such as patient question-asking and expectations also appear to be associated with and influence patient-pharmacist interpersonal communication. Additional research needs to address the identified facilitators and barriers to enhance patient participation and pharmacist counseling behavior.
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Affiliation(s)
- Bonyan Qudah
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, 777 Highland Ave., Madison, WI, 53705, USA.
| | - Tanvee Thakur
- Research Triangle Institute, 3005 Boardwalk Drive, Suite 105, Ann Arbor, MI, 48108, USA
| | - Betty Chewning
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, 777 Highland Ave., Madison, WI, 53705, USA
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Abuelmagd W, Osman BB, Håkonsen H, Jenum AK, Toverud EL. Experiences of Kurdish immigrants with the management of type 2 diabetes: a qualitative study from Norway. Scand J Prim Health Care 2019; 37:345-352. [PMID: 31299877 PMCID: PMC6713117 DOI: 10.1080/02813432.2019.1639911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: To explore the experiences of immigrant Kurdish patients in Oslo, Norway, related to the management of type 2 diabetes mellitus (T2DM). Design: A qualitative study with focus group interviews. Setting: Participants were recruited at meeting places in Oslo through Kurdish networks. Subjects: Eighteen Kurdish immigrants (9 females and 9 males) living in Oslo, aged 40 to 64 years, diagnosed with T2DM participated in a total of five focus groups. Participants had to be proficient in the Norwegian language to be eligible. Main outcome measures: Immigrant Kurdish patients' experiences with being diagnosed with T2DM, their disease management, and need for medical information. Results: Participants stressed that living with T2DM was emotionally challenging, mainly because they were afraid of possible complications of the disease. They claimed to adhere satisfactorily to their medicines and blood glucose measurements. The majority of participants shared that they had made changes to their diet, even though it was difficult. To the contrary, physical activity received only minimal attention. The participants' main source of information was general practitioners and the majority of them were satisfied with the information that they had received about their disease and its management. Conclusion: Kurdish T2DM patients in the present study from Norway reported that they adhered to the medical treatment, even if they were stressed about living with the disease. However, they were more occupied with changing their diet than to be physically active. Therefore, healthcare personnel should try to be aware of lifestyle challenges among their patients. KEY POINTS Eighteen Kurdish patients in Oslo with Type 2 diabetes claimed to be adherent to medication treatment and blood glucose measurement. The participants shared that they had made changes to their diet, even though it was hard. There was generally little attention given to the need for physical activity in their daily lives. The participants were in need of more information and support in making healthy lifestyle changes.
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Affiliation(s)
- Walaa Abuelmagd
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
- CONTACT Walaa Abuelmagd Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Bavi Botan Osman
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
| | - Helle Håkonsen
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Else-Lydia Toverud
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
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Abuelmagd W, Håkonsen H, Mahmood KQUA, Taghizadeh N, Toverud EL. Living with Diabetes: Personal Interviews with Pakistani Women in Norway. J Immigr Minor Health 2019; 20:848-853. [PMID: 28698971 DOI: 10.1007/s10903-017-0622-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The prevalence of Type 2 diabetes (T2D) among Pakistani women in Norway is remarkably high. This study aims to assess how they live with the disease and their response to lifestyle and medical information. 120 Pakistani women living in Norway (mean age: 55.7 years) were personally interviewed about their T2D using a structured questionnaire (response rate: 95%). The participants were first-generation immigrants (mean residence time: 28.7 years) of whom 27% were illiterates. Poor health was reported by one-third, and 71% had developed macrovascular comorbidities. A majority reported physical inactivity and an unhealthy diet included religious fasting. One-third was not able to self-measure their blood glucose. There was a great variation in antidiabetic drug regimens and one-fourth had to use insulin in addition to tablets. Pakistani women in Norway showed suboptimal control of their T2D in terms of lifestyle habits, comorbidities and drug use. Low literacy and cultural factors seem to challenge adherence to lifestyle and medical information.
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Affiliation(s)
- Walaa Abuelmagd
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Blindern, P.O. Box 1068, 0316, Oslo, Norway.
| | - Helle Håkonsen
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Blindern, P.O. Box 1068, 0316, Oslo, Norway
| | | | - Najmeh Taghizadeh
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Blindern, P.O. Box 1068, 0316, Oslo, Norway
| | - Else-Lydia Toverud
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Blindern, P.O. Box 1068, 0316, Oslo, Norway
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Sudo K, Hamamoto Y. Health behaviors of foreign mothers in Japan regarding their young children and the factors that affect these behaviors: A qualitative study. Jpn J Nurs Sci 2019; 16:420-432. [PMID: 30688004 DOI: 10.1111/jjns.12251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/29/2018] [Accepted: 11/06/2018] [Indexed: 11/27/2022]
Abstract
AIM The number of foreign residents in Japan is increasing and these residents therefore should no longer be disregarded as members of Japanese society. The purpose of this study was to elucidate the health behaviors of foreign mothers in Japan regarding their children and the factors that affected these behaviors. METHODS A qualitative descriptive research design was used, involving a content analysis. Six focus group interviews were conducted with a total of 24 foreign mothers who were members of childrearing circles. RESULTS The health behaviors were classified as "Gathering information about child health management," "Preventing obstructions to child health care," "Perceiving the child's health condition," "Deciding to take the child to a healthcare facility," "Selecting adequate healthcare facilities," and "Managing at home when the child is sick." The factors that affected the health behaviors were classified as "Japanese culture and customs," "Child's health condition," "Culture and customs of the mother's native country," "Family," "Mother's health perception," "Healthcare facility and healthcare provider," "Friends," "Mother's health condition," "Internet," "Becoming accustomed to life in Japan," and "Japanese language ability." Gathering information, preventing obstructions to child health care, and perceiving the child's health condition were the most common behaviors. The main factors that affected the health behaviors were the culture and customs of both Japan and the mother's native country and the child's health condition. CONCLUSION It is recommended that healthcare professionals support foreign mothers to gather adequate and appropriate information regarding health, particularly child health, considering not only the culture and customs of the mother's native country, but also of the host country.
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Affiliation(s)
- Kyoko Sudo
- National College of Nursing, Japan, Tokyo, Japan
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12
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Luiking ML, Heckemann B, Ali P, Dekker-van Doorn C, Ghosh S, Kydd A, Watson R, Patel H. Migrants' Healthcare Experience: A Meta-Ethnography Review of the Literature. J Nurs Scholarsh 2018; 51:58-67. [PMID: 30390377 DOI: 10.1111/jnu.12442] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Worldwide, more than 214 million people have left their country of origin. This unprecedented mass migration impacts health care in host countries. This article explores and synthesizes literature on the healthcare experiences of migrants. DESIGN A meta-ethnography study of qualitative studies was conducted. METHODS Eight databases (Medline, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], PsycINFO, Embase, Web of Science, Migration Observatory, National Health Service Scotland Knowledge Network, and Adaptive Spectrum and Signal Alignment [ASSIA]) were searched for relevant full-text articles in English, published between January 2006 and June 2016. Articles were screened against inclusion criteria for eligibility. Included articles were assessed for quality and analyzed using Noblit and Hare's seven-step meta-ethnography process. FINDINGS Twenty-seven studies were included in the review. Five key contextualization dimensions were identified: personal factors, the healthcare system, accessing healthcare, the encounter, and the healthcare experience. These five areas all underlined the uniqueness of each individual migrant, emphasizing the need to treat a person rather than a population. Within a true person-centered approach, the individual's cultural background is fundamental to effective care. CONCLUSIONS From the findings, a model has been designed using the five dimensions and grounded in a person-centered care approach. This may help healthcare providers to identify weak points, as well as to improve the organization and healthcare professionals' ability to provide person-centered care to migrant patients. CLINICAL RELEVANCE The proposed model facilitates identification of points of weakness in the care of migrant patients. Employing a person-centered care approach may contribute to improve health outcomes for migrant patients.
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Affiliation(s)
- Marie-Louise Luiking
- Rho Chi-at-Large, PhD candidate, Sigma European coordinator, Amersfoort, Netherlands
| | - Birgit Heckemann
- Tau Omega, Research Associate, Department of Health Professions, Division of Nursing, Bern University of Applied Sciences, Bern, Switzerland
| | - Parveen Ali
- Phi Mu, Lecturer, School of Nursing & Midwifery, Sheffield University, Sheffield, United Kingdom
| | - Connie Dekker-van Doorn
- Rho Chi-at-Large, Professor, Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
| | - Sumana Ghosh
- Tau Omega, Institute of Health Care, & Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Angela Kydd
- Upsilon Xi-at-Large, Associate Professor, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Roger Watson
- Phi Mu, Professor, Faculty of Health and Social Care, University of Hull, Hull, United Kingdom
| | - Harshida Patel
- Tau Omega, Professor, Institute of Health Care & Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Diaz E, Ortiz-Barreda G, Ben-Shlomo Y, Holdsworth M, Salami B, Rammohan A, Chung RYN, Padmadas SS, Krafft T. Interventions to improve immigrant health. A scoping review. Eur J Public Health 2018; 27:433-439. [PMID: 28339883 PMCID: PMC5445720 DOI: 10.1093/eurpub/ckx001] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Disparities in health between immigrants and their host populations have been described across countries and continents. Hence, interventions for improving health targeting general populations are not necessarily effective for immigrants. Aims: To conduct a systematic search of the literature evaluating health interventions for immigrants; to map the characteristics of identified studies including range of interventions, immigrant populations and their host countries, clinical areas targeted and reported evaluations, challenges and limitations of the interventions identified. Following the results, to develop recommendations for research in the field. Methods: A scoping review approach was chosen to provide an overview of the type, extent and quantity of research available. Studies were included if they empirically evaluated health interventions targeting immigrants and/or their descendants, included a control group, and were published in English (PubMed and Embase from 1990 to 2015). Results: Most of the 83 studies included were conducted in the USA, encompassed few immigrant groups and used a randomized controlled trial (RCT) or cluster RCT design. Most interventions addressed chronic and non-communicable diseases and attendance at cancer screening services, used individual targeted approaches, targeted adult women and recruited participants from health centres. Outcome measures were often subjective, with the exception of interventions for cardiovascular risk and diabetes. Generally, authors claimed that interventions were beneficial, despite a number of reported limitations. Conclusions: Recommendations for enhancing interventions to improve immigrant health are provided to help researchers, funders and health care commissioners when deciding upon the scope, nature and design of future research in this area.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Centre for Minority Health Research, Oslo, Norway
| | - Gaby Ortiz-Barreda
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Michelle Holdsworth
- School of Health and Related Research- ScHARR, University of Sheffield, Sheffield, UK
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Alberta, Canada
| | - Anu Rammohan
- Discipline of Economics, University of Western Australia, Perth, Australia
| | - Roger Yat-Nork Chung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | | | - Thomas Krafft
- Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands
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Diaz E, Kumar BN. Health care curricula in multicultural societies. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2018; 9:42-44. [PMID: 29470179 PMCID: PMC5834828 DOI: 10.5116/ijme.5a7e.bd17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/10/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Bernadette N. Kumar
- Norwegian Center for Migration and Minority Health, Norwegian Institute of Public Health, Oslo, Norway
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Diaz E, Mbanya VN, Gele AA, Kumar B. Differences in primary health care use among sub-Saharan African immigrants in Norway: a register-based study. BMC Health Serv Res 2017; 17:509. [PMID: 28754117 PMCID: PMC5534034 DOI: 10.1186/s12913-017-2404-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 06/21/2017] [Indexed: 12/26/2022] Open
Abstract
Background Immigrants’ utilization of primary health care (PHC) services differs from that of the host populations. However, immigrants are often classified in broad groups by continent of origin, and the heterogeneity within the same continent may hide variation in use among immigrant groups at a national level. Differences in utilization of PHC between sub-Saharan African immigrants have not received much attention. Methods Registry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration. African immigrants and their descendants registered in Norway in 2008 (36,366 persons) where included in this study. Using χ2 test and logistic regression models, we assessed the differences in the use of PHC, including general practitioner (GP) and emergency room (ER) services, and the distribution of morbidity burden for immigrants from Somalia, Ethiopia, Eritrea, and Gambia. For the analyses, we used the number of visits and medical diagnoses from each consultation registered by the physician. Result Among the total studied population, 66.1% visited PHC within 1 year. The diagnoses registered were similar for all four immigrants groups, regardless of country of origin. Compared to immigrants from Somalia, the age and sex adjusted odds ratios (OR) for use of GP were significantly lower for Ethiopians (OR 0.91; 0.86–0.97), Eritreans (OR 0.85; 0.79–0.91), and Gambians (OR 0.88; 0.80–0.97). Similarly, we also observed lower use of ER among Ethiopians (OR 0.88; 0.81–0.95), Eritreans (OR 0.56; 0.51–0.62) and Gambians (OR 0.81; 0.71–0.92). However, immigrants from Somalia reduced their use of PHC with longer duration of stay in Norway. Differences between groups persisted after further adjustment for employment status. Conclusion Despite the similarities in diagnoses among the sub-Saharan African immigrant groups in Norway, their use of PHC services differs by country of origin and length of stay. It is important to assess the reasons for the differences in these groups to identify barriers and facilitators to access to healthcare for future interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2404-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Centre for Minority Health Research, Oslo, Norway
| | - Vivian N Mbanya
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O Box 1130, Blindern, 0318, Oslo, Norway.
| | - Abdi A Gele
- Norwegian Centre for Minority Health Research, Oslo, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Bernadette Kumar
- Norwegian Centre for Minority Health Research, Oslo, Norway.,Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O Box 1130, Blindern, 0318, Oslo, Norway
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Paravattil B, Kheir N, Yousif A. Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar. Int J Clin Pharm 2017. [PMID: 28466396 DOI: 10.1007/s11096‐017‐0469‐8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar. Method This is a randomized, cross sectional study where simulated patients visited community pharmacies and presented the pharmacist with a new prescription or requested a refill for either a diabetes or asthma medication. Pharmacists completed a questionnaire at the end of the simulated interaction, which was utilized to determine if patient, pharmacist, or pharmacy characteristics had any influence on the counseling provided to patients. A scoring system was devised to assess the pharmacist's counseling practices. Main outcome measure To evaluate the type of information provided by community pharmacists to the simulated patient regarding diabetes and asthma. Results One hundred and twenty-nine pharmacists were enrolled in the study. Eighty one percent of pharmacists had a score <35%. Medication name (95%), directions (47%), indication (43%), and dose (41%) were the most frequently counseled components by pharmacists during the simulated interaction. Male patients received better counseling compared to the female patients (t = 6.177; p < 0.0001). Pharmacists with a master of pharmacy degree provided significantly better counseling (f = 3.261; p = 0.042). Many pharmacists (65%) provided hypoglycemia management to patients, however, 63% referred the patient to the physician when the patient experienced hypoglycemia from inappropriate medication administration. Only 2 (7%) pharmacists correctly counseled the patient on all 8 inhaler administration steps. Majority of pharmacists (50%) educated on the role of the rescue and controller therapy in asthma, however, 33% referred the patient to the physician when the patient inquired about controller therapy use. Conclusion Patient counseling was substandard with the majority of community pharmacists focusing on the name of the medication. Pharmacists rarely assessed patient's medical history or medication use. Disease management and problem solving skills of pharmacists were suboptimal with many referring patients back to the physician.
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Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar. Int J Clin Pharm 2017; 39:759-768. [PMID: 28466396 DOI: 10.1007/s11096-017-0469-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar. Method This is a randomized, cross sectional study where simulated patients visited community pharmacies and presented the pharmacist with a new prescription or requested a refill for either a diabetes or asthma medication. Pharmacists completed a questionnaire at the end of the simulated interaction, which was utilized to determine if patient, pharmacist, or pharmacy characteristics had any influence on the counseling provided to patients. A scoring system was devised to assess the pharmacist's counseling practices. Main outcome measure To evaluate the type of information provided by community pharmacists to the simulated patient regarding diabetes and asthma. Results One hundred and twenty-nine pharmacists were enrolled in the study. Eighty one percent of pharmacists had a score <35%. Medication name (95%), directions (47%), indication (43%), and dose (41%) were the most frequently counseled components by pharmacists during the simulated interaction. Male patients received better counseling compared to the female patients (t = 6.177; p < 0.0001). Pharmacists with a master of pharmacy degree provided significantly better counseling (f = 3.261; p = 0.042). Many pharmacists (65%) provided hypoglycemia management to patients, however, 63% referred the patient to the physician when the patient experienced hypoglycemia from inappropriate medication administration. Only 2 (7%) pharmacists correctly counseled the patient on all 8 inhaler administration steps. Majority of pharmacists (50%) educated on the role of the rescue and controller therapy in asthma, however, 33% referred the patient to the physician when the patient inquired about controller therapy use. Conclusion Patient counseling was substandard with the majority of community pharmacists focusing on the name of the medication. Pharmacists rarely assessed patient's medical history or medication use. Disease management and problem solving skills of pharmacists were suboptimal with many referring patients back to the physician.
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18
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Pharmacists' perspectives about their role in care of patients with diabetes observing Ramadan. Res Social Adm Pharm 2017; 13:109-122. [DOI: 10.1016/j.sapharm.2016.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 11/22/2022]
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19
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Gele AA, Pettersen KS, Torheim LE, Kumar B. Health literacy: the missing link in improving the health of Somali immigrant women in Oslo. BMC Public Health 2016; 16:1134. [PMID: 27809815 PMCID: PMC5093985 DOI: 10.1186/s12889-016-3790-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/20/2016] [Indexed: 01/27/2023] Open
Abstract
Background Existing studies report a positive association between inadequate health literacy and immigrant’s adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. Methods A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Results Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08–12.3) and socially less integrated (OR 8.17, CI 1.21–54.8) were independent predictors of an inadequate health literacy among Somali women. Conclusions Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.
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Affiliation(s)
- Abdi A Gele
- The Institute of Nursing and Health promotion, Oslo and Akershus University College, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway. .,Norwegian Center For Minority Health Research, Oslo University Hospital, Oslo, Norway.
| | - Kjell Sverre Pettersen
- The Institute of Nursing and Health promotion, Oslo and Akershus University College, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - Liv Elin Torheim
- The Institute of Nursing and Health promotion, Oslo and Akershus University College, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - Bernadette Kumar
- Norwegian Center For Minority Health Research, Oslo University Hospital, Oslo, Norway
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21
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Suphanchaimat R, Kantamaturapoj K, Putthasri W, Prakongsai P. Challenges in the provision of healthcare services for migrants: a systematic review through providers' lens. BMC Health Serv Res 2015. [PMID: 26380969 DOI: 10.1186/s12913-015-1065-z.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, cross-border migration has gained significant attention in high-level policy dialogues in numerous countries. While there exists some literature describing the health status of migrants, and exploring migrants' perceptions of service utilisation in receiving countries, there is still little evidence that examines the issue of health services for migrants through the lens of providers. This study therefore aims to systematically review the latest literature, which investigated perceptions and attitudes of healthcare providers in managing care for migrants, as well as examining the challenges and barriers faced in their practices. METHODS A systematic review was performed by gathering evidence from three main online databases: Medline, Embase and Scopus, plus a purposive search from the World Health Organization's website and grey literature sources. The articles, published in English since 2000, were reviewed according to the following topics: (1) how healthcare providers interacted with individual migrant patients, (2) how workplace factors shaped services for migrants, and (3) how the external environment, specifically laws and professional norms influenced their practices. Key message of the articles were analysed by thematic analysis. RESULTS Thirty seven articles were recruited for the final review. Key findings of the selected articles were synthesised and presented in the data extraction form. Quality of retrieved articles varied substantially. Almost all the selected articles had congruent findings regarding language andcultural challenges, and a lack of knowledge of a host country's health system amongst migrant patients. Most respondents expressed concerns over in-house constraints resulting from heavy workloads and the inadequacy of human resources. Professional norms strongly influenced the behaviours and attitudes of healthcare providers despite conflicting with laws that limited right to health services access for illegal migrants. DISCUSSION The perceptions, attitudes and practices of practitioners in the provision of healthcare services for migrants were mainly influenced by: (1) diverse cultural beliefs and language differences, (2) limited institutional capacity, in terms of time and/or resource constraints, (3) the contradiction between professional ethics and laws that limited migrants' right to health care. Nevertheless, healthcare providers addressedsuch problems by partially ignoring the immigrants'precarious legal status, and using numerous tactics, including seeking help from civil society groups, to support their clinical practice. CONCLUSION It was evident that healthcare providers faced several challenges in managing care for migrants, which included not only language and cultural barriers, but also resource constraints within their workplaces, and disharmony between the law and their professional norms. Further studies, which explore health care management for migrants in countries with different health insurance models, are recommended.
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Affiliation(s)
- Rapeepong Suphanchaimat
- International Health Policy Program (IHPP), Ministry of Public Health of Thailand, Tiwanon road, Nonthaburi, 11000, Thailand. .,Banphai Hospital, Banphai district, Khon Kaen, 40110, Thailand.
| | - Kanang Kantamaturapoj
- Department of Social Sciences, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, 73170, Thailand.
| | - Weerasak Putthasri
- International Health Policy Program (IHPP), Ministry of Public Health of Thailand, Tiwanon road, Nonthaburi, 11000, Thailand.
| | - Phusit Prakongsai
- International Health Policy Program (IHPP), Ministry of Public Health of Thailand, Tiwanon road, Nonthaburi, 11000, Thailand.
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Suphanchaimat R, Kantamaturapoj K, Putthasri W, Prakongsai P. Challenges in the provision of healthcare services for migrants: a systematic review through providers' lens. BMC Health Serv Res 2015; 15:390. [PMID: 26380969 PMCID: PMC4574510 DOI: 10.1186/s12913-015-1065-z] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 09/12/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In recent years, cross-border migration has gained significant attention in high-level policy dialogues in numerous countries. While there exists some literature describing the health status of migrants, and exploring migrants' perceptions of service utilisation in receiving countries, there is still little evidence that examines the issue of health services for migrants through the lens of providers. This study therefore aims to systematically review the latest literature, which investigated perceptions and attitudes of healthcare providers in managing care for migrants, as well as examining the challenges and barriers faced in their practices. METHODS A systematic review was performed by gathering evidence from three main online databases: Medline, Embase and Scopus, plus a purposive search from the World Health Organization's website and grey literature sources. The articles, published in English since 2000, were reviewed according to the following topics: (1) how healthcare providers interacted with individual migrant patients, (2) how workplace factors shaped services for migrants, and (3) how the external environment, specifically laws and professional norms influenced their practices. Key message of the articles were analysed by thematic analysis. RESULTS Thirty seven articles were recruited for the final review. Key findings of the selected articles were synthesised and presented in the data extraction form. Quality of retrieved articles varied substantially. Almost all the selected articles had congruent findings regarding language andcultural challenges, and a lack of knowledge of a host country's health system amongst migrant patients. Most respondents expressed concerns over in-house constraints resulting from heavy workloads and the inadequacy of human resources. Professional norms strongly influenced the behaviours and attitudes of healthcare providers despite conflicting with laws that limited right to health services access for illegal migrants. DISCUSSION The perceptions, attitudes and practices of practitioners in the provision of healthcare services for migrants were mainly influenced by: (1) diverse cultural beliefs and language differences, (2) limited institutional capacity, in terms of time and/or resource constraints, (3) the contradiction between professional ethics and laws that limited migrants' right to health care. Nevertheless, healthcare providers addressedsuch problems by partially ignoring the immigrants'precarious legal status, and using numerous tactics, including seeking help from civil society groups, to support their clinical practice. CONCLUSION It was evident that healthcare providers faced several challenges in managing care for migrants, which included not only language and cultural barriers, but also resource constraints within their workplaces, and disharmony between the law and their professional norms. Further studies, which explore health care management for migrants in countries with different health insurance models, are recommended.
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Affiliation(s)
- Rapeepong Suphanchaimat
- International Health Policy Program (IHPP), Ministry of Public Health of Thailand, Tiwanon road, Nonthaburi, 11000, Thailand.
- Banphai Hospital, Banphai district, Khon Kaen, 40110, Thailand.
| | - Kanang Kantamaturapoj
- Department of Social Sciences, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, 73170, Thailand.
| | - Weerasak Putthasri
- International Health Policy Program (IHPP), Ministry of Public Health of Thailand, Tiwanon road, Nonthaburi, 11000, Thailand.
| | - Phusit Prakongsai
- International Health Policy Program (IHPP), Ministry of Public Health of Thailand, Tiwanon road, Nonthaburi, 11000, Thailand.
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Mamen AV, Håkonsen H, Kjome RLS, Gustavsen-Krabbesund B, Toverud EL. Norwegian elderly patients' need for drug information and attitudes towards medication use reviews in community pharmacies. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2015; 23:423-8. [PMID: 25801503 DOI: 10.1111/ijpp.12184] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 02/01/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Medication use review (MUR) is a community pharmacy service in several countries. Knowledge about what patients want from such a service is limited. The aim of this study was therefore to investigate Norwegian elderly patients' need for drug information and their attitudes towards MURs. METHODS In Norway's two largest cities, 162 patients (72% women; mean age: 78.9 years) who used at least one prescription drug were recruited from 18 senior centres. They were interviewed personally with a structured questionnaire (29 closed and 4 open-ended questions). KEY FINDINGS The average number of prescription drugs used was 4.4. Seventy per cent also used over-the-counter drugs. The main source of drug information was the general practitioner (GP) followed by package inserts and pharmacy staff. For drug-related problems, 62% would contact the GP compared with 24% who preferred the pharmacist. Fifty per cent remembered no information when collecting prescriptions. However, 56% wanted to know more about their medication and 55% were interested in a MUR. The main topics they wished to address were effect/side effects and interactions. Lack of privacy was reported to be a major obstacle in the current situation. CONCLUSIONS This study shows that community pharmacies in Norway play a minor role regarding drug information to elderly polypharmacy patients. The GP is both their main information source and whom they contact for drug-related problems. However, half of the patients would like to know more about their medication. More than half were positive towards taking part in a MUR.
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Affiliation(s)
- Anette Vik Mamen
- Research Group on Social Pharmacy/Centre for Pharmacy, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Helle Håkonsen
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Reidun L S Kjome
- Research Group on Social Pharmacy/Centre for Pharmacy, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Else-Lydia Toverud
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
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