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Ho CH, Denton AH, Blackstone SR, Saif N, MacIntyre K, Ozkaynak M, Valdez RS, Hauck FR. Access to Healthcare Among US Adult Refugees: A Systematic Qualitative Review. J Immigr Minor Health 2023; 25:1426-1462. [PMID: 37009980 DOI: 10.1007/s10903-023-01477-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/04/2023]
Abstract
Refugees encounter numerous healthcare access barriers in host countries, leading to lower utilization rates and poorer health outcomes. In the US, social inequities and fragmented health systems may exacerbate these disparities. Understanding these factors is necessary to ensure equitable care of refugee populations. A systematic literature review of qualitative studies on US adult refugee healthcare access from January 2000 to June 2021 was performed in accordance with PRISMA. Studies were analyzed deductively and then inductively to incorporate previous findings in other resettlement countries and emergence of US-specific themes. 64 articles representing 16+ countries of origin emerged from the final analysis, yielding nine interrelated themes related to health literacy, cost of services, cultural beliefs, and social supports, among others. The main challenges to refugees' healthcare access emerge from the interactions of care fragmentation with adverse social determinants. Given diverse barriers, integrated care models are recommended in treating refugee populations.
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Affiliation(s)
- Chi H Ho
- Department of Public Health Sciences, Frank Batten School of Leadership and Public Policy, University of Virginia, Charlottesville, VA, USA
| | - Andrea H Denton
- Claude Moore Health Sciences Library, University of Virginia, Charlottesville, VA, USA
| | - Sarah R Blackstone
- Office of Institutional Research, James Madison University, Harrisonburg, VA, USA
| | - Nadia Saif
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Kara MacIntyre
- Office of Institutional Research, James Madison University, Harrisonburg, VA, USA
| | - Mustafa Ozkaynak
- College of Nursing, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Rupa S Valdez
- Department of Public Health Sciences, Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, USA
| | - Fern R Hauck
- Department of Family Medicine, Department of Public Health Sciences, University of Virginia, PO Box 800729, Charlottesville, VA, 22908-0729, USA.
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Sar BK. Refugee Family Health Brokers' (FHBs') Experiences with Health Care Providers: A Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5381. [PMID: 37047995 PMCID: PMC10094286 DOI: 10.3390/ijerph20075381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/24/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The resettlement and post-resettlement quality of life of refugees is often marred by chronic health/mental health conditions. To adequately care for refugees suffering these conditions, a promising strategy is the use of refugee Family Health Brokers (FHBs). FHBs are safe and trusted family members functioning as intermediaries between one's family and health care providers. Although FHBs are known to positively influence health care utilization in their families, little is known about them and this aspect of their family caregiving role and experiences, particularly with health care providers, necessitating further research. METHODS Fourteen Bhutanese and three Bosnian refugee FHBs participated in a 2-hr focus group discussing their experiences with health care providers after being surveyed about their FHB role. RESULTS Thematic analysis yielded five themes centered around perceptions, knowledge, communication, behavior, and responsibilities reflective of FHBs' experiences, which can be understood as symptoms of existing structural inequalities. CONCLUSIONS FHBs primarily conveyed problems, struggles, and dilemmas they experienced more so than rewarding aspects of being an FHB. Suggestions are provided on how to avert these negative experiences from occurring and becoming barriers to developing allyship with FHBs in the context of existing structural inequalities.
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Affiliation(s)
- Bibhuti K Sar
- Kent School of Social Work and Family Science, University of Louisville, Louisville, KY 40208, USA
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3
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Amburg P, Thompson RA, Curtis CA, Squires A. Different countries and cultures, same language: How registered nurses and midwives can provide culturally humble care to Russian‐speaking immigrants. Res Nurs Health 2022; 45:405-409. [DOI: 10.1002/nur.22252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Polina Amburg
- Marjorie K. Unterberg School of Nursing and Health Studies Monmouth University West Long Branch New Jersey USA
| | | | - Cedonnie A. Curtis
- School of Nursing and Health Sciences La Salle University Philadelphia Pennsylvania USA
| | - Allison Squires
- Rory Meyers College of Nursing New York University New York New York USA
- Department of General Internal Medicine Grossman School of Medicine, New York University New York New York USA
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4
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Amburg P, Lindgren T, Ivanov LL. Traditional health-related practices of Russian-speaking immigrants. Public Health Nurs 2021; 39:372-380. [PMID: 34492125 DOI: 10.1111/phn.12966] [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: 02/18/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
The population of foreign-born residents continues to grow in the United States. One of the largest growing groups of immigrants is the population of Russian-speakers moving from the countries of the former Union of Soviet Socialistic Republics (Soviet Union/USSR). Like many other immigrants, Russian speakers present with various health concerns. Empirical literature indicates a gap in research that addresses culturally based beliefs and behaviors related to health in this group of immigrants. A qualitative ethnographic study that addresses the health-related practices of Russian-speaking immigrants was conducted on the East Coast of the United States. Twenty-eight participants, ages 36-86, were interviewed, along with participant observation and analysis of documents. Data analysis revealed three related categories: perception of health, perception of illness, and health-related practices. Perceptions of health were influenced by families and defined roles within the family. Perceptions of illness were outlined by approaches to disease management and remedies to illness. Subsequently, the health-related practices of Russian-speaking immigrants were molded by perceptions of health and illness. Further research is recommended to examine specific health-related practices of Russian-speaking immigrants in the United States and to explore more diverse groups within this aggregate.
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Affiliation(s)
- Polina Amburg
- The Marjorie K. Unterberg School of Nursing and Health Studies, Monmouth University, Long Branch, New Jersey
| | - Teri Lindgren
- Community Health Systems School of Nursing, University of California, San Francisco, California
| | - Luba Louise Ivanov
- College of Nursing, Chamberlain College of Nursing, Downers Grove, Illinois
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Eluka NN, Morrison SD, Sienkiewicz HS. "The Wheel of My Work": Community Health Worker Perspectives and Experiences with Facilitating Refugee Access to Primary Care Services. Health Equity 2021; 5:253-260. [PMID: 33937612 PMCID: PMC8082038 DOI: 10.1089/heq.2020.0150] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Community health workers (CHWs) are trusted community leaders and public health workers dedicated to promoting the health and well-being of community members. CHWs, who share similar language and culture, work with refugee communities that are often missed in traditional U.S. health systems. CHWs help refugees gain access to health care through culturally appropriate strategies. However, the scope of their study as cultural brokers with regard to refugee health access is largely unknown in the peer-reviewed literature. This qualitative research study used a constructivist grounded approach to examine the extent to which CHWs helped refugee clients gain access to the health care system. Methods: Data were collected through interviews with a purposeful sample of 10 CHW participants affiliated with a primary care access program in Greensboro, North Carolina. Results: The diagram derived from this study provided a schema that allowed for an improved understanding of CHW perspectives and experiences when connecting refugee clients to the health care system. Conclusions: Further research incorporating CHW voices is recommended because CHWs are instrumental in improving the health and well-being of refugees.
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Affiliation(s)
- Nneze N. Eluka
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Sharon D. Morrison
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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Orzechowski M, Nowak M, Bielińska K, Chowaniec A, Doričić R, Ramšak M, Łuków P, Muzur A, Zupanič-Slavec Z, Steger F. Social diversity and access to healthcare in Europe: how does European Union's legislation prevent from discrimination in healthcare? BMC Public Health 2020; 20:1399. [PMID: 32928175 PMCID: PMC7490891 DOI: 10.1186/s12889-020-09494-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022] Open
Abstract
Background Social diversity can affect healthcare outcomes in situations when access to healthcare is limited for specific groups. Although the principle of equality is one of the central topics on the agenda of the European Union (EU), its scope in the field of healthcare, however, is relatively unexplored. The aim of this study is to identify and systematically analyze primary and secondary legislation of the EU Institutions that concern the issue of access to healthcare for various minority groups. In our research, we have concentrated on three features of diversity: a) gender identity and sexual orientation, b) race and ethnicity, and c) religion or belief. Method and materials For the purpose of this analysis, we conducted a search of database Eur-Lex, the official website of European Union law and other public documents of the European Union, based on specific keywords accompanied by review of secondary literature. Relevant documents were examined with regard to the research topic. Our search covered documents that were in force between 13 December 2007 and 31 July 2019. Results Generally, the EU legal system prohibits discrimination on grounds of religion or belief, racial or ethnic origin, sex, and sexual orientation. However, with regard to the issue of non-discrimination in access to healthcare EU secondary law provides protection against discrimination only on the grounds of racial or ethnic origin and sex. The issue of discrimination in healthcare on the grounds of religion or belief, gender identity and sexual orientation is not specifically addressed under EU secondary law. Discussion The absence of regulations regarding non-discrimination in the EU secondary law in the area of healthcare may result from the division of competences between the European Union and the Member States. Reluctance of the Member States to adopt comprehensive antidiscrimination regulations leads to a situation, in which protection in access to healthcare primarily depends on national regulations. Conclusions Our study shows that EU antidiscriminatory law with regard to access to healthcare is fragmentary. Prohibition of discrimination of the level of European binding law does not fully encompass all aspects of social diversity.
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Affiliation(s)
- Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany.
| | - Marianne Nowak
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany
| | - Katarzyna Bielińska
- Center for Bioethics and Biolaw, Faculty of Philosophy, University of Warsaw, Warsaw, Poland
| | - Anna Chowaniec
- Center for Bioethics and Biolaw, Faculty of Philosophy, University of Warsaw, Warsaw, Poland
| | - Robert Doričić
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Mojca Ramšak
- Institute for History of Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Paweł Łuków
- Center for Bioethics and Biolaw, Faculty of Philosophy, University of Warsaw, Warsaw, Poland
| | - Amir Muzur
- Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | - Zvonka Zupanič-Slavec
- Institute for History of Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany
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Kaneoka M, Spence W. The cultural context of sexual and reproductive health support: an exploration of sexual and reproductive health literacy among female Asylum Seekers and Refugees in Glasgow. INTERNATIONAL JOURNAL OF MIGRATION HEALTH AND SOCIAL CARE 2019. [DOI: 10.1108/ijmhsc-01-2019-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Sexual and reproductive health (SRH) incorporates prevention of unplanned pregnancies, unsafe abortions, and sexually transmitted infections (STIs). The sourcing, understanding and application of related information are important for health and this defines sexual and reproductive health literacy (SRHL). Health care utilization rates among Asylum Seekers and Refugees (ASRs) may not be high and they are unlikely to seek sufficient SRH information and care in their host countries, leaving some needs unmet. No SRHL research related to Scotland’s Asylum Seeking and Refugee Women (ASRW) exists. In this qualitative study, the purpose of this paper is to explore the SRHL-related views and experiences of adult ASRW living in Glasgow and their views on assistance required to improve their SRHL.
Design/methodology/approach
In total, 14 semi-structured interviews were audio-recorded and transcribed and qualitative thematic analysis employed.
Findings
Five themes and 13 sub-themes with four key findings highlighted: experience of unmet SRHL needs, similarities and differences in the source of SRH information, SRH views and behaviours influenced by cultural and religious factors, barriers and facilitators to accessing SRH information/care and developing SRHL.
Research limitations/implications
This was a small scale qualitative study affording limited transferability. The work addressed a highly sensitive topic among women from conservative home country cultures.
Practical implications
Routine collection of sexual and reproductive health data by the NHS should be explored for this group. NHS staff should be aware of the rights of asylum seekers, Refugees and failed asylum seekers, to NHS healthcare free at the point of delivery in Scotland (National Health Service, 2019; Scottish Government, 2018), and be well trained in the likely religious and cultural norms of these groups. Host communities should consider improving access to SRH information and care in ASRWs first languages.
Social implications
The study identified weaknesses in the opportunities for social integration afforded this group and the coordination of existing social opportunities. The stigmatization of immigrants in the UK is well understood and has repercussions for many individuals and societal organizations implicated in the promotion of this.
Originality/value
This paper addresses a very sensitive topic with women from conservative cultures. With few publications in this area, and none pertaining to Scotland, the paper makes a small but original contribution that might be considered a starting point for researchers and relevant services in Scotland.
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Baker JR, Raman S, Kohlhoff J, George A, Kaplun C, Dadich A, Best CT, Arora A, Zwi K, Schmied V, Eapen V. Optimising refugee children's health/wellbeing in preparation for primary and secondary school: a qualitative inquiry. BMC Public Health 2019; 19:812. [PMID: 31242897 PMCID: PMC6595577 DOI: 10.1186/s12889-019-7183-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/16/2019] [Indexed: 01/27/2023] Open
Abstract
Background Children from refugee backgrounds are less likely to access appropriate health and social care than non-refugee children. Our aim was to identify refugee children’s health/wellbeing strengths and needs, and the barriers and enablers to accessing services while preparing for primary and secondary school, in a low socio-economic multicultural community in Australia. Method Ten focus groups were facilitated with Arabic-speaking refugee parents of children aged 2–5 years (n = 11) or in first year secondary school (n = 22); refugee adolescents starting high school (n = 16); and key service providers to refugee families (n = 27). Vignettes about a healthy child and a child with difficulties guided the discussions. Data was thematically analysed and feedback sought from the community via the World Café method. Results Personal resilience and strong family systems were identified as strengths. Mental health was identified as a complex primary need; and whilst refugees were aware of available services, there were issues in knowing how to access them. Opportunities for play/socialisation were recognised as unmet adolescent needs. Adults spoke of a need to support integration of “old” and “new” cultural values. Parents identified community as facilitating health knowledge transfer for new arrivals; whilst stakeholders saw this as a barrier when systems change. Most parents had not heard of early childhood services, and reported difficulty accessing child healthcare. Preschooler parents identified the family “GP” as the main source of health support; whilst parents of adolescents valued their child’s school. Health communication in written (not spoken) English was a significant roadblock. Differences in refugee family and service provider perceptions were also evident. Conclusions Refugee families face challenges to accessing services, but also have strengths that enable them to optimise their children’s wellbeing. Culturally-tailored models of care embedded within GP services and school systems may assist improved healthcare for refugee families. Electronic supplementary material The online version of this article (10.1186/s12889-019-7183-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jess R Baker
- the University of New South Wales, Liverpool Hospital Mental Health Centre Level 1, Liverpool, NSW, 2170, Australia.
| | - Shanti Raman
- South Western Sydney Local Health District, Health Services Building Level 3, Cnr Campbell & Goulburn St, Liverpool, NSW, 2170, Australia
| | - Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Hospital Rd, Randwick, NSW, 2031, Australia.,Karitane, 138-150 The Horsley Dr, Carramar, NSW, 2163, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,University of Sydney, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia
| | - Catherine Kaplun
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Locked Bag 1797, Penrith, 2751, Australia
| | - Catherine T Best
- Western Sydney University, The MARCS Institute, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- School of Science and Health, Penrith, NSW, 2751, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.,Oral Health Service, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia
| | - Karen Zwi
- Sydney Children's Hospital, Corner Avoca and Barker Street, Randwick, NSW, 2031, Australia
| | - Virginia Schmied
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry South West Sydney (AUCS), University of New South Wales & Ingham Institute, Elizabeth Street, Liverpool, Sydney, 2170, Australia.,Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, 2170, Australia
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Oral Health Beliefs, Attitudes, and Practices of Albanian Immigrants in the United States. J Community Health 2018; 42:235-241. [PMID: 27614890 DOI: 10.1007/s10900-016-0248-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research indicates a high prevalence of oral disease among Albanians. There is a lack of evidence regarding oral health beliefs and practices among Albanian immigrants in the United States and abroad. This research seeks to better understand the oral health beliefs, attitudes, and practices among Albanian immigrants living in the United States. A descriptive study was employed with a purposive sample (n = 211) of Albanian adult immigrants. A cross-sectional validated questionnaire was provided in both English and Albanian, with a response rate of 66 %. Results revealed a high use of dental services among respondents, with 68 % reported as having a dental visit and cleaning within the past year. Although 25 % of participants stated their parents and grandparents have used folk remedies, 88 % of them stated that use of folk remedies did not influence their decision to seek professional dental care. Increasing age was inversely associated with the belief in the importance of retaining natural teeth, as older respondents were less likely to agree with the prior statement; older respondents were more likely to agree with the statement "bleeding gums are normal." Low oral health care access and utilization was not a factor among the majority of the Albanian immigrants studied. Focusing on providing age appropriate oral health education and behavioral strategies could increase oral health knowledge and potentially improve poor oral health status among this population.
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Mangrio E, Sjögren Forss K. Refugees' experiences of healthcare in the host country: a scoping review. BMC Health Serv Res 2017; 17:814. [PMID: 29216876 PMCID: PMC5721651 DOI: 10.1186/s12913-017-2731-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/14/2017] [Indexed: 11/16/2022] Open
Abstract
Background During the last years, Europe experienced an increase in immigration due to a variety of worldwide wars and conflicts, which in turn resulted in a greater number of physical and mental health issues present among the refugees. These factors place high demands not only on the refugees, but also on healthcare professionals who meet the refugees in different situations. Information about the refugees’ experiences of the healthcare systems in their host countries is urgently needed to improve the quality of healthcare delivered, as well as to provide opportunities for better access. The aim of this scoping review is to compile research about the experiences that the refugees have with the healthcare systems in their host countries. Methods This study was conducted as a scoping review and the methodology is derived from Levac et al. and with inspiration from the framework of Arksey & O’Malley. A systematic article search was done in Medline, Cinahl and Psychinfo. A total of 619 articles were found in the search and finally 26 articles met the inclusion criteria and were included. Results The results show that communication between healthcare professionals and refugees is important, however, insufficient language knowledge acts as an effective communication barrier. There is a need for more information to be given to the refugees about the reception country’s healthcare system in both oral and written formats, as well as the right to healthcare. Support from healthcare professionals is also important for refugees to have a positive experience with healthcare. In some of the studies included, refugees experienced discrimination due to low proficiency in the language of the host country, and/or because of their race or accent, which shows that culturally appropriate healthcare is needed for them. Conclusions Since refugees are suffering from poor mental and physical health and could therefore be at a greater risk of morbidity and mortality in comparison to the rest of the population of the host country, there is an urgent need for improvements in communication, interpretation, support, and deliverance of culturally appropriate healthcare.
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Affiliation(s)
- Elisabeth Mangrio
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden. .,MIM, Malmö Institute for Studies of Migration, Diversity and Welfare, Malmö University, Malmö, Sweden.
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.,MIM, Malmö Institute for Studies of Migration, Diversity and Welfare, Malmö University, Malmö, Sweden
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Refugee experiences of general practice in countries of resettlement: a literature review. Br J Gen Pract 2016; 65:e171-6. [PMID: 25733438 DOI: 10.3399/bjgp15x683977] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Refugees and asylum seekers often struggle to use general practice services in resettlement countries. AIM To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. DESIGN AND SETTING Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. METHOD Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. RESULTS From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. CONCLUSION The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management.
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Kroening AL, Moore JA, Welch TR, Halterman JS, Hyman SL. Developmental Screening of Refugees: A Qualitative Study. Pediatrics 2016; 138:peds.2016-0234. [PMID: 27527798 PMCID: PMC5005020 DOI: 10.1542/peds.2016-0234] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Refugee children are at high developmental risk due to dislocation and deprivation. Standardized developmental screening in this diverse population is challenging. We used the Health Belief Model to guide key-informant interviews and focus groups with medical interpreters, health care providers, community collaborators, and refugee parents to explore key elements needed for developmental screening. Cultural and community-specific values and practices related to child development and barriers and facilitators to screening were examined. METHODS We conducted 19 interviews and 2 focus groups involving 16 Bhutanese-Nepali, Burmese, Iraqi, and Somali participants, 7 community collaborators, and 6 providers from the Center for Refugee Health in Rochester, New York. Subjects were identified through purposive sampling until data saturation. Interviews were recorded, coded, and analyzed using a qualitative framework technique. RESULTS Twenty-one themes in 4 domains were identified: values/beliefs about development/disability, practices around development/disability, the refugee experience, and feedback specific to the Parents' Evaluation of Developmental Status screen. Most participants denied a word for "development" in their primary language and reported limited awareness of developmental milestones. Concern was unlikely unless speech or behavior problems were present. Physical disabilities were recognized but not seen as problematic. Perceived barriers to identification of delays included limited education, poor healthcare knowledge, language, and traditional healing practices. Facilitators included community navigators, trust in health care providers, in-person interpretation, visual supports, and education about child development. CONCLUSIONS Refugee perspectives on child development may influence a parent's recognition of and response to developmental concerns. Despite challenges, standardized screening was supported.
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Affiliation(s)
| | - Jessica A. Moore
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | | | | | - Susan L. Hyman
- Department of Pediatrics, Golisano Children’s Hospital, and
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14
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Mirza M, Luna R, Mathews B, Hasnain R, Hebert E, Niebauer A, Mishra UD. Barriers to healthcare access among refugees with disabilities and chronic health conditions resettled in the US Midwest. J Immigr Minor Health 2016; 16:733-42. [PMID: 24052476 DOI: 10.1007/s10903-013-9906-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Chronic conditions and related functional disabilities are highly prevalent among resettled refugees in the United States. There is a need to explore this population's access to appropriate healthcare services in order to identify service disparities and improve interventions. Using a community-based participatory research approach, semi-structured interviews were conducted with key informants to identify healthcare access barriers affecting disabled and chronically ill refugees. Eighteen participants were interviewed, revealing three main barriers: (1) inadequate health insurance, (2) language and communication barriers, and (3) a complex maze of service systems. These barriers were found to operate at systems, provider, and individual levels. Broad-based policy and practice interventions are required to address barriers including: an expanded pool of medical interpreters, peer navigators, innovative health information technologies, and greater collaboration and information-sharing between service systems. Further research is needed to monitor the impact the Affordable Care Act on service access of refugees with disabilities and chronic conditions.
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Affiliation(s)
- Mansha Mirza
- Department of Occupational Therapy, College of Applied Health Science, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA,
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15
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Abstract
PURPOSE A dimensional analysis of access to healthcare services by the refugee population was conducted. BACKGROUND Refugees resettled to the United States are categorized as a vulnerable population and have limited economic and social resources. METHODS Dimensional analysis was employed to identify the concept by varying perspectives and dimensions. The perspectives from the healthcare provider and the refugee, as the healthcare consumer, were explored. RESULTS The following dimensions were identified: culture, language discrimination and stigmatization, and logistical concerns. Findings support that specific refugee groups have not been well-represented in the literature. CONCLUSION Knowledge of this unique population is integral to healthcare professionals who encounter refugees in clinical practice. Regardless of the specific group, access to healthcare services must be determined for better health outcomes.
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Affiliation(s)
- Amy Szajna
- Thomas Jefferson University, Jefferson School of Nursing, Philadelphia, PA
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16
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Van Son CR, Gileff TY. Relying on what they know: older Slavic emigres managing chronic health conditions. QUALITATIVE HEALTH RESEARCH 2013; 23:1660-1671. [PMID: 24132306 DOI: 10.1177/1049732313508842] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
As the U.S. population ages and becomes increasingly diverse, health care professionals need to recognize the role of culture and life course in managing chronic health conditions. Older émigrés, in particular, face daunting challenges learning to navigate a new language, country, and health care system. In this focused ethnography, data collection included 16 months of participant observation and interviews with 28 Slavic participants (older émigrés, family caregivers, and key informants). Participants shared beliefs about the causes of chronic conditions, described treatments used, identified barriers to care, and expressed their expectations of U.S. health care providers. The findings provide insight into older émigrés' explanatory models of health, which can be used by health care providers to improve health care delivery to this underserved population.
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Brouwer AM, Mosack KE, Wendorf AR, Sokolova L. Patterns of Missing Data in Ethnic Minority Health Research: A Survey Project With Russian-Speaking Immigrant Women With Hypertension. Res Theory Nurs Pract 2013; 27:276-95. [DOI: 10.1891/1541-6577.27.4.276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We explored cultural-level variables and their associations with missing data in a group of immigrants from the Former Soviet Union (FSU). Elderly hypertensive women (N = 105) completed a health survey. Prevalence of missing data and z scores were calculated to determine which survey items and measures were more likely to have missing data. Hierarchical linear regressions were performed to test whether cultural variables predicted the rate of missing data beyond individual variables. Culture variables associated with survey nonresponse and missing data were related to depression, anxiety, medication beliefs and practices, attitudes toward physicians, and cultural and behavioral identity. An interpretation of the patterns of missing data and strategies to reduce the likelihood of missing data in this population are discussed. Cultural norms likely influence patients’ orientations toward their health care providers. Providers would do well to normalize difficulties with medical adherence and encourage patients to ask questions about such directives. We recommend that researchers consider the cultural appropriateness of survey items and consider alternative methods (i.e., qualitative designs) for culturally sensitive topics such as mental health and sexuality.
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Competence trust among providers as fundamental to a culturally competent primary healthcare system for immigrant families. Prim Health Care Res Dev 2012; 14:80-9. [PMID: 22794189 DOI: 10.1017/s1463423612000254] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To explore how an organization's trust in the cultural competency of other service providers (competence trust) can influence the effectiveness of a services network in meeting the needs of recent immigrant families. BACKGROUND Primary health care for recent immigrants arriving in Canada is delivered through a network of community-based services. To ensure the functioning of the network and its ability to facilitate access to needed services for new arrivals, network members need to be able to work together collaboratively. A case study involving services for an urban community in Atlantic Canada was undertaken in 2009 to explore how service organizations worked together to address the needs of recent immigrant families with young children. This paper focuses on provider perceptions of cultural competency among local service organizations and how this influenced trust and desire to work together for the benefit of families. METHODS The case study utilized both social network analysis and qualitative inquiry methodology. Twenty-one of 27 selected organizations responded to the online social network survey, and 14 key informant interviews were conducted. Social network measures and network mapping were used to demonstrate trusting relationships and associated interactions, while interview data were used to explain the relationships observed. FINDINGS Perceived cultural competency affected the degree of trust and collaboration within the services network when addressing the needs of recent immigrant families. Competence trust toward other providers increased the desire and commitment to work together, while lack of competence trust created avoidance. Non-government organizations were identified among the most culturally competent. The perceived positive and negative experiences of families with different providers influenced the level of trust among network members. The development of systemic cultural competences within a services network is needed in order to improve collaborations and access to services for immigrant families.
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Baker CJ, Fortney CA, Wewers ME, Ahijevych KL. The cultural context of smoking among immigrants from the former Soviet Union. J Transcult Nurs 2011; 22:166-73. [PMID: 21311086 DOI: 10.1177/1043659610395774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this descriptive, qualitative study was to gain understanding of the cultural context of smoking among immigrants from former Soviet Union countries now living in the Midwest United States. Semistructured interviews were conducted in focus group or individual settings (N = 14), including smokers and former smokers recruited from community settings. Social factors and stress management strongly motivated smoking behavior. Personal willpower was the most helpful cessation strategy, with firm lack of openness to pharmacologic approaches. Top past stressors included food insecurity and societal unrest, with the top current stressors being acculturative issues. The importance of social connectedness and the relatively low priority of prevention were also themes. Based on these interviews, interventions should include acculturative stress management and maintaining social connectedness, while addressing life experiences in the insecurity of basic needs. Smoking cessation interventions that are tailored beyond just language use and address these specific issues are suggested.
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Affiliation(s)
- Cathy J Baker
- Case Western Reserve University, Cleveland, OH, USA.
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20
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Ivanov LL, Jie Hu, Pokhis K, Roth W. Preventive Health Care Practices of Former Soviet Union Immigrant Women in Germany and the United States. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2010. [DOI: 10.1177/1084822310370945] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To examine the use of preventive health care practices of mammography, Pap smear, and breast self-exam in immigrant women from the former Soviet Union in Germany and the United States. Design: A descriptive cross-sectional exploratory study was used to examine the preventive health care practices of immigrant women in Germany and the United States. Sample: A convenience sample of 15 German immigrant women from the former Soviet Union were solicited from the Salztal Klinik in Germany and matched by age with 24 U.S. immigrant women from the former Soviet Union solicited from a community center for immigrants. Measurements: Data were collected using a demographic survey and the Language, Identity, and Behavior Acculturation Measure. Results: Significant differences were found between the German and U.S. immigrant groups in use of mammography (χ2 = 8.069, df = 1, p < .005) and Pap smear (χ2 = 7.245, df = 1, p < .008). Conclusion: The low use of mammography and Pap smear among German immigrant women may be related to differences in health care systems, age, and health beliefs. Further study is needed to determine the affects of age and health beliefs related to health promotion and disease prevention to better understand how to intervene and improve the health of immigrant women from the former Soviet Union.
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Affiliation(s)
| | - Jie Hu
- University of North Carolina-Greensboro, Greensboro, NC, USA
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21
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22
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Isaacs S. Transnational Cultural Ecologies: Evolving Challenges for Nurses in Canada. J Transcult Nurs 2009; 21:15-22. [DOI: 10.1177/1043659609348623] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Canada is experiencing an evolving cultural ecology as new arrivals of immigrants now realize opportunities for sustaining familiar ties with home countries through advancing technologies and travel. Those arriving will have diverse experiences and preferences, many with opportunities for meeting their health needs elsewhere. For those less privileged, options for health care and health enabling resources are more limited as existing health systems continue to give preference to a dominant culture based on a European heritage—even though, progressively, Canadian society becomes more diverse in its cultural makeup. We as nurses and others engaged in health care systems need to consider our own acculturation processes as we adapt to the changes happening in our society. Systemic approaches to cultural competency in health care need to be considered that enable nurses and other health care providers to be adaptive and resilient in a transnational world.
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Affiliation(s)
- Sandra Isaacs
- McMaster University, Hamilton, Ontario, Canada, , Public Health Agency of Canada, Ottawa, Ontario, Canada
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23
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Čajdrić-Vrhovac A, Weaver TL. Exploring the Meaning of Cigarette Smoking in a Sample of Resettled Bosnian Refugees. J Ethn Subst Abuse 2009; 8:1-14. [PMID: 19266371 DOI: 10.1080/15332640802683334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Asylum seekers' expectations of and trust in general practice: a qualitative study. Br J Gen Pract 2008; 58:e1-11. [PMID: 19068152 DOI: 10.3399/bjgp08x376104] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The UK has substantial minority populations of short-term and long-term migrants from countries with various types of healthcare systems. AIM This study explored how migrants' previous knowledge and experience of health care influences their current expectations of health care in a system relying on clinical generalists performing a gatekeeping role. DESIGN OF STUDY Two qualitative methods. SETTING Glasgow, UK. METHOD Focus groups or semi-structured interviews were conducted with 52 asylum seekers. Analyses identified several areas where previous experience affected current expectations. An overview of health systems in each country of origin was established by combining responders' accounts with World Health Organization statistics. RESULTS Asylum seekers had previous experience of a diverse range of healthcare systems, most of which were characterised by a lack of GPs and direct access to hospital-based specialists. For some responders, war or internal conflict resulted in a complete breakdown of healthcare systems. Responders' accounts also highlighted the difficulties that marginalised groups had in accessing health care. Although asylum seekers were generally pleased with the care they received from the NHS, there were areas where they experienced difficulties: confidence in their GP and access to hospital-based specialists and medication. These difficulties encountered might be explained by previous experience. CONCLUSION GPs and other healthcare professionals need to be aware that experience of different systems of care can have an impact on individuals' expectations in a GP-led system. If these are not acknowledged and addressed, a lack of confidence and trust in the GP may undermine the effectiveness of the clinical consultation.
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Helweg-Larsen M, Stancioff LM. Acculturation matters: risk perceptions of smoking among Bosnian refugees living in the United States. J Immigr Minor Health 2008; 10:423-8. [PMID: 18066716 DOI: 10.1007/s10903-007-9107-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The relationship between acculturation and health behavior change is complex. Little research has focused on acculturation and perceptions of health-related risks. This study investigated acculturation and risk perceptions of heart attack and lung cancer among a group of refugees. Questionnaires were distributed to a sample of Bosnian refugees living in the United States (N = 55). Results indicated that smokers thought they were less at risk than other smokers and no more at risk than non-smokers, whereas non-smokers did not think they were less at risk than other non-smokers. Greater acculturation was associated with greater perception of smokers' risk of heart attack and lung cancer. Smoking cessation interventions with refugees should incorporate culturally appropriate risk information.
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Aroian KJ, Vander Wal JS. Health service use in Russian immigrant and nonimmigrant older persons. FAMILY & COMMUNITY HEALTH 2007; 30:213-23. [PMID: 17563483 DOI: 10.1097/01.fch.0000277764.77655.b7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Health service use was compared in Russian immigrant (n=105) and White nonimmigrant (n=101) older persons. Study participants completed a health utilization questionnaire, the Short-Form-36 Health Survey, and a health behavior diary. Controlling for health status and demographic variables, Russians reported significantly more service use, fewer physical access problems, and lower appointment availability, but nonimmigrants reported significantly more provider problems. Significant predictors of service use for the total sample included symptom self-care, health status, and age. In group-specific analyses, health status and age were significant for both groups and education was also significant for Russians.
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Affiliation(s)
- Karen J Aroian
- Wayne State University College of Nursing, Detroit, MI 48202, USA.
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O'Donnell CA, Higgins M, Chauhan R, Mullen K. "They think we're OK and we know we're not". A qualitative study of asylum seekers' access, knowledge and views to health care in the UK. BMC Health Serv Res 2007; 7:75. [PMID: 17537258 PMCID: PMC1892018 DOI: 10.1186/1472-6963-7-75] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Accepted: 05/30/2007] [Indexed: 11/10/2022] Open
Abstract
Background The provision of healthcare for asylum seekers is a global issue. Providing appropriate and culturally sensitive services requires us to understand the barriers facing asylum seekers and the facilitators that help them access health care. Here, we report on two linked studies exploring these issues, along with the health care needs and beliefs of asylum seekers living in the UK. Methods Two qualitative methods were employed: focus groups facilitated by members of the asylum seeking community and interviews, either one-to-one or in a group, conducted through an interpreter. Analysis was facilitated using the Framework method. Results Most asylum seekers were registered with a GP, facilitated for some by an Asylum Support nurse. Many experienced difficulty getting timely appointments with their doctor, especially for self-limiting symptoms that they felt could become more serious, especially in children. Most were positive about the health care they received, although some commented on the lack of continuity. However, there was surprise and disappointment at the length of waiting times both for hospital appointments and when attending accident and emergency departments. Most had attended a dentist, but usually only when there was a clinical need. The provision of interpreters in primary care was generally good, although there was a tension between interpreters translating verbatim and acting as patient advocates. Access to interpreters in other settings, e.g. in-patient hospital stays, was problematic. Barriers included the cost of over-the-counter medication, e.g. children's paracetamol; knowledge of out-of-hours medical care; and access to specialists in secondary care. Most respondents came from countries with no system of primary medical care, which impacted on their expectations of the UK system. Conclusion Most asylum seekers were positive about their experiences of health care. However, we have identified issues regarding their understanding of how the UK system works, in particular the role of general practitioners and referral to hospital specialists. The provision of an Asylum Support nurse was clearly a facilitator to accessing primary medical care. Initiatives to increase their awareness and understanding of the UK system would be beneficial. Interpreting services also need to be developed, in particular their role in secondary care and the development of the role of interpreter as patient advocate.
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Affiliation(s)
- Catherine A O'Donnell
- General Practice and Primary Care, Division of Community-based Sciences, University of Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK
| | - Maria Higgins
- General Practice and Primary Care, Division of Community-based Sciences, University of Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK
| | - Rohan Chauhan
- General Practice and Primary Care, Division of Community-based Sciences, University of Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK
| | - Kenneth Mullen
- Psychological Medicine, Division of Community-based Sciences, University of Glasgow, Academic Centre, Gartnavel General Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK
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Andreeva VA, Unger JB, Pentz MA. Breast Cancer among Immigrants: A Systematic Review and New Research Directions. J Immigr Minor Health 2007; 9:307-22. [PMID: 17431785 DOI: 10.1007/s10903-007-9037-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This paper highlights the relationship between migration and female breast cancer. A comprehensive review aimed at identifying risk and protective factors that cut across races and ethnicities was performed. A total of 79 studies (1971-2005) from 16 countries were reviewed. The findings are consistent with existing knowledge about the importance of potentially modifiable environmental and behavioral determinants of risk, acting both pre- and post-migration. While the acculturation-based risk transition model is strong, it is not always supported. As a new direction for migrant studies, we extrapolate the review findings to the experience of Eastern European (EE) immigrants. Health data on this population, typically characterized by low health motivation and passive receipt of preventive efforts, are largely unavailable. Based on relevant theory, empirical and qualitative studies, two breast cancer prevention models for the EE immigrant population are proposed and the need for future research using ethnically disaggregated data is discussed.
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Affiliation(s)
- Valentina A Andreeva
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA 91803, USA.
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Shpilko I. Russian-American health care: bridging the communication gap between physicians and patients. PATIENT EDUCATION AND COUNSELING 2006; 64:331-41. [PMID: 16859861 DOI: 10.1016/j.pec.2006.03.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Revised: 02/27/2006] [Accepted: 03/25/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVES The objectives of this article are two-fold: (1) to gather in one place reliable information about Russian-Americans' past medical practices and their current outlook on health care and to provide health care professionals with an overview of the major afflictions suffered by this ethnic group; and (2) to educate Russian-speaking patients about the American heath care system and social services geared towards immigrants by locating and evaluating free, culturally appropriate patient education Web sites available in Russian. METHODS In order to draw data on specific diseases and conditions affecting the Russian-speaking population, the author searched various scholarly health-related electronic databases. A number of well-established U.S. government consumer-health Web sites were searched to locate patient education resources that can be utilized by recent Russian immigrants. RESULTS The author provides an overview of the major health problems encountered by the Russian-speaking population before emigration and potential health concerns for Russian immigrant communities. In addition, the author provides a scholarly exploration of patient education materials available in Russian. CONCLUSION In this increasingly diverse society, physicians are faced with the challenge of providing culturally sensitive health care. Multicultural Web-based health resources can serve as a valuable tool for reducing communication barriers between patients and health care providers, thus improving the delivery of quality health care services. Recommendations for further research are indicated. PRACTICE IMPLICATIONS The author offers recommendations for practitioners serving Russian-speaking immigrants. Suggestions on utilization of Web resources are also provided.
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Affiliation(s)
- Inna Shpilko
- Queens College, City University of New York, Benjamin Rosenthal Library, Flushing, NY 11367, USA.
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Kudadjie-Gyamfi E, Consedine NS, Magai C. On the importance of being ethnic: Coping with the threat of prostate cancer in relation to prostate cancer screening. ACTA ACUST UNITED AC 2006; 12:509-26. [PMID: 16881753 DOI: 10.1037/1099-9809.12.3.509] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The relation between coping with a possible prostate cancer diagnosis and screening behavior was examined in men from seven precise ethnic groups. Five coping styles differed in their likelihood of use across ethnic groups and had somewhat different associations with frequency of prostate-specific antigen (PSA) testing. As expected, PSA test frequency differed among men from different ethnic groups and was differentially predicted by coping styles. Analyzing the results using typical groups of White, Black, and Hispanic, rather than precise ethnic groups, obscured these results. Researchers investigating psychological variables in preventive health behaviors must analyze diversity within the framework provided by ethnic specificity. Such an approach will guide the development and provision of interventions that are more sensitive to the characteristics of specific ethnic groups of at risk men.
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