Refugee Health: A Global and Multidisciplinary Challenge

Nursing Praxis on Intercultural Care with War-Affected Refugees

The purpose of this study was to describe the nursing praxis of nurses and midwives on intercultural care in Poland with refugees from Ukraine. A qualitative descriptive study was conducted by an international, inter-professional research team, co-led by nurse scientists in the USA and Poland. In-depth interviews were completed in 2023 with 15 Polish nurses and midwives who cared for refugees from Ukraine. Nursing praxis was identified in four themes: Mobilizing resources, Clarifying health services, (In)visibility of trauma, and Discerning cultural nuances. Nurses were at the forefront of professional and volunteer efforts to assist refugees. Nursing praxis focused on building trust and creating a "sense of security" among refugees. There was a systemic lack of trauma-informed care and language access for nurses, hindering intercultural care. The study suggests nurses advocate for institutional support of qualified interpreters on health care teams where language differences persist. Nursing education should include intercultural care for war-affected refugees who are likely to experience long term psychological trauma. Ukrainian leaders could partner with investigators on research and program development for sustainable solutions in refugee communities.

Barriers and enabling factors for utilizing physical rehabilitation services by Afghan immigrants and refugees with disabilities in Iran: a qualitative study

INTRODUCTION

Individuals with a migrant background often underutilize physical rehabilitation services (PRS) compared to the host population. This disparity is attributed to various barriers, including limited access to information, language barriers, illiteracy, and cultural factors. To improve PRS utilization by Afghan immigrants and refugees in Iran, it is crucial to identify these barriers and enabling factors. In response, this study explored the barriers and enabling factors for utilizing PRS among Afghan immigrants and refugees with disabilities in Iran.

METHODS

This qualitative study was conducted in Iran between January and March 2023. Participants were selected through convenient and snowball sampling. Individual, semi-structured interviews were carried out both in face-to-face and online formats. Data analysis occurred concurrently with data collection, using the directed content analysis approach.

RESULTS

Findings from our research indicate that common barriers to PRS utilization among Afghan immigrants and refugees include insufficient insurance coverage, high service costs, expensive transportation and accommodation, limited knowledge about Iran's health system, inadequate awareness of available supports, restricted access to PRS in remote areas, impatience among PRS providers, fear of arrest and deportation, a lack of trust in modern treatments, stringent immigration rules, high inflation rates limiting the ability to pay for PRS, and limited social support. On the other hand, several enabling factors were identified, such as strengthening insurance coverage, utilizing the capacities of charities and NGOs, providing information about available services, promoting respectful behavior by healthcare providers towards patients, facilitating cultural integration, and increasing immigrants' awareness of available services and eligibility criteria.

CONCLUSION

The barriers and enabling factors uncovered in this study offer valuable insights into the complexities surrounding PRS utilization by Afghan immigrants and refugees with disabilities in Iran. Understanding and addressing these factors is essential for developing targeted interventions and policies that can improve access and utilization, ultimately leading to enhanced health outcomes for this vulnerable population.