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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Hughes E, Kean S, Cuthill F. Fluctuating power: an exploration of refugee health nursing within the resettlement context in Victoria, Australia. J Res Nurs 2022; 27:217-228. [PMID: 35813176 PMCID: PMC9264413 DOI: 10.1177/17449871221083786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The Refugee Health Program (RHP) is a nurse-led community initiative, introduced in 2005 with the aim of responding to complex health issues of refugees arriving in Victoria, Australia. Little is known about refugee health nursing in the resettlement context and the impact of dedicated refugee healthcare. Aim To explore the experiences and perspectives of Refugee Health Nurses (RHNs), Refugee Health Managers (managers) and refugees, gaining insight into professional relationships and the complexities of offering a specialised refugee health service. Method A focused ethnographic approach incorporated semi-structured interviews with five RHNs, two managers and eight refugees, two focus groups with refugees and participant observation within the RHP during April 2017 to December 2017. Data collection was undertaken across two sites and interviews, focus groups and observations were transcribed and thematically analysed. Social constructionism asserts that the focus of enquiry should be on interaction, group processes and social practices. Emphasis is placed upon relationships between RHNs, managers and refugees, with knowledge viewed as relational and interactional. Results Professional relationships between RHNs and refugees are complex, with power oscillating between them. Contrary to discourses of ‘vulnerability’ of refugees, both RHNs and refugees demonstrated power in their relationships with each other. Nurses also suggested that these relationships were stressful and could lead to burnout. Key themes were developed: (1) nursing autonomy and gatekeeping; (2) vicarious trauma and burnout; and (3) refugee negotiation of care. Conclusions The balance of power is central to therapeutic relationships. In relationships between RHNs and refugees, power fluctuates as RHNs are exposed to vicarious trauma and symptoms of burnout, while refugees exercise agency by recognising benefits to specialised care. In developing effective therapeutic relationships between RHNs and refugees, attention should be paid to how care is delivered to protect RHNs from burnout while ensuring that refugees receive appropriate care.
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Affiliation(s)
- Emma Hughes
- Lecturer, Nursing Studies, Edinburgh Napier University, Edinburgh, Scotland
| | - Susanne Kean
- Lecturer, Nursing Studies, University of Edinburgh, Edinburgh, Scotland
| | - Fiona Cuthill
- Senior Lecturer, Nursing Studies, University of Edinburgh, Edinburgh, Scotland
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İlhan MN, Ertek İE, Gözükara MG, Akil Ö, Ursu P, Ergüder T, Polat S, Şimşek MY, Aktaş M, Gazanfer ÖB, İlhan SÖ, Kaptan H. Substance Use in Refugee Camps and Local Community: Şanlıurfa Sample. ACTA ACUST UNITED AC 2020; 58:121-127. [PMID: 34188594 DOI: 10.29399/npa.24856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 07/17/2020] [Indexed: 11/07/2022]
Abstract
Introduction Although substance use has increased in recent years in Turkey, it is still lower than in other European countries. Turkey is home to the largest Syrian refugee population. In this study, it was aimed to evaluate the prevalence of tobacco, alcohol, and substance use among local people living in city centers and refugees living in refugee camps in Şanlıurfa. Methods The study was based on a cross-sectional epidemiologic survey conducted with a total of 6041 people, 4040 (67%) from camps and 2001 (33%) from districts. Face-to-face interviews were accompanied by local interviewers or interpreters who spoke Arabic, and a survey form used in our country for drug addiction screening was used. According to the number of samples selected, households with proportional distribution were chosen from the districts, which were selected from the address based from Turkish Statistical Institute. In the refugee camps, interviews were conducted in tents selected using a random numbers table according to the number of samples. Results The lifetime prevalence of tobacco use was 22.3% (n=902) in the camps, whereas in the districts this rate was 33.5% (n=670). The lifetime prevalence of alcohol use was found as 0.2% in the camps and 3.5% in the districts. The lifetime prevalence of substance use was found as 2.6% in the camps and 4.3% in the districts. The most commonly used substance type was cannabis. Some 45.7% of the people who used a substance in the camps were male and 54.3% were female. In districts, these rates were 64.4% and 35.6%, respectively. Conclusion Alcohol and substance use rates are low in Turkey compared with most countries in the world. Substance use in the city center is higher than in refugee camps in Şanlıurfa. Substance use is a significant mental health problem that concerns every community including refugees. Identifying characteristics and attitudes related to substance use may help to improve policies regarding protective measures.
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Affiliation(s)
- Mustafa Necmi İlhan
- Gazi University Faculty of Medicine, Department of Public Health, Ankara, Turkey
| | - İrem Ekmekçi Ertek
- Gazi University Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | | | - Öznur Akil
- Harran University Faculty of Medicine, Department of Psychiatry, Şanlıurfa, Turkey
| | - Pavel Ursu
- World Health Organization, Ankara Office, Turkey
| | | | - Sertaç Polat
- T. C. Ministry of Health, Public Health Directorate, Ankara, Turkey
| | | | - Mahmut Aktaş
- Şanlıurfa Health Office, Public Health Directorate, Şanlıurfa, Turkey
| | | | - Sevil Özger İlhan
- Gazi University Faculty of Medicine, Department of Pharmacology, Ankara, Turkey
| | - Hulagu Kaptan
- Dokuz Eylül University Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey
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Basheti IA, Ayasrah SM, Basheti MM, Mahfuz J, Chaar B. The Syrian refugee crisis in Jordan: a cross sectional pharmacist-led study assessing post-traumatic stress disorder. Pharm Pract (Granada) 2019; 17:1475. [PMID: 31592018 PMCID: PMC6763294 DOI: 10.18549/pharmpract.2019.3.1475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/28/2019] [Indexed: 12/28/2022] Open
Abstract
Background: The United Nations has declared the Syrian crisis as the worst humanitarian
crisis of the twenty-first century. Pharmacists play a vital role in
humanitarian aid and in delivering health advices for refugees. Many Syrian
refugees are in need of psychosocial assessments. Objective: Objective of this study was to investigate the prevalence of post-traumatic
stress disorder (PTSD), assessed by pharmacists among Syrian civilian
refugees residing in Amman, Jordan. Methods: A cross-sectional study involving Syrian civilian refugees living in Amman,
Jordan, was conducted using the published and validated Arabic version of
the Harvard Trauma Questionnaire (HTQ). Pharmacists recruited civilian
Syrian refugees and completed the HTQ. The questionnaire included 45
questions, with the first 16 questions (HTQ-16) intended to assess the
trauma symptoms felt by refugees. Assessments were done by the pharmacists
and refugees were categorized to suffer PTSD if their mean item score for
the HTQ-16 scale was > 2.5. Results: Study participants (n=186; mean age 31.5 years; 51.3% males) had a
HTQ-16 mean score of 2.35 (SD=0.53), with a range of 1.19 - 3.63. Over a
third of participants (38.7%) were categorized as having PTSD. Males
reported significantly worse PTSD symptoms (mean=2.42, SD=0.50) compared to
females (mean=2.26, SD=0.57). Correlation between the mean item score for
the HTQ-16 and characteristics of the study participants showed higher mean
item score correlated with being a male, older in age, a smoker, and if
trauma was experienced. Conclusions: Many Syrian civilian refugees living in Jordan suffer from PTSD. Male
participants were found to be more affected by the severity of the disorder.
Pharmacists are suitably situated to identify civilian Syrian refugees
suffering from PTSD in dire need of help, paving the way for much needed
healthcare resources to be delivered to this particular group of
refugees.
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Affiliation(s)
- Iman A Basheti
- Professor in Clinical Pharmacy. Department of Clinical Pharmacy, Faculty of Pharmacy, Applied Science Private University. Amman (Jordan).
| | - Shahnaz M Ayasrah
- Department of Applied Science/Nursing, Al-Balqa Applied University a. Al-Salt (Jordan).
| | - Mariam M Basheti
- Faculty of Pharmacy, Jordan University of Science and Technology. Irbid (Jordan).
| | - Judeh Mahfuz
- Professor in human resource management. Applied Science Private University. Amman (Jordan).
| | - Betty Chaar
- Associate Professor in pharmacy practice. School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW a (Australia).
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Elmore CE, Tingen JM, Fredgren K, Dalrymple SN, Compton RM, Carpenter EL, Allen CW, Hauck FR. Using an interprofessional team to provide refugee healthcare in an academic medical centre. Fam Med Community Health 2019; 7:e000091. [PMID: 32148713 PMCID: PMC6910747 DOI: 10.1136/fmch-2018-000091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction The International Family Medicine Clinic (IFMC) was established in 2002 by the University of Virginia Department of Family Medicine to provide comprehensive, timely, culturally sensitive and high-quality healthcare to the growing refugee and special immigrant population in Central Virginia, USA. Methods The purpose of this paper is to describe the IFMC, with a specific focus on interprofessional roles, interprofessional collaboration, community partnerships and the services and resources available to IFMC patients. Results The clinic has served over 3100 refugees from 60 countries in its 16-year history. In 2019, the clinic staff now includes 4 attending physicians, 2 nurse practitioners and 14 residents who have dedicated clinic time to see refugees; a registered nurse care coordinator and a social worker dedicated to the IFMC refugee population; 2 clinical psychologists and doctoral students in clinical psychology; and a clinical pharmacist. The IFMC also provides onsite psychiatric care. A process flow map depicts the interconnectivity of interprofessional team members working together with other specialty care providers within the medical centre and with community partners on behalf of refugee patients through the resettlement process. Conclusion Individuals who arrive in the USA as refugees are a particularly vulnerable patient group and often require an interprofessional team approach. The IFMC may serve as a model for other institutions interested in starting a similar interprofessional, refugee-centred medical home.
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Affiliation(s)
- Catherine E Elmore
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Jeffrey M Tingen
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA.,Department of Pharmacy Services, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Kelly Fredgren
- Department of Social Work, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Sarah N Dalrymple
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Rebekah M Compton
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Elizabeth L Carpenter
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Claudia W Allen
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Fern R Hauck
- Department of Family Medicine, University of Virginia Health System, Charlottesville, Virginia, USA.,Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia, USA
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Abstract
Background:All over the world, migration is affecting millions of people who either choose or are forced to leave their countries of origin. Health is considered to be one of the important aspects of migration that is highly influenced by the circumstances created by mobility within or across countries. In the context of forced migration, it is well-established that refugees are susceptible to various diseases and other health conditions which might occur or deteriorate based on the health systems and health care provision in receiving countries. There is a considerable amount of research on the challenges encountered by refugees in receiving countries, in terms of health care systems and services. However, there seems to be little focus on the health care providers’ perspectives of the challenges in health care provision in refugee settings. This review aims to explore some of the articles discussing the challenging issues surrounding refugee health from a provider’s perspective.Methods:A systematic review was conducted through five main online databases: Medline (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA); Science Direct (Elsevier; Amsterdam, Netherlands); Scopus (Elsevier; Amsterdam, Netherlands); Sage (Sage Publications; Thousand Oaks, California USA); and Google Scholar (Google Inc.; Mountain View, California USA), including only the articles published in English. In addition, grey literature resources available online were used.Results:Forty-eight articles were included in this review, mainly based on the amount of emphasis they placed on providers’ viewpoints in refugee health settings. Most of the articles were retrieved based on their availability in the databases which Hacettepe University (Ankara, Turkey) is subscribed to. Almost all of the articles mentioned the challenges caused by linguistic and cultural barriers, and some focused on providers’ limited knowledge and skills, as well as inefficient health care systems. There was little emphasis on ethical discussions, and the physical and emotional impact of caring for refugees on health care professionals. In the few articles discussing ethical and personal dimensions, issues concerning stress, burnout, and safety risks were found to be the recurring themes.Conclusions:Evidence gathered suggests that the challenges faced by health care providers involve a variety of factors that are specific to health care settings involving refugees, such as linguistic and cultural barriers, and a lack of proper support and training. It seems that the challenges that health care providers face in refugee settings could be further investigated both from professional and personal aspects for a better understanding of refugee health care.Kavukcu N, Altıntaş KH. The challenges of the health care providers in refugee settings: a systematic review. Prehosp Disaster Med. 2019;34(2):188–196
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Affiliation(s)
- Kimberly Lane Carter
- Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA.,Penn Center for Primary Care, University of Pennsylvania Health System, Philadelphia, PA
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Abstract
The recent crisis in the Middle East has prompted the exodus of millions of refugees from the region who are at present seeking shelter across Europe and in the United States. Among the most immediate needs of refugees upon arrival in a host country is health care, and it is one of the most sustained interactions they experience. Home visits are a common form of primary care for refugees. The authors review the literature to identify themes related to challenges and strategies for providing home based primary care to refugees. The literature review was performed by searching cross-disciplinary databases utilizing Onesearch, but focusing primarily on results produced through CINAHL, EBSCOHOST, and Pub Med databases. To maximize the number of studies included, there was no time frame placed upon publication dates of articles within the search. A total of 55 articles were included in this paper.
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Affiliation(s)
- C Febles
- Department of Global Studies and Languages, Idaho State University, 921 South 8th Avenue, STOP 8067, Pocatello, ID, 83209, USA.
| | - M A Nies
- Division of Health Sciences, Idaho State University, Pocatello, ID, USA
| | - K Fanning
- School of Nursing, Idaho State University, Pocatello, ID, USA
| | - S S Tavernier
- School of Nursing, Idaho State University, Pocatello, ID, USA
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Al Alawneh M, Nuaimi N, Basheti IA. Pharmacists in humanitarian crisis settings: Assessing the impact of pharmacist-delivered home medication management review service to Syrian refugees in Jordan. Res Social Adm Pharm 2018; 15:164-172. [PMID: 29661563 DOI: 10.1016/j.sapharm.2018.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 04/03/2018] [Accepted: 04/08/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Refugees all over the world are facing several health-related problems. Chronic diseases among Syrian refugees in Jordan are high. The Home Medication Management Review (HMMR) service could be ideal to optimize refugees' health management. OBJECTIVES To assess the impact of the HMMR service on the type and frequency of Treatment Related Problems (TRPs) among Syrian refugees living in Jordan. METHODS This prospective randomized single blinded intervention-control study was conducted in three main cities in Jordan, between May and October 2016. Syrian refugees with chronic conditions were recruited and randomized into intervention and control groups. The HMMR service was conducted for all patients to identify TRPs at baseline. Data were collected via two home visits for all study participants. Clinical pharmacist's recommendations were written in a letter format to the physicians managing the patients in the intervention group only. Physicians' approved recommendations were conveyed to the patients via the pharmacist. Interventions at the patient level were delivered by the pharmacist directly. Patients were reassessed for their TRPs and satisfaction 3 months after baseline. RESULTS Syrian refugees (n = 106) were recruited with no significant differences between the intervention (n = 53) and control groups (n = 53). A total of 1141 TRPs were identified for both groups at baseline, with a mean number of 10.8 ± 4.2 TRPs per patient. At follow-up, there was a significant decrease in the number of TRPs among the intervention group (P < 0.001, paired sample t-test) but not among the control group (P = 0.116). Physicians' approval rate of the pharmacist's recommendations was high (82.9%), and more than 70.0% of refugees in the intervention group reported high satisfaction with the HMMR service. CONCLUSION Identified TRPs are high amongst Syrian refugees living in Jordan. The HMMR service significantly reduced the number of TRPs, and was highly accepted by the physicians. Refugees reported high satisfaction with this service.
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Affiliation(s)
- Majdoleen Al Alawneh
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
| | - Nabeel Nuaimi
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
| | - Iman A Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan; Faculty of Pharmacy, The University of Sydney, Australia.
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Procter NG, Kenny MA, Eaton H, Grech C. Lethal hopelessness: Understanding and responding to asylum seeker distress and mental deterioration. Int J Ment Health Nurs 2018; 27:448-454. [PMID: 28322492 DOI: 10.1111/inm.12325] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 11/28/2022]
Abstract
The mental deterioration of the so called 'legacy caseload' (asylum seekers who arrived in Australia by boat between August 2012-December 2013) has become a national concern and is garnering international attention. Prolonged uncertainty is contributing to mental deterioration and despair. There have been at least 11 deaths by suicide since June 2014. Social support services have been limited and legal assistance in short supply; this is associated with lengthy delays with visa applications. Thwarted belongingness, purpose and identity, a shortage of available services, and barriers to legal support for processes attendant upon Refugee Status Determination increase the likelihood that the mental health of asylum seekers will deteriorate further, potentially developing into worsening decline, which will lead to increased self-harm and suicide. This article summarises recent suicide deaths in Australia, positing practical assistance and support for asylum seekers living in the community. Therapeutic engagement should be trauma-informed wherever possible, helping asylum seekers to reframe their sense of lethal hopelessness.
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Affiliation(s)
- Nicholas G Procter
- School of Nursing and Midwifery, University of South Australia, Perth, Western Australia, Australia.,Mental Health and Substance Use Research Group, Adelaide, South Australia, Australia
| | - Mary Anne Kenny
- School of Law, Murdoch University, Perth, Western Australia, Australia
| | - Heather Eaton
- School of Nursing and Midwifery, University of South Australia, Perth, Western Australia, Australia.,Mental Health and Substance Use Research Group, Adelaide, South Australia, Australia
| | - Carol Grech
- School of Nursing and Midwifery, University of South Australia, Perth, Western Australia, Australia
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Kotovicz F, Getzin A, Vo T. Challenges of Refugee Health Care: Perspectives of Medical Interpreters, Case Managers, and Pharmacists. J Patient Cent Res Rev 2018; 5:28-35. [PMID: 31413994 DOI: 10.17294/2330-0698.1577] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin. Methods Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. Results Four overarching themes regarding health care for refugee patients were identified: 1) difficulty balancing the dynamic of autonomy versus support for refugees; 2) educational needs of refugee families outpacing available resources; 3) challenges for refugees developing trust; and 4) diversity of cultures, education levels, and experiences among refugee families. Language barriers in accessing health care services and insufficient time to meet educational needs of refugees were major challenges outside of the clinic visit setting. Poor health literacy and difficulties communicating health needs and building trust within the interactive triad of refugee, physician, and interpreter impacted clinic visits. Conclusions Refugee patients and other participants in refugee care work to navigate a complicated path to equitable health care for a vulnerable population. Continued pursuit of strategies that increase time allocation, education, and support for all parties are needed as we seek to improve health outcomes for newly arrived refugee families.
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Affiliation(s)
- Fabiana Kotovicz
- Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI.,Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Anne Getzin
- Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI.,Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Thy Vo
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.,Department of Psychiatry Residency Training, University of Pittsburgh, Pittsburgh, PA
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