| 1. |
- Heckemann, Birgit, 1969, et al.
(författare)
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Migrants Access and Encounters of Healthcare in a Host Country
- 2017
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Ingår i: 2nd International Conference of the Urban Research and Education Knowledge Alliance (U!REKA). 20-21November 2017, Edinburgh.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background The aim of this paper is to present part of the findings of a literature search undertaken by an international group of researchers, all members of the Sigma Theta Tau International (STTI) nursing organisation. This part addresses the conference theme of Urban Displacement: Migration and Refugees. The group got together to discuss the lack of knowledge about migrants health care experiences. In light of the increasing number of migrants across Europe, the group felt there was a paucity of information relating to migrants, concluding that migrants’ perceptions about the quality of health care must be regarded as a potentially crucial source of information for gathering data to detect significant gaps in the health care delivery services. The researchers from Sweden, the Netherlands, England and Scotland met together over the past two years to explore available literature related to migrants´ experiences of health care and their health care seeking behaviours. The results of this work have been submitted to an STTI conference in November 2017 and the full paper is under review for publication. Methodology Eight academics from 8 higher education institutions in the countries involved, undertook a meta-ethnography of qualitative studies during January 2000– June 2016. A literature search using the search engines MEDLINE, CINAHL, PsychInfo, EMBASE, Web of Science, Migration Observatory (UK), NHS Scotland Knowledge Network, ASSIA and the Cochrane Library was performed. Search terms used included ‘migrant’, ‘migrant patient’ ‘immigrants’, ‘quality of care’, ‘nursing care’, ‘satisfaction with nursing care’, ‘experiences of care’ ‘expectations’. Google and Google Scholar were used to identify studies not published in indexed journals. Findings Two hundred and sixty four articles were identified and a scan of titles brought this down to 62. A further review of abstracts brought this number to 49 and a full reading of each article reduced the numbers further. Twenty seven qualitative studies were included in the analysis. The majority of these (n= 19) originated from Europe Various migrant groups were included; undocumented migrants or refugees of uncertain legal status (n=2) migrants with legal residency permit who tend to stay in host country for economic or safety reasons (n= 23) and retirees with the choice to stay in the host country or return to their home country (n=2). Thematic analysis revealed five dimensions: personal factors; healthcare system; access to healthcare; the encounter; and healthcare experience. In keeping with the conference theme, this paper reports on the Access to Healthcare and The Encounter dimensions. Access to healthcare This dimension addressed the barriers or enablers to healthcare in the host country. When a need for services is identified by migrants, their socio-economic and legal status would appear to affect their access to services. In order to even access the correct service, the individual migrant and/or their families need to know how to go about such access. Language difficulties and lack of information can serve to adversely affect their rights. An additional issue is that service providers can prove to be gatekeepers to the required services. These issues can have a detrimental effect on the individual migrant’s health and they may seek alternative health-seeking strategies. The Encounter When an individual migrant does access the services, the manner in which they are treated as a person and as a patient is determined by the staff they encounter. This juncture has huge implications for the trajectory of a person’s care. Yet the encounter can prove problematic due to language difficulties and a lack of mutual knowledge of how to act in a culturally appropriately way. This also covers the misunderstandings of what an individual migrant wants from service providers, what they are used to in their own countries and what the service provider states that the person with migrant status needs. It is therefore important for service providers to treat the individual in an holistic manner, ascertaining their expectations and perceived need. Such care is at the heart of person-centredness. Conclusion and Implications Migrants’ access and encounters with health services should be seriously considered. Rather than being disconnected from society, they need to be able to improve their physical and social status, thus being able to integrate and contribute to their new home country in which they are a valued member. It is therefore essential for service provision to address the needs of migrants. For nursing, the nursing education and research agenda should focus on improvement of the necessary nursing competencies with person centred care at the core of care delivery. Upskilling care staff in cultural care will serve to facilitate the optimal conditions to improve migrants’ access to health care and their care encounter.
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| 2. |
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| 3. |
- Jack, Kirsten, et al.
(författare)
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Clinical leadership in nursing students: A concept analysis.
- 2022
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Ingår i: Nurse education today. - : Elsevier BV. - 1532-2793 .- 0260-6917. ; 108
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Tidskriftsartikel (refereegranskat)abstract
- To undertake a concept analysis of clinical leadership in nursing students.Concept analysis.A comprehensive search was conducted using the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline and PsychINFO using the following search terms: clinical leadership AND management AND preregistration OR pre-registration OR undergraduate AND nursing student* OR student nurse*.Nursing student clinical leadership was explored using the eight-step process of concept analysis proposed by Walker and Avant (2014).The defining attributes included effective interpersonal communication skills, contemporary clinical knowledge and being a role model to others.This concept analysis provides a definition of clinical leadership in nursing students. It will support understanding of the concept and how it is enacted in clinical placement settings.
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| 4. |
- Luiking, Marie Louise, et al.
(författare)
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Connect, Collaborate, and Catalyze is at the Heart of Sigma European Region
- 2019
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Ingår i: Sigma Nursing Repository. - USA.
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Konferensbidrag (refereegranskat)abstract
- The purpose of this session is to share and communicate how President Beth Tigges’ call to action is at the heart of what Sigma Europe does. Collaboration Connect, & Catalyze between nurses is a key ingredient to quality, safety, cost efficient and effective care within health care settings and nursing research. We feel that it is important to collaborate in research and evidence based practice strategies in order to connect with our members and have outcomes that improve on global health and the healthcare profession. The European Region continues to deliver on their Strategic plan moving towards 2020. This session will give insight into the work of our International collaborative research which is being undertaken by the Sigma European research committee and Nurse Education interest Group. This is pivotal in connecting our members across Europe and raising the awareness of the following important research topics. In 2015, the net migration had reached 244 million, with 22 million people migrating to and within Europe, the continent hosts the second largest number of international migrants worldwide.(1) Health services appear to be ill-equipped to deal with the problems caused by mass migration; attention to migrants' healthcare needs is a fairly recent topic of integration policies in many countries.(2) Ensuring the physical and mental health of the migrant population is not merely important to the individual, but a societal concern. The Sigma European Research Collaboration in order to obtain a proper overview of the barriers and enablers set itself the task to systematically synthesize available literature related to migrants´ experiences of health care and their health care seeking behaviours. It intends to continue its research into healthcare for migrants. (3)Following on from that our aims are to look into the differences and similarities of migrants’ healthcare experiences in different European countries. The migrants’ healthcare experiences might not only be influenced by the cultural diversity of the migrants but also by the cultural diversity of the host countries. The Nurse Education Interest Group is looking at a prominent issue across the European Nursing education programs. Healthcare systems need good leadership to be able to deliver continuous improvements to the services they provide. Leadership is not in essence about managing but about advocating, encouraging, promoting and sometimes challenging the norm. Our Nurse Education Interest Group want to research this important topic. Our question is whether leadership qualities among undergraduates is already present or should it be taught within the programs. Otherwise is leadership a term for preparedness to take on the role of a graduate nurse position when qualified and are undergraduate nursing students prepared for their role as nurse leaders? Sigma Europe is now in its 4th year of hosting the Virtual Ph-D Connect Up Conference. The Virtual Conference is hosted entirely over the Internet. It allows our members and interested participants to attend live meetings and events from their computers from all over Europe. In the virtual Ph-D Connect Up Conference Ph-D students get the chance to present their work and get advice and feedback from the attending Sigma members. The advice and feedback from the European wide Sigma research members has provided new insights and possible new lines of inquiry for the Ph-D studies. The work that we are doing to reach out to members and potential members through our social media will be mentioned. On Facebook we are offering not only event information but also access to seminal scientific papers to discuss. In our newsletter in order to be considered on the cutting edge we have topics such as Step forward Innovations and Nursing Hot spots. By following our Strategic plan 2020 we are on track to spread the knowledge gained from our various innovations and collaboratives. We want to serve our members and help develop the nursing practice and nursing profession here in Europe and globally. Through this presentation, we seek to provide a clear picture of how Sigma Europe is actualizing Beth Tigges’ call to action, not just at the local and regional level but also at the international level.
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| 5. |
- Luiking, Marie-Louise, et al.
(författare)
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Migrant Health: Assessing Healthcare Needs in Different European Countries
- 2019
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Ingår i: Sigma Nursing Repository. - USA.
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Konferensbidrag (refereegranskat)abstract
- Purpose: The objective of this project is to explore gaps and opportunities in the provision of migrants´ healthcare needs in four European countries (Sweden, the United Kingdom, the Netherlands and Portugal). The aim is to develop an evidence-based tool kit that optimizes support structures to improve migrant patients' access to healthcare. Background: Mass migration concerns all countries worldwide. The increasing number of migrants in Europe is a challenge to financial and human resources in health services that needs to be addressed urgently. Even though migrants have the right to care in European countries, due to lack of knowledge about healthcare systems and their entitlements migrants face more obstacles in accessing healthcare compared with native populations. Additional obstacles can be language barriers or cultural differences. The current drive towards developing person-centred care in many European countries emphasizes the activation of patients’ individual resources in managing illness and maintaining health. Research shows that migrant patients use various strategies to gain access to healthcare and the individual’s network plays an important role. The individual resources and strategies that migrants draw upon have to date received little attention and little is known about how person-centred care can contribute to fostering migrant health. The current project aims to address this gap in knowledge including the perspective of different stakeholders Method Setting: Four European countries (The United Kingdom, Sweden, the Netherlands and Portugal). The Design: An explorative study comprising a (1) a review of the literature and comparison of the health care systems and provision in the four participating countries. (2) An exploration of strategies, obstacles and opportunities in care seeking and provision including different stakeholders (migrants, healthcare professionals). Sample: First generation migrants, aged 18 or above, living in either of the four participating countries (UK, Sweden, Netherlands, Portugal). Healthcare professionals from different settings (hospitals, community) who meet migrant patients in their daily practice Data collection and analysis 1. A literature review 2. A mixed methods study (convergent parallel design). a) Quantitative data collection: A purposed-designed questionnaire be used to assess migrant patients’ demographic data, perceived health status and health-seeking behaviours. The data will be analysed descriptively and through inferential statistics, sub-groups analysis will be conducted for each individual country b) Qualitative data collection: individual interviews and focus group discussions with stakeholders. The data will be analysed descriptively Results: We expect this study to provide unique insights into the problems associated with migrant healthcare within the European countries, but we also expect to identify opportunities to foster self-care strategies and autonomy in migrant patients. Conclusion: This research will provide an evidence base to develop tool and instruments that enhance care provision for migrant patients, a patient population that remains to date underserved.
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| 6. |
- Luiking, Marie-Louise, et al.
(författare)
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Migrants´ Experiences in the Healthcare System
- 2019
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Ingår i: Women, Migrations and Health - Ensuring Transcultural Healthcare. - Slovenia : University of Primorska Press. - 9789617055450 ; , s. 95-105
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Bokkapitel (refereegranskat)abstract
- The publication of a book forms part of the Integra project. The added value of this volume lies in its unique and innovative content that seeks to enhance health professionals’ knowledge and cross-border cooperation. The monograph benefits from the input of internationally well-regarded researchers in the field of sexual and reproductive healthcare, which make it particularly valuable. The book builds on the results of a literature search, original research and well-established good practices and guidelines. The topics range from cultural competencies, health education, barriers to healthcare, social integration through to migrant women’s perspectives on sexual and reproductive health issues. The various chapters may be seen as a comprehensive, consistent and logical whole that includes a variety of evidence-based guidelines as part of an interdisciplinary approach. This volume is able to inform health professionals, researchers and policymakers in their efforts to ensure adequate healthcare for migrant women and their families. As such, we strongly believe this publication holds the potential to promote inclusive transcultural healthcare across Europe.
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| 7. |
- Luiking, Marie Louise, et al.
(författare)
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Migrants' healthcare experience: a meta-ethnography review of the literature.
- 2019
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Ingår i: Journal of Nursing Scholarship. - : Wiley. - 1527-6546 .- 1547-5069. ; 51:1, s. 58-67
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Worldwide, more than 214 million people have left their country of origin. This unprecedented mass migration impacts on healthcare in host countries. This paper explores and synthesizes literature on the healthcare experiences of migrants. Design: A meta- ethnography study of qualitative studies was conducted. Methods: Eight databases (MEDLINE, CINAHL, PsychInfo, EMBASE, Web of Science, Migration Observatory, National Health Service Scotland Knowledge Network, and ASSIA) were searched for relevant full text articles in English, published between January 2006 and June 2016. Articles were screened against inclusion criteria for eligibility. Included articles were assessed for quality and analysed using Noblit and Hare’s seven step meta ethnography process. Findings: Twenty-seven studies were included in the review. Five key contextualization dimensions were identified: Personal Factors, The Healthcare System, Accessing Healthcare, The Encounter and Healthcare Experiences. These five areas all underlined the uniqueness of each individual migrant emphasizing the need to treat a person rather than a population. Within a true person-centred approach, the individual’s cultural background is fundamental to effective care. Conclusion: From the findings, a model has been designed using the five dimensions and grounded in a person-centred care approach. This may help healthcare providers to identify weak points, improve the organisation and healthcare professionals to provide person-centred care to migrant patients. Clinical relevance: The proposed model facilitates identification of points of weakness in the care for migrant patients. Employing a person-centred care approach may contribute to improve health outcomes for migrant patients.
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| 8. |
- Luiking, Marie-Louise, et al.
(författare)
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Sigma European international PhD virtual connect event : fostering a community of practice
- 2024
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Konferensbidrag (refereegranskat)abstract
- Background: Virtual scholarly events have become commonplace in contemporary nursing education. The Sigma European regional PhD Virtual Connect is such an event, which has increasingly been informed by the Theory of Communities of Practice (CoP). The theory of CoP proposes that learning occurs inevitably from our participation in the world (Wenger, 2010b). A CoP can be defined as a group of people with shared interests and motivation who engage in the process of joined learning with and from each other, and who do better due to the group's sustained interaction (Wenger, 2010b). A CoP can therefore take the form of a learning network, which in the context of the current study is a virtual scholarly event. The aim of this study was to explore the perception of PhD candidates about their participation in this event.Method: An open-ended qualitative survey was conducted with the participants from the PhD Virtual Connect event. Data were analysed through thematic analysis.Results: Twelve participants from various countries answered the online survey anonymously. Four themes were identified: 1) “connectedness with peers and sharing expertise”, 2) “developing ourselves as nursing researchers”, 3) “a learning ecosystem that expands horizons”, 4) “leadership and engagement”.Conclusion: The results reflect the good experience of participants and reveal the alignment of the pedagogical structure with the CoP theory.
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| 9. |
- Luiking, Marie-Louise, et al.
(författare)
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The Dividends of Collaboration: An STTI European Research Taskforce Experience
- 2017
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Ingår i: 44th Biennial Convention 2017: Influence Through Action: Advancing Global Health, Nursing, and Midwifery. Indianapolis, Indiana, USA.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Collaboration is often perceived as a compromising endeavour. However fostering a common vision, outcome/goal and building a trusting relationship can lay the foundation for partnerships that can lead to remarkable achievement. Collaboration between nurses is a key ingredient to quality, safety and cost efficient and effective care within health care and nursing research. The Sigma Theta Tau International (STTI) European regional committee aims to raise awareness and promote fruitful collaboration between nursing scholars in Europa as well as to expand STTI critical mass across Europe. The committee, which is made up of the European chapter presidents drafted and adopted a policy document including a strategy plan for further developing and promoting STTI across Europe. One of the key long-term goals of the STTI European Policy document revised in 2014, is to conduct a collaborative research project by 2020 (STTI European 2014). A short-term goal is a publication based on a review of literature. The intended rational is to address common issues in education, clinical practice or patient safety in a European research collaboration and to realise teamwork among STTI scholars. This paper outlines an ongoing project across Europe to produce relevant literature for a publication on migrant patients’ experiences of healthcare. Health care is a basic human right for all people, the World Health Care organisation (WHO) Constitution enshrines “…the highest attainable standard of health as a fundamental right of every human being.” (WHO 2015)Vulnerable and marginalized groups in societies for example migrants tend to bear an undue proportion of health problems. Access to health care is considered a determinant of health inequalities. The term "migrant" is defined in the Oxford English Dictionary as "one who moves, either temporarily or permanently, from one place, area or country of residence to another" (Oxford diction). The topic was selected because Europe has seen mass migration of people fleeing war torn Middle East countries to live in Europe. This topic was highly relevant to all members, as more than a million migrants and refugees crossed into Europe in 2015. This mass migration led to crises, as countries struggled to cope with the influx and created division in the European Union (EU) over how best to deal with resettling people. Tensions in the EU have been rising because of the disproportionate burden faced by some countries. The STTI group agreed that with increasing numbers of people on the move, healthcare of migrants has become a key global public-health issue. The sheer scale of human displacement has turned migrant health into a priority for the European public-health agenda. Aim: To share the experience of setting up a successful scholarly collaboration among European nurses, the Research Task Force will (1) report and discuss lessons learned about international collaboration and global partnerships and (2) show the steps taken by the European research collaboration on disseminating the nursing care knowledge gained by writing a review article. Method: Under the lead of the European STTI Research co-ordinator in Sweden, individual STTI members from the Netherlands, Sweden and United Kingdom formed a taskforce group. This taskforce group decided upon the topic of the review, the method of communications and division of work. Results: Several Skype meetings were held to come to the right topic for the international taskforce. The criteria for the topic were: high relevance to all participating (and other) European countries, having high priority in the European public-health agenda. It was decided to centre the review on migrants’ experiences of using health care services. The mass migration from the middle east and Africa to the EU, not only created the problem of providing healthcare on a vast scale but also the problem that new arrivals had different ideas and expectations of the healthcare systems and also experienced specific problems in accessing the healthcare systems. Within the concept of experiences we intend to explore the sub themes quality of life and satisfaction with the health care that migrants are receiving. In further virtual meetings keywords for the search in the literature databases were discussed and decided upon. The participants from the different countries all searched one or more literature databases. The database assignment to the participant in the different countries was primarily based on the accessibility of certain databases by the different participants. The final articles for the review were selected after further discussions among the international participants about the exact content of these articles. The participants from the different countries could often clarify unexpected findings in articles from their own or neighboring countries. The findings from the articles were collected in a spreadsheet. After individual analysis by the participants the results will be discussed. Multiple participants will write separate parts of the final article . Working together as an international, virtual group offered a number of valuable learning experiences, particularly because the individual members of the group had not necessarily met face to face before the collaboration. Barriers we encountered were related to scheduling the meetings and technical problems in using Skype as a medium to conduct the meetings. These required particular moderating skills and somewhat slowed down the process of the project. On the other hand, the international group members who committed to the collaboration also brought a wealth of expertise to the topic that enabled a fruitful and stimulating exchange, which will enrich our publication. Conclusion: The project has demonstrated the richness that comes with exploring a topic within a multinational group. It also highlighted that a successful collaboration in a virtual research group requires commitment and particular organizational and leadership skills. It was made possible by the communality of members being in the STTI European Research Taskforce. Although we have just reached the stage, after a year, of identifying the literature that will inform our publication, we have first-hand experience of the benefits of working together. We have all learned so much on the facilitators and barriers to working across countries and being heavily reliant upon Skype, but we feel that our publication will add to the body of knowledge on migrant patients’ experiences of healthcare because we have approached the topic in a truly European manner. The discussion will address the results of the review article on migrant experiences of Health Care. In addition, the discussion will outline the differences and similarities and address how this STTI European research collaboration group both nationally and internationally can use the results to build new partnerships, to improve communication and the quality of care in the work environment.
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| 10. |
- Zlotnick, Cheryl, et al.
(författare)
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A Multi-national Collaboration: Examining the Healthcare Encounters of Migrant Nurses
- 2022
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Ingår i: Virginia Henderson repository.
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Konferensbidrag (refereegranskat)abstract
- Purpose: Globally, almost 13% of nurses are migrants who were educated or working outside of their birth country. Due to nursing shortages, many high-income countries are recruiting nurses from other countries. These "migrant" nurses contribute to cultural diversity and reduce staffing shortages but suffer from poorer mental and physical health status than their non-migrant peers. Compounding this disparity are research findings that migrant nurses experience obstacles obtaining healthcare for themselves. This study's research questions and hypotheses centered on the relationship between the migrant nurses' self-reported acculturation to the host country and their assessment of their healthcare encounters. Methods: This mixed-methods study contained a cross-sectional questionnaire (quantitative component) and interviews (qualitative component). With Ethics' Committee approval, data were collected by disseminating an online link via social media outlets targeting nurses in Europe, Israel and elsewhere. The online, anonymous questionnaire required about 15 minutes for completion. Bivariate and multivariable analyses included linear regression models and the use of Hayes Process model 4 macro testing mediation. At the end of the questionnaire, migrant nurse respondents were invited to participate in online interviews. The migrant nurse respondents' interviews lasted approximately one hour. The transcribed interviews were analyzed using inductive thematic analysis. Attention to scientific rigor included measuring reliability (internal consistency) via Cronbach's alpha for all quantitative scales; and conducting peer-debriefing to assess reliability and validity of the qualitative results. Results: The quantitative sample included migrant nurses (n=73) who were mostly female, married, with graduate level education and employed full-time. Their ages averaged 41 years, and on average, they had lived in their host countries for 13 years. About a third were born in Europe, about a half in Asia including the Middle east, and the remainder were born in Africa or the Americas. Country of residence was primarily Europe. Findings from testing for mediation indicated that there was a significant indirect effect between the nursing migrants' perception of healthcare system on their health encounter assessment (b=0.01051, t=-2.2255, p=0.030) but no evidence of a direct effect between nurse acculturation and health encounter assessment (b=0.1589, t=1.0823, p=0.284). The qualitative sample consisting of narratives from migrant nurses (n=5) yielded three main thematic areas: assimilation to the culture, access to health care and healthcare encounter in the host country. Some narrative quotes support the quantitative finding of no direct effect. Conclusion: Quantitative results suggested a fully mediated model in which the relationship between migrant nurse acculturation and healthcare encounter assessment was mediated by fewer barriers to the healthcare access. Qualitative results showed that nurses who reported feeling acculturated to the host country had problematic healthcare encounters, which supported the quantitative finding that there is no direct effect (acculturation alone does not influence the healthcare encounter assessment). Since current literature suggests that many migrant nurses have unmet needs for mental and physical healthcare, it is clear that healthcare institutions employing migrant nurses need to provide them with assistance both to acculturate and to overcome barriers to obtaining healthcare.
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