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- 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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- 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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