No abstract

Australia is one of a few countries with a resettlement program for refugees. The organisation and provision of health services for refugees pose challenges to health service managers and service providers. Some groups have experienced severe trauma and, in the case of Hazara refugees, years of persecution and displacement. This qualitative study gained access to Hazara refugees in order to gain an understanding of their oral health experiences and to seek participant views on factors that impacted on their oral health status. All participants had poor oral health status, multiple tooth extractions, and had placed a low priority on their oral health. They had experienced violence and traumatic events associated with war and looting. Participants reported that they had limited access to dental practitioners and oral education; lived for extended periods with oral pain and untreated oral problems; and treated oral pain with traditional pain remedies and tooth extractions. Service providers need to consider that elements of the refugee experience may affect health-seeking behavior and adherence to treatment.

Nurses played a significant role in providing care to Kosovar and East Timorese refugees at the East Hills Reception Centre in Sydney, Australia, during Operation Safe Haven in 1999–2000. To ascertain the needs of nurses in this setting, 13 nurses participated in two focus group interviews, and two in‐depth interviews were conducted with nursing managers. Qualitative thematic analysis was conducted on the resulting transcripts. Nurses reported that, overall, they had the necessary clinical skills but needed specific refugee health profiles and training in culturally competent and trauma‐sensitive care. The nurses experienced trauma‐related, cultural, environmental and role‐related stressors. They used a variety of informal psychosocial supports but reported the need for ongoing counselling and debriefing. While clinical skills were considered important, nurses identified other factors as having more impact on their ability to provide comprehensive care for traumatized refugees, particularly their role as client advocates.

There is little information about managing frontline complaints with opioid-dependent women. Semi-structured interviews were conducted with a purposive sample of 13 opioid-dependent women and 10 staff at an Opioid Treatment Service. A multidisciplinary team conducted a thematic analysis on the transcripts. Difficulties that prevented women making complaints included the anticipation of not being taken seriously, the fear of repercussions including infant removal, and practical difficulties in making written complaints. Staff reported that complaints at the dosing window were often delivered emotively and could be personalised. They had difficulty assessing complaints to determine whether there were substantive health care issues that should be followed up. Women and staff believed that case managers had a role in providing support for the complaints process.

The research was conducted to describe Vietnamese-speaking parents' practices in children's oral health care and to identify barriers parents had in accessing child dental services after being notified that their child needed treatment. A qualitative study design was employed, using a stratified purposive sample of five focus groups and three semi-structured interviews. A multidisciplinary team conducted a thematic analysis on the translated transcripts of the focus groups and interview notes. The retention of four traditional patterns of oral care and service use may increase the risk of oral disease among Vietnamese children: traditional oral hygiene practices using salt; delayed introduction of tooth-brushing; not attending a dental clinic for preventive care; and the use of lay remedies, rather than dental care, to cure pain. Language was identified as the major barrier to attending the child dental service, following notification of treatment need. The results suggest that the retention of cultural oral health practices and patterns of service use may increase the risk of oral disease among Vietnamese children. Oral health messages need to provide information in the language spoken at home; messages about dental services and western and traditional practices in oral care.