BackgroundIn Denmark, immigrants have been found to have a higher use of healthcare services abroad. Since this use may have an impact on both the individual patient and the healthcare system in the country of residence, research into underlying reasons is of increasing relevance. This study therefore investigates what motives patients with an immigrant background have for seeking healthcare services in their region of origin.MethodsThe study was based on 10 semi-structured interviews with 10 patients who had an immigrant background, primarily originating from Turkey and the Middle East, recruited at a clinic of immigrant medicine in Denmark. The interviews were analysed thematically to elucidate motives for seeking healthcare services abroad, with focus on identifying push and pull factors.ResultsFour motives for seeking healthcare in the region of origin were salient in the material: the perception of availability, in terms of quantity and access; familiarity, conceptualised as feeling comfortable within the healthcare system; perception of quality of services; and finally, the perceived need for a second opinion. All motives emerged simultaneously as push factors, motivating immigrants to explore healthcare services abroad, and pull factors, attracting them to their country of origin. Affordability did not emerge as an independent motive but influenced the other factors.ConclusionThe use of healthcare services abroad by patients with an immigrant background constitutes active health-seeking behaviours shaped by a range of factors perceived to be limiting access to high-quality services in Denmark. Further research, including quantitative studies, should be initiated to investigate the importance of these motives among larger, more diverse immigrant groups, consequences for treatment regimes, and the healthcare professionals’ perspective on the use of healthcare in the region of origin among immigrant patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1346-1) contains supplementary material, which is available to authorized users.

Purpose The purpose of this paper is to explore the association between the quality of prison life and mental health among prisoners and the occurrence of violence. Design/methodology/approach In total, 203 prisoners from Dubrava Correctional Center in Kosovo participated. Data on background characteristics of the prisoners, quality of prison life, mental health symptoms and exposure to physical, psychological and sexual violence were collected through interviewer-administered questionnaires. Data were analyzed using general linear models (GLM) and manual backwards model search with step-wise exclusion. Findings The GLM analysis showed a significant negative association between anxiety symptom load (−1.4), physical violence (−1.5) and psychological violence (−1.9), and quality of prison life. Furthermore, it appeared that prisoners rating of quality of life (QoL) increased with time among prisoners not exposed to violence, while this was not seen among prisoners exposed to violence. Finally, there was an inverse association between the dimensions of respect, fairness, humanity and good staff/prisoner relations, and the proportion of prisoners exposed to violence. Originality/value An environment with higher levels of respect, fairness, humanity and good relations between staff and prisoners was associated with lower levels of violence. Hence, a prison that focuses on promoting QoL and good mental health among prisoners will show lower levels of violence, thereby making the prison a more tolerable place for the prisoners and a better working environment for prison staff.

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