Approaches to delivering appropriate care to engage and meet the complex needs of refugee and asylum seekers in Australian primary healthcare: A qualitative study

Patel, Pinika; Muscat, Danielle Marie; Bernays, Sarah; Zachariah, Dipti; Trevena, Lyndal

doi:10.1111/hsc.14065

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…In mainstream practice, GPs’ attitudes play an important role in ensuring migrants’ adherence to and navigation of the healthcare system. With a patient-centered approach, providing culturally adapted care and assisting with building patients’ health systems literacy can enhance care experiences [ 22 ]. When GPs care for underserved populations, they develop specific skills to improve physician‒patient relationships and meet their patients’ health-related needs [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Illegal migrants cannot do so but benefit from the same access to global coordinated care pathways through ambulatory GPs and often identify them as referral physicians [ 21 ]. GPs and their care organizations can enhance or limit vulnerable migrants’ access to needed care, depending on their ability to develop a culturally patient-centered approach and listen to their patients’ health and social needs, a welcoming environment, and the availability of interpretation services [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Care-seeking strategies of migrants during the transition from a specific primary healthcare facility for uncovered individuals to common ambulatory general practice: A French qualitative study

Maeva,

Anne,

Marie

et al. 2024

BMC Public Health

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Background Migrants have complex health needs but face multiple barriers to accessing health care. In France, permanent healthcare access offices (PASSs), as specific primary health care facilities (SPHCs), provide care to people without health insurance coverage. Once these patients obtain health insurance, they are referred to common ambulatory general practice. The aim of this study was to explore migrants’ experiences and strategies for seeking common primary care after having been treated by an SPHC. Methods We conducted a qualitative study based on grounded theory between January and April 2022. We held semi-structured interviews with migrants who had consulted a PASS. Two researchers performed an inductive analysis. Results We interviewed 12 migrants aged 22 to 65 to confirm data saturation. The interviewees relied on “referents”: professional referents (to be properly treated for specific health problems), guides (to find their way through the healthcare system), or practical referents (to address practical issues such as translation, travel needs, or medical matters). Those who considered the PASS to be a referent expressed disappointment and incomprehension at the time of discharge. Referral procedures and the first encounter with common ambulatory general practice were decisive in whether the interviewees accessed and stayed in a coordinated primary care pathway. The perceived quality of care depended on a feeling of being considered and listened to. For interviewees who received first-time services from an ambulatory general practice, the way in which they were referred to and their first experience with an ambulatory GP could influence their adherence to care. Conclusions The conditions of transition from SPHCs to common ambulatory general practice can impact migrants’ adherence to a coordinated primary care pathway. Referral can improve these patients’ care pathways and ease the transition from a PASS to ambulatory care. Healthcare professionals at SPHCs should pay special attention to vulnerable migrants without previous experience in ambulatory general practice and who depend on referents in their care pathways. For these patients, adapted referral protocols with further individual support and empowerment should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Care-seeking strategies of migrants during the transition from a specific primary healthcare facility for uncovered individuals to common ambulatory general practice: A French qualitative study

Maeva,

Anne,

Marie

et al. 2024

BMC Public Health

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Factors influencing general practice nurse's implementation of culturally responsive care, using normalization process theory: A cross‐sectional study

Oakley,

Manning,

Macfarlane

et al. 2024

Journal of Advanced Nursing

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AimsTo explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory.DesignA self‐administered online cross‐sectional survey.MethodsA participatory co‐designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus‐Based Checklist for Reporting of Survey Studies (CROSS).ResultsGPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients.ConclusionThis analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices.ImpactUsing normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro‐level (individual), meso‐level (organizational) and macro‐level (structural) factors that require attention for normalizing culturally responsive care in general practice services.Patient or Public ContributionThe study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.

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Corrigendum to “Approaches to Delivering Appropriate Care to Engage and Meet the Complex Needs of Refugee and Asylum Seekers in Australian Primary Healthcare: A Qualitative Study”

Patel

Muscat

Bernays

et al. 2023

Health & Social Care in the Community

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Approaches to delivering appropriate care to engage and meet the complex needs of refugee and asylum seekers in Australian primary healthcare: A qualitative study

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 4 publications

References 31 publications

Care-seeking strategies of migrants during the transition from a specific primary healthcare facility for uncovered individuals to common ambulatory general practice: A French qualitative study

Care-seeking strategies of migrants during the transition from a specific primary healthcare facility for uncovered individuals to common ambulatory general practice: A French qualitative study

Factors influencing general practice nurse's implementation of culturally responsive care, using normalization process theory: A cross‐sectional study

Corrigendum to “Approaches to Delivering Appropriate Care to Engage and Meet the Complex Needs of Refugee and Asylum Seekers in Australian Primary Healthcare: A Qualitative Study”

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