Experience of skin disease and relationships with healthcare providers: a qualitative study of Traveller women in Ireland

Abstract

Summary Background Significant health disparities exist between members of the Travelling community and those of the general population. Barriers to Traveller engagement with health services include the experience or perception of discrimination, and cultural and health literacy barriers. Experience of skin disease and interactions with healthcare providers has not been widely explored in this ethnic minority. The formation of positive relationships between the Travelling community and healthcare providers is important in the promotion of treatment adherence and improving health outcomes. Objectives To investigate Travellers’ experience of skin disease and their relationships with healthcare providers. Methods Focus groups were conducted with a purposive sample of female members of the Irish Travelling community with experience of skin health issues, between January 2018 and April 2018. Three focus groups were conducted at three separate locations with 10 participants in each group. Themes were identified from the focus group transcripts using an inductive thematic analysis framework. Results Emergent themes surrounding relationships between Travellers and healthcare providers included health literacy, discrimination, information inconsistency, trust and communication. Factors that were valued in the creation of positive relationships included an appreciation of varying degrees of health literacy, the provision of sufficient information tailored to an individual's needs and a demonstration of cultural competence. Conclusions Dermatologists are well placed to provide practical, customized, treatment guidance and engage patients while integrating their culturally based beliefs.

Learning from patients’ experiences: the case of Travellers and their experiences of using health services for skin complaints

“…This issue of the BJD includes an important article by Gilhooley et al . who have looked at Irish Traveller women's experiences of skin disease and their relationships with healthcare providers.…”

“…However, the authors also found that women's accounts contained pointers to strategies that can ameliorate many of the problematic issues identified in the research. Gilhooley et al . recommend tailoring health information for Irish Travellers according to health literacy levels, and that healthcare professionals should demonstrate cultural competence with this group – by customizing best evidence to suit the needs of this community.…”

“…Gilhooley et al . 's article further captures a theme permeating the realm of health studies where there is a growing realization that sometimes the circumstances of people's day‐to‐day lives pose immense challenges to implementing the treatments recommend by well‐meaning clinicians . As treatment and care moves away from clinical settings, the apparent certainty of a clinical recommendation is not only constrained and enabled by people's everyday life, but also by the resources available to people within their socio‐contextual realm .…”

Take 10: ten qualitative studies on under‐researched groups and hard‐to‐reach issues in dermatology

“…Authors responded to our challenge with a wider range of submissions and almost double the number submitted last time, showing the growing interest in qualitative research in this field. Our second spotlight for summer 2019 showcases 10 studies, comprising a complementary mix of six original articles and four research letters . These papers involve interdisciplinary authorship teams from dermatology, psychology, general practice, nursing, public health and applied health services research in Australia, Germany, the Netherlands, the Republic of Ireland, the U.K. and the U.S.A.…”

“…The first three papers, offer vivid insights into the experiences of under‐researched groups. Gilhooley and colleagues examined experiences of skin disease and relationships with healthcare providers among Irish Traveller women. Focus groups highlighted aspects of care that women valued.…”