Perspective of asylum-seeking caregivers on the quality of care provided by a Swiss paediatric hospital: a qualitative study

Abstract

ObjectivesThis study investigated the perspective of asylum-seeking caregivers on the quality of healthcare delivered to their children in a qualitative in-depth interview study. The health of asylum-seeking children is of key interest for healthcare providers, yet knowledge of the perspective of asylum-seeking caregivers when accessing healthcare is limited.SettingThe study took place in a paediatric tertiary care hospital in Basel, Switzerland.ParticipantsInterviews were done with 13 asylum-seeking caregivers who had presented with their children at the paediatric tertiary care hospital. Nine female and four male caregivers from Tibet, Eritrea, Afghanistan, Syria, Iraq, Albania and Macedonia were included. A diverse sample was chosen regarding cultural and social background, years of residence in Switzerland and reasons for seeking care. A previously developed and pilot-tested interview guide was used for semistructured in-depth interviews between 36 and 92 min in duration. Data analysis and reporting was done according to Consolidated Criteria for Reporting Qualitative Research. The number of interviews was determined by saturation of data.ResultsThe interviewees described a mismatch of personal competencies and external challenges. Communication barriers and unfamiliarity with new health concepts were reported as challenges. These were aggravated by isolation and concerns about their child’s health. The following factors were reported to strongly contribute to satisfaction of healthcare delivery: a respectful and trusting caregiver–provider relationship, the presence of interpreters and immediate availability of treatment.ConclusionsA mismatch of personal competencies and external challenges importantly influences the caregiver–provider relationship. To overcome this mismatch establishment of confidence was identified as a key factor. This can be achieved by availability of interpreter services, sufficient consultation time and transcultural trainings for healthcare workers. Coordination between the family, the government’s asylum system and the medical system is required to facilitate this process.

Caregivers with limited language proficiency and their satisfaction with paediatric emergency care related to the use of professional interpreters: a mixed methods study

“…A Swedish study showed that professional interpreters are associated with the improvement of relationship between the patient and caregivers, the increase of patient safety and patient involvement in care 70. As also described in other studies, respect, friendliness and kindness led to trustful relationships and were described as important reasons for caregivers’ satisfaction with care 71. Complaints about the relationship often derived from misconceptions and misunderstandings.…”

Health care provided to recent asylum-seeking and non-asylum-seeking pediatric patients in 2016 and 2017 at a Swiss tertiary hospital - a retrospective study

“…This allows the comparison of main diagnosis in asylum-seeking and non-asylum-seeking inpatients [ 40 ], an in-depth analysis of the subgroup of frequently visiting patients [ 41 ] as the investigation of potentially preventable hospital admissions and emergency department visits [ 42 ]. Further to this an earlier qualitative study from our institution was done to understand the perspective of the asylum-seeking families on including on aspects for the escape and the quality of care provided at the hospital [ 43 ].…”

Reasons for admission in asylum-seeking and non-asylum-seeking patients in a paediatric tertiary care centre

“…One explanation for this finding might be that asylum-seeking children are less likely to be admitted for trauma and injury as these occur less commonly. Alternatively, the injuries are equally common but asylum-seeking children potentially experience barriers to presenting to an emergency department, including lack of information about the local health care system, worries about high charges or language barriers [26][27][28].…”