Refugees' perceptions of primary care: What makes a good doctor's visit?

Mutitu, Anne; Zabler, Bev; Holt, Jeana M

doi:10.35680/2372-0247.1382

Cited by 6 publications

(8 citation statements)

References 35 publications

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“…The women experience higher rates of adverse perinatal outcomes, like stillbirths, neonatal deaths, and perinatal mortality, compared with U.S-born White and Hispanic women (Contag et al, 2021). The causes for these disparities relate to barriers around access and utilization (Mutitu et al, 2019), such as acculturation, communication and language barriers, cultural beliefs, unfamiliar systemic and structural health care systems, and health care provider’s knowledge and attitudes toward immigrants (Fair et al, 2020; Omenka et al, 2020).…”

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confidence: 99%

Somali Refugee Women’s Experiences and Perceptions of Western Health Care

Njenga

2022

J Transcult Nurs

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Introduction: The purpose of this study was to explore Somali refugee women’s experiences and perceptions of Western health care in the United States. This study took place in the Midwestern region of the United States. Methodology: This qualitative descriptive study collected data from 15 participants through in-depth interviews. Results: Six themes emerged: (a) communication and resource provision, (b) participatory decision-making, (c) provider attitudes toward cultural practices, (d) understanding the U.S. health care system, (e) resistance to Western health care and, (f) religious beliefs. Discussion and Conclusion: Accounts of the women in this study ran the gamut from positive views to those that were more critical and replete with complaints about Western health care providers and the system. Somali refugee women need culturally competent health care providers who provide sensitive care, offer resources, and involve the women in decision-making about their care.

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confidence: 99%

Somali Refugee Women’s Experiences and Perceptions of Western Health Care

Njenga

2022

J Transcult Nurs

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“…Another explanation for the cause of the disconnect in the expectations of care could be that perhaps many refugees and asylum seekers presented to healthcare services in their country of origin with an acute problem. In this instance, there would be some sort of resolution to the acute and often symptomatic problem and this could be the norm in their country of origin 34 . However in comparison in the Australian primary healthcare setting, there is a greater preventative healthcare lens that accounts for the routine testing and monitoring 3 .…”

Section: Discussionmentioning

confidence: 99%

“…In this instance, there would be some sort of resolution to the acute and often symptomatic problem and this could be the norm in their country of origin. 34 However in comparison in the Australian primary healthcare setting, there is a greater preventative healthcare lens that accounts for the routine testing and monitoring. 3 There is not only a contrast in the healthcare systems but there could also be a contrast in the condition in which the patient presents themselves.…”

Section: Discussionmentioning

confidence: 99%

Exploring the expectations, experiences and tensions of refugee patients and general practitioners in the quality of care in general practice

Patel

Muscat

Trevena

et al. 2021

Health Expectations

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Background Refugees and asylum seekers arrive in the Australian community with complex health needs and expectations of healthcare systems formed from elsewhere. Navigating the primary healthcare system can be challenging with communication and language barriers. In multicultural societies, this obstacle may be removed by accessing language‐concordant care. Emerging evidence suggests language‐concordance is associated with more positive reports of patient experience. Whether this is true for refugees and asylum seekers and their expectation of markers of quality patient‐centred care (PCC) remains to be explored. This study aimed to explore the expectations around the markers of PCC and the impacts of having language‐concordant care in Australian primary healthcare. Methods We conducted semi‐structured individual in‐language (Arabic, Dari, and Tamil) remote interviews with 22 refugee and asylum seekers and 9 general practitioners (GPs). Interview transcripts were coded inductively and deductively, based on the research questions, using Thematic Analysis. Extensive debriefing and discussion took place within the research team throughout data collection and analysis. Results Community member expectations of markers of PCC are constantly evolving and adapting based on invisible and visible actions during clinical encounters. Challenges can occur in the clinical encounter when expectations are ‘unsaid’ or unarticulated by both community members and GPs due to the assumption of shared understanding with language concordant care. Expectations of what constitutes satisfactory, quality PCC are dynamic outcomes, which are influenced by prior and current experiences of healthcare. Conclusion This study highlights the importance of understanding that language concordant care does not always support aligned expectations of the markers of quality PCC between community members and their GP. We recommend that GPs encourage community members to provide explicit descriptions about how their prior experiences have framed their expectations of what characterizes quality PCC. In addition, GPs could develop a collaborative approach, in which they explain their own decision‐making processes in providing PCC to refugees and asylum seekers. Patient or Public Contribution Bilingual researchers from multicultural backgrounds and experience working with people from refugee backgrounds were consulted on study design and analysis. This study included individuals with lived experiences as refugees and asylum seekers and clinicians as participants.

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“…A nurse-led refugee health service has been suggested as a viable approach in offering dedicated healthcare for refugees on resettlement, improving health experiences and outcomes for this population (Ogunsiji et al, 2018). Mutitu et al (2019) acknowledge the importance of specialist nurse-led clinics in providing quality, patient-centred and cost-effective care for refugees in the community, but as an underutilised field, little is known about targeted refugee healthcare.…”

Section: Introductionmentioning

confidence: 99%

“…Mutitu et al (2019) acknowledge the importance of specialist nurse-led clinics in providing quality, patient-centred and cost-effective care for refugees in the community, but as an underutilised field, little is known about targeted refugee healthcare.…”

Section: Introductionmentioning

confidence: 99%

Fluctuating power: an exploration of refugee health nursing within the resettlement context in Victoria, Australia

Hughes

Kean

Cuthill

2022

Journal of Research in Nursing

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Background The Refugee Health Program (RHP) is a nurse-led community initiative, introduced in 2005 with the aim of responding to complex health issues of refugees arriving in Victoria, Australia. Little is known about refugee health nursing in the resettlement context and the impact of dedicated refugee healthcare. Aim To explore the experiences and perspectives of Refugee Health Nurses (RHNs), Refugee Health Managers (managers) and refugees, gaining insight into professional relationships and the complexities of offering a specialised refugee health service. Method A focused ethnographic approach incorporated semi-structured interviews with five RHNs, two managers and eight refugees, two focus groups with refugees and participant observation within the RHP during April 2017 to December 2017. Data collection was undertaken across two sites and interviews, focus groups and observations were transcribed and thematically analysed. Social constructionism asserts that the focus of enquiry should be on interaction, group processes and social practices. Emphasis is placed upon relationships between RHNs, managers and refugees, with knowledge viewed as relational and interactional. Results Professional relationships between RHNs and refugees are complex, with power oscillating between them. Contrary to discourses of ‘vulnerability’ of refugees, both RHNs and refugees demonstrated power in their relationships with each other. Nurses also suggested that these relationships were stressful and could lead to burnout. Key themes were developed: (1) nursing autonomy and gatekeeping; (2) vicarious trauma and burnout; and (3) refugee negotiation of care. Conclusions The balance of power is central to therapeutic relationships. In relationships between RHNs and refugees, power fluctuates as RHNs are exposed to vicarious trauma and symptoms of burnout, while refugees exercise agency by recognising benefits to specialised care. In developing effective therapeutic relationships between RHNs and refugees, attention should be paid to how care is delivered to protect RHNs from burnout while ensuring that refugees receive appropriate care.

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Refugees' perceptions of primary care: What makes a good doctor's visit?

Cited by 6 publications

References 35 publications

Somali Refugee Women’s Experiences and Perceptions of Western Health Care

Somali Refugee Women’s Experiences and Perceptions of Western Health Care

Exploring the expectations, experiences and tensions of refugee patients and general practitioners in the quality of care in general practice

Fluctuating power: an exploration of refugee health nursing within the resettlement context in Victoria, Australia

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