Good practice in health care for migrants: views and experiences of care professionals in 16 European countries

BMC Public Health

Research Article

Rosa Puigpinósi Riera¹  Ulrike Kluge²  Allan Krasnik³  Kristian Wahlbeck⁴  Mindaugas Stankunas⁵  Joaquim JF Soares⁶  Elisabeth Ioannidis⁷  Tim Greacen⁸  Attila Sarvary⁹  Vincent Lorant^1,10  Sónia Dias^1,11  Marta Welbel^1,12  Majda Lamkaddem^1,13  Christa Straßmayr^1,14  Andrea Gaddini^1,15  Sima Sandhu^1,16  Stefan Priebe^1,16  Marija Bogic^1,16 

[1] Agency of Public Health of Barcelona, Pça. Lesseps, 1, 08023, Barcelona, Spain;Clinic for Psychiatry and Psychotherapy, Charité - University Medicine Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany;Danish Research Centre for Migration, Ethnicity and Health (MESU), Unit of Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014, Copenhagen, Denmark;Department for Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), P.O.B. 30, FIN-00271, Helsinki, Finland;Department of Health Management, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, LT 44307, Kaunas, Lithuania;Department of Public Health Sciences, Section of Social Medicine, Karolinska Institutet, SE- 171 76, Stockholm, Sweden;Department of Sociology, National School of Public Health, 196 Alexandras avenue, 11521, Athens, Greece;Etablissement public de santé Maison Blanche, 3-5 rue Lespagnol, 75020, Paris, France;Faculty of Health Sciences at Nyíregyháza, University of Debrecen, Sóstói út 31/B, 4400, Nyíregyháza, Hungary;Institute of Health and Society, Catholic University of Louvain, Clos Chapelle aux Champs 30.05, 1200, Brussels, Belgium;Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Rua da Junqueira, 96, 1349-008, Lisbon, Portugal;Institute of Psychiatry and Neurology, Ul. Sobieskiego 9, 02-957, Warsaw, Poland;International and Migrant Health, NIVEL (Netherlands Institute for Health Services Research), PO Box 1568, Otterstraat 118-124, 3500 BN, Utrecht, The Netherlands;Ludwig Boltzmann Institute for Social Psychiatry, Lazarettgasse 14A-9121090, Vienna, Austria;Public Health Agency for the Lazio Region, Via S. Costanza 53, 00185, Rome, Italy;Unit for Social and Community Psychiatry, London and the Barts School of Medicine and Dentistry, Queen Mary University of London, Newham Centre for Mental Health, E13 8SP, London, UK;

关键词: Health Care Professional;    Host Country;    Good Practice;    Language Barrier;    Asylum Seeker;   

DOI  :  10.1186/1471-2458-11-187

 received in 2010-12-06, accepted in 2011-03-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHealth services across Europe provide health care for migrant patients every day. However, little systematic research has explored the views and experiences of health care professionals in different European countries. The aim of this study was to assess the difficulties professionals experience in their service when providing such care and what they consider constitutes good practice to overcome these problems or limit their negative impact on the quality of care.MethodsStructured interviews with open questions and case vignettes were conducted with health care professionals working in areas with high proportion of migrant populations in 16 countries. In each country, professionals in nine primary care practices, three accident and emergency hospital departments, and three community mental health services (total sample = 240) were interviewed about their views and experiences in providing care for migrant patients, i.e. from first generation immigrant populations. Answers were analysed using thematic content analysis.ResultsEight types of problems and seven components of good practice were identified representing all statements in the interviews. The eight problems were: language barriers, difficulties in arranging care for migrants without health care coverage, social deprivation and traumatic experiences, lack of familiarity with the health care system, cultural differences, different understandings of illness and treatment, negative attitudes among staff and patients, and lack of access to medical history. The components of good practice to overcome these problems or limit their impact were: organisational flexibility with sufficient time and resources, good interpreting services, working with families and social services, cultural awareness of staff, educational programmes and information material for migrants, positive and stable relationships with staff, and clear guidelines on the care entitlements of different migrant groups. Problems and good care components were similar across the three types of services.ConclusionsHealth care professionals in different services experience similar difficulties when providing care to migrants. They also have relatively consistent views on what constitutes good practice. The degree to which these components already are part of routine practice varies. Implementing good practice requires sufficient resources and organisational flexibility, positive attitudes, training for staff and the provision of information.

【 授权许可】

CC BY   
© Priebe et al; licensee BioMed Central Ltd. 2011