Dataset Information

Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context.

ABSTRACT:

Objective

Migration has increased globally. Emergency departments (EDs) may be the first and only contact some migrants have with healthcare. Emergency care providers' (ECPs) views concerning migrant patients were examined to identify potential health disparities and enable recommendations for ED policy and practice.

Design

Systematic review and meta-synthesis of published findings from qualitative studies.

Data sources

Electronic databases (Ovid Medline, Embase (via Ovid), PsycINFO (via OVID), CINAHL, Web of Science and PubMed), specialist websites and journals were searched.

Eligibility criteria

Studies employing qualitative methods published in English.

Settings

EDs in high-income countries.

Participants

ECPs included doctors, nurses and paramedics.

Topic of enquiry

Staff views on migrant care in ED settings.

Data extraction and synthesis

Data that fit the overarching themes of 'beliefs' and 'challenges' were extracted and coded into an evolving framework. Lines of argument were drawn from the main themes identified in order to infer implications for UK policy and practice.

Results

Eleven qualitative studies from Europe and the USA were included. Three analytical themes were found: challenges in cultural competence; weak system organisation that did not sufficiently support emergency care delivery; and ethical dilemmas over decisions on the rationing of healthcare and reporting of undocumented migrants.

Conclusion

ECPs made cultural and organisational adjustments for migrant patients, however, willingness was dependent on the individual's clinical autonomy. ECPs did not allow legal status to obstruct delivery of emergency care to migrant patients. Reported decisions to inform the authorities were mixed; potentially leading to uncertainty of outcome for undocumented migrants and deterring those in need of healthcare from seeking treatment. If a charging policy for emergency care in the UK was introduced, it is possible that ECPs would resist this through fears of widening healthcare disparities. Further recommendations for service delivery involve training and organisational support.

SUBMITTER: Harrison HL

PROVIDER: S-EPMC6677953 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context.

Harrison Hooi-Ling HL Daker-White Gavin G

BMJ open 20190731 7

<h4>Objective</h4>Migration has increased globally. Emergency departments (EDs) may be the first and only contact some migrants have with healthcare. Emergency care providers' (ECPs) views concerning migrant patients were examined to identify potential health disparities and enable recommendations for ED policy and practice.<h4>Design</h4>Systematic review and meta-synthesis of published findings from qualitative studies.<h4>Data sources</h4>Electronic databases (Ovid Medline, Embase (via Ovid), ...[more]

PMID: 31371292

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Project description:IntroductionMigrants and refugees belong to the most marginalized groups in the world. Barriers related to the determinants of health can often preclude access to basic human rights, and have a negative impact on health. Therefore, it is essential to understand how to properly interface with people with different perceptions of health and disease and how to design programs based on available resources.AimTo explore the experience of socio-health workers who work in the context of a reception project in Italy related to taking care of the health needs of a migrant population in a multicultural context.MethodsThis research was a qualitative phenomenological study with an interpretive approach adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines. The conversations were audio-recorded, transcribed, and read in depth. Reflexive analysis was used to analyze the data.ResultsSixteen health and social workers were interviewed. Three main themes were extracted: (1) nature of needs and their facets; (2) interconnection between skills and in relationships; (3) struggles against shortages. The results highlight the participants' attribution of meaning to the needs and requirements of migrants, their experience in the relationship with the team and the migrants, and the difficulties in carrying out their role.DiscussionWhat the study found underscores the importance of designing interventions that consider the unique perceptions and experiences of professionals who engage with migrants in daily practice. The complex health needs, experiences, and different cultural representations of health and illness must be read and approached with a culturally competent vision.ConclusionThe study reveals how much the strengths of taking care of migrants' health lie in the ability to interconnect various competencies. This study gives elements for professionals and health organizations to understand the complexity of caring for the migrant population.

Project description:BackgroundThe health status and lifestyle of migrants is often poorer than that of the general population of their host countries. The Nepalese represent a relatively small, but growing, immigrant community in the UK, about whom very little is known in term of public health. Therefore, our study examined the health and lifestyle of Nepalese migrants in the UK.MethodsA cross-sectional survey of Nepalese migrants in UK was conducted in early 2007 using a postal, self-administered questionnaire in England and Scotland (n = 312), and telephone interviews in Wales (n = 15). The total response rate was 68% (327 out of 480). Data were analyzed to establish whether there are associations between socio-economic and lifestyle factors. A multivariate binary logistic regression was applied to find out independent effect of personal factors on health status.ResultsThe majority of respondents was male (75%), aged between 30 and 45 (66%), married or had a civil partner (83%), had university education (47%) and an annual family income (69%) ranging from pound5,035 to pound33,300. More than one third (39%) of the respondents have lived in the UK for 1 to 5 years and approximately half (46%) were longer-term residents. Most (95%) were registered with a family doctor, but only 38% with a dentist. A low proportion (14%) of respondents smoked but more than half (61%) consumed alcohol. More than half (57%) did not do regular exercises and nearly one fourth (23%) of respondents rated their health as poor. Self reported 'good' health status of the respondents was independently associated with immigration status and doing regular exerciseConclusionThe self reported health status and lifestyle, health seeking behaviour of Nepalese people who are residing in UK appears to be good. However, the overall regular exercise and dentist registration was rather poor. Health promotion, especially aimed at Nepalese migrants could help encourage them to exercise regularly and assist them to register with a dentist.

Dataset Information

Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context.

Objective

Design

Data sources

Eligibility criteria

Settings

Participants

Topic of enquiry

Data extraction and synthesis

Results

Conclusion

Publications

Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context.

Similar Datasets

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