Exploring the expectations, experiences and tensions of refugee patients and general practitioners in the quality of care in general practice.
communication
patient engagement
refugee
Journal
Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
16
11
2021
received:
21
09
2021
accepted:
07
12
2021
pubmed:
25
12
2021
medline:
6
4
2022
entrez:
24
12
2021
Statut:
ppublish
Résumé
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. 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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 34951092
doi: 10.1111/hex.13411
pmc: PMC8957721
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
639-647Informations de copyright
© 2021 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Références
Aust New Zealand Health Policy. 2005 Oct 09;2:23
pubmed: 16212674
Patient Educ Couns. 2020 Oct;103(10):1883-1901
pubmed: 32507590
J Natl Med Assoc. 2008 Nov;100(11):1275-85
pubmed: 19024223
Patient Educ Couns. 2008 Jul;72(1):155-62
pubmed: 18485657
BMC Public Health. 2019 Jun 14;19(1):755
pubmed: 31200684
Front Sociol. 2020 Nov 05;5:557563
pubmed: 33869495
Health Expect. 2022 Apr;25(2):639-647
pubmed: 34951092
BMC Fam Pract. 2015 May 06;16:55
pubmed: 25943553
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Int J Equity Health. 2018 Sep 24;17(1):151
pubmed: 30249270
Br J Gen Pract. 2015 Mar;65(632):e171-6
pubmed: 25733438
Aust Fam Physician. 2012 Mar;41(3):147-9
pubmed: 22396929
Patient Educ Couns. 2015 Oct;98(10):1243-7
pubmed: 26277827
Public Health Res Pract. 2018 Mar 15;28(1):
pubmed: 29582035
J Immigr Minor Health. 2014 Dec;16(6):1238-46
pubmed: 24375384
Am Fam Physician. 2011 Feb 15;83(4):429-36
pubmed: 21322519
Med Care Res Rev. 2021 Feb;78(1):3-23
pubmed: 31291823
BMJ Open. 2017 Aug 4;7(8):e015981
pubmed: 28780549
Int J Environ Res Public Health. 2021 Feb 04;18(4):
pubmed: 33557234
BMC Womens Health. 2021 Mar 8;21(1):100
pubmed: 33685463
J Gen Intern Med. 2019 Aug;34(8):1591-1606
pubmed: 31147980
Health Expect. 2005 Mar;8(1):4-17
pubmed: 15713166
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Br J Gen Pract. 2000 Jul;50(456):531-2
pubmed: 10954931
BMC Med Educ. 2019 Nov 6;19(1):378
pubmed: 31690300