Migrants' Healthcare Experience: A Meta-Ethnography Review of the Literature.
Luiking ML, Heckemann B, Ali P, Dekker-van Doorn C, Ghosh S, Kydd A, Watson R, Patel H. J Nurs Scholarsh. 2019 Jan;51(1):58-67. doi: 10.1111/jnu.12442. Epub 2018 Nov 2. PMID: 30390377
Purpose: Worldwide, more than 214 million people have left their country of origin. This unprecedented mass migration impacts health care in host countries. This article explores and synthesizes literature on the healthcare experiences of migrants.
Design: A meta-ethnography study of qualitative studies was conducted.
Methods: Eight databases (Medline, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], PsycINFO, Embase, Web of Science, Migration Observatory, National Health Service Scotland Knowledge Network, and Adaptive Spectrum and Signal Alignment [ASSIA]) were searched for relevant full-text articles in English, published between January 2006 and June 2016. Articles were screened against inclusion criteria for eligibility. Included articles were assessed for quality and analyzed using Noblit and Hare's seven-step meta-ethnography process.
Findings: Twenty-seven studies were included in the review. Five key contextualization dimensions were identified: personal factors, the healthcare system, accessing healthcare, the encounter, and the healthcare experience. These five areas all underlined the uniqueness of each individual migrant, emphasizing the need to treat a person rather than a population. Within a true person-centered approach, the individual's cultural background is fundamental to effective care.
Conclusions: From the findings, a model has been designed using the five dimensions and grounded in a person-centered care approach. This may help healthcare providers to identify weak points, as well as to improve the organization and healthcare professionals' ability to provide person-centered care to migrant patients.
Clinical relevance: The proposed model facilitates identification of points of weakness in the care of migrant patients. Employing a person-centered care approach may contribute to improve health outcomes for migrant patients.
Keywords: Cultural diversity; Ethnography; Health education; Nurse patient relationship; Quality of services.