Garcés Isabel C, Scarinci Isabel C, Harrison Lynda
Division of Preventive Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South, MT 631, Birmingham, Alabama 35294, USA .
J Immigr Minor Health. 2006 Oct;8(4):377-85. doi: 10.1007/s10903-006-9008-8.
The purpose of this study was to examine the sociocultural factors associated with health maintenance and health care seeking among Latina immigrants. Data were collected from eight focus groups with 54 Latina immigrants between the ages of 19 and 62 (M=29.3+/-9.34). The PEN-3 model provided the framework for the study. Most of the participants came from Mexico; 46% had not completed high school; 85.2% had been in the United States for less than 7 years, and 73.6% reported not having health insurance coverage. Participants identified both positive and negative perceptions, enablers, and nurturers associated with health maintenance and health care seeking. Participants acknowledged the importance of physical, mental, and spiritual health and what they should do to be healthy. Despite such knowledge, they tended to engage in unhealthy behaviors due to a variety of nonstructural barriers such as lack of time, "tradition," and procrastination. They tended to use alternative/complementary medicine first, and then seek medical help if these practices are not effective. Many women believe that they do not have control over their own health attributing this lack of control to the "system." Participants also mentioned structural barriers to seeking health care such as lack of transportation, lack of proper documentation, lack of health insurance, language barriers, long waiting time at the clinics, and lack of knowledge on where to go for affordable care. Our study suggests that there are important structural and nonstructural barriers that hinder health maintenance and care seeking. The findings also lend support to the PEN-3 model, and suggest that positive perceptions, enablers, and nurturers associated with health maintenance and health care seeking, if properly reinforced, can counterbalance negative perceptions, enablers and nurturers in this population.
本研究的目的是探讨与拉丁裔移民的健康维护及寻求医疗保健相关的社会文化因素。研究数据来自八个焦点小组,共有54名年龄在19至62岁之间的拉丁裔移民(平均年龄M = 29.3 ± 9.34)。PEN - 3模型为该研究提供了框架。大多数参与者来自墨西哥;46%未完成高中学业;85.2%在美国居住不到7年,73.6%的参与者表示没有医疗保险。参与者识别出了与健康维护及寻求医疗保健相关的积极和消极认知、促成因素及滋养因素。参与者认可身体、心理和精神健康的重要性以及为保持健康应采取的措施。尽管有这些认知,但由于各种非结构性障碍,如时间不足、“传统”观念和拖延,他们往往会做出不健康的行为。他们倾向于首先使用替代/补充医学,若这些方法无效才寻求医疗帮助。许多女性认为自己无法掌控自身健康,将这种缺乏掌控归因于“体制”。参与者还提到了寻求医疗保健的结构性障碍,如交通不便、缺乏适当的文件、没有医疗保险、语言障碍、诊所等待时间长以及不知道去哪里能获得负担得起的医疗服务。我们的研究表明,存在重要的结构性和非结构性障碍阻碍健康维护及寻求医疗保健。研究结果也支持了PEN - 3模型,并表明与健康维护及寻求医疗保健相关的积极认知、促成因素及滋养因素,若得到适当强化,可抵消该人群中的消极认知、促成因素及滋养因素。