Sobrun-Maharaj Amritha, Tse Samson, Hoque Ekramul
Centre for Asian Health Research and Evaluation, School of Population Health, The University of Auckland, Auckland, New Zealand.
J Prim Health Care. 2010 Mar;2(1):43-53.
The Accident Compensation Corporation (ACC) administers New Zealand's (NZ) accident compensation scheme. Asians in NZ are apparently under-serviced by ACC and may be experiencing barriers to accessing services. This study identifies barriers that Asians in NZ face in accessing ACC's injury-related services and compensations.
By utilising a qualitative research design, 113 Chinese, Korean, Indian, and South East Asian participants residing in Auckland, NZ were recruited through maximum variation and purposive snowball sampling. Data were gathered during 2006 through 22 individual in-depth interviews and 14 focus group discussions based on semi-structured interview schedules. Interviewees included Asian general practitioners, traditional health providers, users and non-users of injury-related services, case managers and Asian community leaders. Data were analysed using a general inductive approach.
Results show that personal/cultural characteristics such as age, gender, English language competence, injury-related language competence, differing Asian worldviews, and consequent help-seeking behaviours act as barriers to accessing services and entitlements. This is exacerbated by logistical and environmental factors such as cost, transport, time, inadequate interpretation and translation services, as well as institutional barriers such as lack of information about services, culturally inappropriate services, discriminatory attitudes and employment risks.
It is evident that Asians living in NZ are experiencing several cultural, environmental and institutional barriers to accessing ACC services. There is clearly a need for more culturally relevant information and injury-related services if Asian immigrants' use of such services and entitlements is to be increased.
事故赔偿公司(ACC)负责管理新西兰的事故赔偿计划。在新西兰,亚洲人显然未得到ACC充分的服务,可能在获取服务方面面临障碍。本研究确定了新西兰亚洲人在获取ACC与伤害相关的服务和赔偿时所面临的障碍。
采用定性研究设计,通过最大差异抽样和目的抽样滚雪球法,招募了113名居住在新西兰奥克兰的中国、韩国、印度和东南亚参与者。2006年期间,根据半结构化访谈提纲,通过22次个人深度访谈和14次焦点小组讨论收集数据。受访者包括亚洲全科医生、传统医疗服务提供者、与伤害相关服务的使用者和非使用者、个案管理人员以及亚洲社区领袖。采用一般归纳法对数据进行分析。
结果表明,年龄、性别、英语语言能力、与伤害相关的语言能力、不同的亚洲世界观以及由此产生的求助行为等个人/文化特征成为获取服务和权益的障碍。成本、交通、时间、口译和笔译服务不足等后勤和环境因素,以及服务信息缺乏、文化上不适当的服务、歧视性态度和就业风险等制度障碍,使这一情况更加恶化。
显然,生活在新西兰的亚洲人在获取ACC服务方面面临多种文化、环境和制度障碍。如果要增加亚洲移民对这类服务和权益的使用,显然需要提供更多与文化相关的信息和与伤害相关的服务。