Institute of Nursing Science, University of Basel, Basel, Switzerland.
BMC Public Health. 2010 Nov 1;10:659. doi: 10.1186/1471-2458-10-659.
Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO) and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients.
A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory.
The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population), due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient.
Health policies for asylum seekers need to be designed to assure access to adequate contraception, and to provide psychological care for this vulnerable group of patients. Care for asylum seekers may be emotionally very challenging for health professionals.
处理怀孕、分娩和新生儿护理对寻求庇护的女性及其医疗保健提供者来说是一个挑战。我们的研究旨在确定在瑞士寻求庇护的女性人群中的生殖健康问题，并研究她们所接受的护理。这些女性通过一个特殊的健康维护组织（HMO）投保，并在巴塞尔大学医院的妇女诊所就诊。我们还调查了参与提供这些患者医疗保健服务的卫生专业人员如何看待他们的经验。
混合方法结合了对定量描述性数据和定性数据的分析，这些数据来自于对卫生保健提供者的半结构化访谈以及患者档案。我们分析了在 HMO 投保的 80 名在妇女诊所就诊的寻求庇护者的记录。我们对半结构化访谈了来自不同专业群体的 10 名护理提供者。对定量数据进行描述性分析。定性数据分析受扎根理论指导。
寻求庇护者的主要健康问题是由于避孕措施不足导致的人工流产率很高（比当地人口高 2.5 倍），以及由于被迫移民和当前困难的生活状况导致的心理社会压力。语言障碍被确定为卫生保健提供者提供护理的主要困难。卫生保健提供者在照顾寻求庇护者时也面临着重大的情感挑战。医生面临的额外问题是，他们经常需要代表负责庇护程序的当局以官方身份行事，并且他们还必须做出关于控制支出的决策，以满足 HMO 的要求。他们认为这些决策有时与他们对病人的责任相冲突。
寻求庇护者的卫生政策需要设计，以确保获得足够的避孕措施，并为这一脆弱群体的患者提供心理护理。照顾寻求庇护者可能对卫生专业人员的情感构成很大的挑战。
