The Danish Research Centre for Migration, Ethnicity and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
BMC Fam Pract. 2013 Jan 28;14:17. doi: 10.1186/1471-2296-14-17.
Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients' refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems.
The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis.
One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms.
General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this study suggest that the development of conversational models for general practitioners including points to be aware of in the treatment of refugee patients may serve as a support in the management of refugee patients in primary care.
难民在精神疾病的发展方面是一个特别脆弱的群体，许多人可能遭受过酷刑或其他创伤经历。全科医生是进入精神科系统的门户，了解患者的难民背景对于确保获得足够的护理至关重要。本研究旨在调查全科医生如何为有精神健康问题的难民提供护理。
该研究是作为欧盟项目“欧洲移民获得医疗服务的最佳实践：欧洲的准入、质量和适宜性（EUGATE）”的一部分进行的。从哥本哈根附近的移民比例较高的地区有针对性地选择了九名全科医生进行半结构式访谈。访谈的分析受到定性内容分析的启发。
分析中确定的一个主要主题是沟通。这包括使用专业口译员，以及沟通不仅仅是分享共同的语言。护理质量是另一个出现的主题，包括意识到可能的创伤史、由于语言障碍难民参与某些治疗的可能性有限以及全科医生感到绝望。全科医生也可能为难民选择不同的转诊途径，他们报告说，他们的患者对心理问题和身体症状之间的区别缺乏理解。
全科医生提供的难民护理与为大多数人群提供的护理不同。全科医生在难民医疗保健治疗中采用的不同策略可能是丹麦全科医疗组织的巨大差异以及难民医疗保健管理中缺乏国家战略的结果。本研究的结果表明，为全科医生制定对话模式，包括在治疗难民患者时需要注意的要点，可能有助于在初级保健中管理难民患者。
