De Gagne Jennie C, Oh Jina, So Aeyoung, Kim Suk-Sun
School of Nursing, Duke University, Durham, NC, USA.
Health Soc Care Community. 2014 Jul;22(4):417-28. doi: 10.1111/hsc.12098. Epub 2014 Mar 12.
This study examined the healthcare experiences of Korean immigrants aged 40-64 living in the North Carolina Triangle area of the Southeastern United States. Using a mixed methods design, we collected quantitative data via a questionnaire from 125 participants and conducted a focus group with 10 interviewees from December 2010 to February 2011. The quantitative data were analysed using t-tests and chi-square tests, and a thematic analysis was used for the focus group study. Questionnaire findings showed that only 27.2% had sufficient English skills to communicate adequately. Participants with insurance were significantly more likely to be employed (P < 0.001), had higher incomes (P = 0.011) and higher education (P < 0.001), and had greater English-speaking ability (P = 0.011) than those without insurance. Participants who did not use healthcare services showed significantly less knowledge (P < 0.001) of and less satisfaction (P = 0.034) with the healthcare system than those using healthcare services. Sixty-two participants (49.6%) reported having no health insurance for one or more of the following reasons: high costs (75.8%), medical tourism (22.6%) and lack of information or knowledge (6.5%). The following themes emerged from the data collected during the focus group: (i) barriers to utilisation of healthcare services; (ii) facilitators of utilisation of healthcare services; and (iii) social support seeking for health management. Our mixed methods study findings indicate that healthcare disparities exist among Korean immigrants and that a number of factors, including health literacy, may contribute to their poor health outcomes. Continued collaboration among community members, healthcare professionals and academicians is needed to discuss the community's health concerns and to develop sustainable programmes that will ensure meaningful access to care for those with limited English proficiency and medically underserved populations.
本研究调查了居住在美国东南部北卡罗来纳州三角地区的40至64岁韩国移民的医疗保健经历。采用混合方法设计,我们于2010年12月至2011年2月通过问卷调查从125名参与者中收集了定量数据,并对10名受访者进行了焦点小组访谈。定量数据采用t检验和卡方检验进行分析,焦点小组研究采用主题分析。问卷调查结果显示,只有27.2%的人具备足够的英语技能进行充分沟通。有保险的参与者比没有保险的参与者更有可能就业(P<0.001)、收入更高(P=0.011)、受教育程度更高(P<0.001),且英语口语能力更强(P=0.011)。未使用医疗保健服务的参与者对医疗保健系统的了解程度(P<0.001)和满意度(P=0.034)明显低于使用医疗保健服务的参与者。62名参与者(49.6%)报告因以下一种或多种原因没有医疗保险:费用高昂(75.8%)、医疗旅游(22.6%)以及缺乏信息或知识(6.5%)。焦点小组收集的数据中出现了以下主题:(i)医疗保健服务利用的障碍;(ii)医疗保健服务利用的促进因素;(iii)寻求健康管理的社会支持。我们的混合方法研究结果表明,韩国移民中存在医疗保健差异,包括健康素养在内的一些因素可能导致他们健康状况不佳。社区成员、医疗保健专业人员和学者需要继续合作,讨论社区的健康问题,并制定可持续的计划,以确保英语水平有限和医疗服务不足人群能够切实获得医疗服务。