Lindenmeyer Antje, Redwood Sabi, Griffith Laura, Teladia Zaheera, Phillimore Jenny
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
School of Social and Community Medicine, University of Bristol, Bristol, UK.
BMJ Open. 2016 Sep 22;6(9):e012561. doi: 10.1136/bmjopen-2016-012561.
The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices.
An exploratory, qualitative study based on the thematic analysis of semistructured interviews.
A purposive sample of 10 practices. We interviewed 6 general practitioners, 5 nurses and 6 administrative staff; those based at the same practice opted to be interviewed together. 10 interviewees were from an ethnic minority background; some discussed their own experiences of migration.
Creating a fit between patients and practice was complex and could be problematic. Some participants defined this in a positive way (reaching out, creating rapport) while others also focused on ways in which patients did not fit in, for example, different expectations or lack of medical records. A small but vocal minority put the responsibility to fit in on to migrant patients. Some participants believed that practice staff and patients sharing a language could contribute to achieving a fit but others outlined the disadvantages of over-reliance on language concordance. A clearly articulated, team-based strategy to create bridges between practice and patients was often seen as preferable.
Although participants agreed that a fit between patients and practice was desirable, some aimed to adapt to the needs of recently arrived migrants, while others thought that it was the responsibility of migrants to adapt to practice needs; a few viewed migrant patients as a burden to the system. Practices wishing to improve fit might consider developing strategies such as introducing link workers and other 'bridging' people; however, they could also aim to foster a general stance of openness to diversity.
本研究的主要目的是探索在一个超级多元化城市中，基层医疗专业人员为新移民提供护理的经历，并找出满足移民护理需求的障碍和促进因素。本文聚焦于一个强烈的新出现的主题：参与者对使患者与医疗机构相匹配的描述和理解。
基于对半结构化访谈进行主题分析的探索性定性研究。
从10家医疗机构中选取的有目的的样本。我们采访了6名全科医生、5名护士和6名行政人员；来自同一家医疗机构的人员选择一起接受采访。10名受访者来自少数族裔背景；一些人讨论了他们自己的移民经历。
使患者与医疗机构相匹配是复杂的，可能会出现问题。一些参与者以积极的方式对此进行了定义（主动接触、建立融洽关系），而另一些人则关注患者不匹配的方面，例如，不同的期望或缺乏病历。一小部分但声音较大的少数人将适应的责任归咎于移民患者。一些参与者认为医疗机构工作人员和患者使用同一种语言有助于实现匹配，但另一些人则概述了过度依赖语言一致性的弊端。一种明确阐述的、基于团队的在医疗机构与患者之间架起桥梁的策略通常被认为更可取。
尽管参与者一致认为患者与医疗机构相匹配是可取的，但一些人旨在适应新移民的需求，而另一些人则认为移民有责任适应医疗机构的需求；少数人将移民患者视为系统的负担。希望改善匹配度的医疗机构可能会考虑制定策略，如引入联络人员和其他“桥梁”人员；然而，它们也可以旨在培养一种对多样性持开放态度的总体立场。
