Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
University of Colorado Denver School of Medicine, Denver, CO, USA.
Acad Psychiatry. 2019 Oct;43(5):471-479. doi: 10.1007/s40596-019-01053-7. Epub 2019 Mar 29.
Psychiatric residents are increasingly called upon to work cross-culturally, serving diverse populations including refugees. This study aims to (1) understand the training experience of psychiatry residents working with refugees and (2) assess the level of satisfaction of refugees, most of whom are Iraqi, who seek psychological treatment at the University of Colorado Hospital (UCH)'s Refugee Mental Health Program of Colorado (RMHPC).
Using qualitative methodology, over a 1-year period, independent evaluators interviewed a group of nine residents who chose to participate in an RMHPC elective and also interviewed ten Iraqi refugee patients who sought services at the clinic. Recordings of the interviews were transcribed and analyzed using thematic analysis. Emerging themes were identified for both resident and refugee patient interviews.
Five major themes emerged summarizing residents' experiences: (1) adapting practices to meet refugee needs, (2) value of supervision, (3) cultural barriers, (4) need for extra resources, and (5) effect on future practice. Four major themes emerged summarizing Iraqi refugees' experiences: (1) reasons for seeking treatment, (2) barriers to treatment, (3) residents' knowledge of culture and needs, and (4) quality of treatment.
This study's findings highlight the complexities of effectively treating refugee patients and suggest ideas for training residents. Additionally, they offer important frameworks for developing, implementing, and evaluating culturally responsive practices in the context of training psychiatry residents and other mental health professionals. An essential key to this process was giving voice to refugees who accessed and engaged our services.
精神科住院医师越来越多地需要跨文化工作，为包括难民在内的不同人群提供服务。本研究旨在：(1)了解与难民一起工作的精神科住院医师的培训经验；(2)评估在科罗拉多大学医院(UC)难民心理健康计划(Colorado RMHPC)寻求心理治疗的大多数伊拉克难民的满意度。
在为期一年的时间里，独立评估员采用定性方法，对选择参加 RMHPC 选修课程的 9 名住院医师进行了访谈，并对在诊所寻求服务的 10 名伊拉克难民患者进行了访谈。使用主题分析对访谈的录音进行了转录和分析。为居民和难民患者访谈确定了一些新兴主题。
总结出了五个概括居民经验的主要主题：(1)调整实践以满足难民的需求；(2)监督的价值；(3)文化障碍；(4)需要额外的资源；(5)对未来实践的影响。总结出了四个概括伊拉克难民经历的主要主题：(1)寻求治疗的原因；(2)治疗障碍；(3)居民对文化和需求的了解；(4)治疗质量。
本研究的结果强调了有效治疗难民患者的复杂性，并为培训住院医师提出了一些想法。此外，它们为在培训精神科住院医师和其他心理健康专业人员的背景下制定、实施和评估文化响应实践提供了重要框架。这一过程的一个关键是让接受并参与我们服务的难民发声。
