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瑞士慢性疾病移民女性的医疗服务体验。

Experiences With Health Care Services in Switzerland Among Immigrant Women With Chronic Illnesses.

机构信息

Institute of Sport Science, University of Tübingen, Tübingen, Germany.

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

出版信息

Front Public Health. 2020 Oct 16;8:553438. doi: 10.3389/fpubh.2020.553438. eCollection 2020.

Abstract

Descriptive data indicate a high burden of chronic illness among immigrant women in Switzerland. Little is known about how immigrant women with chronic illnesses experience healthcare services. This paper presents a methodological approach theoretically informed by Sen's capability approach and Levesque's framework of access to healthcare to study patient-reported experiences (PREs) of Swiss healthcare services among immigrant women with chronic conditions. We conducted 48 semi-structured qualitative interviews in Bern and Geneva with Turkish ( = 12), Portuguese ( = 12), German ( = 12), and Swiss ( = 12) women. Participants were heterogenous in age, length of stay, SES, and educational attainment, illness types and history. We also conducted semi-structured interviews with healthcare and social service providers ( = 12). Interviewed women participated in two focus group discussions ( = 15). Interviews were transcribed verbatim and analyzed using Atlas.ti software, based on Gale et al.'s framework approach. Findings informed three stakeholder dialogues in which women as well as healthcare providers and policymakers from various territorial levels participated. Our methodological approach succeeded in integrating women's perspectives-from initial data collection in interviews to identify issues, focus group discussions to increase rigor, and stakeholder dialogues to develop tailored recommendations based on PREs. This is one of the first studies in Switzerland that used PREs to research healthcare services and healthcare needs among immigrant women with chronic illnesses. This paper provides new insights on how to better understand existing challenges and potentially improve access to and quality of care.

摘要

描述性数据表明,瑞士移民妇女的慢性病负担很重。对于患有慢性病的移民妇女如何体验医疗保健服务,知之甚少。本文介绍了一种方法学方法,该方法在理论上受到 Sen 的能力方法和 Levesque 的医疗保健获取框架的启发,用于研究患有慢性疾病的移民妇女对瑞士医疗保健服务的患者报告体验(PREs)。我们在伯尔尼和日内瓦进行了 48 次半结构化定性访谈,参与者分别为土耳其裔(= 12)、葡萄牙裔(= 12)、德国裔(= 12)和瑞士裔(= 12)女性。参与者在年龄、居住时间、社会经济地位和教育程度、疾病类型和病史方面存在差异。我们还对医疗保健和社会服务提供者(= 12)进行了半结构化访谈。接受采访的妇女参加了两次焦点小组讨论(= 15)。访谈逐字记录并使用 Atlas.ti 软件进行分析,该软件基于 Gale 等人的框架方法。研究结果为三个利益相关者对话提供了信息,来自不同地区的妇女以及医疗保健提供者和政策制定者参加了这些对话。我们的方法学方法成功地整合了妇女的观点——从访谈中最初收集数据以确定问题,到焦点小组讨论以提高严谨性,再到利益相关者对话以根据 PREs 制定量身定制的建议。这是瑞士最早使用 PREs 研究慢性疾病移民妇女医疗保健服务和医疗保健需求的研究之一。本文提供了新的见解,说明如何更好地了解现有挑战,并有可能改善获得和护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2172/7608491/6f276ebd6ce5/fpubh-08-553438-g0001.jpg

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