Reece Mackenzie J, Rubin Sarah
Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Cleveland, USA.
Cureus. 2021 Jan 8;13(1):e12572. doi: 10.7759/cureus.12572.
Refugees resettling into the United States are faced with complex barriers to accessing basic health care. Qualitative research is needed from the primary health care providers' (PHCP) experience caring for refugees. Examination of PHCPs' experience adds to a holistic understanding of the healthcare needs of refugees and points to specific health system interventions to improve care. Consideration for Patient-Centered Medical Homes (PMCH) within refugee communities is advanced. Objective: Gather experiences through narratives from PHCPs to understand challenges and barriers in meeting the health care needs of refugees and suggest solutions. Design: Qualitative, descriptive framework. Open-ended, semi-structured interviews.
In-depth interviews (n=seven) with current licensed PHCPs (four physicians and three family nurse practitioners) working in clinic practice settings throughout Northeast Ohio, providing care to four or more refugee families per week. Approach: Interviews were recorded and transcribed. Transcripts were coded and analyzed utilizing thematic analysis to identify themes.
Three themes related to challenges faced by PHCPs: 1) coordination and comprehensive care, 2) accessibility of services, 3) provision of patient-centered care. Conclusions: The challenges PHCPs describe in delivering healthcare to refugee families were physical access to resources and care coordination. Support was found for inclusion of PCMH within refugee communities.
重新安置到美国的难民在获得基本医疗保健方面面临复杂的障碍。需要从初级医疗保健提供者(PHCP)照顾难民的经历进行定性研究。考察PHCP的经历有助于全面了解难民的医疗保健需求,并指出改善护理的具体卫生系统干预措施。推进在难民社区内对以患者为中心的医疗之家(PMCH)的考量。目的:通过PHCP的叙述收集经验,以了解满足难民医疗保健需求方面的挑战和障碍,并提出解决方案。设计:定性的描述性框架。开放式、半结构化访谈。
对俄亥俄州东北部诊所工作的现任持牌PHCP(四名医生和三名家庭护士从业者)进行深入访谈(n = 7),他们每周为四个或更多难民家庭提供护理。方法:访谈进行录音和转录。利用主题分析对转录本进行编码和分析以识别主题。
与PHCP面临的挑战相关的三个主题:1)协调与综合护理,2)服务可及性,3)提供以患者为中心的护理。结论:PHCP在为难民家庭提供医疗保健方面描述的挑战是资源的实际可及性和护理协调。支持在难民社区纳入PCMH。