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增加移民针对耻辱性疾病的就医行为的干预措施:一项范围综述

Interventions to increase migrants' care-seeking behaviour for stigmatised conditions: a scoping review.

作者信息

Place Vanessa, Nabb Benjamin, Viksten Assel Karima, Bäärnhielm Sofie, Dalman Christina, Hollander Anna-Clara

机构信息

Karolinska Institutet, Stockholm, Sweden.

Transkulturellt Centrum, Stockholm, Sweden.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2021 Jun;56(6):913-930. doi: 10.1007/s00127-021-02065-1. Epub 2021 Mar 29.

Abstract

BACKGROUND

Despite availability of effective treatments, migrants in high-income countries seek care for conditions associated with stigma to a lower extent than the rest of the population. We conducted a scoping review to map the literature on interventions to increase migrants' care-seeking behaviour in high-income countries for stigmatised conditions. Main body of the abstract: We searched 15 electronic databases and journals, hand-searched references and citations, to identify studies on interventions to increase migrants' care-seeking in high-income countries for stigmatised conditions. We applied language restrictions for English and Swedish, and searched the full time period up to 5 July 2019. Our primary outcome of interest was care utilisation.

RESULTS

5447 records were identified in the literature searches. We identified 16 eligible studies, all from North America, that reported interventions to increase migrants' care-seeking behaviour for hepatitis B (n = 1) and mental health (n = 15). Three approaches were identified: health communication (n = 10), support groups (n = 2), and primary care-based approaches (n = 4). There was a general trend towards community-based interventions tailored to individual migrant groups. Significant gaps were identified in the literature, including studies conducted in Europe and studies including men or children. Furthermore, the choice of study designs introduced significant bias that prevented accurate conclusions on intervention effectiveness.

CONCLUSION

The available evidence on interventions to increase migrants' in high-income countries care-seeking behaviour for stigmatised conditions is limited in scope and quality. Future research, using reliable study designs, is needed to fill the remaining gaps and to boost the scope and reliability of the evidence.

摘要

背景

尽管有有效的治疗方法,但高收入国家的移民因与耻辱感相关的疾病而寻求治疗的比例低于其他人群。我们进行了一项范围综述,以梳理关于在高收入国家增加移民针对有耻辱感疾病的就医行为的干预措施的文献。摘要主体:我们检索了15个电子数据库和期刊,手工检索参考文献和引用文献,以识别关于在高收入国家增加移民针对有耻辱感疾病的就医行为的干预措施的研究。我们设置了英语和瑞典语的语言限制,并检索了截至2019年7月5日的整个时间段。我们感兴趣的主要结果是医疗服务利用情况。

结果

在文献检索中识别出5447条记录。我们确定了16项符合条件的研究,均来自北美,这些研究报告了旨在增加移民针对乙型肝炎(n = 1)和心理健康(n = 15)的就医行为的干预措施。确定了三种方法:健康传播(n = 10)、支持小组(n = 2)和基于初级保健的方法(n = 4)。总体趋势是针对个体移民群体开展基于社区的干预措施。文献中发现了重大差距,包括在欧洲开展的研究以及纳入男性或儿童的研究。此外,研究设计的选择引入了重大偏差,妨碍了对干预效果得出准确结论。

结论

关于在高收入国家增加移民针对有耻辱感疾病的就医行为的干预措施的现有证据在范围和质量上有限。需要采用可靠的研究设计进行未来研究,以填补剩余差距并提高证据的范围和可靠性。

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