Child, Youth and Family Services, South Eastern Sydney Local Health District, Sydney, NSW, 2010, Australia.
School of Women's and Children's Health, University of NSW (UNSW), Sydney, NSW, 2052, Australia.
BMC Womens Health. 2021 May 27;21(1):222. doi: 10.1186/s12905-021-01368-4.
Women from migrant and refugee backgrounds who live in high-income countries are at increased risk of adverse perinatal outcomes, including mental health issues, preterm birth and maternal and infant mortality. There is a need to implement and evaluate models of care to meet their specific needs in order to improve health outcomes, their experiences of care, and overcome barriers to access. In Sydney, Australia, a unique model of care was implemented to support women and families from migrant and refugee backgrounds to access health and community-based services through the continuum of pregnancy to the early parenting period. This model of care is known as the Cross Cultural Workers (CCWs) in Maternity and Child and Family Health Service (the CCW Service). The aim of this study was to explore the perceptions of service providers regarding the CCW Service and identify recommendations for improvement.
A mixed-methods study was conducted consisting of surveys and face to face semi-structured interviews. Service providers were recruited from hospital-based maternity and community-based services. Survey data were analysed descriptively. Interviews were analysed using qualitative content analysis.
Sixty-nine service providers completed surveys and 19 were interviewed. The CCW Service was highly regarded by service providers who perceived it to be critical in improving care for women from migrant and refugee backgrounds. The overarching theme from the interviews was the ability of the CCW Service to act as a 'bridge to health' through the provision of culturally responsive care. There were three main categories; supporting access to health and community-based services, improving the healthcare experience, and organisational factors, including part-time hours, capacity, heavy workloads and confusion/lack of clarity regarding the CCW role, which affected CCWs' capacity to optimally support service providers in providing culturally responsive care. These limitations meant CCWs were not able to meet demand, and fully operationalise the model.
Service providers perceived the CCW model to be a culturally responsive model of care tailored to the needs of women and families from migrant and refugee backgrounds, that reduces barriers to access, and has the potential to improve perinatal outcomes, and women's experience and satisfaction with care.
生活在高收入国家的移民和难民背景的女性面临着更高的不良围产期结局风险，包括心理健康问题、早产以及母婴死亡率。需要实施和评估护理模式，以满足她们的特殊需求，从而改善健康结局、她们的护理体验，并克服获得护理的障碍。在澳大利亚悉尼，实施了一种独特的护理模式，通过妊娠到早期育儿期的连续过程，支持移民和难民背景的妇女及其家庭获得卫生和社区服务。这种护理模式被称为母婴和家庭健康服务中的跨文化工作者（CCWs）（CCW 服务）。本研究旨在探讨服务提供者对 CCW 服务的看法，并确定改进建议。
采用混合方法研究，包括调查和面对面半结构式访谈。从医院产科和社区服务中招募服务提供者。对调查数据进行描述性分析。对访谈进行定性内容分析。
69 名服务提供者完成了调查，19 名服务提供者接受了访谈。服务提供者高度评价 CCW 服务，认为它对改善移民和难民背景的妇女的护理至关重要。访谈的主题是 CCW 服务通过提供文化响应性护理，作为“通往健康的桥梁”的能力。有三个主要类别；支持获得卫生和社区服务、改善医疗体验和组织因素，包括兼职工作时间、能力、工作量大以及对 CCW 角色的困惑/不明确，这影响了 CCW 支持服务提供者提供文化响应性护理的能力。这些限制意味着 CCWs 无法满足需求，无法充分发挥该模式的作用。
服务提供者认为 CCW 模式是一种针对移民和难民背景的妇女及其家庭的需求量身定制的文化响应护理模式，它减少了获得护理的障碍，并有可能改善围产期结局，以及妇女对护理的体验和满意度。
