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改善难民和寻求庇护者的初级卫生保健质量:干预措施的系统评价。

Improving primary health care quality for refugees and asylum seekers: A systematic review of interventional approaches.

机构信息

School of Population Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia.

School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.

出版信息

Health Expect. 2022 Oct;25(5):2065-2094. doi: 10.1111/hex.13365. Epub 2021 Oct 15.


DOI:10.1111/hex.13365
PMID:34651378
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9615090/
Abstract

BACKGROUND: It has been widely acknowledged that refugees are at risk of poorer health outcomes, spanning mental health and general well-being. A common point of access to health care for the migrant population is via the primary health care network in the country of resettlement. This review aims to synthesize the evidence of primary health care interventions to improve the quality of health care provided to refugees and asylum seekers. METHODS: A systematic review was undertaken, and 55 articles were included in the final review. The Preferred Reporting Items for Systematic Reviews was used to guide the reporting of the review, and articles were managed using a reference-management software (Covidence). The findings were analysed using a narrative empirical synthesis. A quality assessment was conducted for all the studies included. RESULTS: The interventions within the broad primary care setting could be organized into four categories, that is, those that focused on developing the skills of individual refugees/asylum seekers and their families; skills of primary health care workers; system and/or service integration models and structures; and lastly, interventions enhancing communication services. Promoting effective health care delivery for refugees, asylum seekers and their families is a complex challenge faced by primary care professionals, the patients themselves and the communication between them. CONCLUSION: This review highlights the innovative interventions in primary care promoting refugee health. Primary care interventions mostly focused on upskilling doctors, with a paucity of research exploring the involvement of other health care members. Further research can explore the involvement of interprofessional team members in providing effective refugee/migrant health. PATIENT OR PUBLIC CONTRIBUTION: Patient and public involvement was explored in terms of interventions designed to improve health care delivery for the humanitarian migrant population, that is, specifically refugees and asylum seekers.

摘要

背景:人们普遍认识到,难民面临着更差的健康结果的风险,包括心理健康和整体健康。移民人口获得医疗保健的一个常见途径是通过安置国的初级卫生保健网络。本综述旨在综合初级卫生保健干预措施的证据,以改善为难民和寻求庇护者提供的医疗保健质量。

方法:进行了系统综述,最终综述纳入了 55 篇文章。采用系统评价报告的首选报告项目来指导综述报告,并使用参考管理软件(Covidence)管理文章。使用叙述性实证综合分析方法对研究结果进行分析。对所有纳入的研究进行了质量评估。

结果:在广泛的初级保健环境中,干预措施可以分为四类,即那些专注于提高难民/寻求庇护者及其家人个人技能的措施;初级卫生保健工作者的技能;系统和/或服务整合模式和结构;最后,是加强沟通服务的干预措施。促进难民、寻求庇护者及其家庭的有效医疗服务提供是初级保健专业人员、患者自身以及他们之间沟通所面临的复杂挑战。

结论:本综述强调了初级保健中促进难民健康的创新干预措施。初级保健干预措施主要侧重于提高医生的技能,而很少有研究探讨其他医疗保健成员的参与。进一步的研究可以探索多专业团队成员在提供有效的难民/移民健康方面的参与。

患者或公众贡献:从旨在改善人道主义移民人口(即难民和寻求庇护者)医疗保健服务的干预措施方面探讨了患者和公众的参与情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4f/9615090/19a8c89726a9/HEX-25--g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4f/9615090/cddbdb81e586/HEX-25--g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4f/9615090/19a8c89726a9/HEX-25--g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4f/9615090/cddbdb81e586/HEX-25--g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4f/9615090/19a8c89726a9/HEX-25--g001.jpg

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[5]
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[6]
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[8]
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本文引用的文献

[1]
Cultural Competence in Refugee Service Settings: A Scoping Review.

Health Equity. 2021-3-16

[2]
Quality assessment with diverse studies (QuADS): an appraisal tool for methodological and reporting quality in systematic reviews of mixed- or multi-method studies.

BMC Health Serv Res. 2021-2-15

[3]
PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews.

Syst Rev. 2021-1-26

[4]
Strategies to reach and motivate migrant communities at high risk for TB to participate in a latent tuberculosis infection screening program: a community-engaged, mixed methods study among Eritreans.

BMC Public Health. 2020-3-12

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A Digital Communication Assistance Tool (DCAT) toObtain Medical History from Foreign-LanguagePatients: Development and Pilot Testing in a PrimaryHealth Care Center for Refugees.

Int J Environ Res Public Health. 2020-2-20

[6]
Building capacity in primary health care to respond to the needs of asylum seekers and refugees in Melbourne, Australia: the 'GP Engagement' initiative.

Aust J Prim Health. 2020-2

[7]
Enhancing Immunization Rates in Two Urban Academic Primary Care Clinics: A Before and After Assessment.

J Patient Cent Res Rev. 2020-1-27

[8]
Intensive psychotherapy and case management for Karen refugees with major depression in primary care: a pragmatic randomized control trial.

BMC Fam Pract. 2020-1-28

[9]
Barriers to Accessing Acute Care for Newly Arrived Refugees.

West J Emerg Med. 2019-10-16

[10]
An online resource supporting refugee healthcare in Australian general practice: An exploratory study.

Aust J Gen Pract. 2018-11

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