Marie Cederschiöld University.
Nurs Ethics. 2024 Nov;31(7):1349-1360. doi: 10.1177/09697330231215947. Epub 2023 Nov 24.
Research shows that undocumented migrants have difficulties in accessing healthcare. Act 2013:407 came into force in 2013 and entitled undocumented migrants to healthcare that cannot be deferred. To date, studies about undocumented migrants' access to care in Sweden and the impact of Act 2013:407 are sparse. Hence, the aim of this study was to describe professionals' experiences of access to healthcare for undocumented migrants in Sweden and the impact of Act 2013:407.
A qualitative design with semi-structured interviews was employed. Nine interviews were carried out in 2015 with nurses at two NGO healthcare centres for undocumented migrants - and an additional seven interviews in 2022 with staff at an NGO healthcare centre for undocumented migrants and personnel at a regional health and medical care administration. Interpretive description was used for the analyses.
Permission to carry out the study was obtained from managers at the participating NGOs and the regional health and medical care administration. Participants received verbal and written information about the study, and informed consent was obtained from all participants.
Six categories emerged from the analysis: Changes since the Act was introduced, General problems with healthcare access, Care for undocumented migrants - politics and social economy, Lack of knowledge, 'Healthcare that cannot be deferred' and Being an undocumented migrant.
Undocumented migrants' social needs are as great as their needs for healthcare. Healthcare staff are burdened with healthcare cost considerations which affect their judgement of care provision and prioritization. Healthcare staff attitudes towards undocumented migrants affect their access to healthcare. Undocumented migrants in need of healthcare are especially vulnerable due to their legal status, being ill and the fear of being reported and deported. To assure undocumented migrants' access to healthcare and maintain healthcare ethics, the only possible solution is to provide healthcare based on needs.
研究表明，无证移民在获得医疗保健方面存在困难。2013 年法案第 407 条于 2013 年生效，赋予无证移民获得不可推迟的医疗保健的权利。迄今为止，关于瑞典无证移民获得医疗保健的机会以及 2013 年法案第 407 条的影响的研究很少。因此，本研究的目的是描述瑞典专业人员在无证移民获得医疗保健方面的经验以及 2013 年法案第 407 条的影响。
采用半结构式访谈的定性设计。2015 年，在两家 NGO 无证移民医疗中心对 9 名护士进行了访谈，并于 2022 年在一家 NGO 无证移民医疗中心的工作人员和区域卫生和医疗保健管理部门的工作人员中进行了另外 7 次访谈。使用解释性描述进行分析。
参与的 NGO 和区域卫生和医疗保健管理部门的经理已获得开展研究的许可。参与者收到了关于研究的口头和书面信息，并获得了所有参与者的知情同意。
分析产生了六个类别：该法案出台后的变化、一般医疗保健准入问题、无证移民的护理-政治和社会经济、知识匮乏、“不可推迟的医疗保健”和无证移民。
无证移民的社会需求与其医疗保健需求一样大。医疗保健人员承担着医疗保健费用考虑因素的负担，这会影响他们对护理提供和优先排序的判断。医疗保健人员对无证移民的态度会影响他们获得医疗保健的机会。由于法律地位、患病以及害怕被举报和驱逐出境，需要医疗保健的无证移民尤其脆弱。为了确保无证移民获得医疗保健并维护医疗保健伦理，唯一可能的解决方案是根据需求提供医疗保健。
