Ngondwe Ponsiano, Tefera Gashaye Melaku
College of Social Work, Florida State University, Tallahassee, FL 32304, USA.
Healthcare (Basel). 2025 Feb 4;13(3):313. doi: 10.3390/healthcare13030313.
Immigrants with disabilities (IWDs) are disproportionately affected by a lack of access to healthcare services and face unique challenges compared to the general population. This qualitative meta-synthesis examines the barriers, facilitators, and lived experiences of IWDs accessing healthcare in the U.S. and Canada.
A theory-generating qualitative meta-synthesis approach was used to analyze and synthesize raw qualitative data. Using eight databases, 752 studies were retrieved, and 10 were selected and synthesized after a three-stage review. The final articles were assessed using the Critical Appraisal Skills Program (CASP) checklist, and a PRISMA flow chart was used to report on the selection process.
The analysis identified structural barriers, including the bureaucracy and complexity of the system, healthcare costs, transportation, communication, long wait times, and a lack of integrated services. Cultural barriers included denial and trust, stigma and discrimination, awareness and language gaps, and lack of social support. Facilitators of access included support from immediate family members, community health centers, and social workers.
The findings highlight the need for policy reforms to reduce bureaucratic hurdles, improve communication within healthcare systems, and enhance cultural competence among healthcare providers. Addressing these issues through integrated service models and targeted support can significantly improve the quality of life as a result of improved healthcare access for IWDs.
残疾移民（IWDs）在获得医疗服务方面受到的影响尤为严重，与普通人群相比面临着独特的挑战。这项定性元综合研究考察了美国和加拿大残疾移民在获取医疗保健方面的障碍、促进因素和生活经历。
采用一种生成理论的定性元综合方法来分析和综合原始定性数据。通过八个数据库检索到752项研究，经过三阶段评审后，选取并综合了10项研究。使用批判性评估技能计划（CASP）清单对最终文章进行评估，并使用PRISMA流程图报告选择过程。
分析确定了结构性障碍，包括系统的官僚作风和复杂性、医疗成本、交通、沟通、长时间等待以及缺乏综合服务。文化障碍包括否认和信任、耻辱和歧视、认知和语言差距以及缺乏社会支持。获取医疗服务的促进因素包括直系家庭成员、社区健康中心和社会工作者的支持。
研究结果强调需要进行政策改革，以减少官僚障碍，改善医疗系统内部的沟通，并提高医疗服务提供者的文化能力。通过综合服务模式和有针对性的支持来解决这些问题，可以显著提高残疾移民的生活质量，因为他们获得医疗服务的机会得到了改善。
