Zaini Amirah Zafirah, Loganathan Tharani, Hargreaves Sally, Zimmerman Cathy, Majid Hazreen Abdul, Danaee Mahmoud
Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
J Immigr Minor Health. 2025 Aug 8. doi: 10.1007/s10903-025-01747-1.
Acculturation plays a significant role in migrant health. However, there has been little synthesis of the relationship between migrants' acculturation and healthcare access. This systematic review examines how acculturation is measured and its relationship with healthcare access among labour migrants. A systematic search of primary research studies (January 2000-July 2024) was conducted in PubMed, ScienceDirect, Scopus, and Web of Science using predefined MeSH terms and keywords. Records were screened by two independent reviewers and data were extracted on study characteristics, the measures of acculturation, healthcare access outcomes, and covariates. Assessment of study quality was done using the Newcastle-Ottawa quality assessment scale. Results were reported following PRISMA 2020 guidelines. The protocol was registered in PROSPERO (registration number CRD42024532204). Twenty-four studies met the inclusion criteria for final analysis. Four main acculturation proxies influencing labour migrants' access to healthcare were identified: length of stay, proficiency in local languages, country of origin, and immigration status. Longer residency and higher local languages proficiency were associated with better healthcare access. The influence of the origin country varied by migrant group. Irregular immigration status negatively affected healthcare access, with undocumented migrants having the poorest access. The identification of key acculturation proxies suggests targets for inclusive policies that improve specific areas of acculturation to increase equitable healthcare access for labour migrants. Future research is needed in low-and middle-income destination countries, incorporating validated instruments of acculturation, longitudinal studies, and the exploration of other contributing factors for a greater understanding of the acculturation process.
文化适应在移民健康中起着重要作用。然而，关于移民文化适应与医疗服务可及性之间的关系，目前几乎没有综合研究。本系统综述探讨了文化适应的衡量方式及其与劳务移民医疗服务可及性的关系。我们使用预定义的医学主题词和关键词，在PubMed、ScienceDirect、Scopus和Web of Science数据库中对2000年1月至2024年7月期间的原始研究进行了系统检索。由两名独立评审员对记录进行筛选，并提取有关研究特征、文化适应的衡量指标、医疗服务可及性结果和协变量的数据。使用纽卡斯尔-渥太华质量评估量表对研究质量进行评估。结果按照PRISMA 2020指南进行报告。该方案已在PROSPERO注册（注册号CRD42024532204）。24项研究符合最终分析的纳入标准。确定了影响劳务移民医疗服务可及性的四个主要文化适应代理指标：停留时间、当地语言熟练程度、原籍国和移民身份。停留时间越长和当地语言熟练程度越高，医疗服务可及性越好。原籍国的影响因移民群体而异。非法移民身份对医疗服务可及性有负面影响，无证移民的可及性最差。关键文化适应代理指标的确定为包容性政策指明了目标，这些政策可改善文化适应的特定领域，以增加劳务移民公平获得医疗服务的机会。低收入和中等收入目的地国家需要开展未来研究，纳入经过验证的文化适应工具、纵向研究，并探索其他影响因素，以更深入了解文化适应过程。
