Health professionals confront the intentional harms of indefinite immigration detention: an Australian overview, evaluation of alternative responses and proposed strategy

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Michael Dudley ◽  
Peter Young ◽  
Louise Newman ◽  
Fran Gale ◽  
Rohanna Stoddart
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Professionals ◽  
Asylum Seekers ◽  
Conflicts Of Interest ◽  
Immigration Detention ◽  
Aggressive Approach ◽  
Content Type ◽  
Indefinite Detention ◽  
Degrading Treatment

Purpose Indefinite immigration detention causes well-documented harms to mental health, and international condemnation and resistance leave it undisrupted. Health care is non-independent from immigration control, compromising clinical ethics. Attempts to establish protected, independent clinical review and subvert the system via advocacy and political engagement have had limited success. The purpose of this study is to examine the following: how indefinite detention for deterrence (exemplified by Australia) injures asylum-seekers; how international legal authorities confirm Australia’s cruel, inhuman and degrading treatment; how detention compromises health-care ethics and hurts health professionals; to weigh arguments for and against boycotting immigration detention; and to discover how health professionals might address these harms, achieving significant change. Design/methodology/approach Secondary data analyses and ethical argumentation were employed. Findings Australian Governments fully understand and accept policy-based injuries. They purposefully dispense cruel, inhuman and degrading treatment and intend suffering that causes measurable harms for arriving asylum-seekers exercising their right under Australian law. Health professionals are ethically conflicted, not wanting to abandon patients yet constrained. Indefinite detention prevents them from alleviating sufferings and invites collusion, potentially strengthening harms; thwarts scientific inquiry and evidence-based interventions; and endangers their health whether they resist, leave or remain. Governments have primary responsibility for detained asylum-seekers’ health care. Health professional organisations should negotiate the minimum requirements for their members’ participation to ensure independence, and prevent conflicts of interest and inadvertent collaboration with and enabling systemic harms. Originality/value Australia’s aggressive approach may become normalised, without its illegality being determined. Health professional colleges uniting over conditions of participation would foreground ethics and pressure governments internationally over this contagious and inexcusable policy.

Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study (Preprint)

2019 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Professional ◽  
Clinical Setting ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Smartphone App ◽  
Implementation Study ◽  
Pilot Testing ◽  
Effective Implementation

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

Responding and adapting to change: an allied health perspective

2020 ◽  
Vol 33 (4) ◽  
pp. 339-349
Author(s):  
Lisa Beasley ◽  
Sandra Grace ◽  
Louise Horstmanshof
Keyword(s):  
Health Care ◽  
Change Management ◽  
Scoping Review ◽  
Health Professionals ◽  
Allied Health ◽  
Change Processes ◽  
Allied Health Professionals ◽  
Content Type ◽  
Scoping Reviews ◽  
Change Leaders

Purpose The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change. Design/methodology/approach A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process. Findings The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice. Research limitations/implications This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health. Practical implications Social implications This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes. Originality/value To the best of the authors’ knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change.

Refugee health in Europe: mapping review of research literature (2015–2019)

2020 ◽  
Vol 25 (4) ◽  
pp. 349-369
Author(s):  
Irina Ibragimova ◽  
Martina Žužak
Keyword(s):  
Health Care ◽  
Systematic Reviews ◽  
Asylum Seekers ◽  
Research Literature ◽  
Refugee Health ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Content Type ◽  
Mapping Review ◽  
Refugees And Asylum Seekers

PurposeThe purpose of this paper is to map research literature on all aspects of refugee health in Europe (2015–2019): by research domain, study design, targeted population, type of setting, host country, journal title. This will help to identify recent research trends in the field, provide policymakers with useful source of information and help researches to target important gaps in evidence.Design/methodology/approachWHO (with other international agencies) has developed strategic documents and produced technical guidance, which formulate priority issues of refugee health in Europe. These documents state the need for relevant information and research data to support effective decision-making at all levels of health care systems. Although recent bibliometric analysis of global migration health research (2000–2016) concluded that 25.4% of retrieved documents were about refugees and asylum seekers, still there remain critical gaps in the knowledge base on a wide range of determinants of health service delivery and access for refugees and asylum seekers in the WHO European Region. Mapping review design was chosen as it maps and categorizes existing literature from which to commission further reviews and/or primary research by identifying gaps in research literature. Search strategy was developed and searches were executed in six databases: PubMed Medline; Scopus; ProQuest (Thesis and Dissertations); Cochrane Library; BASE; eLibrary (Russian journal articles).FindingsMapping review revealed that although research in some domains of refugee health was growing (mental health, infectious diseases, access to health care), there are still gaps in evidence in many important aspects: maternal and reproductive health, NCD, nutrition and economic evaluations. Most of 1,291 retrieved studies used observational or quasi-experimental design (75%), while very few were experimental studies (1.8%). Secondary research constituted a significant portion of retrieved publications: systematic reviews and meta-analysis – 8%, other reviews with systematic approach – 16%.Originality/valueDetailed mapping of research by a combination of setting, population and research domains and comparison of results with those from previous decades and with planned trials and systematic reviews.

scholarly journals From “Academic Projectitis” to Partnership: Community Perspectives for Authentic Community Engagement in Health Professional Education

2018 ◽  
Vol 4 (1) ◽  
pp. 79-96 ◽  
Author(s):  
Cathy Kline ◽  
Wafa Asadian ◽  
William Godolphin ◽  
Scott Graham ◽  
Cheryl Hewitt ◽  
...  
Keyword(s):  
Health Care ◽  
Service Learning ◽  
Health Professional ◽  
Community Engagement ◽  
Professional Education ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Common Interest ◽  
Health Professional Education ◽  
Community Based

Health professional education (HPE) has taken a problem-based approach to community service-learning with good intentions to sensitize future health care professionals to community needs and serve the underserved. However, a growing emphasis on social responsibility and accountability has educators rethinking community engagement. Many institutions now seek to improve community participation in educational programs. Likewise, many Canadians are enthusiastic about their health care system and patients, who are “experts by lived experience,” value opportunities to “give back” and improve health care by taking an active role in the education of health professionals. We describe a community-based participatory action research project to develop a mechanism for community engagement in HPE at the University of British Columbia (UBC). In-depth interviews and a community dialogue with leaders from 18 community-based organizations working with vulnerable populations revealed the shared common interest of the community and university in the education of health professionals. Patients and community organizations have a range of expertise that can help to prepare health practitioners to work in partnership with patients, communities, and other professionals. Recommendations are presented to enhance the inclusion of community expertise in HPE by changing the way the community and university engage with each other.

scholarly journals “Escaping the Sunken Place: indefinite detention, asylum seekers, and resistance in Yarl’s Wood IRC”

2020 ◽  
Vol 31 (1) ◽  
pp. 167-186
Author(s):  
AIDAN SEYMOUR-BUTLER
Keyword(s):  
Asylum Seekers ◽  
British Politics ◽  
Hunger Strike ◽  
Immigration Detention ◽  
Migration System ◽  
Legal Challenges ◽  
Indefinite Detention ◽  
The Law ◽  
Immigration And Asylum ◽  
Philosophical Questions

 The Law Society has recently raised concerns about the UK’s migration system, stating that ‘failures in UK immigration and asylum undermine the rule of law’. Nowhere are those problems more apparent than in the UK’s handling of migrants and asylum seekers in detention centres. A particular recurring issue that speaks to the Law Society’s concern is the absence of a defined time limit for immigration detention. The possibility of indefinite detention has been a source of tension both within British politics, and within UK immigration detention centres. An example of this can be understood with reference to the Yarl’s Wood Immigration Removal Centre (IRC) in Bedfordshire, known for its controversial and rebellious past. In 2015 Nick Hardwick, a former chief prisoner inspector, labelled the Centre a place of ‘national concern’, after examining the mistreatment of vulnerable detainees. Yarl’s Wood’s problematic history, seems to have continued into the present, following a detainee led hunger strike that resulted in ‘renewed concerns’ over health care in detention centres. In addition to protesting the standard of medical treatment received by detainees, the strikers’ underlying focus was on indefinite detention.  The Home Office’s response to these strikes was unsympathetic, it sent a letter to detainees suggesting that their continued participation in the strike may in fact result in their removal being accelerated. Although, the hunger strike ended in March 2018 the Home Office’s response to the strike raised some interesting legal and philosophical questions about human rights and resistance in detention centres. In order to grapple with some of these issues, this paper has been separated into two parts. The first part will attempt to contextualise the existing immigration regime and explore how legal disputes might fit within the broader scheme of opposing indefinite detention. It will also briefly examine the legal challenges that may arise from the use of threats of accelerated deportations. 

An empirical investigation of precursors influencing social media health information behaviors and personal healthcare habits during coronavirus (COVID-19) pandemic

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Muhammad Riaz ◽  
Xiwei Wang ◽  
Sherani Sherani ◽  
Yu Guo
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Information ◽  
Health Professionals ◽  
Equation Modeling ◽  
Personal Health ◽  
Data Set ◽  
Content Type ◽  
Information Behaviors ◽  
Emergency Situations

Purpose Drawing upon the communicative ecology theory (CET), this study aims to identify the potential precursors of social media health information seeking intentions (ISI) and examine their effects on health information re-sharing behaviors and PHH during coronavirus (COVID-19) pandemic. Design/methodology/approach The data is collected through an online survey conducted in two different universities situated in highly COVID-19-affected cities – Wuhan and Zhengzhou, China. The valid data consists of 230 useful responses from WeChat users and to analyze the final data set structural equation modeling (SEM) is used. Findings The results indicate that perceived health information credibility (PIC), trust on the medium (TRM) and peer influence (PI) significantly affect health ISI which further affects health information re-sharing behaviors (IRB) and personal health-care habits (PHH). Besides, the results also identify that PI has a direct, positive and significant effect on health IRB via social media during the COVID-19 pandemic. Research limitations/implications This study investigates the health information intentional behavior precursors and their consequences via WeChat (taken as social media platform) during COVID-19 pandemic. Future studies may conduct research by examining online information behaviors on other social media platforms – Twitter, WhatsApp, Facebook, etc. – in health emergency situations. Practical implications The health information producers and providers have to deal with communicative ecology sentiments elegantly in emergency situations such as during the COVID-19 pandemic. They need to do collective efforts by introducing new tools or social apps which deal with valuable, reliable and accurate health content and information generated by the pandemic experts and health professionals. In such a way, the social apps and tools (Information providers) will act as mediators between the health professionals (Information producers) and general social media users (information seekers). Such initiatives will ultimately bring forth positive effect on individuals’ PHH as a whole within a network, community, environment or nations during a health emergency – COVID-19 pandemic. Originality/value This research is one of the first studies to examine the potential precursors of social media health ISIs and their resultant effects on individual’s health IRB and PHH during the COVID-19 pandemic. As currently it is noticed, an incredible upsurge of health information via social media has intense impacts on personal health-care research and practice, particularly during health emergency situations such as COVID-19 pandemic conditions.

Policies and initiatives/programs that promote health and self-care in asylum seekers living in high income countries: a narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gloria Nkhoma ◽  
Chiao Xin Lim ◽  
Gerard Kennedy ◽  
Ieva Stupans
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Asylum Seekers ◽  
Self Care ◽  
High Income ◽  
Narrative Review ◽  
Health Conditions ◽  
Food Banks ◽  
Free Access ◽  
Content Type

Purpose This paper aims to identify health-care entitlements that exist for asylum seekers with chronic non-communicable disease (CNCD) that promote their health and self-care, and to explore health policies, initiatives and programmes with the potential to foster self-care in this populace. Design/methodology/approach Narrative review of literature conducted by searching EMBASE, CINAHL, WEB OF SCIENCE and PSYCINFO databases for articles published from 2010 to 2021. Included articles focussed on policies, programmes or initiatives with the potential to promote health in adult asylum seekers residing in high-income countries. Studies inclusive of other migrant groups such as undocumented migrants and those with mental health conditions were excluded. Eleven studies fitting the inclusion criteria were assessed against the study objectives. Findings Free access to health-care services and pharmaceutical products, free access to food banks and supermarket model food banks, English and cooking lessons, community integration training sessions and culturally competent health-care workers were found to promote health and self-care. There is little research on self-care and health promotion in adult asylum seekers with CNCD. CNCDs represent high burden of disease in asylum seekers but have a low priority in reported research. Originality/value This narrative review is the first to explicitly focus on asylum seekers in high-income countries with CNCD, excluding mental health conditions, and to explore initiatives, programmes and policies that enhance health promotion to facilitate self-care in this populace.

Assessing migrants’ satisfaction from health care services in Cyprus: a nationwide study

2019 ◽  
Vol 16 (1) ◽  
pp. 108-118
Author(s):  
Christos Panagiotopoulos ◽  
Menelaos Apostolou ◽  
Agamemnonas Zachariades
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health System ◽  
Health Professionals ◽  
Health Care Services ◽  
Service Providers ◽  
Health Concern ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose As long as migration is recognized as a public health concern, policies exist to address migrants’ health, and provide comprehensive information on how public and private health care system operates, health rights and what their health care plan does or does not cover. Thereby, responding to patients’ expectations significantly affects overall satisfaction with health care services because this dimension is most strongly associated with patient satisfaction. The purpose of this paper is to constitute the first quantitative large-scale study (n=1,512) in Cyprus and Greece exploring the level of satisfaction among third-country nationals (TCN) in relation to their health care needs. Design/methodology/approach The questionnaire used in this study has been developed and measured (Cronbach α =0.7) in a similar study in Greece (Galanis et al., 2013) and it has been used by other studies too (Vozikis, 2015). Findings The authors can conclude that participants’ knowledge of the health system is not good as 70.2 percent that they do not have a good knowledge. The findings suggest that nearly one in two TCN faced problems in accessing clinics or communicating due to various factors. Practical implications The findings of this study provide the context for further exploration of different means to improve cultural awareness amongst health and social care professionals, including multicultural training of health and social service providers and medical pluralist approaches that may be closer to migrants’ cultural and health background. Overall, types of interventions to improve cultural competency included training/workshops/programs for health practitioners (e.g. doctors, nurses and community health workers), culturally specific/tailored education or programs for patients/clients, interpreter services, peer education, patient navigators and exchange programs (Truong, 2014). To the above, practices can also be added as multicultural education to all health professionals in order to develop enthusiasm and be able to acknowledge immigrants’ difficulties. Adding to the above recommendation, interdisciplinary education with allied health professionals (psychologists, social workers and nurses) may lead to a more holistic approach of this group’s needs, especially in the forthcoming health system where primary care will play a vital role. Social implications Access to the health system may lead to social inclusion of TCN in the local society and improve their quality of life. It is also important for TCN to feel that the current health system is aware of issues related to their social and cultural background; thus, it will make the health system and those who work look more friendly and approachable. Originality/value In an era of crisis and of great debate around a forthcoming National Health System, these findings indicate that healthcare providers in Cyprus will need to address several challenges in managing care for migrants. In order for that to happen, assessing patient satisfaction is thereby important in the process of quality evaluation, especially when dealing with population subgroups at higher risk of inequalities such as immigrants or ethnic minorities. Such studies help systems to develop by measuring their weaknesses and enhancing their strengths. Voicing clients/patients feedback is always helpful to minimize risks.

scholarly journals “A prison with extra flavours”: experiences of immigrants in Swedish immigration detention centres

2015 ◽  
Vol 11 (2) ◽  
pp. 73-85 ◽  
Author(s):  
Soorej Jose Puthoopparambil ◽  
Beth Maina Ahlberg ◽  
Magdalena Bjerneld
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Well Being ◽  
Structured Interviews ◽  
Immigration Detention ◽  
Content Type ◽  
Care Services ◽  
Lack Of Control ◽  
Health And Well Being

Purpose – The immigration detention environment largely influences the health and well-being of detainees by either aggravating medical conditions or contributing to new illness. There is limited research on how detainees experience and try to cope with this environment. The purpose of this paper is to describe experiences of detainees in Swedish immigration detention centres. Design/methodology/approach – Semi-structured interviews were conducted in three detention centres with a total of 21 detainees who had been detained for at least two weeks. Interview transcripts were analysed using thematic analysis. Findings – The detainees likened immigration detention to imprisonment. They experienced lack of control over their life situation mainly through arbitrary restrictions and lack of proper response from authorities making it appear futile to seek help. This perceived lack of control forced them into passivity. Differences in amenities provided in the centres were observed and some of these were reported to assist in making detention more bearable. Research limitations/implications – This study provides only one stakeholder perspective. The perspectives of other stakeholders, such as detention staff, health care professionals and volunteers must be explored to improve understanding and mitigate the effects of detention. Originality/value – Irrespective of the better standards of detention in Sweden, the detainees considered detention as imprisonment affecting their health and well-being. If states deem detention to be necessary, improved staff-detainee interaction should be ensured through proper staff training, arbitrary restrictions within detention should be avoided and health care services should be improved.

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