Decision letter for "Immigrant parents’ experiences of accessing child healthcare services in a host country: A qualitative thematic synthesis"

2020 ◽  
Author(s):  
Shahrzad Arfa ◽  
Per Koren Solvang ◽  
Berit Berg ◽  
Reidun Jahnsen

Abstract • Background: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on immigrants’ utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. By focusing on experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway, this study generated knowledge of how accessible and tailored the services were from their point of view. Methods: This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. Results: The findings show how the “immigrant experience” influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of years of struggle in the healthcare system to access the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how parents’ experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers’ intercultural communication skills and dominant organizational culture. Conclusions: The parents’ experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents’ experiences, this study highlights the importance of mobilization at both the individual and systemic levels to fill the current gap and provide tailored and accessible services to the entire population.


2020 ◽  
Author(s):  
Shahrzad Arfa ◽  
Per Koren Solvang ◽  
Berit Berg ◽  
Reidun Jahnsen

Abstract Background: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on migrants’ utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. This study, by focusing on experiences of immigrant parents of children with disabilities who are navigating the Norwegian healthcare system in general and the pediatric rehabilitation services in particular, will generate knowledge of how accessible and tailored the services are from their point of view. Methods: This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. Results: The findings show how the “immigrant experience” influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of the years of struggle in the healthcare system to gain access to the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how the parents’ experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers’ intercultural communication skills and dominant organizational culture. Conclusions: The parents’ experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents’ experiences, this study highlights the importance of mobilization at both the individual and system levels to fill the current gap and provide tailored and accessible services to the entire population. Keywords: Immigrant parents, Children with disabilities, Healthcare system.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Raquel Herrero-Arias ◽  
Esperanza Diaz

Abstract Background Patients’ experiences with health providers and their diagnostic and treatment expectations are shaped by cultural health beliefs and previous experiences with healthcare services in home country. This study explores how Southern European immigrant parents navigate the Norwegian healthcare system, through its focus on how this group manage their expectations on diagnosis and treatment practices when these are unmet. Methods The study had a qualitative research design. Fourteen in-depth interviews and two focus group discussions with 20 Southern European immigrant parents were conducted in 2017 in three Norwegian municipalities. With the help of NVivo software, data were transcribed verbatim and coded. Following a thematic analysis approach to identify patterns in immigrants’ experiences with the Norwegian healthcare services, the codes were organized into two themes. Results The first theme includes immigrants’ expectations on diagnostic tests and medical treatment. Southern European immigrants expected more diagnostic tests and pharmacological treatment than what was deemed necessary by Norwegian health providers. Experiences with unmet expectations influenced how immigrants addressed their and their children’s healthcare needs. The second theme comprises immigrants’ experiences of seeking healthcare in Norway (attending medical consultations in the private sector, seeking immigrant healthcare providers, and navigating the healthcare through their Norwegian social networks). This category includes also the alternative solutions immigrants undertook when they were dissatisfied with the diagnosis and treatment practices they were offered in Norway (self-medication and seeking healthcare in home countries). Conclusions Cultural health beliefs and previous experiences with healthcare services from home country shaped immigrants’ expectations on diagnosis and treatment practices. This had great implications for their navigation through the healthcare system and interactions with health providers in the host country. The study suggests that successful inclusion of immigrants into the Norwegian healthcare system requires an acknowledgement of the cultural factors that influence access and use of healthcare services. Exploring immigrants’ perspectives and experiences offers important information to understand the challenges of cross-cultural healthcare and to improve communication and equitable access.


2018 ◽  
Vol 14 (4) ◽  
pp. 425-438 ◽  
Author(s):  
Sanjana Arora ◽  
Astrid Bergland ◽  
Melanie Straiton ◽  
Bernd Rechel ◽  
Jonas Debesay

Purpose The purpose of this paper is to synthesise data from the existent literature on the experiences of non-western older migrants in Europe in accessing and using healthcare services. Design/methodology/approach In total, 1,606 records were reviewed and 12 studies were selected. A thematic synthesis using Thomas and Harden’s approach was conducted. Findings The findings resulted in the three overarching themes: traditional discourses under new circumstances; predisposed vulnerabilities of older migrants and the healthcare system; and the conceptualization of health and the roles of healthcare professionals. The authors found that older migrants’ experience of accessing healthcare is influenced by many factors, such as health literacy, differences in healthcare beliefs and language barriers, and is not limited to cultural and traditional discourses of care. Findings reveal that there is a limited body of knowledge on barriers experienced by older migrant women. Research limitations/implications The geographical scope of the study and subsequent type of healthcare systems should be taken into account while understanding barriers to care. Another limitation is that although we studied different migrant groups, the authors synthesised barriers experienced by all. Future research could study migrants as separate groups to better understand how previous experiences with healthcare in their home country and specific social, cultural and economic circumstances shape them. Originality/value This paper provides a synthesis of the experiences of migrants from non-western countries who moved to a host country with a very different language, culture and healthcare system.


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