scholarly journals Communication Experiences in Primary Healthcare with Refugees and Asylum Seekers: A Literature Review and Narrative Synthesis

2021 ◽  
Vol 18 (4) ◽  
pp. 1469
Author(s):  
Pinika Patel ◽  
Sarah Bernays ◽  
Hankiz Dolan ◽  
Danielle Marie Muscat ◽  
Lyndal Trevena
Keyword(s):  
Asylum Seekers ◽  
Healthcare Providers ◽  
Narrative Synthesis ◽  
Western Countries ◽  
Communication Interaction ◽  
Communication Challenges ◽  
Care Consultation ◽  
Refugees And Asylum Seekers ◽  
Understanding Of Illness ◽  
Population Numbers

Refugee and asylum seeker population numbers are rising in Western countries. Understanding the communication experiences, within healthcare encounters, for this population is important for providing better care and health outcomes. This review summarizes the literature on health consultation communication experiences of refugees and asylum seekers living in Western countries. Seven electronic databases were searched from inception to 31 March 2019. Studies were included if they aimed to improve, assess or report on communication/interaction in the primary health care consultation setting with refugees or asylum seekers, and were conducted in Western countries. A narrative synthesis of the literature was undertaken. Thematic analysis of the 21 included articles, showed that refugees and asylum seekers experience a range of communication challenges and obstacles in primary care consultations. This included practical and relational challenges of organizing and using informal and formal interpreters and cultural understanding of illness and healthcare. Non-verbal and compassionate care aspects of communication emerged as an important factor in helping improve comfort and trust between healthcare providers (HCP) and refugees and asylum seekers during a healthcare encounter. Improvements at the systems level are needed to provide better access to professional interpreters, but also support compassionate and humanistic care by creating time for HCPs to build relationships and trust with patients.

Overcoming the deficiency of refugee mental health research

2019 ◽  
Author(s):  
Kristina Kalfic ◽  
Glenn Mitchell ◽  
Lezanne Ooi ◽  
Sibylle Schwab ◽  
Natalie Matosin
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Research ◽  
Asylum Seekers ◽  
Scientific Discovery ◽  
Mental Health Research ◽  
Psychiatric Research ◽  
Risk And Resilience ◽  
Refugee Mental Health ◽  
Refugees And Asylum Seekers

The growing number of refugees and asylum seekers are one of the most significant global challenges of this generation. We are currently witnessing the highest level of displacement in history, with over 65 million displaced people in the world. Refugees and asylum seekers are at higher risk to develop mental illness due to their trauma and chronic stress exposures, and particularly post-migration stressors. Yet global and Australian psychiatric research in this area is greatly lacking, particularly with respect to our understanding of the molecular underpinnings of risk and resilience to mental illness in traumatised populations. In this Viewpoint, we explore the reasons behind the lack of refugee mental health research and use this context to propose new ways forward. We believe that scientific discovery performed with a multidisciplinary approach will provide the broad evidence-base required to improve refugee mental health. This will also allow us to work towards the removal of damaging policies that prolong and potentiate mental health deterioration among refugees and asylum seekers, which impacts not only on the individuals but also host countries’ social, economic and healthcare systems.

scholarly journals A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD

2021 ◽  
Vol 6 (6) ◽  
pp. e005029
Author(s):  
Giulia Turrini ◽  
Federico Tedeschi ◽  
Pim Cuijpers ◽  
Cinzia Del Giovane ◽  
Ahlke Kip ◽  
...  
Keyword(s):  
Low Income ◽  
Asylum Seekers ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Risk Of Bias ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Treatment As Usual ◽  
Refugees And Asylum Seekers

IntroductionRefugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers.MethodsRandomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically identified. PTSD symptoms at postintervention was the primary outcome. Standardised mean differences (SMDs) and ORs were pooled using pairwise and NMA. Study quality was assessed with the Cochrane Risk of Bias (RoB) tool, and certainty of evidence was assessed through the Confidence in Network Meta-Analysis application.ResultsA total of 23 studies with 2308 participants were included. Sixteen studies were conducted in high-income countries, and seven in low-income or middle-income countries. Most studies were at low risk of bias according to the Cochrane RoB tool. NMA on PTSD symptoms showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 to −0.38) and eye movement desensitisation and reprocessing (EMDR) (SMD=−1.30; 95% CI −2.40 to −0.20) were significantly more effective than waitlist (WL). CBT was also associated with a higher decrease in PTSD symptoms than treatment as usual (TAU) (SMD −1.51; 95% CI −2.67 to −0.36). For all other interventions, the difference with WL and TAU was not significant. CBT and EMDR ranked best according to the mean surface under the cumulative ranking. Regarding acceptability, no intervention had less dropouts than inactive interventions.ConclusionCBT and EMDR appeared to have the greatest effects in reducing PTSD symptoms in asylum seekers and refugees. This evidence should be considered in guidelines and implementation packages to facilitate dissemination and uptake in refugee settings.

scholarly journals Conducting epigenetics research with refugees and asylum seekers: attending to the ethical challenges

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Faten Taki ◽  
Inmaculada de Melo-Martin
Keyword(s):  
Asylum Seekers ◽  
Evidence Base ◽  
Ethical Challenges ◽  
Physical And Mental Health ◽  
Healthcare Barriers ◽  
Humanitarian Action ◽  
Disease States ◽  
Conducting Research ◽  
Refugees And Asylum Seekers ◽  
Epigenetic Research

AbstractAn increase in global violence has forced the displacement of more than 70 million people, including 26 million refugees and 3.5 asylum seekers. Refugees and asylum seekers face serious socioeconomic and healthcare barriers and are therefore particularly vulnerable to physical and mental health risks, which are sometimes exacerbated by immigration policies and local social discriminations. Calls for a strong evidence base for humanitarian action have encouraged conducting research to address the barriers and needs of refugees and asylum seekers. Given the role of epigenetics factors to mediate the effect of psychological and environmental exposures, epigenetic modifications have been used as biomarkers for life adversity and disease states. Therefore, epigenetic research can be potentially beneficial to address some of the issues associated with refugees and asylum seekers. Here, we review the value of previous and ongoing epigenetic studies with traumatized populations, explore some of the ethical challenges associated with epigenetic research with refugees and asylees and offer suggestions to address or mitigate some of these challenges. Researchers have an ethical responsibility to implement strategies to minimize the harms and maximize the short and long-term benefits to refugee and asylee participants.

scholarly journals Oral health problems facing refugees in Europe: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eiad Zinah ◽  
Heba M. Al-Ibrahim
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Critical Appraisal ◽  
Oral Health Care ◽  
Health Problems ◽  
Host Countries ◽  
Refugees And Asylum Seekers

Abstract Introduction Europe has been experiencing a flow of refugees and asylum seekers driven by conflicts or poverty. Their oral health is often neglected despite its clear impact on quality of life. Objective To explore the status of oral health among refugees and asylum seekers groups by examining the available literature and to determine which evidence exists regarding the problems they face in terms of oral health. Methods The current paper followed PRISMA guidelines. A scoping review methodology was followed to retrieve 2911 records from five databases and grey literature. Twelve articles met the following inclusion criteria: experimental research concentrated on the oral and dental health of refugees and/or asylum seekers between 1995 and 2020 in English. Analysis was both descriptive and thematic, whilst a critical appraisal was applied using the Critical Appraisal Skills Program (CASP). Results Seven studies (58,3%) were quantitative, while five studies (41,6%) were qualitative. In general, the quality of most of the studies (83.3%) was good. Limited access to oral health care services was shown with a higher prevalence of oral diseases compared to the native populations of the host countries. Approaches to improve oral health have been implemented in some studies and have shown positive outcomes. Conclusions Oral health care strategies should consider the oral health problems facing refugees in Europe, and oral health promotion campaigns are essential to give adequate guidance on how to access oral health care in the host countries.

Communication regarding adverse neonatal birth events: Experiences of parents and clinicians

2021 ◽  
pp. 251604352110177
Author(s):  
Davia Liba Loren ◽  
Anne Drapkin Lyerly ◽  
Lauren Lipira ◽  
Madelene Ottosen ◽  
Emily Namey ◽  
...  
Keyword(s):  
Family Involvement ◽  
Extended Family ◽  
Healthcare Providers ◽  
High Expectations ◽  
Normal Birth ◽  
Qualitative Thematic Analysis ◽  
Academic Medical ◽  
Adverse Neonatal Outcomes ◽  
Communication Challenges ◽  
Communication Dynamics

Objectives Communicating with parents about adverse birth outcomes is challenging. We sought to describe attitudes and experiences of parents and providers regarding communication about adverse newborn birth events. Methods From 2011–2012, we conducted semi-structured in-depth interviews with parents who believed they had experienced an adverse birth-related neonatal outcome and focus groups with healthcare providers who have communicated with parents about adverse newborn birth events from three geographically diverse US academic medical centers. We conducted qualitative thematic analysis to identify key themes. Results Parents and providers described unique communication challenges around adverse neonatal outcomes in six categories: 1) High expectations for a positive delivery experience and the view that birth is a life event, not a medical encounter; 2) Powerful emotions associated with birth, amplified when an adverse event occurs; 3) Rapid changes when expectations for a normal birth take a sudden negative turn; 4) Family involvement adding complexity to communication; 5) Multiple patients and providers complicating communication dynamics with inter-professional teams seeking to coordinate information and care; and, 6) Concerns about litigation surrounding the birth experience. Strategies to educate parents and enhance communication were identified by both parents and providers. Conclusion Both parents and providers experience – and may suffer as a result of – communication challenges following adverse birth events affecting the newborn. Training and resources for this care environment are needed to meet parental, extended family, and provider expectations for communication when these events occur.

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