scholarly journals The Lived Experience of Syrian Refugees in Canada: A Phenomenological Study

Author(s):  
Khaldoun Aldiabat ◽  
Enam Alsrayheen ◽  
Catherine Aquino-Russell ◽  
Michael Clinton ◽  
Roger Russell

Health care providers in Canada are expected to take care of people from a variety of cultural backgrounds, and it is difficult for health care providers to deeply understand the lived experiences of some individuals to provide them with culturally sensitive care. Syrian refugees comprise one such group of newcomers to Canada. This phenomenological study aimed to uncover the meaning of the lived experiences of Syrian refugees using Giorgi’s (2009) method. Seven participants’ descriptions were viewed through the lens of the social determinants of health model. Seven essences of the general structural description or the meaning Syrian refugees gave to their experiences of living in Canada were synthesized. Syrian refugees live paradoxical experiences that are both rewarding and less rewarding when viewed through the lens of the social determinants of health (social support, environment, culture, education, health services, employment, and income). These experiences have influenced their health in both positive and negative ways. This study highlights the need for more culturally sensitive health care interventions and assistance for Syrian refugees/newcomers in Canada. As a next step, an action research study involving Syrian refugees as co-researchers may help address the social determinant of health risks in this population.

2017 ◽  
Vol 45 (3) ◽  
pp. 431-441 ◽  
Author(s):  
Joanna Theiss ◽  
Marsha Regenstein

Despite evidence that social factors can result in poor health outcomes, and the emergence of payment models that encourage the use non-medical interventions to improve health, many health care providers do not identify the social determinants of health within patient populations through routine screening. This Article explores the possible reasons for this inconsistency by considering screening practices in medical-legal partnerships (MLPs), the health care approach most concerned with identifying and treating the social determinants of health. Through an analysis of the results of a national survey and qualitative interviews with MLPs, we discovered that screening is not operationalized or consistent within many MLPs. We conclude that although health care providers may recognize the value of screening, they are not yet embracing the practice, perhaps because of an unspoken fear that fulsome screening identifies so many unmet social and legal needs that community-based resources cannot satisfy demand. This fear is unfounded. Approaches such as MLP demonstrate that social and legal needs can be efficiently treated through collaboration with other professionals, often within the health care setting. Nevertheless, providers must first operationalize screening to truly understand the scope of the need in their patient populations and collaborate to address those needs.


Author(s):  
Emily L. Silverberg ◽  
Trevor W. Sterling ◽  
Tyler H. Williams ◽  
Grettel Castro ◽  
Pura Rodriguez de la Vega ◽  
...  

One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14–3.90), out of work (OR 2.82; 95% CI: 1.62–4.92), unable to work (OR 2.14; 95% CI: 1.57–2.91), did not graduate high school (OR 1.91; 95% CI: 1.30–2.79), only graduated high school (OR 1.43; 95% CI 1.08–1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09–1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
O. Pearson ◽  
◽  
K. Schwartzkopff ◽  
A. Dawson ◽  
C. Hagger ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background: Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods: The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed . A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results: Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions: This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2019 ◽  
Vol 13 ◽  
Author(s):  
Carolina Gabriele Gomes da Rocha ◽  
Ivonete Heideman Teresinha Schulter Buss Heidemann ◽  
Pamela Camila Fernandes Rumor ◽  
Fabiano Oliveira Antonini ◽  
Michelle Kuntz Durand ◽  
...  

Objetivo: conhecer como são trabalhados os Determinantes Sociais da Saúde na consulta de Enfermagem do pré-natal na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo, exploratório, com 15 enfermeiras, mediante a realização de entrevistas semiestruturadas, prosseguindo-se com a análise temática dos dados. Resultados: limita-se a compreensão sobre os Determinantes Sociais da Saúde a fatores relacionados à situação socioeconômica e à rede familiar da gestante. Revelou-se a atuação da equipe multiprofissional e enfatizou-se a necessidade de envolver ações intersetoriais. Identificaram-se limites e dificuldades relacionados à atuação dos enfermeiros sobre os determinantes e condicionantes que interferem na vida das gestantes. Conclusão: revela-se que, apesar de os enfermeiros não compreenderem o conceito de modo amplo, a atuação mostra-se como uma realidade durante o pré-natal. Acrescenta-se, no entanto, que são múltiplas as barreiras enfrentadas pelas gestantes e são muitos os limites e dificuldades encontrados pelos profissionais para atuar amplamente sobre os Determinantes Sociais de Saúde. Descritores: Promoção da Saúde; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Cuidado Pré-natal; Equidade em Saúde.ABSTRACTObjective: to know how the Social Determinants of Health are dealt with in the Prenatal Nursing consultation in Primary Health Care. Method: this is a qualitative, descriptive, exploratory study, with 15 nurses, through semi-structured interviews, continuing with the thematic analysis of the data. Results: the understanding about the Social Determinants of Health is limited to factors related to the socioeconomic situation and the pregnant woman's family network. The performance of the multiprofessional team was revealed and the need to involve intersectoral actions was emphasized. Limits and difficulties related to the performance of nurses on the determinants and conditions that interfere in the lives of pregnant women were identified. Conclusion: it is revealed that, although nurses do not understand the concept broadly, acting is a reality during prenatal care. However, there are multiple barriers faced by pregnant women and there are many limits and difficulties encountered by professionals to act broadly on the Social Determinants of Health. Descriptors: Health Promotion; Social Determinants of Health; Primary Health Care; Nursing; Pré-natal Care; Health Equity.RESUMENObjetivo: conocer cómo se abordan los Determinantes Sociales de la Salud en la consulta de Enfermería Prenatal en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo, exploratorio, con 15 enfermeras, a través de entrevistas semiestructuradas, continuando con el análisis temático de los datos. Resultados: la comprensión de los Determinantes Sociales de la Salud se limita a factores relacionados con la situación socioeconómica y la red familiar de la mujer embarazada. Se reveló el desempeño del equipo multiprofesional y se enfatizó la necesidad de involucrar acciones intersectoriales. Se identificaron los límites y las dificultades relacionadas con el desempeño de los enfermeros sobre los determinantes y las condiciones que interfieren en la vida de las mujeres embarazadas. Conclusión: se revela que, aunque los enfermeros no entienden el concepto en general, la actuación es una realidad durante la atención prenatal. Sin embargo, las mujeres embarazadas enfrentan múltiples barreras y los profesionales enfrentan muchos límites y dificultades para actuar ampliamente sobre los Determinantes Sociales de la Salud. Descriptores: Promoción de la Salud; Determinantes Sociales de la Salud; Atención Primaria de Salud; Enfermería; Atención Prenatal; Equidad en Salud.


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