Purpose: The purpose of this qualitative study was to highlight the lived experiences of Hispanic migrant workers seeking healthcare at a community care clinic in rural Appalachia with participation from student nurses learning about qualitative research methods. Design/method: A phenomenological qualitative study was approved by the institutional IRB. Senior BSN nursing students, community care clinic staff and interpreters, and nurse educators participated in structured interviews during healthcare visits from Hispanic migrant workers at a local community care clinic in rural Appalachia. An audit trail provided the process to highlight common themes on health from the lived experiences of the Hispanic migrant worker population. Results: Several barriers on healthcare viewed by the Hispanic migrant workers included transportation, financial resources, medication prescriptions, and language. Positive lived experiences included; resources, quality care, and trust. Discussion/conclusion: Surprisingly, this research highlighted strengths of the interpersonal connection between the rural clinic staff and the Hispanic migrant workers. Participants vocalized their satisfaction when trust was established through the clinic’s efforts in providing interpreters, extended hours after normal field work hours, and personnel’s attitudes toward the promotion of health. The Hispanic Worker Study findings parallel similar lived experiences of the culture among people from rural Appalachia. Implications: Healthcare members must establish ‘trust’ as one of the interpersonal relationship strategies with multiple and diverse populations in order to create holistic culturally competent healthcare.

In recent years, Florida has acquired a reputation as fertile ground for human trafficking. On the heels of state and federal anti-human trafficking legislation, a host of organizations have risen to provide a range of services. In this thesis, I discuss findings from 26 interviews conducted with law enforcement, service providers, legal representatives and trafficked persons to contextualize the variability in the way anti-trafficking work is conceptualized by stakeholders across the state. Additionally, I explore how conflicting organizational policies on the local, state, and federal levels impact stakeholder collaboration and complicate trafficked persons' attempts to navigate already complex processes of social/health services and documentation. Lastly, I provide policy recommendations that attempt to address the major issues associated with anti-trafficking work identified through the analysis of participant interviews.

Burmese refugees are entering the US at record speed. Resettlement agencies focus on immediate needs, and ethnic community-based organizations (ECBOs) fill any service gaps through community-driven programs. The Tampa Bay Burmese Council (TBBC) is an ECBO in Tampa, FL dedicated to the Burmese community. This research explores the reproductive beliefs of the women in the community, paying particular attention to any differences that arise due to beliefs specific to their ethnic group. Findings include the importance of menses for women's health, the preference for both male and female children, a lack of knowledge about family planning methods, a tendency to use family planning only after the ideal family composition is reached, and periods of food and activity prohibitions during pregnancy and the postpartum period. The recommendations offered will be used by the TBBC to apply for grants to fund needed community-based services.

Lebanon hosts over one million refugees displaced from Syria as a result of the armed conflict—of whom, approximately 15% are adolescents aged between 12 and 17 years of age. Many female adolescent migrants report a decrease in quality of life and an increase in family tensions. This study sought to investigate the emotional well-being of adolescent Syrian girls in Lebanon. We hypothesized that married girls may experience additional hardships and thus greater feelings of dissatisfaction in daily life, given their young marriage and responsibilities at home. This study was part of a large mixed-methods study on the experiences of Syrian refugee girls in Lebanon (n = 1422). Using line-by-line coding and thematic analysis, 188 first-person narratives from Syrian girls were analysed. Our results highlight poor emotional well-being among married and unmarried girls, with sadness, fear and anger commonly mentioned. Some participants expressed feelings of hope, happiness, gratefulness and empowerment. Unmarried girls (n = 111) were more likely to associate their shared stories with negative feelings such as sadness (47% vs. 22%), disappointment (30% vs. 19%), and frustration (32% vs. 22%) than were married girls (n = 77). Four themes emerged as important determinants: access to education, perceived safety, peer support, and longing for life back in Syria. Continued efforts to improve emotional well-being for married and unmarried refugee girls are needed in Lebanon, in particular those that address the nuances for these groups.

Syfte: Syftet var att studera sjuksköterskors upplevelser av att arbeta med tolksamtal iasylhälsan.Bakgrund: Senaste årens ökande flyktingströmmar har skapat ökat tryck på primärvårdensasylhälsa och behovet av tolkar. Bristande kommunikation kan hindra sjuksköterskansomvårdnad och kunskap om upplevelsen av tolksamtalet i primärvården är därför viktig,något som saknas generellt i forskningen. Socialstyrelsens kartläggning beskrev problem medtillgängligheten av auktoriserade tolkar och en ojämlik situation över landet.Metod: Studien genomfördes som en kvalitativ intervjustudie med sju sjuksköterskor,intervjuerna spelades in, transkriberades och analyserades med manifest kvalitativinnehållsanalys med en induktiv ansats.Resultat: Tre huvudkategorier identifierades: Att tolkens roll påverkar samtalet beskrev hurtolkens professionalitet kunde främja eller störa samtalet samt hur tolkens genus och kulturkunde påverka samtalet. Att sjuksköterskans roll påverkar samtalet beskrev sjuksköterskansprofessionalitet som en förutsättning då de tvingades hitta egna lösningar i arbetet och sinsträvan efter ett vårdande samtal med kontakt och förståelse med patienten. Attorganisationen påverkar samtalet beskrev respondenterna en begränsande organisation medbrist på tolkar, avsaknad av struktur och samarbete mellan vården, tolkförmedlingar ochmyndigheter. Respondenterna beskrev en pressad arbetssituation och behovet av utbildningsom nödvändigt för kvalitetssäkrad vård.Slutsats: Sjuksköterskorna behöver tolken som en brygga för sin röst för att kunna ge godvård. Det finns ett behov av ett systematiskt sätt att arbeta med tolk, med utbildning ochträning för tolkar och sjuksköterskor. Detta skulle kvalitetssäkra vården och förbättraarbetssituationen för sjuksköterskorna. Kompetens inom transkulturell omvårdnad är viktigför rättvis vård i det mångkulturella Sverige. / Aims: The aim was to study nurses' experience of working with interpreter conversations inmigrant health.Background: The last years increase in refugees has created rising demands on migranthealth and interpreters in primary healthcare. Lack of communication can hinder nurses' careand knowledge of the experience of interpreter conversations is therefore important,something lacking in research. The National Board of Health and Welfares survey describedproblems of availability of medical interpreters and an unequal situation nationwide.Methods: The study was a qualitative interview study with seven nurses. Interviews wererecorded, transcribed and analyzed with qualitative content analysis.Results: Three main categories were identified: The interpreter’s role affects the conversationdescribed how interpreter professionality could enable or disable the conversation as couldinterpreter sex and culture. The nurses' role affects the conversation described how theprofessionality of the nurse was essential as they needed to find own solutions workwise aswell as the pursuit of a caring conversation with the patient. The organization affects theconversation described a limiting organization with a lack of interpreters, structure andcooperation between healthcare and authorities. Education was stressed as quality-assurance.Conclusions: Nurses need the interpreter as bridge for their voice to enable good care. Thereis need for a systematic way to work with interpreters through education and Nurse-Interpreter training. This would quality-assure healthcare and improve working conditions.Competence in transcultural nursing is important for equal health care in today's multiculturalSweden

Philosophiae Doctor - PhD (School of Public Health) / South Africa has an estimated two million documented and undocumented immigrants. In addition, Statistics South Africa (2014) notes very significant internal migration. This mobile population is affected by chronic communicable and non-communicable diseases such as TB, HIV, and diabetes, although it has a Constitutional right to health and healthcare. Their quality of healthcare and disease control also affects the general population and the burden on the health system can be increased by inadequately managed chronic conditions as well as acute health care needs. Access to healthcare and continuity of care reflect both patient agency and the health system. Community Health Workers (CHWs) play an important role in linking communities and patients to health services and vice versa. The aim of this study was to understand how agricultural migrants in the Cape Winelands District of Western Cape Province of South Africa navigated the healthcare system to access healthcare services including securing continuity of care, and in particular the role of CHWs in this process, in order to inform policy and practice.

No description available.

Objectif : Des recherches antérieures ont identifié une mauvaise utilisation des soins prénataux chez les migrants sans assurance maladie au Canada. Cependant, les facteurs qui influencent cette utilisation restent largement inexplorés. L'objectif de cette étude était de quantifier l'utilisation des soins prénataux dans ce groupe et d'identifier les barrières et les facteurs facilitant l'utilisation des soins prénataux. Méthodes : Une étude transversale sur les migrants sans assurance maladie à Montréal, Canada, a été menée entre janvier 2016 et août 2017. Les participants ont été recrutés dans une clinique bénévole locale et dans la communauté en utilisant un échantillonnage à partir de lieux et en boule de neige. Les mesures des résultats comprenaient l'utilisation des soins prénataux, l'initiation des soins prénataux et l'adéquation des soins prénataux. L'analyse de régression a identifié les barrières et les facteurs facilitant l'utilisation des soins prénataux. Résultats : 125 grossesses antérieures au Canada ont été recensées parmi 101 femmes. 65.0% des grossesses impliquaient une utilisation des soins prénataux et 44.6% impliquaient un début tôt des soins. Parmi les 62 grossesses menées à terme, 29.5% ont reçu des soins prénataux adéquats. Les femmes ≥35 ans (OR 0.13, IC à 95%: 0.03-0.54, p = 0.01), entre 18 et 24 ans (OR 0.30, IC à 95%: 0.09-0.99, p=0.049), et celles qui ne savaient pas où consulter (OR 0.25, IC à 95%: 0.06-0.99, p=0.049) avaient significativement moins de chances (p <0.05) d’utiliser les soins prénataux. Les femmes âgées de 30 à 34 ans (OR 0.27, IC à 95%: 0.10-0.72, p=0.01) avaient significativement moins de chances (p <0.05) de commencer tôt les soins prénataux. En revanche, les femmes mariées ou en union de fait (OR 3.16, IC à 95%: 1.04-9.62, p=0.04) avaient significativement plus de chances (p <0.05) de commencer tôt les soins prénataux. Conclusion : Notre étude a révélé que l'utilisation des soins prénataux chez les migrants sans assurance était très faible. Les facteurs influençant l'utilisation des soins prénatals étaient variés et liés à la démographie, au réseau social et à la migration. Les politiques futures devraient viser à améliorer l'accès aux soins prénatals au sein de cette population vulnérable. / Objective: Previous research has identified poor prenatal care use among uninsured migrants in Canada, however, the factors influencing this usage remain largely unexplored. The study objective was to quantify the use of prenatal care among this group and to identify the barriers and facilitating factors to prenatal care use. Methods: A cross-sectional survey of uninsured migrants in Montreal, Canada was carried out between January 2016 and August 2017. Participants were recruited from a local volunteer clinic and from the community using venue-based and snowball sampling. Outcome measures included prenatal care use, prenatal care initiation, and prenatal care adequacy. Regression analysis identified barriers and facilitating factors to prenatal care use. Results: 125 previous pregnancies in Canada were identified among 101 women. 65.0% of pregnancies involved prenatal care use and 44.6% involved an early initiation of care. Among the 62 pregnancies carried to term, 29.5% received adequate prenatal care. Women ≥35 years of age (OR 0.13, 95% CI: 0.03-0.54, p=0.01), between the ages of 18-24 (OR 0.30, 95% CI: 0.09-0.99, p=0.049), and those who did not know where to consult (OR 0.25, 95% CI: 0.06-0.99, p=0.049) were significantly less likely (p<0.05) to use prenatal care. Women aged 30-34 (OR 0.27, 95% CI: 0.10-0.72, p=0.01) were significantly less likely (p<0.05) to initiate prenatal care early. In contrast, women who were married or in common-law relationships (OR 3.16, 95% CI: 1.04-9.62, p=0.04) were significantly more likely (p<0.05) to initiate prenatal care early. Conclusion: Our study found that prenatal care use among uninsured migrants was very poor. Factors influencing prenatal care use were varied and related to demographics, social network, and migration. Future policy should aim to improve access to prenatal care among this vulnerable population.