The road to equitable healthcare: A conceptual model developed from a qualitative study of Syrian refugees in Norway
Refugees in high-income countries face barriers to healthcare access even when they have the same rights and entitlements as the host population. Disadvantages in healthcare access contribute to differences in health outcomes and impact acculturation. This study explores perceived changes in health...
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| Veröffentlicht in: | Social science & medicine (1982) 2022-01, Vol.292, p.114540-114540, Article 114540 |
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| container_title | Social science & medicine (1982) |
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| creator | Haj-Younes, Jasmin Abildsnes, Eirik Kumar, Bernadette Diaz, Esperanza |
| description | Refugees in high-income countries face barriers to healthcare access even when they have the same rights and entitlements as the host population. Disadvantages in healthcare access contribute to differences in health outcomes and impact acculturation. This study explores perceived changes in health status and experiences with the Norwegian healthcare system of Syrian refugees living in Norway, using a trajectory perspective.
We conducted 15 semi-structured interviews in April 2020 among purposefully recruited adult refugees from Syria resettled in Norway. Interviews were carried out in Arabic and analysed with Systematic Text Condensation using NVivo software. We used Lévesque's access model and Edberg's migration trajectory perspective as theoretical frameworks. A conceptual model was developed – The Migrant Sensitive Access Model - that highlights the factors contributing to a positive versus negative healthcare journey.
Findings were summarized under three main themes: changes in health and well-being, expectations, and trust. Perceived changes in health status and attributed causes for change were related to the resettlement phase, gender, and were highly informed by pre-migration and migration experiences. The users’ perception of the caregiver, communication, and time were identified as key factors in the care-access journey in inspiring trust or distrust in the caregiver.
Syrian refugees in Norway appreciate the Norwegian healthcare system but are impeded in their access to care. Many of the barriers can be bridged during the doctor-patient interaction with a diversity sensitive caregiver. The model we propose gives a comprehensive overview of key areas determining the healthcare experience of this population. The results of this study can be useful to policymakers and healthcare providers when addressing disparities in healthcare access for forced migrants.
•Healthcare access for a refugee is closely interrelated to acculturation.•Many access barriers were found despite universal health coverage.•Barriers can be bridged by establishing trust in the healthcare system.•We propose a conceptual framework for the healthcare experience of refugees. |
| doi_str_mv | 10.1016/j.socscimed.2021.114540 |
| format | Article |
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We conducted 15 semi-structured interviews in April 2020 among purposefully recruited adult refugees from Syria resettled in Norway. Interviews were carried out in Arabic and analysed with Systematic Text Condensation using NVivo software. We used Lévesque's access model and Edberg's migration trajectory perspective as theoretical frameworks. A conceptual model was developed – The Migrant Sensitive Access Model - that highlights the factors contributing to a positive versus negative healthcare journey.
Findings were summarized under three main themes: changes in health and well-being, expectations, and trust. Perceived changes in health status and attributed causes for change were related to the resettlement phase, gender, and were highly informed by pre-migration and migration experiences. The users’ perception of the caregiver, communication, and time were identified as key factors in the care-access journey in inspiring trust or distrust in the caregiver.
Syrian refugees in Norway appreciate the Norwegian healthcare system but are impeded in their access to care. Many of the barriers can be bridged during the doctor-patient interaction with a diversity sensitive caregiver. The model we propose gives a comprehensive overview of key areas determining the healthcare experience of this population. The results of this study can be useful to policymakers and healthcare providers when addressing disparities in healthcare access for forced migrants.
•Healthcare access for a refugee is closely interrelated to acculturation.•Many access barriers were found despite universal health coverage.•Barriers can be bridged by establishing trust in the healthcare system.•We propose a conceptual framework for the healthcare experience of refugees.</description><identifier>ISSN: 0277-9536</identifier><identifier>EISSN: 1873-5347</identifier><identifier>DOI: 10.1016/j.socscimed.2021.114540</identifier><identifier>PMID: 34763966</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Access to healthcare ; Acculturation ; Adult ; Caregivers ; Change agents ; Changes ; Clinical outcomes ; Conceptual models ; Health care access ; Health care industry ; Health equity ; Health services ; Health Services Accessibility ; Health status ; Humans ; Interviews ; Migrants ; Migrants and transients ; Migration ; Norway - epidemiology ; Perceived changes ; Physician patient relationships ; Policy making ; Public health ; Qualitative Research ; Refugees ; Relocation ; Software ; Syria ; Well being</subject><ispartof>Social science & medicine (1982), 2022-01, Vol.292, p.114540-114540, Article 114540</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Ltd.</rights><rights>Copyright Pergamon Press Inc. Jan 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-987a9974342a9cfea5292995e02fec1cca214a8e73ca7d2297405e02206509533</citedby><cites>FETCH-LOGICAL-c448t-987a9974342a9cfea5292995e02fec1cca214a8e73ca7d2297405e02206509533</cites><orcidid>0000-0002-5454-8560 ; 0000-0001-7698-4331 ; 0000-0002-7533-1408</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0277953621008728$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27843,27901,27902,33751,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34763966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haj-Younes, Jasmin</creatorcontrib><creatorcontrib>Abildsnes, Eirik</creatorcontrib><creatorcontrib>Kumar, Bernadette</creatorcontrib><creatorcontrib>Diaz, Esperanza</creatorcontrib><title>The road to equitable healthcare: A conceptual model developed from a qualitative study of Syrian refugees in Norway</title><title>Social science & medicine (1982)</title><addtitle>Soc Sci Med</addtitle><description>Refugees in high-income countries face barriers to healthcare access even when they have the same rights and entitlements as the host population. Disadvantages in healthcare access contribute to differences in health outcomes and impact acculturation. This study explores perceived changes in health status and experiences with the Norwegian healthcare system of Syrian refugees living in Norway, using a trajectory perspective.
We conducted 15 semi-structured interviews in April 2020 among purposefully recruited adult refugees from Syria resettled in Norway. Interviews were carried out in Arabic and analysed with Systematic Text Condensation using NVivo software. We used Lévesque's access model and Edberg's migration trajectory perspective as theoretical frameworks. A conceptual model was developed – The Migrant Sensitive Access Model - that highlights the factors contributing to a positive versus negative healthcare journey.
Findings were summarized under three main themes: changes in health and well-being, expectations, and trust. Perceived changes in health status and attributed causes for change were related to the resettlement phase, gender, and were highly informed by pre-migration and migration experiences. The users’ perception of the caregiver, communication, and time were identified as key factors in the care-access journey in inspiring trust or distrust in the caregiver.
Syrian refugees in Norway appreciate the Norwegian healthcare system but are impeded in their access to care. Many of the barriers can be bridged during the doctor-patient interaction with a diversity sensitive caregiver. The model we propose gives a comprehensive overview of key areas determining the healthcare experience of this population. The results of this study can be useful to policymakers and healthcare providers when addressing disparities in healthcare access for forced migrants.
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Abildsnes, Eirik ; Kumar, Bernadette ; Diaz, Esperanza</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-987a9974342a9cfea5292995e02fec1cca214a8e73ca7d2297405e02206509533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Access to healthcare</topic><topic>Acculturation</topic><topic>Adult</topic><topic>Caregivers</topic><topic>Change agents</topic><topic>Changes</topic><topic>Clinical outcomes</topic><topic>Conceptual models</topic><topic>Health care access</topic><topic>Health care industry</topic><topic>Health equity</topic><topic>Health services</topic><topic>Health Services Accessibility</topic><topic>Health status</topic><topic>Humans</topic><topic>Interviews</topic><topic>Migrants</topic><topic>Migrants and transients</topic><topic>Migration</topic><topic>Norway - epidemiology</topic><topic>Perceived changes</topic><topic>Physician patient relationships</topic><topic>Policy making</topic><topic>Public health</topic><topic>Qualitative Research</topic><topic>Refugees</topic><topic>Relocation</topic><topic>Software</topic><topic>Syria</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haj-Younes, Jasmin</creatorcontrib><creatorcontrib>Abildsnes, Eirik</creatorcontrib><creatorcontrib>Kumar, Bernadette</creatorcontrib><creatorcontrib>Diaz, Esperanza</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PAIS Index</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Sociological Abstracts</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Sociological Abstracts</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Sociological Abstracts (Ovid)</collection><collection>MEDLINE - Academic</collection><jtitle>Social science & medicine (1982)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haj-Younes, Jasmin</au><au>Abildsnes, Eirik</au><au>Kumar, Bernadette</au><au>Diaz, Esperanza</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The road to equitable healthcare: A conceptual model developed from a qualitative study of Syrian refugees in Norway</atitle><jtitle>Social science & medicine (1982)</jtitle><addtitle>Soc Sci Med</addtitle><date>2022-01</date><risdate>2022</risdate><volume>292</volume><spage>114540</spage><epage>114540</epage><pages>114540-114540</pages><artnum>114540</artnum><issn>0277-9536</issn><eissn>1873-5347</eissn><abstract>Refugees in high-income countries face barriers to healthcare access even when they have the same rights and entitlements as the host population. Disadvantages in healthcare access contribute to differences in health outcomes and impact acculturation. This study explores perceived changes in health status and experiences with the Norwegian healthcare system of Syrian refugees living in Norway, using a trajectory perspective.
We conducted 15 semi-structured interviews in April 2020 among purposefully recruited adult refugees from Syria resettled in Norway. Interviews were carried out in Arabic and analysed with Systematic Text Condensation using NVivo software. We used Lévesque's access model and Edberg's migration trajectory perspective as theoretical frameworks. A conceptual model was developed – The Migrant Sensitive Access Model - that highlights the factors contributing to a positive versus negative healthcare journey.
Findings were summarized under three main themes: changes in health and well-being, expectations, and trust. Perceived changes in health status and attributed causes for change were related to the resettlement phase, gender, and were highly informed by pre-migration and migration experiences. The users’ perception of the caregiver, communication, and time were identified as key factors in the care-access journey in inspiring trust or distrust in the caregiver.
Syrian refugees in Norway appreciate the Norwegian healthcare system but are impeded in their access to care. Many of the barriers can be bridged during the doctor-patient interaction with a diversity sensitive caregiver. The model we propose gives a comprehensive overview of key areas determining the healthcare experience of this population. The results of this study can be useful to policymakers and healthcare providers when addressing disparities in healthcare access for forced migrants.
•Healthcare access for a refugee is closely interrelated to acculturation.•Many access barriers were found despite universal health coverage.•Barriers can be bridged by establishing trust in the healthcare system.•We propose a conceptual framework for the healthcare experience of refugees.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34763966</pmid><doi>10.1016/j.socscimed.2021.114540</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-5454-8560</orcidid><orcidid>https://orcid.org/0000-0001-7698-4331</orcidid><orcidid>https://orcid.org/0000-0002-7533-1408</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Social science & medicine (1982), 2022-01, Vol.292, p.114540-114540, Article 114540 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); PAIS Index; Sociological Abstracts |
| subjects | Access to healthcare Acculturation Adult Caregivers Change agents Changes Clinical outcomes Conceptual models Health care access Health care industry Health equity Health services Health Services Accessibility Health status Humans Interviews Migrants Migrants and transients Migration Norway - epidemiology Perceived changes Physician patient relationships Policy making Public health Qualitative Research Refugees Relocation Software Syria Well being |
| title | The road to equitable healthcare: A conceptual model developed from a qualitative study of Syrian refugees in Norway |
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