Working atmosphere within this discrete sample of dental care practice seemed to be an important influence on reported working condition and job satisfaction for dental nurses. Because of the high association of job satisfaction with physical working condition, the importance of paying more attention to an ergonomic working position for dental nurses to ensure optimal quality of care is highlighted.

The presented results contribute to an understanding of factors that influence levels of satisfaction of female and male physicians. Therefore, research and intervention about job satisfaction should consider gender as well as the stereotypes that come along with these social roles.

Introduction. Equity in health is an essential issue and it would appear that it is not guaranteed for all human beings, especially refugee groups. The aim of this qualitative descriptive study was to explore the experiences of refugees, health care professionals, and administrators of refugee health care in a host country. Methods. The study used qualitative methods which consisted of a convenience sample of stakeholders directly and indirectly involved in care for refugees and refugees themselves. The study participants were located in a rural area in the federal state of Schleswig-Holstein, Germany. Focus groups and interviews were conducted with 25 participants. A semistructured interview guideline was used for the focus groups and interviews. The data were evaluated using qualitative content analysis. Results. Four main categories were identified which are important for equity in health care: legal aspects, sociocultural aspects, environmental aspects, and communication aspects. Legal frameworks and language barriers were perceived as strong barriers for accessing health care. Conclusions. The findings suggest that the host countries should address the specific needs of this population group at a systemic and individual level. Based on the views of the participants interviewed it can be concluded that the refugee population group is particularly affected by limited access to health care services. Bureaucratic barriers, unfamiliarity with a new health system, and language issues all contribute to limiting access to health care services.

Objective The aim of this systematic review was to identify quality indicators (QI) developed for health care for refugees. Methods We conducted a systematic review of international QI databases such as the Agency for Health care Research and Quality in addition to a systematic search in PubMed, Cochrane library and Web of Science, using the terms “refugee” and “quality indicator”, complemented by a search in reference lists and grey literature. All papers which included QIs for refugees, especially for health care were included. In a first step all existing QIs were screened for their relevance to refugees. In a second step, all health care QIs were extracted. In a final step, these health care QIs were classified into process, structure and outcome indicators. Results Of 474 papers, 23 were selected for a full-text review. Of these 23 publications, 6 contained 115 QIs for health and health care for refugees. The main health care topics identified were reproductive health, health care service and health status. Conclusions Most indicators were indicators for outcome and structure quality, the smallest group were process indicators. Within the area of refugee health care, most QIs that have been found were QIs regarding reproductive health. QI databases do not yet include indicators specifically related to refugees.

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BackgroundThe evaluation of quality of primary health care from the perspective of refugees is very underdeveloped. It depends mainly on the availability of instruments in the language of the refugees. The aim of this study was to translate, culturally adapt, and examine the psychometric properties especially the internal consistency and convergent construct validity of the Arabic version of the European Project on Patient Evaluation of General Practice Care (EUROPEP) questionnaire.MethodsThe German version of the EUROPEP questionnaire was translated into Arabic language. In total, 619 Arabic-speaking people were invited to participate in this study. Refugees who lived in collective living quarters in the German federal state of Schleswig-Holstein were recruited. The EUROPEP questionnaire is a multidimensional instrument that comprises 23 items, each with a 5-point Likert-type response. Cronbach’s alpha, descriptive statistics, and principal component analysis were used to assess a part of psychometric properties. Convergent construct validity was assessed with the validated questionnaire on satisfaction with ambulatory care – quality from the patient perspective (ZAP questionnaire) by using Spearman rank-order correlation test.ResultsA total of 136 questionnaires of refugees were returned (response rate 22%). Of these respondents, 95 participants who had visited a general practitioner were included in the validation study. The exploratory factor analysis extracted four factors, namely, “medical care,” “physician–patient relationship,” “coordination of care,” and “accessibility to care.” The internal consistency ranged between α=0.942 for “medical care” and α=0.869 for “coordination of care.” The convergent construct validity is supported by a significant positive correlation between the overall score of the EUROPEP questionnaire and the overall score of the ZAP questionnaire (rrho=0.820; p<0.01).ConclusionThe Arabic version of the EUROPEP questionnaire shows appropriate internal consistency and convergent construct validity. The availability of this instrument in Arabic language encourages further research in the field of outcome quality from refugees’ perspective in other health service research projects.

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