Enquadramento: a presença de diferentes culturas pela enorme diversidade de imigrantes em Portugal provoca alterações no comportamento dos profissionais de saúde. Objetivo: conhecer os fatores que influenciam a procura dos cuidados de saúde segundo o género dos imigrantes ucranianos na região metropolitana do Porto. Metodologia: estudo exploratório-descritivo e correlacionai com abordagem quantitativa e qualitativa. A informação foi recolhida por questionário e 11 entrevistas numa amostra de conveniência constituída por 212 imigrantes ucranianos. Resultados: evidência de dificuldades no acesso aos cuidados de saúde não se verificando diferenças significativas quanto ao género. Uma vez que as mulheres Ucranianas procuram mais os cuidados, são elas que referem mais obstáculos no acesso à saúde (comunicação ineficaz, barreira linguística, barreira cultural, diferentes interpretações dos sintomas, desarticulação entre serviços, crenças, dificuldade na conjugação de horários, custos com os tratamentos, desconhecimento dos direitos como imigrante, situação de ilegalidade, receio de descriminação). Conclusão: barreiras culturais e linguísticas e desarticulação entre serviços influenciam negativamente a procura dos cuidados. As mulheres são as maiores utilizadoras dos serviços de saúde. Os serviços devem dispor de tradutores, mediadores culturais. Espera-se que os serviços e os profissionais de saúde desenvolvam planos dirigidos aos imigrantes. Sugere-se formação que aumente a competência cultural dos profissionais.
A new legislative framework for devolution has been introduced into England marking a potentially significant step towards addressing the unfinished business of Labour's devolution settlement. What promised to be a bespoke and bottom-up commitment to devolution for English local government has manifested into a top-down, prescriptive and inconsistent process of agreeing the decentralisation of functions and finances to groups of principal local authorities. The paper reports on the progress of the new wave of devolution in England to date, through a review of agreed devolution deals and assesses the extent to which the current 'devolution revolution' represents the beginning of a shift away from a centralised system built from the bottom up, or looks set to result in another typically top-down reform to local government. The paper presents the initial findings of early research, which will be used to develop key research questions for a further long-term research project.
The coexistence of multiple cultures is a challenge that requires behavioral changes for the health professionals, in particular nurses. This work’s objective was to understand the factors and beliefs that influence the demand for health care from immigrants in the Porto metropolitan area (Portugal), and their accessibility to the health services. We developed an exploratory-descriptive qualitative study. We obtained the data through semi-structured interviews of eleven Ukrainian residents of the Porto metropolitan area. We used the twelve cultural domains of Purnell. Sampling was non-probability, of convenience and in “snowball”. Participants were required to give their free and informed consent. The results indicated some difficulties accessing health care due to inefficient communication, resulting from the language barrier and/or of different interpretations, and the disarticulation between the different immigrant support services. This study allowed the implementation of strategies designed to promote health care directed to immigrants, taking into consideration the diversity and vulnerability when accessing health services.
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