Abstract:There is a substantial body of literature that highlights disparities in asylum seeker health and healthcare access and the difficulties that healthcare professionals face when providing care to asylum seekers and refugee populations. Few studies, however, have explored these processes within the context of Maltese society. This study aimed to gain an insight into cross-cultural healthcare practices through an exploration of clinical encounters between asylum seekers and healthcare professionals in the primary… Show more
“…The exploration of encounters between asylum seekers and healthcare professionals (HCPs) in the primary healthcare setting in Malta suggests that the forces influencing asylum seekers and HCP behaviours and responses are complex and relate to discourses, policies and practices at a series of interconnected levels. To illustrate this, we discuss these findings using a multi-level framework that draws on the concept of candidacy (Dixon-Woods et al, 2006; Depares, 2016) (Figure 1), which addresses the structural, psychological and sociological factors that impact experiences throughout a candidate patient’s healthcare pathway, with an additional focus on the attitudes and expectations of all the stakeholders (Methley et al, 2016). The framework proposes that discordant healthcare encounters are not simply a manifestation of essential cultural differences between the two parties but are shaped by factors that emanate from a complex interplay of historical and contemporary discourses, inequitable structures, multiple intersecting identities and past experiences.Figure 1.Conceptual multi-level framework.…”
Section: Discussionmentioning
confidence: 99%
“…The researcher carried out an analysis of identity and subjectivity in relation to self and participant–researcher relationships in a reflexive effort to avoid ‘othering’ practices (Mohammed, 2006). Further details of the theoretical and methodological underpinnings of the study can be found in Depares (2016).…”
Section: Methodsmentioning
confidence: 99%
“…Interview participants comprised 11 asylum seekers (AS) seven males and four females; four cultural mediators (CM) and seven Maltese healthcare professionals (HCP), five nurses and two medical doctors. All were recruited through purposive sampling and invited to participate by an intermediary in accordance with identified inclusion and exclusion criteria (Depares, 2016). Asylum seekers were recruited through a nongovernmental organisation (NGO), an Open Centre and a community centre.…”
Background There is a substantial body of literature that discusses the problematic nature of asylum seeker healthcare in several European countries. However, little is known about how asylum seekers experience primary healthcare in Malta. Aim This paper draws on a qualitative study that aimed to explore the nature of healthcare encounters between asylum seekers and healthcare professionals in Maltese primary healthcare and the contextual processes which influence these interactions. Methodology The study utilised critical ethnography, informed by postcolonial theory. Data were collected through observation of encounters between healthcare professionals and asylum seekers (130 hours) and in-depth interviews with asylum seekers ( n11), cultural mediators ( n4) and Maltese healthcare professionals ( n7). Results Thematic analysis of the combined data resulted in three themes: ‘the impact of seeking refuge’, ‘seeking mutual understanding’ and ‘seeking resolution’. Healthcare encounters between asylum seekers and professionals are characterised by ‘othering’ practices, pre-conceived expectations and mutual mistrust. These are shaped by a complex interplay of factors, including damaging experiences of migration, derogatory political and public discourses and inadequate resources. Conclusion In Maltese primary care, healthcare encounters are highly problematic for both patients and professionals. Nurses could take the lead in developing services to assess complex needs and aid asylum seekers in navigating the healthcare system.
“…The exploration of encounters between asylum seekers and healthcare professionals (HCPs) in the primary healthcare setting in Malta suggests that the forces influencing asylum seekers and HCP behaviours and responses are complex and relate to discourses, policies and practices at a series of interconnected levels. To illustrate this, we discuss these findings using a multi-level framework that draws on the concept of candidacy (Dixon-Woods et al, 2006; Depares, 2016) (Figure 1), which addresses the structural, psychological and sociological factors that impact experiences throughout a candidate patient’s healthcare pathway, with an additional focus on the attitudes and expectations of all the stakeholders (Methley et al, 2016). The framework proposes that discordant healthcare encounters are not simply a manifestation of essential cultural differences between the two parties but are shaped by factors that emanate from a complex interplay of historical and contemporary discourses, inequitable structures, multiple intersecting identities and past experiences.Figure 1.Conceptual multi-level framework.…”
Section: Discussionmentioning
confidence: 99%
“…The researcher carried out an analysis of identity and subjectivity in relation to self and participant–researcher relationships in a reflexive effort to avoid ‘othering’ practices (Mohammed, 2006). Further details of the theoretical and methodological underpinnings of the study can be found in Depares (2016).…”
Section: Methodsmentioning
confidence: 99%
“…Interview participants comprised 11 asylum seekers (AS) seven males and four females; four cultural mediators (CM) and seven Maltese healthcare professionals (HCP), five nurses and two medical doctors. All were recruited through purposive sampling and invited to participate by an intermediary in accordance with identified inclusion and exclusion criteria (Depares, 2016). Asylum seekers were recruited through a nongovernmental organisation (NGO), an Open Centre and a community centre.…”
Background There is a substantial body of literature that discusses the problematic nature of asylum seeker healthcare in several European countries. However, little is known about how asylum seekers experience primary healthcare in Malta. Aim This paper draws on a qualitative study that aimed to explore the nature of healthcare encounters between asylum seekers and healthcare professionals in Maltese primary healthcare and the contextual processes which influence these interactions. Methodology The study utilised critical ethnography, informed by postcolonial theory. Data were collected through observation of encounters between healthcare professionals and asylum seekers (130 hours) and in-depth interviews with asylum seekers ( n11), cultural mediators ( n4) and Maltese healthcare professionals ( n7). Results Thematic analysis of the combined data resulted in three themes: ‘the impact of seeking refuge’, ‘seeking mutual understanding’ and ‘seeking resolution’. Healthcare encounters between asylum seekers and professionals are characterised by ‘othering’ practices, pre-conceived expectations and mutual mistrust. These are shaped by a complex interplay of factors, including damaging experiences of migration, derogatory political and public discourses and inadequate resources. Conclusion In Maltese primary care, healthcare encounters are highly problematic for both patients and professionals. Nurses could take the lead in developing services to assess complex needs and aid asylum seekers in navigating the healthcare system.
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