Experiences With Health Care Services in Switzerland Among Immigrant Women With Chronic Illnesses

Frahsa, Annika; Farquet, Romaine; Bayram, Tevfik; Araujo, Luna De; Meyer, Sophie; Sakarya, Sibel; Cattacin, Sandro; Abel, Thomas

doi:10.3389/fpubh.2020.553438

Cited by 5 publications

(16 citation statements)

References 22 publications

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“…This is a sub‐study of MIWOCA, short for Migrant Women's Health Care Needs for Chronic Illness Services in Switzerland (SNF NRP74 2017‐2020), a larger research project in which we researched access to and quality of healthcare service among women in Switzerland with chronic illness and migration experience. 18 , 19 MIWOCA included migrant and native‐born women with chronic illnesses across diverse cultural and social backgrounds as well as care providers and other relevant stakeholders. Women participated in interviews and focus group discussions (FGDs).…”

Section: Methodsmentioning

confidence: 99%

“…Detailed information about the study population, sampling strategies and data collection has been described previously. 18 In the current paper, we present a methodological approach to linking data sources based on the empirical fieldwork conducted during the MIWOCA project. We used data from multiple sources: observations and field notes from regular project meetings and three stakeholder dialogues, an analysis of project documents (such as minutes, reports, notes, patient vignettes, MIWOCA evidence and policy briefs), as well as a re‐analysis of qualitative semi‐structured interviews with women with chronic illnesses and health/social service providers ( n = 48; n = 12) and two FGDs ( n = 15).…”

Section: Methodsmentioning

confidence: 99%

“…Given this background, the present paper demonstrates how a PRE approach can be used to link various data sources addressing healthcare system shortcomings. In doing so, we draw on data and insights from an empirical research study (Migrant Women's Health Care Needs for Chronic Illness Services in Switzerland [MIWOCA]) on immigrant women's healthcare needs and access to chronic illness care 18 . In the current paper, we illustrate how a multistage qualitative methodology can integrate patients' experiences in consecutive steps of the knowledge‐production process and engage patients as co‐producers of knowledge for improving care services.…”

Section: Introductionmentioning

confidence: 99%

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Integrating Patient‐reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience

Abel

Tadesse

Frahsa

et al. 2022

Health Expectations

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Background: Patient-reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access. Methods:The MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12) and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettes and policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production.Results: Deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflect and rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co-producers for system-level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland.Conclusions: Building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient-doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Integrating Patient‐reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience

Abel

Tadesse

Frahsa

et al. 2022

Health Expectations

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“…Examining access to healthcare through patients’ perspectives is relevant for this study because it addresses aspects of healthcare that are difficult to measure, such as satisfaction, participation, perceptions, and preferences [ 23 – 26 ]. This perspective also provides data on “why” problems occur [ 24 ]. Thus, it makes a unique contribution to planning efforts for improving healthcare services based on users’ own needs and expectations [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…This perspective also provides data on “why” problems occur [ 24 ]. Thus, it makes a unique contribution to planning efforts for improving healthcare services based on users’ own needs and expectations [ 24 ]. This approach is in line with the World Health Organization’s framework on integrated people-centered health services, which calls for health systems to prioritize people when developing health systems [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Oppression and internalized oppression as an emerging theme in accessing healthcare: findings from a qualitative study assessing first-language related barriers among the Kurds in Turkey

Bayram

Sakarya

2023

Int J Equity Health

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Background Language has been well documented to be a key determinant of accessing healthcare. Most of the literature about language barrier in accessing healthcare is in the context of miscommunication. However, it is critical to consider the historical and political contexts and power dynamics underlying actions. The literature in this matter is short. In this paper we aimed to find out how first-language affects access to healthcare for people who do not speak the official language, with a particular focus on language oppression. Methods We conducted this qualitative study based on patient-reported experiences of the Kurds in Turkey, which is a century-long oppressed population. We conducted 12 in-depth interviews (all ethnically Kurdish, non-Turkish speaking) in Şırnak, Turkey, in 2018–2019 using maximum variation strategy. We used Levesque’s ‘Patient-Centred Access to Healthcare’ framework which addresses individual and structural dimensions to access. Results We found that Kurds who do not speak the official language face multiple first-language related barriers in accessing healthcare. Poor access to health information, poor patient-provider relationship, delay in seeking health care, dependence on others in accessing healthcare, low adherence to treatments, dissatisfaction with services, and inability to follow health rights were main issues. As an unusual outcome, we discovered that the barrier processes in accessing healthcare are particularly complicated in the context of oppression and its internalization. Internalized oppression, as we found in our study, impairs access to healthcare with creating a sense of reluctance to seek healthcare, and impairs their individual and collective agency to struggle for change. Conclusions A human-rights-based top-down policy shift, and a bottom-up community empowerment approach is needed. At the system level, official recognition of oppressed populations, acknowledgement of the determinants of their health; and incorporating their language in official capacities (particularly education and healthcare) is crucial. Interventions should include raising awareness among relevant professions and stakeholders that internalized oppression is an issue in accessing healthcare to be considered. Given that internalized oppression can be in other forms than language or ethnicity, future research aimed at examining other aspects of access to healthcare should pay a special attention to internalized oppression.

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Approaches for enhancing patient-reported experience measurement with ethnically diverse communities: a rapid evidence synthesis

Harrison,

Iqbal,

Chitkara

et al. 2024

Int J Equity Health

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Background Patient-reported experience measures (PREMs) are used to drive and evaluate unit and organisational-level healthcare improvement, but also at a population level, these measures can be key indicators of healthcare quality. Current evidence indicates that ethnically diverse communities frequently experience poorer care quality and outcomes, with PREMs data required from this population to direct service improvement efforts. This review synthesises evidence of the methods and approaches used to promote participation in PREMs among ethnically diverse populations. Methods A rapid evidence appraisal (REA) methodology was utilised to identify the disparate literature on this topic. A search strategy was developed and applied to three major electronic databases in July 2022 (Medline; PsycINFO and CINAHL), in addition to websites of health agencies in Organisation for Economic Co-operation and Development countries via grey literature searches. A narrative evidence synthesis was undertaken to address the review question. Results The review resulted in 97 included studies, comprised 86 articles from electronic database searches and 11 articles from the grey literature. Data extraction and synthesis identified five strategies used in PREM instruments and processes to enhance participation among ethnically diverse communities. Strategies applied sought to better inform communities about PREMs, to create accessible PREMs instruments, to support PREMs completion and to include culturally relevant topics. Several methods were used, predominantly drawing upon bicultural workers, translation, and community outreach to access and support communities at one or more stages of design or administration of PREMs. Limited evidence was available of the effectiveness of the identified methods and strategies. PREMs topics of trust, cultural responsiveness, care navigation and coordination were identified as pertinent to and frequently explored with this population. Conclusions The findings provide a basis for a maturity model that may guide change to increase participation of ethnically diverse communities in PREMs. In the short-medium term, health systems and services must be able to recognise and respond to cultural and linguistic diversity in the population when applying existing PREMs. In the longer-term, by working in collaboration with ethnically diverse communities, systems and services may co-create adapted or novel PREMs that tackle the factors that currently inhibit uptake and completion among ethnically diverse communities.

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Experiences With Health Care Services in Switzerland Among Immigrant Women With Chronic Illnesses

Cited by 5 publications

References 22 publications

Integrating Patient‐reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience

Integrating Patient‐reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience

Oppression and internalized oppression as an emerging theme in accessing healthcare: findings from a qualitative study assessing first-language related barriers among the Kurds in Turkey

Approaches for enhancing patient-reported experience measurement with ethnically diverse communities: a rapid evidence synthesis

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