RESUMEN
To achieve equity for refugee patients in mental health care settings, patient-centered, trauma-informed, and cultural humility practices have gained recognition; however, the use of these practices is not well defined. The implementation process of these practices may require providers' increased self-efficacy, motivation, and cultural intelligence (CQ). Overall, this study aims to understand training needs of health care providers to be able to provide refugee patients with culturally meaningful, patient-centered, and trauma-informed care. This is an explanatory sequential mixed-methods study and surveys (n = 20) were followed by in-depth interviews (n = 7) with health care providers. The results indicate that there is a positive relationship between providers' self-efficacy and CQ. The interviews revealed three major themes including sources of self-efficacy, the importance of trust-building, and creating trauma-informed healthcare systems. The findings suggest that a trauma-informed, patient-centered training focusing on self-efficacy and CQ enhancing activities for health care providers can improve mental health services for refugee patients.
Asunto(s)
Servicios de Salud Mental , Refugiados , Humanos , Refugiados/psicología , Autoeficacia , Personal de Salud/psicologíaRESUMEN
Good mental health is essential to successful integration for refugee populations that resettle in the U.S. We explored perceptions of mental illnesses and barriers to mental health service use as well as solutions to current mental health problems from the perspective of refugees. The interviews with a convenience sampling of 11 community leaders (6 men and 5 women) from various Burmese ethnic communities revealed three major categories, including sources of mental illnesses (e.g. traumatic experiences and post-resettlement challenges), barriers to service use (e.g. lack of understanding about mental health, linguistic challenges, cultural stigma, alternative treatments, and unresponsive system), and proposed community solutions (e.g. community education, culturally-competent providers, and beyond mental health treatment). The findings suggest that the ethnic community can be a source of potential solutions to mitigate barriers to mental health service use.
Asunto(s)
Servicios de Salud Mental , Refugiados , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Salud Mental , Mianmar , PercepciónRESUMEN
The timely use of health-care services is essential to achieve the best health outcomes. We explore barriers to health-care access among refugees from Burma through interviews with key community informants who serve their community as interpreters, health-care professionals, paraprofessionals, and/or representatives. The interviews with a convenience sampling of 11 leaders from Burmese and Karen ethnic communities revealed three stages of health-care use (i.e., before, during, and after doctor's appointments), in which their community members encounter difficulties in accessing health-care services. Using grounded theory analysis approach, specific difficulties and cultural considerations for each stage were emerged. This study suggests that training programs for health-care providers on refugee populations' needs, cultural expectations, attitudes, and health behaviors may ease the process for refugees during each of these three stages. Interpreters as cultural brokers have an important role in facilitating cross-cultural communications not only before and during the appointment but also after doctor's visits, such as in the pharmacy and labs.