Migrants' healthcare experience: A meta-ethnography review of the literature.

(1)

White Rose Research Online URL for this paper:

http://eprints.whiterose.ac.uk/142375/

Version: Accepted Version

Article:

Luiking, M.-L., Heckemann, B., Ali, P. orcid.org/0000-0002-7839-8130 et al. (5 more

authors) (2019) Migrants' healthcare experience: A meta-ethnography review of the

literature. Journal of Nursing Scholarship, 51 (1). pp. 58-67. ISSN 1527-6546

https://doi.org/10.1111/jnu.12442

This is the peer reviewed version of the following article: Luiking, M. , Heckemann, B. , Ali,

P. , Doorn, C. , Ghosh, S. , Kydd, A. , Watson, R. and Patel, H. (2019), Migrants’

Healthcare Experience: A Meta Ethnography Review of the Literature. Journal of Nursing

‐

Scholarship, 51: 58-67, which has been published in final form at

https://doi.org/10.1111/jnu.12442. This article may be used for non-commercial purposes in

accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse

Items deposited in White Rose Research Online are protected by copyright, with all rights reserved unless indicated otherwise. They may be downloaded and/or printed for private study, or other acts as permitted by national copyright laws. The publisher or other rights holders may allow further reproduction and re-use of the full text version. This is indicated by the licence information on the White Rose Research Online record for the item.

Takedown

If you consider content in White Rose Research Online to be in breach of UK law, please notify us by

(2)

For Peer Review

_!

" # $

% & ' (% & $ ) % & * & + ,

-' + ' (- . (- . + ) /$' , 0

(0 $ + (0 (/ & ! ) 0 '' % &,

0 '' ) & , ( &

(3)

For Peer Review

!

" # $%"&'()" *() +' , ( "%- ." # .

% /# ) + . . 0 ) 1 ..( 2

" # # 3 445

3 4 5 # (

! ) # + 6

7 1

8 , 7 + . +

" + " !

6 # 1

! 7 #

1

! 1

" #

Journal of Nursing Scholarship 2

(4)

For Peer Review

"

( / % $(/%2 $ 4 92

: (

1

; 1

< #

$%= 0 . " 1 > , 4 ?2 #

$@ ) 4 52 #

# # #

! $ + / 44?2

# A 1 1

# A $+ 1 ' > 4 B 0

+ > C 4 5B . 0 < , > , 1

4 D2 7 )

"

# #

1 $ + /

44?2 A

# $ # 4 42

(5)

For Peer Review

E

#

1 # # A

1 # #< #

# < %

# #

$) # > + F??2 (

# <

1

# ! A

1 #

! 1 #

# 3 444G3 4 5

8 $ 2 ! ! B $ 2 >

! B $E2 > B

$ 2 > B $D2 #

B $52 > B $92

$) # > + F??2

#

%"&'()" *() +' , (

"%- ." # . % /# $@ 0 @02 ) +

(6)

For Peer Review

. $)+.2 . 0 ) 1 ..( .

H 6 H 6 H 6 H! 6 H 6

H 6 H 6 H 6 #

# - H )&6 H/;6

1

C C . #

< (

#

"

! " # # 3

444 3 4 5 A

. # .

. !

$ $

E 5

# # 5 $ 7 2

5

# F

F #

$%'' -+2 " !

"

6 ( #

(7)

For Peer Review

D

9

%

. ! ! *

.1 , $* .,2 / $* .1 , 4 E2

* .,

!

$%'' -+2

$* ., 4 D 5 4 2B F ? I

# $* 6 1 4 592

9 ! <

$ J F2 " ) . $ J92 & 1

$ J 2 ) $ J 2 " @0 $ JD2

) $ J 2 , $ J 2 7 $ J?2 $ J 2 .

$ J 2 * $J 2 * $ J 2 %

$ J 52 # #

$ J92

$ J 2 # $ J 2 < # $ J 2

< ! $ J 52 * ., $* .1

, 4 E2

% A

$ J 52 $ J 2

(8)

For Peer Review

5

8 $ JE2

$ J 2 $ J 2 $ J 2 $ J 2 $ J 2

# $ J 2 K B

$ J 2

$ J E2

$ J 2 C

# #

5

D

# $-+ %''2

8 $ 2 B $ 2 B $E2 B $ 2

B $D2 (

L

#

1 # (

8

A

! " #7 % . 3

' ; % ( > . 4 D $%

A 1 1 #

$ # % ) - > % 4 DB&

B % 4 5B % ; + > * 4 22

(9)

For Peer Review

9

( A $- 0

0 1 > ) 4 B 0 . > 7 4 5B % 4 5B . 0

C # > 7 4 2 7

# ! #

1 $' L > % 0 4 B ' L ) C ,

> % 0 4 2 7

8"' '

" #(

)*+, ,2

& A 1

A A

$-4 B ' L > % 0 4 B ' L 4 2 .

1 !

@

$- 4 2

# $' L > % 0 4 B

' 4 DB % 4 5B . 4 2 # # A

8"

- . /

0 " #1 )*+$ 2%

A

$- 4 B ' L > % 0 4 B ' 4 D2 1

# 83

4 5 /

(10)

For Peer Review

?

-0 #( )*++ $% ( ! 1 #

$. ; " % # ' 1 > " 1 - 4 5B

44F2 1 1 8 A

#67%

" #.5 0 8 9 00 )*+:

$% 7 1 $* >

4 B % 4 B . 4 52 (

8"- 0 ;

-<

0 " #. 8 - 5 )*+, ++% ( #

1 $- 4 B * 1 > . # 11

4 5B ' 4 DB % 4 52 A=

> 0

" #1 )*+$ :%

' #

' # #

# $- 4 B . 4 5B

44F28"=

0 9 $. 4 52 7

$

2 $# 1 1 2 #

$* 1 > . # 11 4 5B ' 4 DB %

4 5B ; 7 1 -< > 4 28 A 7

7 < 7 ? 5 '

(11)

For Peer Review

F

>

@ 0 #!

)*+: A% * 1

# 1 $' L

4 B % 4 52

'

A

$0

4 5B . 4 2 +

#

# $' L > % 0 4 B

' L 4 B % 4 528 A ( B>9 ! <

9 - 9 ;

; A

$' L > % 0 4 2

#

6

A # 8 2 B 2

A B E2

B 2

/ 1

# ,

$ 2 A $ 2

(12)

For Peer Review

4

$E2 & $ 2 #

# #

7

% # #

M #

1

C #

H 6 H 6 #

#

# "

# < # % "

#

A

! 7

(

# !

(13)

For Peer Review

6

A <

A

1 +

1 # ( #

H 6 $ 2

# (

# # # +

# + #

# ! @0 )+.

1 1 $ > 3 4 92

A

# .

H 6 # H 6 A/ A

#

< % 1 #

% A

# 1 #

A #

! B

< $C > N 4452 @ , * * $,**2

# ,** #

(14)

For Peer Review

1 $% *

. > % * 1 44FB "1 4 2 ,**

1 " A

1

!

! "

; # H 6

# #

# # # O

A

# #

+

1 1 #

A

,**

+ #

# (

6

!

@ ) ( 8

8PP P P P P P P # P

P P% ; 4 D

(15)

For Peer Review

E

, * * )+. 8 8PP 1P 1P

(

, > 3 . $ 4 92 . 1 A 8 - 6

# "

C / 2D$ 2 E

# + % ) 0 - * > % 3 $ 4 D2 - #

# 1 * " 1

# 8 ! ( !

C E $$ 2 e008687. http://doi.org/10.1136/bmjopen-2015-008687

- & 0 % 0 1 > ) % $ 4 2

1 & 1 (

! . 7 > ++$D542 8PP P 4 ?5P 9 D? D54

* .1 , $ 4 E2 * .1 , $* .,2

% 1 ; 8PP 1 P

* 3 > C $ 4 2 % # N # #

# . C ; ! 9 ,*$ 2

5DD 594

* 1 " > . # 11 % $ 4 52 Q: !

# # ,

) ( ! . +:$ 2

8PP P 4 ?5P F E 4 5 9 D F

(16)

For Peer Review

"1 ( . # 0 * ' ) # - 1 " . 0

$ 4 2 , R ; ; C

. B +*$ 2 ? D

7 % . 3 ' ; % ( > . $ 4 D2 "

H # 6B

( ! . 1

( ! . 7 > +$$ 2 F E

8PP P 4 ?5P ??F 4 D 9F

C ) > N $ 4452 / 8 7 #

9 9 ! :)$?28 FE

+ 1 + ' 0 > > " ' $ 4 2 * # #

)

C . 7 D:$52 D 8PP P 4 449P 4F5 4 444D

( / % $(/%2 0 . 0

; 8PP P1

0 + ' > C . $ 4 52

# * C ! > +A$E2 5F9 94F

8PP P 4 449P 4F4E 4 D 4 E9 5

0 7 . . > 7 ) $ 4 52 *

# 1 . !

? )A$ 2

' L + > % 0 % $ 4 2 8

- . 9 > D:$?2 EG D?

8PP P 4 P 59 FD55 5E

(17)

For Peer Review

D

' L + ) " C 3 , & > % 0 % $ 4 2

- . 8 ! > 7

+*$$ 2 5 D F

' ' - 0 O 7 O 3 3 . 1 3 7 $ 4 D2 +

# 8 !

C C , * C 8

! > +2$D2 D4F D 9

% ( $ 4 52 - " ,

- - ' / 8 )D$ 2 G

9 8PP P 4 4?4P E5 ? 94 4 5 ?4D9F

% * . , > % * 1 - $ 44F2 @

C . B +A$E28 4F 9

%= % 0 & . & " 1 > , * $ 4 ?2

@ ; A + 9 B DA#)% D 5

% , ; ' * + - > * % $ 4 2 "

+(K 1 N # # 3 # 8

. QC 7 > 7 D) 9 + . D 5

) # C > + ; $ F??2 % 8 . ! $K 2

' @ 0 8 .

; % 7 7 1 ' -< > . $ 4 2 " .

8

9 C 7 > DF$E2 E F E D 8PP P 4 99P 4E F ? EFF5DD

. ) 0 7 C # 0 > 7 ) $ 4 2 7 8 "

- . ! ? ):$ 2

?DG?F

(18)

For Peer Review

5

. 3 . + & 1 ( - , ' C & > O 3

$ 4 52 ( A 8 *

9 . . ),$52 4EG 4

8PP P 4 449P 44D 4 4 D E4 E ?

. ; 0 < 0 , > , 1 , $ 4 D2 *

8

6 ( ! . > 9 G +$ EF4

8P P 4 ?5P F E 4 D 45D

. 3 ; & " % # + ' 1 % > " 1 - % $ 4 52

- &

! C B 9 $, EGED 8 4 4 5P< < 4 D 4 4

# 3 * $ 4 42 C 6 !

)$$. 28 9?G?

@ ) $ 4 52 ! G )*+$ ;

8PP P P P P P P # P

P P% ; 4 D

+ / $ 44?2 E ;

8PP P# P P?5P?P4? 4 4?4?P P

( - ; - & ' 3 C " . 1 $ 44F2

K # . . 1 %

. 8 ! (!C DDA$# ?E2

8PP P 4 E5P# < # ?E

(19)

For Peer Review

(20)

For Peer Review

! "

# $ %" $& "

' $& ' %" $& %" ( ) * + , -. ! !

/ ! $0 $

+ & +

12 2 # (

- 3 2

!

0 !

! "

% # % + 4

"

5 '. 67

%

(

3 8 &

9 '

& ! !

& %"

!

: ! " " %"

'2 5;'2213

' " < %" (

7 3

'

= > : ! " * $& $& ''

* $&

* + (

4 3 '

!

? 4 > $ & $ +

'2$2

2 &

>

> (

" 3 '' &

!

% $ ! "

& !

6

: 9

' * + (

4 " 3

''

"

! % # !

: ! " @ & &" " '5 " % # 3 (

A B ! 3 '' ! "

!

% $ ! "

!

A " + "

$

5 " 1 %" (

% C )

''

) &

&

% $ ! " D 'E B 'E 9 " D(

% 6

% +

0 +$ ''

F &

% ! "

G # B '5 " 9 (

03 3 8 & * & $D +

4 '

& !

=

* & H& ! # " ::

&

< " 1 %" (

) > ' & & ! > !

' 5E $

! "

H I< " I<5

5$2

'E1 EE

' < " 1'

67 (

D $/ 3

'

F

% !

: ! " J

: !

!

& " 5 $2 3

< 67 (

#+ ! 7

'E

! !

& " $

%"

!

: $ ! " #

E$<

5 5 %" (

(21)

For Peer Review

3 'E "

!

! !

>

& !

: ! " ) +$ + " ) +

! !

# (

> " B

'1

0

& !

: ! " # @ & &" ' @ & &" % # D(D

D $/

4 7 '1 " "

67 %

!

% $ ! " %

5 I2

E5 " 67 (

% 3 '1 & "

%"

!

? $ ! " H $

B !

. " %" (

? 3 '5

+ !

: $ ! " % : G + 5< % ' : G

+

67 0

(

# B & 3 '5 $ +

& & ! ! ? $ $ $ ! ! " ! " H "

:: & # & + > & +

< # & $ +

1 0 $ +

>

# (

D 3 '5 &

> !

: ! ! " # '. ' " 5 > (

>B +

% & ++ '<

&

! 9 "

!

% ! " H '' " . 9 " (

7 3 '< ! =

" %" !

/ ! !

! "

#

B ! % 7 !

2 " 2 %" (

4 '< ! &

!

> ! "

& !

#

% ) D

67

. " (

% " 3 '< & F

!

> ? ! " > # & 4 $

+

'. # (

%

A 0 $

4 & 3 '<

&

! !

% ! " 0 !

#

5

! " 5 ! ! "

9

(

K >#% L $5 M " <$' M

(22)

For Peer Review

Background Access to healthcare

(in host country)

The encounter The healthcare experience

Factors: Personal

Factor:

Relationship migrant and Healthcare professional

Factors:

Comparison with care in home country;

Acceptance of host country

Enculturation (country of origin) Life experience and context Openness/willingn ess to integrate into new country Network

(supportive/unsup portive)

Knowledge about entitlement to care

Socio-economic status

Legal status Identified/ acknowledged need for healthcare

Access to care Insecurity on how to

behave (may be mutual)

Language barriers Mentality: dependent collective vs.

individualistic Biomedical paradigm vs. holistic paradigm' cultural understanding

Positive evaluation

Needs and expectationsmet

(information, care)

Factors: Healthcare system

Negative evaluation

Patient needs and expectationsnot met

(Information, care) Service provision

and quality Legislation and entitlement to care

'Gatekeeping' by healthcare staff

No or insufficient access to care

Adaptation and use of alternative

Health-seeking strategies