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Refugee experiences of general practice in countries of resettlement: a literature review
Authors:I-Hao Cheng  Ann Drillich  Peter Schattner
Affiliation:Southern Academic Primary Care Research Unit (Monash University School of Primary Health Care, South Eastern Melbourne Medicare Local, Monash Health), Dandenong, Victoria, Australia.;Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia.;Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia.
Abstract:

Background

Refugees and asylum seekers often struggle to use general practice services in resettlement countries.

Aim

To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement.

Design and setting

Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013.

Method

Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker’s personal experiences of general practice services were identified, coded, and analysed.

Results

From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor–patient relationships, and problems with the cultural acceptability of medical care.

Conclusion

The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management.
Keywords:general practice   health services accessibility   patient acceptance of health care   patient-centred care   physician patient relations   refugees
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