Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries.
Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries.
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DOI：
10.1016/j.socscimed.2010.04.010
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发表时间：
2010-07
影响因子：
5.4
通讯作者：
Brandt, Joan
中科院分区：
文献类型：
--
作者：
Pavlish, Carol Lynn;Noor, Sahra;Brandt, Joan
关键词：
索马里内战导致大批索马里难民重新定居。美国最大的索马里难民散居地目前居住在明尼苏达州。2007- 2008年，我们与三个社区组织合作，实施了社区联系和合作项目，以解决索马里难民所经历的健康差距问题。具体而言，我们研究了影响索马里妇女的健康经验的因素。利用社会生态的角度和社会行动研究设计，我们进行了6个以社区为基础的焦点小组与57名索马里妇女和采访了11个关键的线人，包括索马里的医疗保健专业人员。通过归纳编码、排序和将数据归为类别，我们分析了每个类别的特定模式。这里报告了关于医疗保健经验的分类结果。我们发现，索马里妇女的健康信念密切相关的情境因素和对比鲜明的生物模型，推动西医。这些不一致的健康信念导致了对治疗和医疗保健相互作用的不同期望。索马里妇女及其医疗保健提供者报告说，由于期望未得到满足，她们遇到了多种挫折，往往降低了人们对医疗保健质量的认识。此外，对心理健康和生育决策的无声担忧浮出水面。为了提供高质量的跨文化医疗服务，提供者必须鼓励患者表达自己的健康解释，期望和担忧。
The civil war in Somalia resulted in massive resettlement of Somali refugees. The largest diaspora of Somali refugees in the United States currently reside in Minnesota. Partnering with three community organizations in 2007–8, we implemented the Community Connections and Collaboration Project to address health disparities that Somali refugees experienced. Specifically, we examined factors that influenced Somali women’s health experiences. Utilizing a socio-ecological perspective and a social action research design, we conducted six community-based focus groups with 57 Somali women and interviewed 11 key informants including Somali healthcare professionals. Inductively coding, sorting and reducing data into categories, we analyzed each category for specific patterns. The categorical findings on healthcare experiences are reported here. We found that Somali women’s health beliefs related closely to situational factors and contrasted sharply with the biological model that drives Western medicine. These discordant health beliefs resulted in divergent expectations regarding treatment and healthcare interactions. Experiencing unmet expectations, Somali women and their healthcare providers reported multiple frustrations which often diminished perceived quality of health care. Moreover, silent worries about mental health and reproductive decision making surfaced. To provide high quality, transcultural health care, providers must encourage patients to voice their own health explanations, expectations, and worries.
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