A critical interpretive synthesis of migrants' experiences of the Australian health system.
A critical interpretive synthesis of migrants' experiences of the Australian health system.
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DOI：
10.1186/s12939-022-01821-2
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发表时间：
2023-01-09
影响因子：
4.8
通讯作者：
Kane S
中科院分区：
文献类型：
--
作者：
Lakin K;Kane S
尽管移民的健康和医疗保健使用在澳大利亚受到学术和政策的广泛关注，但当前的辩论强调需要对这些调查和回应的理论基础进行严格的审查。我们进行了系统回顾和批判性解释综合（CIS），以批判性地研究政策和学术文献如何概念化移民与澳大利亚卫生系统的互动和经历。在PRISMA的指导下，我们不受任何限制地检索文献。我们还搜索了主要州和联邦政府网站以获取相关政策文件。随着 CIS 的进展，我们最初广泛的纳入标准变得更加完善。我们优先考虑论文对我们的调查可能的相关性和理论贡献，而不是方法论质量。 CIS 的 104 篇论文显示，澳大利亚学术文献和政策文件始终根据假设的（1）文化身份、（2）语言归属和/或（3）广泛的地理起源来同质化和减少移民。基于这三种批评并借鉴理论文献，我们提出了关于澳大利亚文献如何更好地概念化移民对澳大利亚卫生系统的经历的综合论证。我们认为，研究和政策都应明确认识到并参与移民在总体上以及在与目的地国卫生系统接触期间定义自己的多方面和不断变化的方式。理解这一概念对于理解移民身份的各个方面在与卫生系统的互动过程中如何动态地共同构建也是必要的。这些理解对于改进政策和计划的设计和实施具有重要意义，这些政策和计划旨在提高澳大利亚卫生系统对移民社区（特别是移民社区以及更广泛的目的地国）的需求和期望的响应能力。在线版本包含可在 10.1186/s12939-022-01821-2 获取的补充材料。
While the health of and healthcare use by migrants has received significant scholarly and policy attention in Australia, current debates highlight that a critical examination of the theoretical underpinnings of these inquiries and responses is needed. We conducted a systematic review and critical interpretive synthesis (CIS) to critically examine how the policy and scholarly literature conceptualises migrants’ interactions with and experiences of the Australian health system. Guided by PRISMA, we searched for literature without imposing any limits. We also searched key State and Federal Government websites for relevant policy documents. Our initially broad inclusion criteria became refined as the CIS progressed. We prioritised the likely relevance and theoretical contribution of the papers to our inquiry over methodological quality. The CIS of 104 papers revealed that the Australian scholarly literature and policy documents consistently homogenise and reduce migrants according to an assumed, (1) cultural identity, (2) linguistic affiliation, and/or (3) broad geographic origin. Based on these three critiques and drawing on the theoretical literature, we propose a synthesising argument on how the Australian literature could better conceptualise migrants’ experiences of the Australian health system. We contend that both research and policy should explicitly recognise and engage with the multifaceted and shifting ways that migrants define themselves, generally, and during their encounters with destination country health systems. Engagement with this notion is necessary for also understanding how aspects of migrants’ identities are dynamically co-constructed during their interactions with the health system. These understandings have implications for improving the design and implementation of policies and programs directed at improving the responsiveness of Australia’s health system to the needs and expectations of migrant communities specifically, and destination countries broadly. The online version contains supplementary material available at 10.1186/s12939-022-01821-2.
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