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Zlotnick C, Patel H, Ali PA, Odewusi T, Luiking ML. Globalization: Migrant nurses' acculturation and their healthcare encounters as consumers of healthcare. Nurs Inq 2024; 31:e12607. [PMID: 37805823 DOI: 10.1111/nin.12607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023]
Abstract
Globally, one of every eight nurses is a migrant, but few studies have focused on the healthcare experiences of migrant nurses (MNs) as consumers or recipients of healthcare. We address this gap by examining MNs and their acculturation, barriers to healthcare access, and perceptions of healthcare encounters as consumers. For this mixed-methods study, a convenience sample of MNs working in Europe and Israel was recruited. The quantitative component's methods included testing the reliability of scales contained within the questionnaire and using Hayes Process Model #4 to test for mediation. The qualitative component's methods included analyzing interviews with iterative inductive thematic analysis. Quantitative findings on MNs (n = 73) indicated that the association between acculturation and perception of the healthcare encounter, which MNs experienced as healthcare consumers, was mediated by barriers to healthcare access, even after adjusting for age and gender (p = 0.03). Qualitative interviews with MNs (n = 13) provided possible explanations for the quantitative findings. Even after working in the host country's healthcare system for several years, MNs reported difficulties with their healthcare encounters as healthcare consumers, not only due to their limited knowledge about the culture and healthcare resources but also due to the biased responses they received.
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Affiliation(s)
- Cheryl Zlotnick
- Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Mount Carmel, Israel
| | - Harshida Patel
- Institute of Health Care and Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Parveen Azam Ali
- Health Sciences School, Doncaster and Bassetlaw Teaching Hospitals, University of Sheffield, Sheffield, England, UK
- International Nursing Review, Sheffield, England, UK
| | - Temitayo Odewusi
- Department of Nursing, Queen Margaret University, Edinburgh, Scotland, UK
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Balkaran K, Linton J, Doupe M, Roger K, Kelly C. Research on Abuse in Home Care: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:885-897. [PMID: 37078630 PMCID: PMC10913332 DOI: 10.1177/15248380231165922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Home care is the preferred care option for most people who need support; yet abuse exists in these settings toward both home care workers and clients. There are no existing reviews that assess the scope of current research on abuse in home care, and tangentially related reviews are dated. For these reasons, a scoping review is warranted to map the current state of research on abuse in home care and examine current interventions in this field. Databases selected for searching were Medline and EMBASE on OVID, Scopus, and the following databases in EBSCOhost: Academic Search Complete, AgeLine, and Cumulative Index to Nursing and Allied Health Literature. Records were included if: (a) they were written in English; (b) the participants were home care workers or clients age 18 years or older; (c) they were published in journals; (d) they undertook empirical research; and (e) they were published within the last 10-year period. Following Graham et al. (2006), the 52 included articles are categorized as either knowledge inquiry or as intervention studies. We find three themes among knowledge inquiry studies: (1) prevalence and types of abuse in home care, (2) abuse in the context of living with dementia, and (3) working conditions and abuse. Analysis from the intervention studies suggest that not all organizations have specific policies and practices to prevent abuse, and no existing interventions to protect the well-being of clients were identified. Findings from this review can inform up-to-date practice and policymaking to improve the health and well-being of home care clients and workers.
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Sheehy L, Crawford T, River J. The reported experiences of internationally qualified nurses in aged care: A scoping review. J Adv Nurs 2024; 80:1299-1313. [PMID: 37904718 DOI: 10.1111/jan.15913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/05/2023] [Accepted: 10/15/2023] [Indexed: 11/01/2023]
Abstract
AIM To examine the experiences of internationally qualified nurses, including those from culturally and linguistically diverse backgrounds, transitioning to and working in the aged care sector of high-income countries. DESIGN A scoping review. DATA SOURCES CINAHL, MEDLINE and PSychINFO databases were searched to find eligible literature published from January 2010 onwards. REVIEW METHODS This scoping review was based on the framework by Arksey and O'Malley and the PRISMA-ScR guidelines. The literature search was conducted by the first author, and all three authors reviewed the retrieved studies for eligibility and inclusion. RESULTS Fourteen articles were eligible. Data was categorized into three broad themes: stress of migration and transition; miscommunication, racism and discrimination; and aged care specific challenges which included two sub-themes 'shock of aged care' and 'bottom care'. CONCLUSION Internationally qualified nurses, particularly if they are culturally and linguistically diverse, face unique stresses and challenges in aged care and face barriers in the recognition of skills and qualifications. The under-utilization of skills is not only a loss in terms of patient care but is linked to fears of de-skilling, losing professional development and opportunities for career progression. IMPACT Internationally qualified nurses are positioned as a solution to aged care shortages in high-income countries; however, there is a scarcity of research exploring their experiences. In the context of the global aged care staffing crisis, an understanding of the stresses and challenges faced by internationally qualified nurses will further strengthen efforts to recruit, support and retain skilled nurses in aged care.
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Affiliation(s)
- Louise Sheehy
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tonia Crawford
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jo River
- Faculty of Health, UTS and Northern Sydney Local Health District, Sydney, New South Wales, Australia
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Schmidt S, Lörzing R, Jahn J, Andersch-Rupprecht C, Emmert M, Nagel E. [Specific Workloads among Employees with a Migration Background in Nursing and Geriatric Care: A Systematic Review]. DAS GESUNDHEITSWESEN 2023; 85:1027-1036. [PMID: 36543260 DOI: 10.1055/a-1966-0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multimorbidity, increasing numbers of chronically ill patients and demographic change are leading to increased care costs in Germany with an increasing shortage of staff in skilled nursing and geriatric care. In this context, more and more caregivers with a migration background of the 1st generation (PmMH) are being recruited and integrated into existing (corporate) cultures. This represents an important starting point for a permanent and needs-based supply landscape. THE AIM OF THE STUDY The aim of the study was to identify and analyze the specific stresses of PmMH at the workplace in nursing and geriatric care MATERIAL AND METHODS: A systematic literature search was carried out in relevant specialist databases (Pubmed, PsychInfo, Web of Science, Cochrane), supplemented by an extended snowball and hand search. This was followed by a descriptive presentation of the results of the study content, which in a subsequent step was iteratively brought together and consolidated into thematic categories by several people. RESULTS A total of 15 publications were identified as relevant and included in the analysis. Specific, migration-associated stress factors could be identified. In particular, the categories: "Discrimination and racism", "Language and communication problems" and "Cultural adjustment" characterized the (collaborative) work in nursing and care for the elderly and led to additional stress for employees and patients. DISCUSSION The present review article identified and summarized specific burdens of PmMH. At this point it can be assumed that these affect both PmMH and patients. So far, operational concepts do not seem to be able to adequately solve the challenges, so that effective, sustainable approaches have to be found. The extent to which the specificed stress factors only affect PmMH is not considered in this context, so that further research is needed.
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Affiliation(s)
- Sebastian Schmidt
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
| | - Romina Lörzing
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
| | - Jennifer Jahn
- Bayreuther Akademie für Gesundheitswissenschaften, Bayreuth, Germany
| | | | - Martin Emmert
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
- Bayerisches Krebsregister, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
| | - Eckhard Nagel
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
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Miyata C. Challenges and career consequences of internationally educated nurses: Empirical research qualitative. Nurs Open 2023; 10:7244-7254. [PMID: 37605373 PMCID: PMC10563401 DOI: 10.1002/nop2.1977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/08/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023] Open
Abstract
AIM To explore challenges, and career consequences of internationally educated nurses, and considerations of development policy, education, and support for them from the perspective of nursing administrators. DESIGN This study applied a qualitative description design. METHODS A semi-structured interview guideline were used, interviewed eight internationally educated nurses and nine nursing administrators were chosen based on a purposive sampling method. Each interview was recorded and transcribed, after which it was analyzed using the qualitative content analysis method. RESULTS Three categories were extracted as the challenges and career consequences, and the support they expect to organization of internationally educated nurses: "Language barrier," "Transition to recover their confidence and increase motivation," and "Close support from many quarters". Four categories were extracted as key considerations of support to internationally educated nurses that nursing administrators had recognized: "Clarification of career path", "Support for insufficient language skills", "Support for their career reconstruction", "Comprehensive support". This research found that nursing administrators had recognized necessity of adequate work-related support, it almost met the needs of internationally educated nurses. we need to make a clear policy how to develop internationally educated nurses as valuable human resource based on the evidence of further research relate to support practiced at each facility. PATIENT OR PUBLIC CONTRIBUTION There was no patient and public involvement since I only conducted interview to nurses in this study.
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Affiliation(s)
- Chiharu Miyata
- Department of Nursing SciencesMie University Graduate School of Medicine Health SciencesTsuJapan
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Isakov T, Kamau S, Koskenranta M, Kuivila H, Oikarainen A, Ropponen P, Mikkonen K. Culturally and linguistically diverse nurses' experiences of how competence facilitates integration into the working environment: A qualitative study. Nurse Educ Pract 2023; 67:103553. [PMID: 36657318 DOI: 10.1016/j.nepr.2023.103553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
AIM This study aims to describe culturally and linguistically diverse nurses' experiences of how they transferred their competence to meet professional competence requirements in non-English speaking environment. BACKGROUND Competence is one factor that affects culturally and linguistically diverse nurses' integration into the working environment. In this study, knowledge, skills, values and personal traits are included in the holistic competence concept. DESIGN Qualitative. METHODS A total of 24 culturally and linguistically diverse nurses involved in Finnish health care participated in this qualitative study. Data were collected through snowball sampling during the summer of 2021 using semi-structured interviews. The collected data were analysed using inductive content analysis. RESULTS The data analysis revealed a total of five main categories describing culturally and linguistically diverse nurses' experiences: 1) before immigration; 2) competence requirements in the country of immigration; 3) assessment of competencies; 4) support factors; and 5) hardships. CONCLUSION Degree recognition, colleagues' tolerance towards culturally and linguistically diverse nurses at the workplace and continuous education focusing on local language could improve culturally and linguistically diverse nurses' integration into the working environment.
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Affiliation(s)
- T Isakov
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu. Attendo Finland/Silkroad, Espoo, Finland.
| | - S Kamau
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Department of healthcare and social services, Jyvaskyla university of applied sciences, Jyvaskyla, Finland.
| | - M Koskenranta
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - H Kuivila
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - A Oikarainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - P Ropponen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Diaconia University of Applied Sciences, Helsinki, Finland.
| | - K Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
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Abstract
The glaring lack of formal and informal caregivers in Germany has not only become apparent in hospitals and nursing homes but also in home care arrangements. One tension is particularly pertinent in such arrangements: a 'family-oriented' logic of the long-term care insurance and the individual wishes of those in need of care meet the actual possibilities of family carers. This care gap has been compensated for by 24-hour care workers, so-called 'live-ins', from Eastern Europe for some years. This contribution maps the 'live-ins' situation comprehensively from an ethical perspective. Based on different constellations regarding the 'live-ins' status as a professional nurse or non-professional caregiver, which ethical principles and moral norms are affected by whom and potentially conflict with each other in such home care arrangements at a micro and meso level of care are outlined. Special attention is paid to the tension between self-care and care for others, and to questions of the shared responsibility in and social responsibility of those external services that are involved in home care in addition to the 'live-in'.In order to uncover, understand and influence the current ethical problems, an ethical framework that considers both the divergent interests of all individuals involved in the home care arrangement and their mutual dependency and vulnerability is needed.
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Affiliation(s)
- Eva Kuhn
- Section Global Health, Institute for Hygiene and Public Health, 39062University Hospital Bonn, Bonn, Germany
| | - Anna-Henrikje Seidlein
- Institute of Ethics and History of Medicine, 60634University Medicine Greifswald, Greifswald, Germany
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Yolci A, Schenk L, Sonntag PT, Peppler L, Schouler-Ocak M, Schneider A. Observed and personally experienced discrimination: findings of a cross-sectional survey of physicians and nursing staff. HUMAN RESOURCES FOR HEALTH 2022; 20:83. [PMID: 36494666 PMCID: PMC9733037 DOI: 10.1186/s12960-022-00779-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discrimination against hospital staff based on ascribed features is prevalent in healthcare systems worldwide. Detrimental effects on health and quality of patient care have been shown. Our study aims to describe and analyse the discrimination experiences of both physicians and nurses, specifically for the German hospital context. METHODS A cross-sectional online survey on observed and personally experienced discrimination at work addressed staff from 22 hospitals of two organizations in Germany. Sociodemographic and occupational as well as institutional characteristics served as independent variables. In multivariable analyses, block- and stepwise logistic regressions were calculated for the two dependent variables (witness and victim of discrimination). Sensitivity analyses with imputed data for missings were performed. RESULTS N = 800 healthcare professionals (n = 243 physicians, n = 557 nurses; response rate: 5.9%) participated in the survey. 305 respondents (38.1%) were witnesses of discrimination, while 108 respondents (13.5%) were victims of discrimination in their wards. Reasons for observed discriminatory acts were predominantly attributed to the ethnicity of the person concerned, their appearance and language, whereas personally affected staff most frequently cited gender as a reason, followed by ethnicity, and physical appearance. In multivariable models, cultural competence significantly increased the likelihood of witnessing discrimination (β = .575; p = .037). In terms of the likelihood of being a victim of discrimination, in addition to cultural competence (β = 2.838; p = < .001), the interaction of the effects of gender and professional group was statistically significant (β = .280; p = .010). CONCLUSIONS Given the extent of experienced and observed discrimination, appropriate institutional responses are needed. Further research on discriminatory structures in the German-speaking health care system should focus on discrimination at the intersection of ethnicity, gender and occupation.
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Affiliation(s)
- Arda Yolci
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Pia-Theresa Sonntag
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Peppler
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Germany
| | - Anna Schneider
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Teixeira G, Lucas P, Gaspar F. International Portuguese Nurse Leaders' Insights for Multicultural Nursing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12144. [PMID: 36231445 PMCID: PMC9564753 DOI: 10.3390/ijerph191912144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. AIM This study aimed to identify nurse managers' interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders' experience in international settings. METHODS A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. RESULTS Nurse managers' interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients' worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories-transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. CONCLUSIONS These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire.
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Stjernswärd S, Jørgensen JW, Glasdam S. Nursing Studentsʼ Recounts of Actions and Interactions in Social Relations in Danish Homecare Settings: Perspectives of Immigrant Nursing Students. TIDSSKRIFT FOR OMSORGSFORSKNING 2022. [DOI: 10.18261/tfo.8.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Dahl K, Nortvedt L, Schrøder J, Bjørnnes AK. Internationally educated nurses and resilience: A systematic literature review. Int Nurs Rev 2022; 69:405-415. [PMID: 35868023 PMCID: PMC9545834 DOI: 10.1111/inr.12787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
Aim To synthesize knowledge extracted from the literature about protecting factors and challenges to resilience, among migrant nurses, and specifically how knowledge synthesized through the process of the literature review is relevant to nursing and health policy. Background How nurses, in general, face challenges is well documented and is often linked to the concept of resilience; however, there seems to be a lack of systematic knowledge synthesis focusing on the resilience of internationally educated nurses following migration. Method The review was guided by the PRISMA guidelines, and a systematic search of peer‐reviewed qualitative and mixed‐method articles reporting empirical research was performed in the MEDLINE, CINAHL, PsycINFO and Academic Search Ultimate databases. Methodological rigour was assessed by the Joanna Briggs’ checklist, and a structured theme‐based ecological framework, inspired by Ungar's model of resilience, was chosen. Results Following critical appraisal, 37 studies were included that identified both challenges and individual, contextual and structural protective factors in host countries and are linked to resilience. Discussion Resilience of internationally educated nurses depends on a combination of individual and contextual protective factors, with the major emphasis being placed on individual protective factors. It is crucial to consider resilience in ensuring that internationally educated nurses’ experience is appreciated, as this is necessary if nurses are to deliver the best possible health service while integrating into their host country. Implication for nursing and health policy Authorities, managers in clinical practice and education, trade unions and nurses in general should be aware of the coping strategies, the strengths and supportive factors that can promote resilience and be aware of the challenges that undermine resilience and negatively impact internationally educated nurses’ practice and social interactions.
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Affiliation(s)
- Kari Dahl
- Oslo Met, Oslo Metropolitan University, Oslo, Norway
| | - Line Nortvedt
- Oslo Met, Oslo Metropolitan University, Oslo, Norway
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Smith JB, Herinek D, Woodward-Kron R, Ewers M. Nurse Migration in Australia, Germany, and the UK: A Rapid Evidence Assessment of Empirical Research Involving Migrant Nurses. Policy Polit Nurs Pract 2022; 23:175-194. [PMID: 35747915 PMCID: PMC9274786 DOI: 10.1177/15271544221102964] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Forecasts predict a growing shortage of skilled nursing staff in countries worldwide. Nurse migration is already a common strategy used to address nursing workforce needs. Germany, the UK, and Australia are reviewed here as examples of destination countries for nurse migrants. Agreements exist between countries to facilitate nurse migration; however, it is not evident how nurse migrants have contributed to data on which these arrangements are based. We examined existing primary research on nurse migration, including educational needs and initiatives to support policymakers’, stakeholders’, and health professions educators’ decisions on measures for ethical and sustainable nurse migration. We conducted a rapid evidence assessment to review available empirical research data which involved, was developed with, or considered migrant nurses to address the research question: what are the findings of research that directly involves migrant nurses in producing primary research data? A total of 56 papers were included. Four main themes were identified in this research data: Research does not clearly define what is meant by the term migrant nurses; discrimination is often reported by migrant nurses; language and communication competencies are important; and structured integration programs are highly valued by migrant nurses and destination healthcare employers. Migrant nurses continue to experience discrimination and reduced career opportunities and therefore should be included in research about them to better inform policy. Structured integration programs can improve the experience of migrant nurses by providing language support (if necessary), a country-specific bridging program and help with organisational hurdles. Not only researching migrant nurses but making them active partners in research is of great importance for successful, ethical, and sustainable migration policies. A broader evidence base, especially with regard to the views and experiences of migrant nurses and their educational support needs, should be promoted to make future immigration policy more needs-based, sustainable and ethically acceptable.
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Affiliation(s)
- Jamie B Smith
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Doreen Herinek
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robyn Woodward-Kron
- 85084The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Australia
| | - Michael Ewers
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Transition experiences of internationally qualified health care professionals: A narrative scoping review. Int J Nurs Stud 2022; 129:104221. [DOI: 10.1016/j.ijnurstu.2022.104221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022]
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McBrien B, O’Brien F, Shetty SR, Eustace-Cook J, Byrne G. Assessment of workplace integration of migrant nurses and midwives within international health care settings. JBI Evid Synth 2022; 20:1799-1805. [DOI: 10.11124/jbies-21-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hasan SI, Yee A, Rinaldi A, Azham AA, Mohd Hairi F, Amer Nordin AS. Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis. PLoS One 2021; 16:e0260221. [PMID: 34855800 PMCID: PMC8638981 DOI: 10.1371/journal.pone.0260221] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022] Open
Abstract
Previous literature has shown that migrant workers manifested higher common mental issues (especially depressive symptom) compared to local workers due to stressors such as financial constraint and lack of access to healthcare. The aim of this systematic review and meta-analysis is to summarize the current body of evidence for the prevalence of depression and anxiety among migrant workers as well as exploring the risk factors and the availability of social support for migrant workers. Seven electronic databases, grey literature and Google Scholar were searched for studies from 2015 to 2021 related to mental health, social support and migrant workers. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Study heterogeneity was evaluated using I2 statistics. Random effects meta-analysis results were presented given heterogeneity among studies. The search returned 27 articles and only seven studies were included in meta-analysis, involving 44 365 migrant workers in 17 different countries. The overall prevalence of depression and anxiety among migrant workers was 38.99% (95% CI = 0.27, 0.51) and 27.31% (95% CI = 0.06, 0.58), respectively. Factors such as age, biological (health issue, family history of psychiatric disorder), individual (poor coping skills), occupational (workplace psychosocial stressors, poor working condition, salary and benefits issue, abuse), environmental (limited access towards healthcare, duration of residence, living condition) and social factor (limited social support) were associated with a mental health outcome in migrant workers. The availability of social support for migrant workers was mainly concentrated in emotional type of support. A high prevalence of depression and anxiety was found among migrant workers across the globe. This finding warrants a collective effort by different parties in providing assistance for migrant workers to promote their mental well-being.
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Affiliation(s)
- Siti Idayu Hasan
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Universiti Malaya Centre for Community & Sustainability, University of Malaya, Kuala Lumpur, Malaysia
| | - Anne Yee
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Ariyani Rinaldi
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
| | - Adlina Aisya Azham
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Department of Social & Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Universiti Malaya Centre for Community & Sustainability, University of Malaya, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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16
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Liem A, Renzaho AMN, Hannam K, Lam AIF, Hall BJ. Acculturative stress and coping among migrant workers: A global mixed-methods systematic review. Appl Psychol Health Well Being 2021; 13:491-517. [PMID: 33811751 DOI: 10.1111/aphw.12271] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 02/02/2023]
Abstract
No existing review has synthesized key questions about acculturation experiences among international migrant workers. This review aimed to explore (1) What are global migrant workers' experiences with acculturation and acculturative stress? (2) What are acculturative stress coping strategies used by migrant workers? And (3) how effective are these strategies for migrant workers in assisting their acculturation in the host countries? Peer-reviewed and gray literature, without time limitation, were searched in six databases and included if the study: focused on acculturative stress and coping strategies; was conducted with international migrant workers; was published in English; and was empirical. Eleven studies met the inclusion criteria. Three-layered themes of acculturation process and acculturative stress were identified as: individual layer; work-related layer; and social layer. Three key coping strategies were identified: emotion-focused; problem-focused; and appraisal-focused. These coping strategies were used flexibly to increase coping effectiveness and evidence emerged that a particular type of acculturative stress might be solved more effectively by a specific coping strategy. Migrant workers faced numerous challenges in their acculturative process. Understanding this process and their coping strategies could be used in developing research and interventions to improve the well-being of migrant workers.
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Affiliation(s)
- Andrian Liem
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Andre M N Renzaho
- School of Social Sciences, Western Sydney University, Penrith South, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith South, NSW, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Vic, Australia
| | - Kevin Hannam
- University of Saint Joseph, Macau, China
- University of Johannesburg, Johannesbuurg, South Africa
- Nebrija University, Madrid, Spain
- Technological Higher Education Institute, Hong Kong, China
| | - Agnes I F Lam
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Brian J Hall
- NYU Shanghai, Shanghai, China
- School of Global Public Health, New York University, New York, NY, USA
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17
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Vikström S, Grönstedt HK, Cederholm T, Franzén E, Faxén-Irving G, Seiger Å, Boström AM. Experiences of supporting older persons in completion of an exercise and nutrition intervention: an interview study with nursing home staff. BMC Geriatr 2021; 21:109. [PMID: 33546610 PMCID: PMC7866449 DOI: 10.1186/s12877-021-02039-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/19/2021] [Indexed: 12/14/2022] Open
Abstract
Background The interactions between nursing home (NH) staff and their residents are crucial not only for the atmosphere at the NH but also for achieving care goals. In order to test the potential effects of daily physical activities (sit-to-stand (STS) exercises) combined with oral nutritional supplementation (ONS), a randomized intervention trial (the Older Person’s Exercise and Nutrition (OPEN) Study) was performed in NH residents. One aspect of the study was to interview and report the NH staff’s experiences of supporting the residents in fulfilling the intervention. Methods In this qualitative study, individual and focus group interviews were performed in eight NH facilities with NH staff who had assisted residents in performing the 12-week ONS/STS intervention. An interview guide developed for this study was used to assess staff experiences of the intervention and its feasibility. The transcribed interviews were analyzed inductively following a constant comparative method and with input from experts in the area, described in Grounded Theory as a reliable technique for researchers to form theory and hypothesis in unexplored areas. Results Three main themes relating to the health-promoting intervention emerged. These included: 1) insights into attitudes towards health in general and NH care specifically; 2) intervention-related challenges, frustrations and needs, and 3) aspects of collaboration and opportunities. The overarching hypothesis derived from the analysis reads: A health-promoting intervention such as the OPEN-concept has great potential for integration into NH life if a combined empathic and encouraging attitude, and a structure to keep it sustainable, are in place. Conclusions NH staff experienced the health-promoting intervention as a potentially positive concept, although it was suggested that it works best if introduced as a general routine in the unit and is integrated into the daily planning of care. Trial registration ClinicalTrials.govIdentifier: NCT02702037. Date of trial registration February 26, 2016. The trial was registered prospectively Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02039-7.
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Affiliation(s)
- S Vikström
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
| | - H K Grönstedt
- Stockholms Sjukhem R&D unit, Stockholm, Sweden.,Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - T Cederholm
- Department of Geriatric Medicine, Uppsala University Hospital, Uppsala, Sweden.,Karolinska University Hospital, Theme Aging, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - E Franzén
- Stockholms Sjukhem R&D unit, Stockholm, Sweden.,Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - G Faxén-Irving
- Stockholms Sjukhem R&D unit, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Å Seiger
- Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - A-M Boström
- Stockholms Sjukhem R&D unit, Stockholm, Sweden.,Karolinska University Hospital, Theme Aging, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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18
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Chen L, Xiao LD, Han W, Meyer C, Müller A. Challenges and opportunities for the multicultural aged care workforce: A systematic review and meta-synthesis. J Nurs Manag 2020; 28:1155-1165. [PMID: 32526803 DOI: 10.1111/jonm.13067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/20/2020] [Accepted: 06/02/2020] [Indexed: 11/30/2022]
Abstract
AIMS To identify (a) the challenges for multicultural aged care teams; (b) the opportunities to facilitate teamwork; and (c) the strategies to assist team members in a multicultural work environment. BACKGROUND High-income countries have an increasingly culturally diverse aged care workforce. Fostering teamwork in such an environment is challenging. METHODS This systematic review of qualitative studies followed the Joanna Briggs Institute (JBI) meta-aggregation approach. Six databases were searched. Retrieved articles were screened by two reviewers. This review identified 111 findings that were aggregated into 15 categories and five themes. FINDINGS Aged care workers' awareness of cultural diversity varies, and their knowledge of each other's cultural background is limited. However, cultural skills are demonstrated, contributing to teamwork. Their experience in cross-cultural encounters is broad, and enhanced team cohesion is desired. CONCLUSIONS The cultural competence of the aged care workforce shapes team building, peer support opportunities and positive cross-cultural experiences. IMPLICATIONS FOR NURSING MANAGEMENT Recommendations are provided for the adaptation of aged care workers to culturally diverse teams, fostering teamwork to enhance care outcomes for clients. Interventions for improvements in cross-cultural leadership and management, and staff experience of cross-cultural encounters are much needed.
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Affiliation(s)
- Li Chen
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Lily D Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Weifeng Han
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Claudia Meyer
- Bolton Clarke Research Institute, Kelvin Grove, Vic., Australia.,Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Clayton, Vic., Australia
| | - Amanda Müller
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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19
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Schilgen B, Nienhaus A, Mösko M. The Extent of Psychosocial Distress among Immigrant and Non-Immigrant Homecare Nurses-A Comparative cross Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051635. [PMID: 32138277 PMCID: PMC7084429 DOI: 10.3390/ijerph17051635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 02/27/2020] [Accepted: 02/29/2020] [Indexed: 01/16/2023]
Abstract
In times of demographic change, most developed countries are increasingly looking to cover the growing domestic demand for healthcare by hiring nurses from abroad. The evidence concerning the health of immigrant care workers is inconsistent since studies report that it is either better or more impaired than that of their non-immigrant counterparts. This study compared the extent of occupational psychosocial stressors and resources affecting immigrant and non-immigrant homecare nurses. The cross-sectional survey was conducted in the homecare nursing service sector in Hamburg. Psychosocial distress, depressive symptomatology, generalized anxiety, somatic symptom burdens, homecare-specific qualitative stressors, as well as resources, have been measured using a standardized questionnaire. There was no significant difference in the extent of psychosocial distress experienced by immigrant and non-immigrant homecare nurses. Somatic symptom burdens most strongly predicted nurses’ psychosocial distress, in general. For immigrant nurses, greater influence and freedom at work, as well as fixed-term employment, was related to increased levels of distress, while age, working full time, and working overtime predicted distress in non-immigrant nurses. A functioning relationship with colleagues and superiors had a declining effect on immigrant nurses’ psychosocial distress, while shift work arrangements benefitted non-immigrant nurses. Even though the extent of psychosocial distress experienced by immigrant and non-immigrant nurses did not significantly differ, the nurse’s individual explanatory model of psychosocial health should be considered in every occupational and political context.
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Affiliation(s)
- Benjamin Schilgen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
- Correspondence:
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Bethanien-Höfe Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
- Department of Occupational Health Research, German Social Accident Insurance Institution for the Health and Welfare Services, Pappelallee 33/35/37, 22089 Hamburg, Germany
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
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20
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Abstract
Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.
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