Supporting academic primary care teams serving refugees: A qualitative study
Waclawik G, Kotovicz F, Walsh-Felx D, Tsering S, Pandhi N. Supporting academic primary care teams serving refugees: A qualitative study. Journal of Refugee & Global Health. 2020;3(1):Article 5.
Introduction: Primary care providers continue to experience significant challenges when caring for refugee patients, yet they are often refugees’ initial point of contact with the U.S. health care system. The purpose of this qualitative study is to expand our understanding of the experiences of academic primary care team members during clinical encounters with refugee patients.
Methods: This multi-perspective, qualitative study included physicians (faculty and residents), nurse practitioners, pharmacists, nurses, and medical assistants (n=10), who have been working with refugee patients for at least one year at two family medicine residency clinics and/or a community health center. Semi-structured in-person interviews were conducted and audio-recorded, transcribed, and openly coded to identify emergent themes. Through an immersion/crystallization and consensus approach, data was categorized into domains and subthemes.
Results: Major domains and subthemes emerged: Building relationships (over time, earning trust, cultural humility); Markers of success in clinical encounters (improving communication, adaptation); Knowledge of or lack of clinical resources (focused trainings, formal debriefs, access to resources, unwritten languages).
Conclusion: Perceptions of success in clinical encounters with refugee patients were primarily associated with communication as opposed to achievement in numeric metrics (e.g. hypertension control). The development of any formalized trainings, tools, and resources to support primary care providers working with refugee patient populations should take these goals into consideration. Lastly, potential solutions were identified to address existing barriers for primary care providers in clinical encounters with refugee patients, but further research and development is necessary to assess their efficacy and utility.