Facilitating a healthy transition for involuntary migrant families within primary health care

Abstract: The refugee families face a complex transition due to the nature of the migration. This exposes them to vulnerability in cohesion and family function. Primary Health Care Nurses (PHCN) and Interpreters in Primary Health Care (PHC) play a vital role in their promotion of health because migrant health care is mainly carried out within PHC. The overall aim of this thesis was to reach a comprehensive understanding of involuntary migrant family health in order to facilitate a healthy transition for the aforementioned families in Sweden from a systems perspective. These findings are based on interviews representing 16 members from ten families from the Balkans, Kurdistan and Africa (study I), 34 PHCNs (study II & III) and ten Interpreters working within PHC and originating from the same countries as the families (study IV). This study was carried out in two municipalities in Sweden. Contextual analysis with reference to phenomenography was used in interpreting the data in studies I-III. A qualitative method and contextual analysis was used in study IV. The Neuman Systems Model was used to unravel environmental influences in all the four studies. The findings of study I & II illustrate the families’ transition experience through four different family profiles respectively describing the families’ wellbeing: A distressed family living under prolonged tension; a contented family who leads a satisfactory life; a frustrated family who cannot lead a fully satisfactory life and a dejected family who feels deserted (study I). Further, a mentally distressed family within the asylum-seeking process; an insecure family with immigrant status; a family with internal instability and being segregated from society; and a stable and well functioning family integrated in society (study II). Stress factors such as living in uncertainty, having traumas, change in family roles, frequent negative attitudes of the host country and social segregation was detrimental to the wellbeing of the family. In promoting their health, PHCNs approached the families through: an ethnocentric approach, an empathic and culturally relative approach, and a holistic approach enabling families to function well in their everyday life (study III). From the Interpreters’ perspective, promoting health was to improve psychological wellbeing by: promoting positive thoughts of a future, promoting consideration of one’s worth and promoting stability of the family unit. Social interactions within the host country together with the recognition and appreciation of the families’ cultural values and beliefs, and competence and proper and elucidative information regarding the functioning of the host country, was considered necessary. Facilitating a healthy transition is possible within PHC. This can be done through cooperation of the family, with other health professionals, community and ethnic organisations. A model was developed in order to help the aforementioned. Competence in intercultural communication and family focused nursing is required. Adequate skills ought to be included in the education of nurses.