Patient-Centered Care Experiences of First-Generation, South Asian Migrants with Chronic Diseases Living in High-Income, Western Countries: Systematic Review

Abstract

Krishna Vakil,1 Tigestu Alemu Desse,2 Elizabeth Manias,2,3 Hamzah Alzubaidi,1,4 Bodil Rasmussen,5– 8 Sara Holton,5,6 Kevin P Mc Namara1 1Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia; 2School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia; 3School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; 4College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates; 5School of Nursing and Midwifery, Centre for Quality and Patient Safety Research – Western Health Partnership, Institute for Health Transformation Deakin University, Geelong, Victoria, Australia; 6The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Melbourne, Victoria, Australia; 7Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 8Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Odense M, DenmarkCorrespondence: Krishna Vakil, Deakin Rural Health, Building D Level 2, Deakin University, Princes Hwy (PO Box 423), Warrnambool, Victoria, 3280, Australia, Tel [phone], Email [email protected]: First-generation migrants from South Asia account for a considerable proportion of the immigrant populations in high-income, western countries and are at a high risk of developing complex, chronic diseases such as cardiovascular disease and diabetes. Yet, previous systematic reviews have not synthesized information about the healthcare needs and preferences of such migrants and the best ways for health services to provide them with appropriate, culturally sensitive, patient-centered care. The aim of this study is to systematically review the international evidence about first-generation, South Asian migrants’ healthcare experiences from the patients’ perspectives.Methods: Five databases were searched for qualitative, quantitative, and mixed methods studies published between January 1990 and April 2020. Fourteen thousand, six hundred and forty-four papers were retrieved and screened using pre-determined eligibility criteria. Sixty-one papers were included in this narrative synthesis. Relevant qualitative findings from the included papers were thematically analyzed, and quantitative findings were summarized.Results: Five themes emerged from findings: 1) Healthcare services engaged; 2) the language barrier; 3) experiences and perceptions of healthcare advice; 4) the doctor–patient relationship; and 5) the role of patients’ families in supporting access and delivery of healthcare.Conclusion: The findings indicate that communication barriers reduce the cultural and linguistic appropriateness of healthcare. Potential solutions include employing healthcare staff from the same cultural background, training healthcare professionals in cultural competence, and proactively including first-generation, South Asian migrants in decision-making about their healthcare. Future research should explore South Asian migrants’ experiences of multimorbidity management, continuity of care, interdisciplinary collaboration, the formation of treatment plans and goals as little to no data were available about these issues.Keywords: patient-centered care, patient participation, migrant, chronic disease, health services, sociological factors, systematic review

Keywords

• "patient-centered care”
• “patient participation”
• “migrant”
• “chronic disease”
• “health services”
• “sociological factors”
• “systematic review”