title: Good practice in health care for migrants: views and experiences of care professionals in 16 European countries.
abstract: BACKGROUND
  Health services across Europe provide health care for migrant patients every day. However, little systematic research has explored the views and experiences of health care professionals in different European countries. The aim of this study was to assess the difficulties professionals experience in their service when providing such care and what they consider constitutes good practice to overcome these problems or limit their negative impact on the quality of care.
  
  
  METHODS
  Structured interviews with open questions and case vignettes were conducted with health care professionals working in areas with high proportion of migrant populations in 16 countries. In each country, professionals in nine primary care practices, three accident and emergency hospital departments, and three community mental health services (total sample = 240) were interviewed about their views and experiences in providing care for migrant patients, i.e. from first generation immigrant populations. Answers were analysed using thematic content analysis.
  
  
  RESULTS
  Eight types of problems and seven components of good practice were identified representing all statements in the interviews. The eight problems were: language barriers, difficulties in arranging care for migrants without health care coverage, social deprivation and traumatic experiences, lack of familiarity with the health care system, cultural differences, different understandings of illness and treatment, negative attitudes among staff and patients, and lack of access to medical history. The components of good practice to overcome these problems or limit their impact were: organisational flexibility with sufficient time and resources, good interpreting services, working with families and social services, cultural awareness of staff, educational programmes and information material for migrants, positive and stable relationships with staff, and clear guidelines on the care entitlements of different migrant groups. Problems and good care components were similar across the three types of services.
  
  
  CONCLUSIONS
  Health care professionals in different services experience similar difficulties when providing care to migrants. They also have relatively consistent views on what constitutes good practice. The degree to which these components already are part of routine practice varies. Implementing good practice requires sufficient resources and organisational flexibility, positive attitudes, training for staff and the provision of information.
authors: Unit for Social and Community Psychiatry, London and the Barts School of Medicine and Dentistry, Queen Mary University of London, Newham Centre for Mental Health, UK. s.priebe@qmul.ac.uk
authors: Stefan
authors: S
authors: Priebe
authors: Sima
authors: S
authors: Sandhu
authors: Sónia
authors: S
authors: Dias
authors: Andrea
authors: A
authors: Gaddini
authors: Tim
authors: T
authors: Greacen
authors: Elisabeth
authors: E
authors: Ioannidis
authors: Ulrike
authors: U
authors: Kluge
authors: Allan
authors: A
authors: Krasnik
authors: Majda
authors: M
authors: Lamkaddem
authors: Vincent
authors: V
authors: Lorant
authors: Rosa Puigpinósi
authors: RP
authors: Riera
authors: Attila
authors: A
authors: Sarvary
authors: Joaquim J F
authors: JJ
authors: Soares
authors: Mindaugas
authors: M
authors: Stankunas
authors: Christa
authors: C
authors: Strassmayr
authors: Kristian
authors: K
authors: Wahlbeck
authors: Marta
authors: M
authors: Welbel
authors: Marija
authors: M
authors: Bogic
mesh_terms: D001291:Attitude of Health Personnel; D003144:Communication Barriers; D003156:Community Mental Health Services / Q000458:organization & administration*; D003466:Cultural Characteristics; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005060:Europe; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017057:Medically Uninsured; D011320:Primary Health Care / Q000458:organization & administration*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D014171:Transients and Migrants