title: Health workers' attitudes toward immigrant patients: a cross-sectional survey in primary health care services.
abstract: BACKGROUND
  Health workers' attitudes toward immigrant patients influence behaviour, medical decisions, quality of care and health outcomes. Despite the increasing number of immigrant patients in health services and the potential influence of health workers' attitudes, there is little research in this area. This study aimed to examine attitudes of different health workers' groups toward immigrant patients and to identify the associated factors.
  
  
  METHODS
  This cross-sectional study was conducted with a random sample of 400 health workers from primary health care services in the Lisbon region, Portugal. Among those, 320 completed a structured questionnaire. Descriptive analysis and multiple linear regression analysis were used for the evaluation of data.
  
  
  RESULTS
  Most participants did not agree that immigrant patients tend to behave like victims, but about half considered that some are aggressive and dangerous. Doctors and nurses showed more positive attitudes than office workers. Among doctors, the older ones reported less positive attitudes compared to the younger ones. Health workers who have less daily contact with immigrants revealed more positive attitudes. Most participants evaluated their knowledge and competencies to work with immigrants as moderate or low.
  
  
  CONCLUSIONS
  Although health workers reveal positive attitudes, this study reinforces the need to develop strategies that prevent negative attitudes and stereotyping in health services. Efforts should be made to improve workers' competencies to deal with culturally diverse populations, in order to promote quality of health care and obtain positive health outcomes among immigrant populations.
authors: Instituto de Higiene e Medicina Tropical & CMDT, Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008, Lisbon, Portugal. smfdias@yahoo.com.
authors: Sónia
authors: S
authors: Dias
authors: Ana
authors: A
authors: Gama
authors: Helena
authors: H
authors: Cargaleiro
authors: Maria O
authors: MO
authors: Martins