Sexual and Gender Minority Migrants' Experiences of Health Service Access and Utilisation: A Qualitative Meta-Synthesis

IF 3.5 3区医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2025-02-14 DOI:10.1111/jocn.17683

Maria Gottvall, Osszián Péter-Szabó, Rummage Isaac, Christoffer Aav, Erik Norgren, Tommy Carlsson

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Abstract

Aims

To describe and synthesise qualitative studies exploring sexual and gender minority migrants' experiences of health service access and utilisation.

Design

Systematic meta-synthesis of qualitative studies.

Data Sources

Systematic searches in four databases and citation screening were conducted in 2023 and 2024. English-language empirical qualitative studies published in scientific journals within 10 years were included. Of 1109 screened, 21 reports were included.

Methods

Included reports were appraised using CASP and JBI checklists. Extracted results were analysed with inductive content analysis in a collaborative process.

Results

All reports had acceptable quality, including 365 participants from 72 countries. A range of external and internal barriers to accessing health services were reported, including financial constraints and fears. Although migrants expressed an appreciation of health services, they also experienced non-affirming behaviours and discrimination related to their intersecting identities. Several essential components in health services necessary to cater to the needs of migrants were addressed, including the personality and manner of health professionals as well as adherence to confidentiality.

Conclusion

Barriers to health services, intersectional discrimination and non-affirming behaviours when interacting with health services are pressing issues that need further attention.

Implication for the Profession and/or Patient Care

Ensuring safety through affirming support is key to achieving high-quality and accessible health services for sexual and gender minority migrants. Nurses and other health professionals need to carefully consider intersectional layers related to sensitivity and safety when supporting sexual and gender minority migrants. Open, friendly, validating, respectful and encouraging communication is essential in clinical settings.

Impact

This review addressed experiences of health services amongst a marginalised population. The findings highlight the importance of affirming care and are relevant for health professionals, stakeholders and decision-makers.

Reporting Method

ENTREQ.

Patient or Public Contribution

Two persons with lived experience were involved in the meta-synthesis.

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性和性别少数移民的卫生服务获取和利用经验：定性元综合。

目的：描述和综合探讨性和性别少数移民获得和利用卫生服务的经验的定性研究。设计：定性研究的系统综合。数据来源：对4个数据库进行系统检索，并于2023年和2024年进行引文筛选。纳入了10年内发表在科学期刊上的英语实证定性研究。在筛选的1109份报告中，纳入了21份报告。方法：采用CASP和JBI检查表对纳入的报告进行评价。在协作过程中对提取的结果进行归纳内容分析。结果：所有报告质量均可接受，包括来自72个国家的365名参与者。据报告，在获得保健服务方面存在一系列外部和内部障碍，包括财政限制和恐惧。虽然移徙者对保健服务表示赞赏，但他们也经历了与他们的交叉身份有关的不肯定行为和歧视。讨论了满足移徙者需要的保健服务的几个基本组成部分，包括保健专业人员的个性和态度以及遵守保密规定。结论：卫生服务障碍、交叉歧视和与卫生服务互动时的不肯定行为是迫切需要进一步关注的问题。对专业和（或）病人护理的影响：通过肯定支助来确保安全是向性和性别少数移徙者提供高质量和可获得的保健服务的关键。护士和其他保健专业人员在支助性和性别少数移徙者时，需要仔细考虑与敏感性和安全性有关的交叉层面。开放、友好、认同、尊重和鼓励的沟通在临床环境中是必不可少的。影响：本次审查涉及边缘人群的卫生服务经验。调查结果强调了肯定护理的重要性，对卫生专业人员、利益攸关方和决策者具有重要意义。报告方式：ENTREQ。患者或公众贡献：两名有生活经验的人参与了综合研究。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.