Study characteristics
| Citation | Topic | Participants | Migrant definition used | Methods | Critical Appraisal Skills Programme score (/10) | Key themes or findings | Implications |
| Ozolins and Hjelm, 2003 Sweden 33 | Nurses’ experiences of problematic situations with migrants in emergency care in Sweden. | 49 nurses: emergency, anaesthetic, ICU, theatres. | Assumed migrant. | Explorative using questionnaire asking for written ‘thick descriptions’ Naturalistic paradigm—to develop theory. | 5 | 9 themes: (1) Behaviour (2) Language (3) Relatives (4) Reliance on authority (5) Organisational factors (6) Gender (7) Threatening situations (8) Previous experiences of violence (9) Natural remedies. | Main problem is communication—language and cultural. Interpreters and training programmes important. |
| Hultsjö and Hjelm, 2005 Sweden 34 | Immigrants in emergency care: Swedish healthcare staff’s experiences. | 35 nurses: 12 emergency ward, 12 ambulance service, 11 psychiatric ward. | Migrants—born outside Sweden. | Explorative, semistructured focus group Krueger and Casey analysis. | 8 | 9 themes: (1) Asylum seeking refugees, (2) Cultural behaviours (3) Relatives (4) Gender (5) Organisational factors (6) Language (7) Perceived threatening situations (8) Earlier experiences of migration (9) Reliance on Health Care staff. | Main problems experienced by HCP were caring for asylum- seeking refugees. |
| Jones, 2008 USA 24 | Emergency nurses caring experiences with Mexican- American patients. | 5 Emergency nurses. | Mexican heritage regardless of citizenship status. 1st or 2nd generation. | Interviews with open ended questions Culture care theory. | 9 | Key themes were: language barrier, Continuity of care and limited cultural knowledge. | HCP should receive training on language and culture. Translators should be available 24 hours a day. |
| Terraza-Núñez et al,
2010 Spain 25 | Health professional perceptions regarding healthcare provision to immigrants in Catalonia. | 49 professionals and managers: primary and secondary care. 7 ER doctors—demographics unclear.Immigrants—Bolivia, China, Morocco, Romania, Gambia. | Semistructured interviews and focus groups. Narrative content analysis. | 7 | Providing healthcare caused distress, overload and exhaustion. Problems: Communication, specific immigrant characteristics, inappropriate use of services, HCP attitudes, organisational, structural deficiencies. | To provide quality of care, interventions to reduce communication and culture barriers are requested. | |
| Priebe et al,
2011 Europe (Best Practice in Health Care Services for Immigrants in Europe (EUGATE) study) 26 | Good practice in healthcare for migrants: views and experiences of care professionals in 16 European countries. | 240 healthcare professionals (HCPs). From each country 3 emergency care providers (ECPs) (48), 9 general practitioners (GPs) (144), 3 mental health HCP (48). | First-generation migrants. Persons born outside the country of current residence aged 18–65 years. | Structured Interviews—open questions Thematic content analysis. | 9 | 8 problems: Language, difficulty arranging care, social deprivation, traumatic experience, lack of familiarity with healthcare system, cultural diff, understanding of illness and treatment, negative attitudes among staff/patients, lack of access to medical history. | HCP in different services experience similar difficulties and similar views on good practice. Implementing good practice needs resources, organisation, training and positive attitudes. |
| Priebe et al, 2011 Europe (EUGATE study) 27 | Good practice in emergency care: views from practitioners. | 48 ECPs. 3 ECPs from each of 16 countries. | First-generation migrants. Persons born outside the country of current residence aged 18–65 years. | Structured Interviews—open questions Thematic content analysis. | 9 | Key themes: language, cultural factors, treatment expectations and system understanding, access, staff–patient relationships, resources, migration stressors, access to medical history. | To improve care need all of translator services, cultural training, guidelines, organisational support. |
| Jensen et al,
2011 Denmark (EUGATE study) 28 | Providing medical care for undocumented migrants (UMs) in Denmark: what are the challenges for health professionals. | 12 HCPs: 3 ER physicians, 9 GPs; 3 managers psychiatric unit. | UMs—without a valid residency permit. | Structured Interviews—open questions Qualitative content analysis—Graneheim and Lundmann. | 9 | Emergency medicine care no different from treatment of another person. Complicated by lack of medical records and contact person. | Lack of guidance means HCP are unsure how to deal with UMs thus leaving it to the individual’s decision. |
| Biswas et al,
2011 Denmark 29 | Access to healthcare and alternative health- seeking strategies among UMs in Denmark. | 8 ECPs: 3 head nurses, 4 nurses. 10 UMs. | UMs | Semistructured interviews and observations Malteruds principle for systematic text condensation. | 10 | Willingness to treat despite migratory status. Challenges: language, barriers, false identification, insecurities about correct standard procedures, not always being able to provide appropriate care. | Need for policies and guidelines to ensure access for UMs and clarity to HCP. |
| Dauvrin et al,
2012 Europe (EUGATE study) 30 | Healthcare for irregular migrants: pragmatism across Europe. A qualitative study. | 240 HCPs. From each country: 3 ECPs (48), 9 GPs (144), 3 mental health HCP (48). | UMs | Structured Interviews—open questions Thematic content analysis. | 9 | Key themes: access problems, communication, legal complications. ECP’s reported less of a difference in care for undocumented versus documented migrants. Notifying authorities was uncommon. | Organisation, local flexibility and legislation might help improve care for UMs. |
| Gullberg and Wihlborg , 2014 Sweden 31 | Nurses’ experiences of encountering UMs in Swedish emergency healthcare. | 16 nurses: 5 ECPs, 5 emergency psych, 2 delivery, 2 primary healthcare, 2 non-governmental organisation. | UMs | 12 semistructured open-ended interviews Phenomenographic. | 9 | Key themes: (1) Nurses confused by migrant status and social existence. (2) Conflicts in encounters—identification system, judgements and emotional reactions (3) Shifts within and between arbitrary boundaries—unclear conditions for interaction, creative manoeuvring. | Guidelines, structural support and increased training for nurses requested. |
| Kietzmann et al,
2015 Germany 32 | Migrants’ and professionals’ views on culturally sensitive prehospital emergency care. | 41 migrants, 20 HCP - 15 ECPs in exec positions, 3 psychologists, 2 medical ethics. | Migrants | Semistructured individual interviews Qualitative content analysis by Mayring. | 7 | 6 categories from the ECPs: importance of basic cultural knowledge, awareness, attitude, empathy, ambiguity tolerance, communication skills. | 8 recommendations: reflecting on self, sharing cultural knowledge, improve basic social competencies, communication skills, interpreters, transparency. |
ICU, Intensive Care Unit; ER, Emergency Room.