Factors influencing utilization and perception of health care: a qualitative study among traumatized Yazidi refugees in Germany

Background Ensuring adequate utilization of healthcare services for displaced populations is critical, yet there are well-documented treatment gaps. Yazidi women captured by the Islamic State (IS) were subjected to extreme trauma and violence. This study aims to understand perceptions of healthcare...

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Published in:BMC psychiatry 2021-07, Vol.21 (1), p.1-346, Article 346
Main Authors: Tran, Virginia M, Fozouni, Laila, Denkinger, Jana K, Rometsch, Caroline, Junne, Florian, Vinck, Patrick, Pham, Phuong
Format: Article
Language:English
Subjects:
Aggression
Captivity
Care and treatment
Codes
Content analysis
Displaced persons
Genocide
Health aspects
Health services utilization
Healthcare utilization
Interpreters
Interviews
Medical care
Mental disorders
Mental health care
Post traumatic stress disorder
Psychiatry
Psychological aspects
Psychologists
Qualitative research
Questionnaires
Refugees
Risk factors
Surveys
Trauma
Utilization
Women refugees
Yezidis
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Summary:Background Ensuring adequate utilization of healthcare services for displaced populations is critical, yet there are well-documented treatment gaps. Yazidi women captured by the Islamic State (IS) were subjected to extreme trauma and violence. This study aims to understand perceptions of healthcare providers and utilization of these services among women who experienced extreme trauma. Methods This is a qualitative study with voluntary participation offered to approximately 400 women resettled through the Special Quota Program. An empirical approach was used to collect data and a grounded theory approach was used for content analysis. Participants ranked their interactions with providers on a Likert scale. Posttraumatic stress disorder (PTSD) symptoms were assessed using the impact of event scale-revised questionnaire. Results A total of 116 Yazidi women participated in this study. The women experienced an average of 6.8 months of captivity by IS and 93% met criteria for probable PTSD. Eighty-three percent of the women interacted with a physician; 80% found this interaction helpful. Sixty-nine percent interacted with psychologists; 61% found this interaction helpful. Six themes emerged: "reminders of trauma" and "hopelessness" in relation to the traumatic experience; "immediate relief" and "healing through pharmaceutical treatment" in relation to provider interventions, and "support" and "cultural differences" in relation to interactions with providers. Conclusions There exist major barriers to care for Yazidi women who experienced extreme trauma, particularly in regards to psychiatric care. Perceptions of healthcare providers and perceived effectiveness of therapy are critical factors that must be taken into consideration to improve healthcare utilization and outcomes. Keywords: Trauma, Refugees, Healthcare utilization
ISSN:1471-244X
1471-244X
DOI:10.1186/s12888-021-03335-7