“Basically, everything needs to be adapted”: provider perceptions of challenges and recommendations for effective health care with Karen people

• Published in: International journal of migration, health and social care health and social care, 2022-10, Vol.18 (3), p.271-285
• Main Authors: Horn, Tonya L., McCleary, Jennifer S.
• Format: Article
• Language: English
• Subjects: Adaptation; Case management; Challenges; Classification; Communication; Content analysis; Coordination; Data collection; Discourse strategies; Education; Health care; Health care access; Health needs; Health planning; Health research; Health services; Interpersonal communication; Interpreters; Interviews; Language proficiency; Medical personnel; Mental disorders; Mental health; Patients; Qualitative research; Refugees; Relocation; Social factors; Strategies; Systematic review; Trauma
• ISSN: 1747-9894; 2042-8650; 1747-9894
• DOI: 10.1108/IJMHSC-01-2022-0001

Purpose Karen people from Burma are a new population in resettlement countries. While research increasingly documents their health needs, few studies describe how health-care providers adapt their practices to serve this group. The purpose of this study was to explore the experiences of providers who work with Karen patients/clients in health settings, documenting the challenges they face, how they adapt their practice and recommendations. Design/methodology/approach This study used a qualitative survey and one phone interview with a total of 20 providers who had first-hand experience caring for Karen people in health settings. Data were analyzed using qualitative content analysis. Findings Two main categories described challenges providers faced in working with Karen people in health settings: system-level challenges and interpersonal communication challenges. Five main categories described specific strategies and support needed to adapt practice for Karen patients in health settings: strategies for improving communication and mutual understanding; partnering with Karen staff, interpreters and cultural brokers; strategies for building trust and rapport; addressing needs related to case management, care coordination and social determinants of health; recommendations for provider training. Originality/value This paper contributes suggestions for adapting practice to meet the health needs of Karen people from the perspective of health-care providers in a location that is nationally recognized for its excellence in refugee health.