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Mahdieh Dastjerdi PhDc University of Alberta / IIQM Dr. Karin Olson Associate Professor of University of Alberta & AHFMR Health Scholar Partially Funded by WRTC/CIHR (University of British Columbia).
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Mahdieh Dastjerdi PhDc University of Alberta / IIQM Dr. Karin Olson Associate Professor of University of Alberta & AHFMR Health Scholar Partially Funded by WRTC/CIHR (University of British Columbia) Becoming Self-sufficientThe Experience of Iranian Immigrants who Access Canadian Health Care Services (Dastjerdi Access Model for Immigrant Populations)
Becoming Self-sufficientThe purpose of this study was to develop a substantive grounded theory (GT) that explained the central issues to this particular group of people
Data GatheringCriteria For Participation • Eighteen years of ages and above at the time of immigration • Speak Persian (Farsi) and /or English • Hold immigrant or refugee status (Iranians who have come to Canada as students, tourists or visitors cannot participate in this study) • Have used Canadian health care services • Live in Edmonton, Canada
Data GatheringSeventeen participants (immigrants/refugees) were interviewed at first, 8 took part in second interview, and 4 participants took part in third interview Age 25-49 y (Mean= 35) Gender F/M ( F=11, M=6) Arrival immigration status I/R/U (I=8, R=4, U=5) Years in Canada 2-15 y (Mean= 7.1 y) Education H/B/M/D (H=4, B= 6, M=6, D= 1)
Approach : Constructivist Grounded Theory Core Category: Stumbling Blocks of Access Basic Social Process: Becoming Self-sufficient
The Process of Accessing HCS: Becoming Integrated and Becoming Self-sufficient Stage 1: Becoming a Stranger (Starting Point) * Ignoring the self * Getting lost * Getting disconnected Stage 2 : Feeling helpless (Entry point) * Becoming in “need" of accessing Health care services * Facing barriers Stage 3: Navigating/ Seeking (Transition point) * Realizing need to know * Discovering the differences in the Health care systems * Searching resources Stage 4: Employing Strategies (Turning Point ) * Weighing options, dealing with barriers, (Turing the/a key) * Evaluating outcomes Stage 5: Becoming Integrated and self-sufficient (Turning the corner)
Needs Stage 2: Feeling Helpless (Entry Point) * Being in need of accessing H.C.S * Facing barriers Structural Barriers Non Structural Barriers Go to stage3Go home (Turning off), Get isolated in Canada (Holding on), Get connected elsewhere (Turning back)
Stage 3: Navigating and Seeking(Transition point) * Realizing the “need" to know * Discovering the differences in the H.C.S * Searching Resources Needs Structural Barriers Non Structural Barriers Navigating and Seeking Go to stage 4 Go home (Turning off), Get Isolated in Canada (Holding on), Get Connoted elsewhere (Turning back)
Stage 3: Navigating and Seeking (Transition point) * Realizing the “need" to know * Discovering the differences in the H.C.S * Searching Resources Needs Structural Barriers Non Structural Barriers - Inside Resources Outside Resources - Go to stage 4 Go home (Turning off), Isolated in Canada (Holding on), Connect elsewhere (Turning back)
Stage 4: Employing Strategies (Turning point) * Weighing options/dealing with barriers/ Turning the/a key (Utilization) * Evaluating outcomes (Quality) Needs + Structural Barriers Non Structural Barriers - Inside Resources Outside Resources - Access UseQuality Go to stage 5
Stage 5: Becoming integrated/ self-sufficient (Turning the corner) Needs + + Turning the corner Structural Barriers Non Structural Barriers - Inside Resources Outside Resources - Access Use Quality
Stage 4: Employing Strategies (Turning point) * Weighing options/dealing with barriers/ Turning the/a key (Utilization) * Evaluating outcomes (Quality) Needs + - Structural Barriers Non Structural Barriers - Inside Resources Outside Resources - Access Use Quality Go to stage 5 Back to navigation / Turning back Stage 3 (misuse /overuse of resources)
Stage 4: Employing Strategies (Turning point) * Weighing options/dealing with barriers/ Turning the/a key (Utilization) * Evaluating outcomes (Quality) Needs + - - Structural Barriers Non Structural Barriers - Inside Resources Outside Resources - Access Use Quality Go to stage 5 Stay in stage 4 (misuse /overuse of HCS)
Stage 3, 4& 5: Navigating and Seeking (Transition point), Employing Strategies (Turning point) & Becoming integrated /self-sufficient (Turning the corner) Needs + -- - + Turning the corner Structural Barriers Non Structural Barriers - Inside Resources Outside Resources - Appropriateness/Acceptability Access Use Quality Go to stage 5 Back to navigation Becoming integrated/ / Turning back Self-sufficient stage 3 (misuse (Turning point) /overuse of resources Stay in stage 4 (misuse /overuse of HCS)