背景:人口结构变化,人口老龄化,医疗保健需求的增加导致了全球医疗保健工作者的短缺。通过从中低收入国家(LMICs)向高收入国家(HICs)寻求更好的机会,移民卫生保健工作者(MHCWs)是减少这种短缺的关键贡献者。经济因素和卫生劳动力需求推动他们的迁移,但他们也面临着适应新国家和新工作环境的挑战。为了有效应对这些挑战,建立基于证据的政策至关重要。如果不这样做,可能会导致移民医疗工作者(MHCW)离开东道国,从而加剧了医护人员的短缺。
目标:回顾和综合MHCW在适应新国家和新的国外工作环境时遇到的障碍。
方法:我们遵循了PRISMA指南,并在PubMed和Embase数据库中进行了搜索。我们纳入了2000年后发表的横断面研究,涉及从LMIC国家迁移到高收入国家的MHCW,并以英文出版。我们建立了数据提取工具,并使用横断面研究评估工具(AXIS)根据预定类别评估文章质量。
结果:通过有针对性的搜索,我们确定了14篇文章。这些文章涵盖了来自中低收入国家的11,025个MHCWS,专注于欧洲,美国,加拿大,澳大利亚,新西兰,和以色列。参与者和受访者的比率各不相同,从12%到90%不等。研究涵盖了各种医疗保健角色和年龄范围,主要是25-45年,一个重要的女性存在。与会者平均在东道国居住3-10年。结果根据河滨文化适应压力清单(RASI)进行分类,并扩展到包括官僚和就业障碍,性别差异,原住民vs.非本地人,和定向计划。
结论:研究结果强调了文化能力培训和量身定制的支持对MHCW整合和工作满意度的重要性。在新的医疗保健环境中花费的时间和定向计划的影响是塑造他们留下或离开意图的关键因素。尽管有局限性,这些研究提供了有价值的见解,强调持续需要采取整体战略以促进成功整合,最终有利于医疗保健系统和所有利益相关者的福祉。
BACKGROUND: Shifting demographics, an aging population, and increased healthcare needs contribute to the global healthcare worker shortage. Migrant Health Care Workers (MHCWs) are crucial contributors to reducing this shortage by moving from low-and middle-income countries (LMICs) to high-income countries (HICs) for better opportunities. Economic factors and health workforce demand drive their migration, but they also face challenges adapting to a new country and new working environments. To effectively address these challenges, it is crucial to establish evidence-based policies. Failure to do so may result in the departure of Migrant Healthcare Workers (MHCWs) from host countries, thereby worsening the shortage of healthcare workers.
OBJECTIVE: To review and synthesize the barriers experienced by MHCWs as they adjust to a new country and their new foreign working environments.
METHODS: We followed the PRISMA guidelines and conducted a search in the PubMed and Embase databases. We included cross-sectional studies published after the year 2000, addressing MHCWs from LMIC countries migrating to high-income countries, and published in English. We established a data extraction tool and used the Appraisal tool for Cross-Sectional Studies (AXIS) to assess article quality based on predetermined categories.
RESULTS: Through a targeted search, we identified fourteen articles. These articles covered 11,025 MHCWS from low- to medium-income countries, focusing on Europe, the USA, Canada, Australia, New Zealand, and Israel. Participants and respondents\' rates were diverse ranging from 12% to 90%. Studies encompassed various healthcare roles and age ranges, mainly 25-45 years, with a significant female presence. Participants resided in host countries for 3-10 years on average. Results are categorized based on the Riverside Acculturation Stress Inventory (RASI) and expanded to include bureaucratic and employment barriers, Gender differences, Natives vs. non-natives, and orientation programs.
CONCLUSIONS: The findings emphasize the importance of cultural competence training and tailored support for MHCWs
integration and job satisfaction. Time spent in the new healthcare setting and the influence of orientation programs are key factors in shaping their intentions to stay or leave. Despite limitations, these studies provide valuable insights, emphasizing the ongoing need for holistic strategies to facilitate successful
integration, ultimately benefiting healthcare systems and well-being for all stakeholders.