Use Of Assessment Frameworks By Nurses When Working With Refugee Families: An Integrative Review

Abstract

Background and purpose: Refugees entering a new country have complex and often immediate health needs. Refugee health nurses are frequently the initial point of triage assessment and coordination of care for newly arrived refugee families. Specific refugee health services have been developed to assist families during their resettlement period, however a family-centred model of care is not always apparent. The aim of this integrative review was to identify and critically appraise published research related to the role of refugee health nurses and to identify and synthesise themes that relate to use of assessment frameworks when caring for refugee families. Model: An integrative review of literature, guided by Whittemore and Knafl (2005) was used to analyse the current research. Methods: Searches were conducted across CINAHL, PROQUEST, Web of Science and Scopus databases from 2009 to 2019. Study quality was assessed using the Mixed Methods Appraisal Tool in order to synthesise the available quantitative and qualitative research. The broader scope of an integrative review allowed the inclusion of grey literature as this presented a more balanced review of current service provision and more diverse perspectives. Results: Ten studies meeting the inclusion criteria were reviewed and appraised. Thematic analysis was completed with the following themes emerging: Working within policy and health system constraints; Understanding assessment challenges when connecting with refugee families; Understanding extended community as family during assessment and Managing self-care and accessing professional support. Conclusions: There is an increasing volume of literature and research related to refugee health, but very few studies describe, discuss or evaluate the actual role of nurses in relation to assessing refugee families. There is a need to increase the understanding of community health nurses’ use of an assessment framework when working with refugee families to identify current practice roles, and develop professional education and inform future research.