Volume 30, Issue 5, May 2014, Pages 544–559
Abstract
Objective
to synthesise data on immigrant women's experiences of maternity services in Canada.
Design
a qualitative systematic literature review using a meta-ethnographic approach
Methods
a
comprehensive search strategy of multiple databases was employed in
consultation with an information librarian, to identify qualitative
research studies published in English or French between 1990 and
December 2011 on maternity care experiences of immigrant women in
Canada. A modified version of Noblit and Hare's meta-ethnographic
theoretical approach was undertaken to develop an inductive and
interpretive form of knowledge synthesis. The seven-phase process
involved comparative textual analysis of published qualitative studies,
including the translation of key concepts and meanings from one study to
another to derive second and third-order concepts encompassing more
than that offered by any individual study. ATLAS.ti qualitative data
analysis software was used to store and manage the studies and
synthesise their findings.
Findings
the
literature search identified 393 papers, of which 22 met the inclusion
criteria and were synthesised. The literature contained seven key
concepts related to maternity service experiences including social
(professional and informal) support, communication, socio-economic
barriers, organisational environment, knowledge about maternity services
and health care, cultural beliefs and practices, and different
expectations between health care staff and immigrant women. Three
second-order interpretations served as the foundation for two
third-order interpretations. Societal positioning of immigrant women
resulted in difficulties receiving high quality maternity health care.
Maternity services were an experience in which cultural knowledge and
beliefs, and religious and traditional preferences were highly relevant
as well but often overlooked in Canadian maternity settings.
Key conclusions and implications for practice
in
order to implement woman-centered care, to enhance access to maternity
services, and to promote immigrant women's health, it is important to
consider these women's social position, cultural knowledge and beliefs,
and traditional customs in the health care.
Keywords
- Meta-ethnography;
- Emigrants and immigrants;
- Maternal-child nursing;
- Canada
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