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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Health literacy and refugees’ experiences of the health examination for asylum seekers – a Swedish cross-sectional study

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Josefin Wångdahl, Per Lytsy, Lena Mårtensson, Ragnar Westerling
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2513-8) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JW was responsible for data collection, data management, data analysis and wrote the manuscript as first author. RW was responsible for the study design and funding partnership. RW and PL supervised the statistical analysis and contributed as discussion partners during the analysis process. LM contributed as a discussion partner regarding the health literacy concept, the background and interpretation. RW, PL and LM had the role of critical revisers of the manuscript. All authors read and approved the final manuscript.

Abstract

Background

The purpose of the health examination for asylum seekers in most countries is to identify poor health in order to secure the well-being of seekers of asylum and to guarantee the safety of the population in the host country. Functional health literacy is an individual’s ability to read information and instructions about health and to function effectively as a patient in the health system, and comprehensive health literacy is an individual’s competence in accessing, understanding, appraising and applying health information. Little is known about refugees’ health literacy and their experiences of the health examination for asylum seekers. The purposes of the study were to investigate refugees’ experiences of communication during their health examination for asylum seekers and the usefulness of that examination, and whether health literacy is associated with those experiences.

Methods

A cross-sectional study was made among 360 adult refugees speaking Arabic, Dari, Somali or English. Health literacy was measured using the Swedish Functional Health Literacy Scale and the short European Health Literacy Questionnaire. Experiences of communication and the usefulness of the health examination were measured in several questions. Associations were sought using univariate and multivariate statistical models.

Results

In the health examination for asylum seekers, a poor quality of communication was experienced by 36 %, receiving little information about health care by 55 %, and receiving little new knowledge by 41 % and/or help by 26 %. Having inadequate as compared to sufficient comprehensive health literacy was associated with the experience of a poorer quality of communication (OR: 9.64, CI 95 %: 3.25–28.58) and the experience of receiving little valuable health care information (OR: 6.54, CI 95 %: 2.45–17.47). Furthermore, having inadequate as compared to sufficient comprehensive health literacy was associated with the experience of not receiving new knowledge (OR: 7.94, CI 95 %: 3.00–21.06) or receiving help with health problems (OR: 8.07, 95 % CI: 2.50–26.07. Functional healthy literacy was not associated with experiences of HEA.

Conclusion

Refugees’ experiences indicate that a low level of comprehensive health literacy can act as a barrier to fulfilling the purposes of the health examination for asylum seekers. Comprehensive health literacy seems to be of greater importance in that context than functional health literacy.
Zusatzmaterial
Additional file 1: Swedish functional health literacy scale ‐ English version. (DOCX 58 kb)
12889_2015_2513_MOESM1_ESM.docx
Additional file 2: Modified version of the HLS-EU-Q16. (DOC 158 kb)
12889_2015_2513_MOESM2_ESM.doc
Additional file 3: Questions about and dependent variables in the health examination with response categories. (DOCX 13 kb)
12889_2015_2513_MOESM3_ESM.docx
Additional file 4: Proportions of respondents with non-good experiences about the communication quality and the usefulness of the health examination a . (DOCX 17 kb)
12889_2015_2513_MOESM4_ESM.docx
Literatur
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