Margaret Lay

The impact of migration on health beliefs and behaviours: the case of Ethiopian refugees in the UK.

The Research Centre for Transcultural Studies in Health, Middlesex University and the Ethiopian Community Centre in the UK conducted a study to explore the migration experiences of Ethiopian refugees in the UK and the impact of this on their health beliefs and behaviours. Data was collected via: i) semistructured interviews were conducted with Ethiopians refugees and asylum seekers and Ethiopian professionals providing services for Ethiopian refugees; ii) a semi-structured questionnaire; iii) a documentary analysis of newspaper articles concerning refugees; and iv) an ethnohistory of Ethiopia.The findings revealed that Ethiopian refugees place a stronger emphasis on externalised factors influencing health (such as happiness and good social relations) than they did in Ethiopia.The study found that participants fled Ethiopia due to oppression, violence, fear and poverty; and once in the UK experience poor housing, unemployment, racism and isolation, all of which impact on their health status.Whilst it is difficult to ascertain how these factors affect health beliefs it is probable that these negative experiences and the consequent unhappiness they have caused have highlighted to them the relationship between health and subjective well-being, something that people who have not suffered such life traumas may take for granted. In the UK Ethiopian refugees are more likely to seek Western medicine than they did in Ethiopia, which reflects both acculturation and differences in health resources.This study highlights that Ethiopian refugees, require holistic health care that addresses all their needs - physical, mental, spiritual, environmental and social-cultural. Nurses should understand that many refugees have had traumatic experiences and continue to live in desperate circumstances.Thus nurses should be aware of the experiences, needs and beliefs of refugees and address their own cultural competence.

Current and emerging practice of end-of-life care in British prisons: findings from an online survey of prison nurses

Background There are concerns about prisoners and detainees not having equal access to end-of-life care while in prison. There is a lack of existing literature about the standards of end-of-life care in UK prisons. Objectives The aim of this study was to investigate the views of current and former prison nurses with regard to the end-of-life care being provided in UK prisons. Methods Prison nurses were invited to participate in an online survey and asked about their role in the prison, prisoners’ access to healthcare facilities, and any barriers and good practices to end-of-life care. The survey included open-ended and closed questions. The closed questions were analysed using descriptive statistics. The open-ended responses were coded and grouped into themes. Results 31 (N=31) prison nurses responded to the survey. The reported barriers to end-of-life care included some prison regimes, lack of appropriate care and visiting facilities, lack of privacy and inadequate visiting hours. Respondents also reported examples of good practice, including having access to specialist palliative care and specialist equipment, and being able to receive visits from family and friends. Conclusions The findings suggest that there is considerable variability in the end-of-life care provided to prisoners in the UK. Further research is needed in order to reduce the health inequalities and improve the quality of end-of-life care experienced by prisoners in the UK.