Page 284 - Encyclopedia of Nursing Research

IMMIGRanT WoMen n 251

Lipson, Muecke, & Smith, 1998). Immigrant Several strategies have been developed
women’s multiple gender roles influence their to provide care for immigrant women. The
ability to access and receive quality care. most effective models are groups that focus I
They are expected not only to cook, do house- on women’s strengths, employ the use of cul-
work, care for children, and often to contrib- tural brokers, and are implemented using
ute income but also to act as family mediators feminist participatory models. Research
and culture brokers. In addition to their focused on limited english–proficient immi-
family responsibilities, immigrant women grants has highlighted the importance of
often are expected to take responsibility for qualified language interpretation and trans-
accessing and navigating host-country insti- lation services and the need for cultural bro-
tutions and bureaucracies (e.g., schools, social kering, orientation, and support programs to
services, health care systems). The ways facilitate the immigrants’ access to and nav-
in which immigrant women express their igation of the complex U.S. health care sys-
symptoms and the meanings they attach to tems (McDowell, Messias, & estrada, 2011).
health care encounters also contribute to their Future areas for scholarship include
health outcomes. The opportunity for immi- methods for defining populations, devel-
grant women to describe and explore their oping culturally competent research tools,
explanatory models of illness with health using appropriate theoretical frameworks,
care providers may contribute to improved and uncovering the critical markers in the
provider–patient relations and, ultimately, to transition process that render immigrants
improved health outcomes (Reizian & Meleis, more vulnerable. Immigrant women face
1987). Research with South asian women increasingly complex social and health prob-
in Canada indicated the ways in which lems. The impact of public policy changes in
essentialism, culturalism, and racialization the social welfare area and the institution
are manifested in health care interactions of health care reform could directly affect
(Johnson et al., 2004). There is a clear need for immigrant women and their families. What
ongoing educational and policy interventions is needed is a comprehensive immigra-
to address such othering practices to support tion reform focused on women. Immigrant
equitable health care for immigrants. women must be part of the dialogues about
Immigrant women tend to work and be such reforms. Their voices and presence in
employed in environments that contribute to policy dialogues must be sought, valued,
increased health risks. These include work- and included (Glasford & Huang, 2008). In
ing at home or in family businesses that pro- the United States, the increasing diversity of
vide limited protections or benefits. When the population and concurrent resurgence of
employed outside the home, immigrant nativism and backlash against immigrants
women often work in low-income jobs such is a concern for nurses and health care pro-
as work in poultry plants, garment shops, or viders. engaging immigrant communities
domestic work where they engage in repeti- in health initiatives, increasing the cultural
tive and awkward movements, are exposed and linguistic competence of nursing and
to risk of injury, and often have little or no health care personnel and systems, and
recourse to occupational health resources developing and testing culturally and lin-
(Burgel, Lashuay, Israel, & Harrison, 2004). guistically appropriate models of care are
Women who accompany male family mem- top priorities with the increasing diversity
bers may be concerned about their personal of populations.
immigration status and, therefore, because of
their insecurity and perceived vulnerability, Afaf Ibrahim Meleis
may be less likely to disclose or report batter- DeAnne K. Hilfinger Messias
ing, harassment, or abuse. Karen J. Aroian