Perceptions and Experiences of Refugee Families in the Pediatric Emergency Department: A Qualitative Interview Study.

Objectives: Refugees face significant barriers that make acculturation and utilization of the US health care system challenging. Prior literature regarding health care access for the refugee population has focused on adult refugee patients. However, children and adolescents account for approximately 40% of refugees arriving in the United States annually. The objective of this study is to explore the perceptions and experiences of refugee families in the pediatric emergency department when accessing emergent care for their children.

Methods: We performed a qualitative study of pediatric refugee families presenting for emergency care through semistructured interviews of refugee families within the pediatric emergency department and focus group sessions with community stakeholders in Atlanta, Georgia over a 3-month period. Interviews were conducted until thematic saturation was reached. All interviews were transcribed and reviewed using an iterative and inductive approach to discover emerging themes.

Results: A total of 1000 families were screened, and 40 (4.0%) were eligible refugee families. Of these families, 20 (50%) completed interviews, 10 (25%) declined participation, and 10 (25%) agreed to participate but had scheduling conflicts. Four major themes emerged from the thematic analysis: (1) impact of social support on navigating the US healthcare system, (2) exacerbation of pre-existing family stressors, (3) language and communication, and (4) respect during the health care encounter.

Conclusions: This study identified important areas of concern to families of pediatric refugees when accessing emergent care. These areas should be further explored as potential areas to optimize equitable emergency department care for pediatric refugee patients.