| Summary: | Recent Canada Employment and Immigration Commission statistics indicate that individuals from Central America continue to claim refugee status at B. C. port-of-entry. No studies have been conducted examining Central American refugee claimants' experiences when trying to access health care services. The purpose of this study, therefore, was to examine from the perspective of the refugee claimants, their experiences accessing health care services in Vancouver.
A conceptual framework developed by this researcher guided the analysis of the data whereby macro political, economic and social domains were depicted as influencing refugee claimants' every day psychosocial/economic realities, their health care seeking experiences and their health status. The policies of the political domain also influenced the health care institutional level.
The research method for this study was a phenomenological approach. Data for the study were derived from unstructured audiotaped interviews conducted by this researcher with the assistance of simultaneous translation by a translator. Interviews with 9 Central Americans, who described their experiences accessing health care, were 50 to 135 minutes long. Participants shared information of their past and present realities which provided a contextual basis for understanding their experiences. The audiotapes of the interviews were transcribed verbatim and were analyzed for emerging concepts and themes. Each concept was comprised of several themes.
The three main concepts that evolved from the data analysis were marginality, health care seeking experiences and the illness experience. These concepts were interpreted in relation to the study's conceptual framework. Fear and suffering, along with unemployment, loss and isolation, and discrimination, are themes reflecting past and present influence on participants' marginality. Participants' health care seeking experiences are understood within this "marginal" context. Health policy and associated bureaucratic processes shaped participants' health care seeking patterns and what transpired at the healthcare institutional level. Difficulty accessing medical coverage and or comprehensive medical care had repercussions on participants' illness experiences. A number of recommendations have been made that address health policy, nursing practice, education, research, administration and professional associations.
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