Nursing Research: Immigrant Women

Immigration is a process of movement of people from one country to another. Immigrants experience a transition that begins with preparation for immigration and includes the act of immigrating, the process of settling in, and over time, identity
transformation. Through-out this transition process, individuals and families experience both euphoric and highly stressed responses. These experiences increase the vulnerability of immigrating populations to health risks. The effects of marginalization and barriers to health care access, resources, and support are magnified for immigrant women.

Immigrant Women

The uniqueness of women’s health care needs is well established and has led to several women’s health care centers. Immigrant women share unique characteristics that require special gender-sensitive research and clinical efforts. Immigrant women share the vulnerabilities and the marginalization of minority women in general. Immigrant women face constraints associated with being new in the United States, such as language, transportation, and role overload. Another constraint is maintaining home country heritage and developing new values and beliefs to integrate themselves and their families into the host culture.
Although most studies of immigrant women focus on groups with gender inequality, there is some evidence that even women from groups without gender inequality experience more psychological distress and have different sources of distress than their male counterparts (Aroian, Norris, & Chiang, 2003). These variables influence immigrant women’s health and health care, and many of the variables have not been adequately studied.
Foreign-born or immigrant women tend to work in environments that increase their health risks. They are more likely to work at home or in family businesses that provide them with limited benefits. When employed outside the home, they often work in low-income jobs such as work in garment shops or domestic work. Women often accompany male family members in immigrating to the United States rather than obtaining their own visas. Therefore, their status is insecure, and they are more vulnerable and less likely to disclose battering, harassment, or abuse. A nursing perspective focusing on immigrant women and their health includes re-search on gender and health, culturally influenced explanatory models of illness, transitions and health, and marginalization and health (Aroian, 2001; Meleis, 1995; Meleis ,Lipson, Muecke, &Smith, 1998).
Immigrant women’s gender relates to their ability to access and receive quality care. They are expected not only to cook, do housework, care for children, and often to contribute income but also to act as family mediators and culture brokers. Health care professionals have limited knowledge of the demands and the nature of immigrant women’s multiple roles and their health care needs, nor has research adequately uncovered the contextual conditions that influence their health-seeking strategies, the nature of their illnesses, and compliance with treatment (Anderson, J., 1991b).
How immigrant women express their symptoms and what meaning they attach to health care encounters also determine their health out-comes. Describing their explanatory models of illness may improve provision of care and ultimately their health (Reizian & Meleis, 1987). Conceptualization of immigration as a transition allows researchers to focus on the process, timing, and critical points in the process of becoming an American. Lipson (1993) described the traumatic experiences of Afghan refugees before leaving Afghanistan, during transit, and while settling in the United States.
Knowledge of the traumatic experiences of the immigrants and refugees helped to explain their responses to the immigration transition and provided a context in which to identify their health care needs. During transitions there is loss of support and networks. In addition to these stressors, women in particular are expected to take responsibility for family health and to mediate between the demands of the new social structure and members of their families for health care, schools, and social services. Several strategies have been developed to provide care for immigrant women. Some of the most effective models are groups that focus on women’s strengths (Meleis, Omidian, & Lipson, 1993; Shepard & Faust, 1994), the use of cultural interpreters (Jezewski, 1993), and feminist participatory models, such as group discussion of dreams to deal with psychosocial issues (Thompson, J., 1991).
However, there is a need for further research to capture the transition experiences of such neglected populations as women immigrants from South America, Eastern Europe, and the Middle East, as well as studies that address issues of language, symbolic interpretation, and cultural competence in health care. In particular, there is need to develop and test nursing interventions that decrease structural barriers to health care as well as those that support culturally appropriate preventive and health-promoting behaviors (Lipson & Meleis, 1999).
Future areas for scholarship include methods for defining populations, developing culturally competent research tools, using appropriate theoretical frameworks, and uncovering the critical markers in the transition process that render immigrants more vulnerable. Developing and testing culturally competent models of care is of top priority with the increasing diversity of populations and the backlash against women and immigrants.