Critical interpretive synthesis of barriers and facilitators to TB treatment in immigrant populations

Abstract

Objective: To systematically review studies of TB treatment experiences in immigrant populations, using Critical Interpretive Synthesis (CIS). Methods: On 26 October 2014, MEDLINE, CINAHL, Embase, LILACS, and PsycINFO were systematically searched. Grey literature and reference lists were hand-searched. Initial papers included were restricted to studies of immigrant patient perspectives; after a model was developed, a second set of papers was included to test the emerging theory. Results: Of 1761 studies identified in the search, a total of 29 were included in the synthesis. Using those studies, we developed a model that suggested treatment experiences were strongly related to the way both individuals and societies adjusted to immigration (‘acculturation strategies’). Relationships with healthcare workers and immigration policies played particularly significant roles in TB treatment. Conclusions: This review emphasised the roles of repatriation policy and healthcare workers in forming experiences of TB treatment in immigrant populations.