Women in Resettlement: Development of an At-Risk Assessment Tool
The purposes of this initial pilot study are to: (1) develop an at-risk assessment instrument for women in resettlement that is grounded in research, and (2) to establish the instrument’s content validity.
Background
Varied and scarce evidence persists about the reliability and validity of assessments used to guide treatment and care decisions with resettled refugee populations. These tools often do not account for the migration experience and its impact on the health and wellbeing of resettled persons. Timely and appropriate services remain fragmented, widening the healthcare disparity gap. Women-headed households are particularly at risk, as they lack social and economic resources. Multifaceted programs in host communities focus on societal integration and productivity of resettled refugees. However, research indicates that refugee groups of diverse ethnicities experience post-resettlement difficulties long after migration (Wong, et. al, 2010, Gordon, Taylor, & Sarkisian, 2010; King, Welch, & Owens, 2010; Mirza & Heinemann, 2011; Anjum, Nordqvist, & Timpka, 2012; Sulaiman-Hill & Thompson, 2012).
Established tools such as the Harvard Trauma Questionnaire (Mollica, Caspi-Yavin, Bollini, Truong, Tor, & Lavelle, 1992) and the Hopkins Symptom Checklist (Lipman, Covi, Shapiro, 1979) provide a Western medical perspective of diagnosis and treatment. While useful for intial symptomatology screening, they may not be valuable in long-term, follow-up care post-resettlement.
Methods
A theoretical model of seeking life balance, developed from a qualitative study of resettled refugee women, is the foundation of the tool (Catolico, 2013). Essential interrelationships throughout the continuum of migration--displacement, transition, and resettlement--resulted in a positive consequence, “harmony”, a turning point. Conversely, the absence of interrelationships resulted in a negative consequence, “disharmony”. The tool items integrate the migration continuum and its consequences upon the health and wellbeing of persons in resettlement. An inter-professional expert panel of clinicians, educators, and researchers who work closely with resettled populations, particularly women and their families, will establish concurrent validity and a concurrent validity index of the tool items.
Outcome
An intended outcome of this initial pilot is, the resettlement assessment tool will provide evidence to guide timely decision-making, which may further mitigate disparities in the care of women in resettlement.
Conclusions and Nursing Implications
Development, implementation, and evaluation of this assessment tool in its formative phases may identify other important items for inclusion. Additionally, the assessment tool may facilitate the provision of vital linkages between women in resettlement and needed support and resources for their health, well-being, and self-sufficiency.