Table 4 GRADE-CERQual Evidence Profile (EP)
Summary of Review Finding | Studies contributing to the review finding | Methodological Limitations | Coherence | Adequacy | Relevance | CERQual Assessment of Confidence in the Evidence | Explanation of CERQual Assessment |
|---|---|---|---|---|---|---|---|
1. Refugees are in an unfamiliar environment, manifested by differences in culture, differences in language, and differences in health systems | [19, 28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59] | Moderate concerns: A total of 6 articles were of high quality, 8 articles were of acceptable quality, and 19 articles were of low quality. | Minor concerns: data reasonably consistent across studies, with some minor deviations | No or very minor concerns: explanatory finding: very high data quantity and richness | No or very minor concerns | High confidence: It is highly likely that the review finding is a reasonable representation of the phenomenon of interest | Although there were moderate concerns over the methodology of some low-quality articles, we have high confidence that the coherence, adequacy and relevance of the data represents the phenomenon well. |
2. Information sharing promotes power and autonomy and is important to help refugees navigate a complex health system. A lack of information sharing results in disempowerment and loss in autonomy. | [28, 29, 31,32,33,34, 38,39,40,41,42, 44, 45, 47,48,49,50,51, 53, 56, 59] | Moderate concerns: A total of 5 articles were high quality, 4 articles were acceptable quality, and 12 articles were low quality. | Minor concerns: data reasonably consistent across studies, with some minor deviations | No or very minor concerns: explanatory finding: very high data quantity and richness | No or very minor concerns | High confidence: It is highly likely that the review finding is a reasonable representation of the phenomenon of interest | Although there were moderate concerns over the methodology of some low-quality articles, we have high confidence that the coherence, adequacy and relevance of the data represents the phenomenon well. |
3. Refugees reclaim power and autonomy through familiar means. At times, they may be successful, but this may perpetuate their unfamiliarity with the health system | [19, 20, 28, 30,31,32,33,34, 37,38,39,40, 42,43,44,45,46, 48,49,50, 52,53,54,55,56,57,58,59,60] | Moderate concerns: A total of 6 articles were high quality, 6 articles were acceptable quality, and 17 articles were low quality. | Minor concerns: data reasonably consistent across studies, with some minor deviations | No or very minor concerns: explanatory finding: very high data quantity and richness | No or very minor concerns | High confidence: It is highly likely that the review finding is a reasonable representation of the phenomenon of interest | Although there were moderate concerns over the methodology of some low-quality articles, we have high confidence that the coherence, adequacy and relevance of the data represents the phenomenon well. |
4. Refugees face barriers and enablers in accessing health services which are related to the acceptability, accommodation, accessibility, affordability, and the availability of health services | [19, 20, 28,29,30,31,32,33,34,35, 37,38,39,40,41,42, 44,45,46,47,48,49,50, 52,53,54,55,56,57,58,59,60] | Moderate concerns: A total of 6 articles were high quality, 8 articles were acceptable quality, and 17 articles were low quality. | Minor concerns: data reasonably consistent across studies, with some minor deviations | No or very minor concern: descriptive finding, high quantity in data | No or very minor concerns | High confidence: It is highly likely that the review finding is a reasonable representation of the phenomenon of interest | Although there were moderate concerns over the methodology of some low-quality articles, we have high confidence that the coherence, adequacy and relevance of the data represents the phenomenon well. |
5. Trust and privacy influence all aspects of access and engagement | [19, 20, 29, 33,34,35, 38, 39, 42, 44, 46, 47, 49, 52,53,54, 56, 60] | Moderate concerns: A total of 4 articles were high quality, 4 articles were acceptable quality, and 10 articles were low quality. | Minor concerns: data reasonably consistent across studies, with some minor deviations | Moderate concerns: descriptive finding: data quantity not sound, but considerably rich | No or very minor concerns | Moderate confidence: It is likely that the review finding is a reasonable representation of the phenomenon of interest | There were moderate concerns over methodology of articles and the adequacy of the data. |