Mistrust among injured immigrant workers: A conceptual framework

BackgroundIn Quebec, injured workers have access to medical assistance, wage replacement indemnities, and rehabilitation measures, with most injuries resolved easily. However, a small percentage of cases require a lengthy rehabilitation process, which is particularly complex when involving immigrants. The therapeutic alliance is at the heart of the process, involving mutual trust and confidence and a degree of consensus about the therapeutic interventions to be used and, ultimately, the return to work.ObjectiveThis article delves into the concept of mistrust as more than the absence of trust, and sheds light on its role in the rehabilitation process of immigrant workers.MethodDrawing from a literature review on mistrust of immigrants in the healthcare setting and comprehensive studies on the rehabilitation process, a conceptual framework for understanding mistrust in this context is proposed.ResultsVulnerable situations, such as precarious employment and/or temporary immigration status, create fertile ground for mistrust. Negative experiences with healthcare professionals or systems further exacerbate mistrust, as do social stigmas within the rehabilitation system. Cross-cultural miscommunications such as differences in communication styles or beliefs about illnesses further complicate matters, emphasizing the need for culturally sensitive approaches.ConclusionAddressing mistrust requires understanding its origins and consequences, as well as providing guidelines for practitioners to enable them to recognize and manage it effectively. Further research is crucial to deepen our understanding of mistrust among immigrant workers and develop strategies for promoting trust and cooperation throughout the rehabilitation process.