Susceptible to negative feelings and consequences during the process of relocation and adjustment from country of origin

• Available work below educational preparation
• Communication barriers
• Cultural barriers
• Inadequate environmental hygiene
• Inadequate knowledge about accessing resources
• Inadequate social support
• Overcrowded housing
• Overt social discrimination
• Parent-child conflicts related to enculturation

• Age and developmental stage
• Education
• Primary language and other languages spoken
• Migration reason and immigration status
• Employment status, working conditions, and any specialized training
• Livings conditions and housing status including number of residents and relationships in same household
• Availability of family and/or friends
• Expectations of immigration
• Coping mechanisms and decision-making ability
• Psychosocial support, including lifestyle, communication status (verbal, nonverbal, phone, and written), family members, and finances

• Patient will not experience complications from immigration transition.
• Patient will adapt to culture of host country.
• Patient will not experience isolation during transition.
• Patient will not experience feelings of fear.
• Patient will not experience feelings of anxiety.
• Patient will identify healthy coping strategies for stress.
• Patient will have sanitary housing.
• Patient will have effective communication in host country.
• Patient will identify sources of support in host country.

Suggested NOC Outcomes

• Provide a nonthreatening environment. A safe environment facilitates communication.
• Discuss specific situation or individuals that threaten the patient or family. Identifying threats guides service needs.
• Establish communication methods with patient. Adequate communication must be implemented to effectively work with the patient.
• Provide instructions in formats that patient can understand. Use of appropriate language, pictures, and graphs assists comprehension.
• Assist patient in clarifying values and expectation to make informed decisions about the situation.
• Respect patient's right to receive or not to receive information and assistance. Patient may need time to ingest and process the current situation.
• Determine status of basic living needs. Identifies needed support systems.
• Educate patient about the different types of health care facilities available. The many types of services can be overwhelming.
• Facilitate care between patient and other health care providers. Acting as the patient's advocate will help navigation through the health care system.
• Educate patient about community resources and contact persons. Knowing where to find assistance encourages appropriate use.
• Refer patient to support as needed: legal aid, support groups, social services. Each support entity has specialized knowledge to guide patient through transition process.

Suggested NIC Interventions

• Patient does not experience complications from immigration transition.
• Patient adapts to culture of host country.
• Patient does not experience feelings of fear.
• Patient does not experience feelings of anxiety.
• Patient identifies healthy coping strategies for stress.
• Patient obtains sanitary housing.
• Patient has effective communication in host country.
• Patient identifies sources of support in host country.

• Patient's perception of issues
• Patient statements that indicate understanding of health-promoting activities, health care systems, support agencies, and necessary self-care skills
• Patient's response to interventions and teaching
• Literature provided to patient
• Evaluations for expected outcomes

• Cadenas, G. A., Bernstein, B. L., & Tracey, T. J. G. (2018). Critical consciousness and intent to persist through college in DACA and U.S. citizen students: The role of immigration status, race, and ethnicity. Cultural Diversity & Ethnic Minority Psychology, 24(4), 564-575. doi:10.1037/cdp0000200
• Philbin, M. M., Flake, M., Hatzenbuehler, M. L., & Hirsch, J. S. (2018). State-level immigration and immigrant-focused policies as drivers of Latino health disparities in the United States. Social Science & Medicine, 199, 29-38. doi:10.1016/j.socscimed.2017.04.007
• Roche, K. M., Vaquera, E., White, R. M. B., & Rivera, M. I. (2018). Impacts of immigration actions and news and the psychological distress of U.S. Latino parents raising adolescents. Journal of Adolescent Health, 62(5), 525-531. doi:10.1016/j.jadohealth.2018.01.004
• Vargas, E., & Ybarra, V. (2017). U.S. citizen children of undocumented parents: The link between state immigration policy and the health of Latino children. Journal of Immigrant & Minority Health, 19(4), 913-920. doi:10.1007/s10903-016-0463-6