INTRODUCTION

Human migration in the contemporary scenario represents a complex and multi-determined social phenomenon that has repercussions in various areas of society as well as in the private lives of individuals.⁽¹⁾ In 2022, it was estimated that there were around 400 million migrants in the world, the largest contingent since the Second World War.^(2-3) This dramatic situation gave prominence to the subject in recent decades, both in the field of political management and in the academic-scientific area, especially due to the intense flow and forced displacement of people, which has occurred in greater volume towards countries in the global North.⁽⁴⁾

These current impressive numbers associated with the migration process result from multiple factors such as global consumerism; the progress in the means of transport; wars; political repression; economic underdevelopment; violence; poverty; food insecurity and, more recently, climate change.^(1,5) Furthermore, contemporary human mobility reflects the search for improving living conditions and guaranteeing individual or family survival when new boarders are crossed.⁽⁶⁾

The migration process has a significant impact on the social, economic, educational and health context of the host country, but it also significantly affects the personal and family lives of those involved. This is because, even if the migration process is motivated by suffering or by the need to seek protection, these individuals end up experiencing the loss of their previously inhabited space and the breaking of social and family ties.⁽⁷⁾ In this sense, the mental health of individuals experiencing the migration process is affected as well as the functionality of their own family - they are not always able to easily adapt to the border transition as they may remain attached to the difficulties and/or conflicts faced in their country of origin, as well as to those significant members who were left behind.⁽⁸⁾

Therefore, it is evident that the very separation from the family of origin or the established family can greatly intensify the suffering of those seeking a new life in another country. On the other hand, families that remain in their places of origin, now without one of their significant members, are also affected. These individuals and families need greater support and care from health and social care professionals to select and implement effective coping measures.⁽⁷⁾

Furthermore, it is important to consider that when families migrate together, they must also learn to experience new things in an adverse context, and cultural adaptations are therefore imperative for individuals and family systems in the destination country. Thus, migration involves not only geographic displacement, but also a process of redefining roles and relationships in a new environment and the experience of learning to live with different cultures and ways of understanding the world, aspects that have the potential to change family dynamics.⁽⁹⁾

Studies conducted in different countries such as Italy⁽¹⁰⁾; Australia⁽¹¹⁾; the Netherlands⁽¹²⁾; and Peru⁽¹³⁾ have contributed to the acquisition of knowledge about the complex life and health situations experienced by immigrants and/or refugees in this constant process of adaptation. However, it is necessary to better understand the experiences that they and their families endure when faced with migration, which are identified/clarified through qualitative research. The construction of this knowledge may be useful for developing public and social policies that contribute to the restructuring and regrouping of family systems, in addition to improving adaptability to change, reducing the biopsychosocial risks of migrant individuals and families and, finally, promoting family integration into the new society.⁽⁶⁾

More recently, the object under study has been highlighted by the International Family Nursing Association (IFNA) and by researchers in the field as an emerging topic for nursing, given the repercussions of the migration process on the health of individuals and their families.^(14-16) It is also noteworthy that, after searches in the PROSPERO, Figshare, Cochrane databases and JBI journals, no ongoing review protocols or systematic reviews with meta-synthesis on the topic were found. Thus, the conduction of this research is justified and, with the purpose of clarifying the transparency of the construction process and increasing the methodological rigor, as well as the quality of the results gathered⁽¹⁷⁾, it was decided to publicize this systematic review protocol.

In view of the above, the objective was to present a systematic review protocol that will seek to synthesize the best qualitative evidence available on the repercussions of the cross-border migration process on family life.

METHODOLOGY

Methods

The proposed systematic review will be conducted according to the JBI methodology for systematic reviews of qualitative evidence.⁽¹⁸⁾ Additionally, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) instrument will be used for writing and detailing the study.⁽¹⁹⁾ This review protocol was registered in the PROSPERO database (ID: CRD42024505655) and submitted to a scientific publication in a peer-reviewed journal.

To develop the review question, the PICo strategy (Population; Phenomena of interest and Context) was used, as shown in Chart 01.

Chart 01: PICo Strategy for Developing the Review Question, Maringá, PR, 2024.

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Inclusion criteria

Population

This review will consider qualitative studies that include individuals and families affected by the cross-border migration process and its repercussions. Specific immigrant populations include individuals who have migrated voluntarily (in search of better socioeconomic and educational conditions) or involuntarily (caused by forced displacement due to environmental, racial, economic, social, political or cultural reasons, who generally have low proficiency in the native language of their new country, have diverse ethnic and cultural characteristics and/or experience underemployment and poverty).

Phenomena of Interest

This review will consider studies that explore the repercussions on the lives of families who have experienced the cross-border migration process, which may include studies on the family (carried out with one family member) or studies with families (in which at least two people from the same family participate).

Context

This review will consider studies conducted worldwide that describe the experiences, in the most varied contexts of family life, of people who crossed the borders of their country of origin, including studies with people who migrated on their own, in family dyads or collectively, in addition to those carried out with individuals and families who remained in their country of origin when one of their family members migrated.

Types of study

This review will consider studies published between 2009 and 2023, since it is from this period that an increase in publications involving the migration process around the world has been observed, as well as because the goal is to seek the most current literature on the subject. In addition, full texts published in Portuguese, English and Spanish will be considered, given the fact that the researchers are fluent in these three languages ​​and that the available resources prevent us from hiring professionals to fully translate articles in other languages.

Only studies that focus on presenting qualitative and interpretative data based on the experiences of individuals and families affected by international cross-border migration will be analyzed, including, but not limited to, projects such as phenomenology, grounded theory, ethnography, action research, and descriptive studies of content, discourse, or thematic analysis. Finally, it is important to note that studies published in peer-reviewed scientific journals as well as unpublished sources and gray literature (i.e. dissertations and theses) will be considered.

Research strategy

A preliminary search limited to PubMed was conducted to identify relevant articles related to the topic of this review. Two researchers, in collaboration with a university research librarian, developed the initial search strategy using broad keywords identified in the Medical Subject Headings (MeSH) that could be contained in the titles and abstracts of the articles, combined by the Boolean operators “AND” and “OR”, as follows: "Refugees" OR "Migrants" OR "Transients and Migrants" OR “Emigration and Immigration” AND "family relations" OR "family" OR "family nursing" OR “family separation” AND "qualitative studies" OR "qualitative" OR "Perception". This search retrieved 443 texts, proving that the strategy developed was adequate.

Thus, this set of keywords will be applied in a second search in the databases, namely: PubMed/MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), PsycInfo; Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO e SocialScience Citation Index. The research strategy, including all identified keywords, will be adapted for each database according to its specificities. Searches in unpublished sources and grey literature will be carried out via Index to Theses, Digital Dissertations, Bank of theses and dissertations of CAPES, Networked Digital Library of Theses and Dissertations and New York Academy of Medicine Grey Literature Report.

The third stage of the search will include the screening analysis of additional studies contained in the reference lists of all studies selected for critical review in order to identify other potential and additional studies that could be included in the review.

The search will be conducted in the first half of 2024, and since this review is not a historical analysis and considering that the preliminary research reveals an increase in sources published from 2009 onwards, the time frame defined will include sources published from January 2009 to December 2023. The details of the research strategy can be found in Chart 02.

Chart 02 - Complete research strategy to be performed in the databases, 2024.

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Source: Prepared by the authors, 2024

Selection of studies

After the search stage, all studies will be analyzed regarding their titles and abstracts, and at this stage, duplicates will be removed. Titles and abstracts will be independently reviewed by two members of the research team, who will meet and discuss the findings of the identified studies, applying the inclusion and exclusion criteria. Inconsistencies in the selection of studies will be discussed with a senior researcher in the group in order to reach consensus. Any reason to exclude full-text studies that fail to meet the inclusion criteria will be duly registered and reported in the systematic review.

Evaluation of the methodological quality

Eligible studies will be critically reviewed by two independent reviewers regarding their methodological quality using the Critical Appraisal Checklist for Interpretive & Critical research (QARI).⁽¹⁸⁾ In the quality assessment stage, articles that fail to achieve 70% positive responses or more in the instrument will be excluded from the analysis. Any disagreements that may arise between the reviewers will be resolved through discussion or with the participation of a third reviewer. The results of the critical review will be put into narratives or charts.

Data extraction

Data will be extracted from the studies included in the review by two independent reviewers, using a data extraction tool developed by JBI, called Qualitative Data Extraction Instrument, available in the Sumari Software⁽¹⁸⁾, which contains the following information: title, authors, year of publication, journal, methodology, method, data analysis used, configuration, geographic and cultural context, participants, interventions, main results and conclusions by the authors and reviewers. After extracting this information, the results will be synthesized, representing the aggregation of data from the primary studies.

Data synthesis

In the aggregation process, as established by the JBI, the findings are aggregated or synthesized by descriptive and conceptual similarity. Thus, subthemes emerge, which are later aggregated into broader and more comprehensive themes. By seeking similarities and differences between the perspectives of the different social actors who experienced the phenomenon under investigation, subthemes and themes will be integrated to generate a set of statements that represent this aggregation, rather than being compared. This will lead to the identification of a meta-theme.

When textual grouping is not possible, the findings will be put into narratives or visual formats (diagrams, charts, figures, among others). The process of synthesizing and finalizing the findings and their accompanying descriptions will be based on a consensus among researchers. To provide greater rigor to the aggregative data synthesis process, any disagreements that may arise will be discussed by the group until consensus is reached and an audit trail regarding the main decisions made throughout the meta-aggregation process will be duly registered.

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Información adicional

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