Reception Centre Nurses' Perceived Competence and Determinants of Implementation Behaviour Regarding the Revised Initial Health Assessment for Asylum Seekers

AIM: The aim of this study was to develop a comprehensive understanding of reception centre nurses' competence requirements and determinants of implementation behaviour related to the revised initial health assessment model for asylum seekers. DESIGN: This cross-sectional mixed-method study was based on data collected through an online Reception Centre Nurses' Competence Survey conducted in Finland in 2024. A total of 217 nurses were invited to participate, of whom 97 responded, yielding a response rate of 45%. Seventy participants also provided responses to the open-ended questions. The survey instrument is included as an appendix. METHODS: The survey consisted of background information, the Determinants of Implementation Behaviour Questionnaire and additional open-ended questions. Quantitative group differences were analysed using the Mann-Whitney U test. Qualitative data were examined using concept-driven thematic analysis. Reporting followed the Good Reporting of a Mixed Methods Study guidelines. RESULTS: Previous healthcare and reception centre experience supported successful implementation of the initial health assessment model, including adaptation to individual client needs. Reception centre experience enhanced understanding of practical model delivery, while healthcare experience strengthened competencies needed to assess diverse client populations. Successful delivery required both clinical and interpersonal competencies, and a public health nursing background contributed to a health-promoting approach and positive client attitudes towards the initial health assessment model. CONCLUSION: The findings indicate that specialized competence and diverse work experience can support the initial health assessment model's implementation. The results highlight the necessity for targeted skills training and improved implementation strategies to support the effective use of the revised model. PATIENT OR PUBLIC CONTRIBUTION: Reception centre nurses were involved in the study and later engaged in a workshop to reflect on the findings. IMPACT: The study addressed the global challenge of meeting the complex and often unique health needs of asylum seekers, which requires highly competent healthcare professionals and the implementation of new clinical practices. Specifically, it examined reception centre nurses' perceived competence to meet the aims of the revised initial health assessment model and determinants of implementation behaviour. Competence was understood as nurses' perceived ability to apply the knowledge, skills, and attitudes required for conducting the revised initial health assessment. Factors influencing the enactment of this competence in practice were examined through determinants of implementation behaviour. Previous healthcare and reception centre experience supported successful implementation of the initial health assessment model, including adaptation to individual client needs. Reception centre experience enhanced understanding of practical model delivery, while healthcare experience strengthened competencies needed to assess diverse client populations. Successful delivery required both clinical and interpersonal competencies, and a public health nursing background contributed to a health-promoting approach and positive client attitudes towards the initial health assessment model. The findings will guide the training of nurses working with asylum seekers by clarifying the specialized competencies and diverse work experience needed for effective practice in reception centres. The results will also support organisations responsible for training and assisting health professionals in this field, highlighting the importance of targeted skills development and strengthened implementation strategies. More broadly, the study will inform healthcare systems and policymakers seeking to enhance the quality and consistency of health assessments for asylum seekers across different service settings, ultimately helping asylum seekers receive safe, effective, and high-quality care.