Mötet med läkaren i svensk sjukvård - erfarenheter hos invandrade patienter från Mellanöstern

Abstract

Master thesis Program in Medicine. Background: Sweden is a multicultural country. In the Swedish society there are different attitudes to various professions, including attitudes to physicians. These attitudes are based on patient’s experiences and preconceptions from the native land and affect him in the medical encounter. Since the 1970s, wars and conflicts in the Middle East have led to a number of refugees and immigrants from the Middle East in Sweden. Studies of these patients’ experiences of meeting Swedish doctors in the health service are scarce. In order to provide better care, there is a need of a deeper understanding of these patients’ views and experiences. The purpose of this study was to explore Middle East patients’ experiences of meeting the Swedish doctor. Method: 12 outpatients at Angered Local Hospital (ANS) with a background from the Middle East and various common conditions in internal medicine were interviewed. A semi-structured interview was used. The questions focused on patients’ experiences from meetings with Swedish doctors. Interviews were translated and were transcribed verbatim. A qualitative content analysis was performed which means that the researcher identifies units of meaning in the text. These units provide the basis for development of categories and condensation to main themes. Result: In the analysis, five main themes emerged. (a) Physician's competence in the consultation. A good doctor is the one that allows patient to be involved in the investigation and treatment. (b) Discrimination. Informants believe that there is some discrimination against them on the basis of ethnicity and background. (c) The importance of language in the meeting. Language skills of the doctor and the patient are factors that determine the meeting's outcome. (d) The interpreter's role. The interpreters are perceived as those parties in the meeting that censor what is said and often do not have sufficient knowledge to translate. (f) Continuity and a holistic view. An irregular contact with physicians creates distrust. The 3 informants appreciated continuity and a holistic approach from the doctor. Conclusions: Results suggests that immigrant Middle East patients experienced it highly important that the doctor in Swedish healthcare involve the patient, have an interactive approach and is capable of creating trust in the patient-doctor relationship. If the patientdoctor contact and information exchange is disturbed, these patients are at risk to experience discrimination. Physician’s broad clinical competence and continuity are beneficial factors in these patient-doctor encounters.