Encounters with patients from Somalia: experience among vocational trainees in Swedish general practice

Kristian Svenberg,Margret Lepp,Bengt Mattsson

doi:10.5116/ijme.51fc.dc05

Kristian Svenberg, Margret Lepp + Show 1 more

Open Access

https://doi.org/10.5116/ijme.51fc.dc05

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Abstract

ObjectivesThis study sought to describe how vocational trainees in general medical practice in Sweden experienced encounters with refugee patients from Somalia.MethodsSixteen vocational trainees in general medical practice in Sweden were interviewed in focus groups. The interviews were transcribed verbatim and analyzed according to a phenomenographic approach.ResultsThree categories with subcategories emerged. In the first category, “meeting the patient”, the family diversity among the patients was noted. Further, the informants noted that few patients presented psychiatric problems. In the second category, “obstacles in the encounter”, the vocational trainees noted difficulties in talking through an interpreter, who often seemed to have an extended dialogue with the patient. Obtaining a medical history was considered a challenge. The third category dealt with how to develop different strategies in the encounter.ConclusionsTo improve the encounter with patients from Somalia and other minority groups, the importance of curiosity, trust and continuity of care should be discussed in medical education. Health care´s own ways of working and thinking in relation to matters of diversity must be observed in medical training.

Highlights

Contemporary Europe and Sweden show increasing cultural diversity and heterogeneity.[1,2] To health care systems, the associated vicissitudes pose new questions and demands, influencing both parties in the medical encounter
To improve the encounter with patients from Somalia and other minority groups, the importance of curiosity, trust and continuity of care should be discussed in medical education
The phenomenon was the experience among vocational trainees of their encounters with patients from Somalia

Summary

Introduction

Contemporary Europe and Sweden show increasing cultural diversity and heterogeneity.[1,2] To health care systems, the associated vicissitudes pose new questions and demands, influencing both parties in the medical encounter. Demands for efficiency and meeting these patients impose contradictory pressures on physicians.[3] The medical encounter is a complex event, involving individual and collective interplay in the light of existing medical and societal cultures. In the intimacy of the consulting room, the doctor has to handle an infinite variety of complaints and symptoms. The intricacies of this setting may be aggravated if communication is obstructed by language barriers and cultural discordance.[4,5] To the patients, immigrants in particular, this situation involves a struggle for understanding, and this may shed light upon inherent power structures of the consultation.[6,7,8]

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