Abstract
ObjectivesThis study aimed to explore Swedish physicians’ perceptions regarding physician-patient communication in an Iranian context and to obtain a deeper understanding of their lived experience when encountering Middle Eastern and Swedish patients in their daily work. MethodsThis is a multi-method study, including conventional content analysis in combination with phenomenological methodology. A triangulation approach to data collection and analysis was used. Serving the purpose of the study, twelve Swedish physicians with previous experience of Middle Eastern patients were purposely selected to participate in the study. They watched a video showing simulated patient encounter in an Iranian context. The video served as a trigger. Semi-structured interviews were conducted focusing on the participants’ perceptions of the video and their lived experiences. Constant comparative analysis was used for a deep understanding of the data. ResultsThe core themes were cultural diversity, doctor-centeredness, and patient-centeredness. Cultural diversity was a convergent theme and included trust, interpersonal interaction, context, and doctor dominancy. Patient-centeredness and doctor-centeredness were divergent themes and included doctors’ authority, equity, the experience of illness, and accountability. ConclusionsThe participants confirmed large cultural differences in doctor-patient communication when encountering Iranian and Swedish patients. Inter-cultural and cross-cultural competencies were made visible. To be able to appreciate other cultures’ health values, beliefs, and behaviors, increased cultural competence in health care is of importance.
Highlights
Cultural competency among health care professionals has become a significant patient safety issue, owing to increasing immigration rates and health problems that are often labeled as “migration-related stresses among immigrants.”[1]
Culture in health care has been defined as “The phenomena to demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities.”[6]. Cross-cultural competence is understood as a range of cognitive, behavioral, and affective components that enable individuals to adapt effectively, while inter-cultural competence can be viewed as skills that lead to effective and appropriate communication with people of other cultures
We interviewed Swedish doctors regarding physician-patient communication after they had watched a video from an Iranian setting, whereas Dahm assigned a standardized patient from the other context, showing this video encounter to students and asking them to explain their experiences regarding the “challenges of patient-centered care.”[15] despite the different methods employed, the results were similar
Summary
Cultural competency among health care professionals has become a significant patient safety issue, owing to increasing immigration rates and health problems that are often labeled as “migration-related stresses among immigrants.”[1] Cultural competency has been defined as an understanding of a culture’s shared beliefs, norms, and values, including their thoughts, styles of communication, ways of interacting, views of roles and relationships, practices, customs, and behaviors regarding these issues.[2] Culture determines how we explain and value our world, and it provides us with a lens through which we can find meaning. Culture in health care has been defined as “The phenomena to demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities.”[6] Cross-cultural competence is understood as a range of cognitive, behavioral, and affective components that enable individuals to adapt effectively, while inter-cultural competence can be viewed as skills that lead to effective and appropriate communication with people of other cultures
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