Trustful communication in the medical encounter: Perspectives of immigrated people with epilepsy.

Abstract

Foreign-born people with epilepsy carry two mutually independent risk factors for poor health. While epilepsy increases the need for trust and clear communication, minority status presents additional barriers in communication, causing misconceptions, inadequate treatment and increased suffering. This study aimed to explore experiences of communication in the medical encounter from the perspectives of foreign-born people with epilepsy. A qualitative approach was applied. Twenty semi-structured in-depth interviews were conducted, recorded, transcribed verbatim and analyzed using manifest and latent content analysis. Within the main theme, "Trustful communication in unpredictable terms of life," three subthemes appeared: "Social struggle overshadowing the epilepsy condition"; "Reliable health consultations as a key to feeling safe" and "Addressing 'the real problem' in the medical encounter." A reduced social network due to migration, together with fears related to epilepsy, seems to increase the need for immediate access to health consultations and the need to be listened to. Patients' narratives shed light on multiple social, medical and psychological events that may present reasons for the lack of medical adherence or missed booked appointments. A respectful approach, listening and confirming the normalcy of epilepsy events seem fundamental for trustful communication in the context of epilepsy, regardless of a patient's culture or country of origin.