Feldmann C Titia, Bensing Jozien M, de Ruijter Arie, Boeije Hennie R
Faculty of Social Sciences, University of Utrecht, The Netherlands.
Sociol Health Illn. 2007 May;29(4):515-35. doi: 10.1111/j.1467-9566.2007.01005.x.
In-depth interviews with Afghan refugees living in The Netherlands about their experience of healthcare, have led to a series of narratives. This article focuses on the relationship between the refugee-patients and their general practitioners (GPs) from the participants' point of view. It was possible to distinguish four different types of narrative, by analysing the individual interviews into critical episodes. Building trust was identified as the crucial issue. A number of possible explanations are given for the differences found. Links are made to participant expectations in respect of health and healthcare and to their personal and social resources. The GP has a key role in the Dutch healthcare system, but is a novel phenomenon for refugees arriving from Afghanistan. The development of a relationship of trust is sometimes compromised by negative personal experience and also by stories relating such experiences circulating in the Afghan community. The elements that constituted positive and negative episodes and led to the development or undermining of trust were identified in the narratives. Negative experience tended to be interpreted as a sign of prejudice on the part of the healthcare professional. The findings of this study are discussed in the wider context of research into patient priorities in general practice.
对生活在荷兰的阿富汗难民关于其医疗保健经历进行的深入访谈，产生了一系列叙述。本文从参与者的角度重点关注难民患者与其全科医生（GP）之间的关系。通过将个体访谈分析为关键事件，可以区分出四种不同类型的叙述。建立信任被确定为关键问题。针对所发现的差异给出了一些可能的解释。这些解释与参与者对健康和医疗保健的期望以及他们的个人和社会资源相关。全科医生在荷兰医疗保健系统中扮演着关键角色，但对于从阿富汗来的难民来说却是一种新现象。信任关系的发展有时会因负面个人经历以及阿富汗社区流传的此类经历的故事而受到损害。在这些叙述中确定了构成积极和消极事件并导致信任发展或受损的因素。负面经历往往被解释为医疗保健专业人员存在偏见的迹象。本研究的结果在关于全科医疗中患者优先事项的更广泛研究背景下进行了讨论。
