Department of Public Health, University of Skövde, PO Box 408, 541 28 Skövde, Sweden.
J Immigr Minor Health. 2013 Feb;15(1):188-97. doi: 10.1007/s10903-012-9581-y.
To investigate variations in explanations given for disparities in health care use between migrant and non-migrant groups, by clients and care providers in Sweden. Qualitative evidence collected during in-depth interviews with five 'migrant' health service clients and five physicians. The interview data generated three categories which were perceived by respondents to produce ethnic differences in health service use: "Communication issues", "Cultural differences in approaches to medical consultations" and "Effects of perceptions of inequalities in care quality and discrimination". Explanations for disparities in health care use in Sweden can be categorized into those reflecting social/structural conditions and the presence/absence of power and those using cultural/behavioural explanations. The negative perceptions of 'migrant' clients held by some Swedish physicians place the onus for addressing their poor health with the clients themselves and risks perpetuating their health disadvantage. The power disparity between doctors and 'migrant' patients encourages a sense of powerlessness and mistreatment among patients.
为了调查在医疗保健使用方面，移民群体和非移民群体之间的差异，由瑞典的客户和医护人员给出的解释存在哪些差异。在深入访谈中收集了定性证据，访谈对象是五名“移民”卫生服务客户和五名医生。受访者认为，访谈数据产生了三个类别，这些类别导致了医疗服务使用方面的种族差异：“沟通问题”、“医疗咨询方法的文化差异”和“对医疗质量不平等和歧视的看法的影响”。对瑞典医疗保健使用差异的解释可以分为反映社会/结构性条件以及权力的存在/不存在的解释，以及使用文化/行为解释的解释。一些瑞典医生对“移民”客户的负面看法，将他们健康状况不佳的责任归咎于客户本身，并有可能使他们的健康劣势永久化。医生和“移民”患者之间的权力差距，使患者感到无能为力和受到虐待。
