Department of Health Promotion and Development, University of Bergen, Alrek Helseklynge, 7807, Årstadveien, 17, 5020, Bergen, Norway.
Child Welfare, Equality and Social Inclusion Research Group, University of Bergen, Bergen, Norway.
Int J Equity Health. 2021 Jan 21;20(1):42. doi: 10.1186/s12939-021-01384-8.
Patients' experiences with health providers and their diagnostic and treatment expectations are shaped by cultural health beliefs and previous experiences with healthcare services in home country. This study explores how Southern European immigrant parents navigate the Norwegian healthcare system, through its focus on how this group manage their expectations on diagnosis and treatment practices when these are unmet.
The study had a qualitative research design. Fourteen in-depth interviews and two focus group discussions with 20 Southern European immigrant parents were conducted in 2017 in three Norwegian municipalities. With the help of NVivo software, data were transcribed verbatim and coded. Following a thematic analysis approach to identify patterns in immigrants' experiences with the Norwegian healthcare services, the codes were organized into two themes.
The first theme includes immigrants' expectations on diagnostic tests and medical treatment. Southern European immigrants expected more diagnostic tests and pharmacological treatment than what was deemed necessary by Norwegian health providers. Experiences with unmet expectations influenced how immigrants addressed their and their children's healthcare needs. The second theme comprises immigrants' experiences of seeking healthcare in Norway (attending medical consultations in the private sector, seeking immigrant healthcare providers, and navigating the healthcare through their Norwegian social networks). This category includes also the alternative solutions immigrants undertook when they were dissatisfied with the diagnosis and treatment practices they were offered in Norway (self-medication and seeking healthcare in home countries).
Cultural health beliefs and previous experiences with healthcare services from home country shaped immigrants' expectations on diagnosis and treatment practices. This had great implications for their navigation through the healthcare system and interactions with health providers in the host country. The study suggests that successful inclusion of immigrants into the Norwegian healthcare system requires an acknowledgement of the cultural factors that influence access and use of healthcare services. Exploring immigrants' perspectives and experiences offers important information to understand the challenges of cross-cultural healthcare and to improve communication and equitable access.
患者与医疗服务提供者的互动经历以及他们对诊断和治疗的期望受到文化健康观念和他们在母国医疗保健服务方面的既往经历的影响。本研究通过探讨这一群体在未达到诊断和治疗预期时如何管理自己的期望，来探究南欧移民父母如何在挪威医疗保健系统中找到自己的定位。
本研究采用定性研究设计。2017 年，在挪威的三个城市中，对 20 名南欧移民父母进行了 14 次深入访谈和 2 次焦点小组讨论。借助 NVivo 软件，我们对访谈进行了逐字转录和编码。在采用主题分析方法识别移民对挪威医疗保健服务体验的模式的基础上，我们将这些代码组织成两个主题。
第一个主题包括移民对诊断测试和医疗治疗的期望。南欧移民期望进行更多的诊断测试和药物治疗，而这超出了挪威医疗服务提供者的建议。未满足的期望影响了移民如何处理他们和他们孩子的医疗需求。第二个主题包括移民在挪威寻求医疗保健的经历（在私营部门就诊、寻求移民医疗服务提供者、通过他们的挪威社交网络获取医疗服务）。这一类别还包括移民在对他们在挪威获得的诊断和治疗方案不满意时采取的替代方案（自我用药和前往母国寻求医疗服务）。
文化健康观念和既往在母国的医疗保健服务经历塑造了移民对诊断和治疗方案的期望。这对他们在医疗保健系统中的定位以及与东道国医疗服务提供者的互动产生了重大影响。该研究表明，要成功将移民纳入挪威医疗保健系统，需要承认影响医疗保健服务获取和使用的文化因素。探索移民的观点和经验提供了重要信息，有助于理解跨文化医疗保健的挑战，并改善沟通和公平的获取机会。
