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The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
FKNK conceived of the study, and participated in its design, and carried out interview and observation studies and analysis, and drafted the manuscript. BMA participated in the design of the study, and analysis, and coordination and helped to draft the manuscript. AKH and CA participated in the analysis and helped to draft the manuscript. All authors read and approved the final manuscript.
AKH is an associate professor of Public Health at the Umeå University Department of Public Health and Clinical Medicine Division of Epidemiology and Global Health in Umeå, Sweden.
CA is a senior clinician and professor at the Umeå University Department of Clinical Microbiology Division of Infectious Diseases in Umeå, Sweden.
BMA is a professor of International Health (Sociology background) at the Uppsala University Department of Women’s and Child Health in Uppsala and Head of research at the Skaraborg Institute of Research and Development in Skövde, Sweden.
Experiences from nations with population diversity show extensive evidence on the need for cultural and linguistic competence in health care. In Sweden, despite the increasing diversity, only few studies have focused on challenges in cross-cultural care. The aim of this study was to explore the perspectives and experiences of caregivers in caring for migrant patients in Northern Sweden in order to understand the challenges they face and generate knowledge that could inform clinical practice.
We used an interpretive description approach, combining semi-structured interviews with 10 caregivers purposively selected and participant observation of patient-provider interactions in caring encounters. The interviews were transcribed and analyzed using thematic analysis approach. Field notes were also used to orient data collection and confirm or challenge the analysis.
We found complex and intertwined challenges as indicated in the three themes we present including: the sociocultural diversity, the language barrier and the challenges migrants face in navigating through the Swedish health care system. The caregivers described migrants as a heterogeneous group coming from different geographical areas with varied social, cultural and religious affiliations, migration histories and statuses, all of which influenced the health care encounter, whether providing or receiving. Participants also described language as a major barrier to effective provision and use of health services. Meanwhile, they expressed concern over the use of interpreters in the triad communication and over the difficulties encountered by migrants in navigating through the Swedish health care system.
The study illuminates complex challenges facing health care providers caring for migrant populations and highlights the need for multifaceted approaches to improve the delivery and receipt of care. The policy implications of these challenges are discussed in relation to the need to (a) adapt care to the individual needs, (b) translate key documents and messages in formats and languages accessible and acceptable to migrants, (c) train interpreters and enhance caregivers’ contextual understanding of migrant groups and their needs, (d) and improve migrants’ health literacy through strategies such as community based educational outreach.