The experiences of Russian-speaking migrants in primary care consultations.

BACKGROUND Some three million Russian-speaking immigrants from the former Soviet Union live in Germany today. Many of them underwent a different kind of medical socialization than the indigenous population, but the experiences and expectations of this group of patients have hardly been studied to date. METHODS In a qualitative study, 24 chronically ill native Germans and 25 chronically ill Russian-speaking immigrants were recruited via notices, through their primary care physicians, and by word of mouth and underwent a semistructured interview in their mother tongue (German or Russian) about their experiences with their primary care physicians. The interviews were recorded using an audio device, translated into German if necessary, and transcribed, and their content was analyzed with the MAXQDA software package. RESULTS The immigrants were less satisfied with their primary care physicians than the native Germans. This manifested itself in a weaker patient-physician connection and frequent changes of physician due to dissatisfaction with treatment. Both groups considered themselves inadequately informed about matters of health, but they gave differing reasons for this. On the other hand, the participants in both groups had practically the same general expectations from their primary care physicians. However, detailed analysis revealed cultural differences. CONCLUSION Physicians in Germany should be more aware of the culturally based expectations of immigrant patients in order to understand their needs better, improve the physician-patient relationship, and ensure equal opportuities in health care. For example, many immigrants would prefer their doctors to communicate with them in a manner that non-immigrants would consider paternalistic.