Patienten beim Hausarzt: Kulturelle Unterschiede bezüglich der Erwartungen und Erfahrungen

Introduction: In the year 2013, there were about 3.2million German citizens with a migration background from the former Soviet Union, respectively the GUS-states. Their medical socialization is different from that of the native German population. Research about the health situation in this section of the population was underrepresented. This study aims at a contribution to fill the lack of knowledge and does so by comparing the expectations and experience of patients with and without a migration background towards their family doctor. Methods: This comparison was done in form of a qualitative study. 24 interviews of Germans and 25 Interviews of migrants were conducted. The interviews with the migrants were carried out in Russian, in order to minimize barriers of speech. After the transcription and translation the interviews were coded wit MAXQDA, using a content-analytic approach. Results: Direct comparison showed that the German patients were more satisfied with their family doctor, although the difference was between an A-grade and a B-grade. As far as the difficulties in doctor-patient-relationships were concerned, the migrant population reported barriers more often. The main barrier was the lack of knowledge in language, but also aloofness or an impersonal working principle on the physician’s side. Other differences between the two groups were seen by looking at the frequency of changing the family doctor and their explanation for it. Even though the total number of changes and the reasons were the same, the frequency distribution was contrary. The German interviewees mainly used “non-modifiable” reasons, such as distance to or change of location. The migrants often applied “modifiable” reasons, grounded in the doctor-patient-relationship. Additionally there was a more passive lifestyle found in the migration group and also a more passive information procurement. But both groups claimed that they were badly informed. Another main difference between the groups was the understanding of responsibility for the procurement of information. Concerning the picture of an ideal doctor, the frequency of visiting the doctor per year, and the consideration of medical tourism, the differences were only marginal. Discussion: Because of the lack of knowledge and missing studies about the population from the former Soviet Union, respectively the GUS-states, this study was supposed to form new hypotheses and not to quantitate or falsify existing hypotheses. Therefore a qualitative method was chosen. In general the conclusions shown match the already existing literature; well aware of the fact, that there were no directly comparable studies. The existing surveys on migrant population in Germany approached either the migrant population in general – with special attention to the Turkish population – or the psychological health of the Russian speaking population. The main difference between the patient groups there could be seen in a different sense of responsibility for their own health and a lower emotional bond to the family doctor. Medical socialisation and language barriers seemed to be plausible conclusions for those results. For a better understanding and an improvement of the physician-patient-relations of the Russian speaking population in Germany this conclusion should lead to further research with different and diverse approaches. The shown hypotheses should be analysed and evaluated concerning the transferability to the whole German population.