Interkulturelles Sprechzimmer – Arzt-Patient-Interaktion aus der Sicht von Patienten mit russisch-sprachigem Migrationshintergrund und Hausärzten. Ergebnisse einer „mixed-methods“-Studie.

Research results show that successful medical interaction has an impact not only on satisfaction with doctor-patient contact, but also on end outcomes such as compliance, treatment success or follow-up costs. In an intercultural context, physician-patient in-teraction is of particular importance, as it can be influenced by specific factors such as difficult mutual understanding, whether of a linguistic or cultural nature. Against this background, this paper is dedicated to the experiences of patients with a Russian-speaking migration background and general practitioners (GP) with and without migration experience. The research interest focuses on the question which aspects are important for the intercultural doctor-patient interaction and how it is influenced. It is examined if the experiences of patients with and without a migration background differ. In addition, it is considered whether these patient groups are experienced by their doctors in the same way or if specific difficulties can be perceived. Furthermore, the role of socialisation is being investigated. A mixed-methods study was conducted to examine different perspectives and as-pects of medical interaction in an intercultural context. The study includes the following partial studies: Interviews with 45 migrants from the states of the former Soviet Union in Russian; interviews with 24 German patients; interviews with 21 GPs with and without Russian-speaking background; letter and online survey among Germans, Russian-speaking migrants in Germany and among residents of Russia in German and Russian; video recordings of GP interactions with patients with and without migration back-ground. The mantel script presents the theoretical background and scientific frame of reference. The group of migrants studied is described and previous scientific results are presented. In addition the particularities of intercultural communication in a medical context will be discussed. The four original papers present the most important results of the "mixed-methods" study. The first article, which appeared in the Journal of Transcultural Nursing, deals with the examination of the measurement equivalence of the questionnaires used in the quantitative survey in German and Russian versions (PHQ-9, PHQ-15, KOPRA, Ham-SCQ). The results show that all four methods meet the methodological requirements and could therefore be used in an intercultural study. The second article, published in the International Journal of Migration, Health and Social Care, shows results of the quantitative online and postal survey among Germans, Russian-speaking migrants and Russians in Russia. No differences are found in the area of psychological complaints. The German study participants say they have more influence on their health than migrants or Russians. They are also more satisfied with their state of health. Compared to migrants, Germans and Russians have higher self-care scores. Migrants report more subjectively somatic complaints than non-migrants. The third article, published in the Deutsches Ärzteblatt, deals with the experiences of Germans and migrants with their German family doctors. These are qualitative data - semi-structured interviews. Migrants are less satisfied with their doctors than German patients. Migrants also change doctors more frequently. Both patient groups report a lack of information regarding health issues, but cite different reasons for this. The fourth original paper, submitted to Social Science and Medicine, deals with the characteristics of GP interaction. Herefore qualitative and quantitative data is analysed. The results show that Germans differ in their communication preferences from the two Russian-speaking groups. From the statements of the doctors with and without migration background and the patients, it is concluded that socialisation in the country of origin is of particular importance for doctor-patient interaction, regardless of possible language barriers. The last section of the mantel script discusses essential results and give an outlook on further research needs. The study documents are enclosed in the appendix.