Intercultural communication in health care. Non-Swedish physicians in Sweden

Sammanfattning: This thesis describes and analyzes intercultural communication between non-Swedish physicians and their Swedish patients, as well as communication between non-Swedish physicians and Swedish medical personnel. The focus is on the impact of cultural differences and the use of Swedish as a foreign language by physicians. In addition, the effects of gender and power in physician-patient and physician-colleague communication were investigated. The thesis is based on a combination of data collection methods (interviews, questionnaires, recordings of naturally occurring medical consultations and staff meetings, and observations) and data analysis (qualitative and quantitative). The goal was to get as complete a picture as possible of intercultural communication in Swedish health care. The thesis presents a general analysis of communication between non-Swedish physicians and their Swedish patients. This analysis includes the views of non-Swedish physicians, Swedish patients and Swedish personnel about communication, an outline of common problems and how the participants solve them, and an overview of the positive aspects of communication. A particular focus of the thesis is the comparative analysis of some aspects of information seeking (analysis of questions used by the non-Swedish and Swedish physicians and their patients in medical consultations), information giving (use of the pronoun man [‘one’] by the Swedish and non-Swedish physicians while providing information to their patients), and acknowledgment and checking (use of repetitions and reformulations for feedback purposes). In addition, an overall comparative analysis of intercultural and Swedish medical consultations was done. Differences and similarities between male and female Swedish and non-Swedish physicians and male and female Swedish patients and personnel are discussed. The power relationship in intercultural medical consultations in which the physician is “weaker” and the patient “stronger” in terms of language competence was analyzed. Furthermore, by comparing “intercultural” communication (between the non-Swedish physicians and Swedish patients) to “monocultural” communication (between Swedish physicians and Swedish patients), some insight into Swedish culture and communication patterns was gained. The work concludes with some ideas for teaching and training developed on the basis of the findings of the thesis.