Caring for foreign‐born persons with psychosis and their families : Perceptions of psychosis care

Sammanfattning: The aim of this thesis was to describe and analyse perceptions of psychosis care among those involved in care, foreign-born persons with psychoses, their families and health care staff, and further to reach agreement about core components in psychosis care. This was in order to find out whether current psychosis care in Sweden is suitable for foreign-born persons and their families. The study design was explorative and descriptive. Health care staff (n=35), persons with psychosis (n=22) and families (n=26) of persons with psychosis were chosen from different regions in Southern Sweden. To capture health care staff’s experiences and to explore whether specific needs occurred within psychiatric care, nine focus group interviews were held. The perspectives of psychosis care among persons with psychoses and their families were captured through individual interviews. Finally, a study was accomplished all over Sweden in which staff, foreign-born persons with psychosis and foreign-born families of persons with psychoses answered a questionnaire to identify core components in psychosis care of foreign-born persons and their families. There was agreement that the core components in psychosis care concern general psychiatric caring, even though varying perceptions were identified. Asking about foreign-born persons’ religious and ethnic background or having the possibility to decide whether care should be provided by male or female staff were agreed to be less important. No agreement could be reached concerning the importance of considering different perceptions of psychosis care, treatments and different ways of managing the psychosis. Nor could agreement be reached as to whether staff should have specific cultural knowledge and whether interpreters should be unknown to the family but speak the right dialect. Perceptions among staff in somatic and psychiatric care as well as perceptions among foreign- and Swedish-born persons with psychosis and their families were more similar than different. General psychiatric care is important for Swedish-born as well as foreign-born persons with psychosis and their families, indicating the importance of not letting culturally determined perceptions dictate the care and take away energy from health care staff and make them lose their focus on the basic elements in general psychiatric care. However, within the general care there were individual perceptions on whose importance those involved in care did not agree. Further development suggested is to illuminate the importance of identifying individual perceptions which may differ between different persons and could be related to cultural background. Staff need to acquire strategies so they can easily manage to encounter and offer general care to foreign-born persons. Development must be achieved on both an organizational level and an individual level.