[Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health]. / Selbstmanagementförderung bei chronischer Krankheit für Menschen mit Migrationshintergrund ­ ein Gruppenkurs mit Peer-Ansatz als Beitrag zu gesundheitlicher Chancengerechtigkeit.

AIM: Limited health literacy and language skills are barriers for people with a migrant background (PMB) to access health information and healthcare services, in particular for those living with chronic conditions. During the introduction of a peer-led Stanford chronic disease self-management course in Switzerland, special interest in the program as well as motivation of PMB was observed. In response, we examined if the program can be implemented in German for people with limited language skills. METHODS: This explorative study is part of the evaluation study on introducing the adapted Stanford program in Switzerland and German-speaking Europe. Following the principles of Grounded Theory, semi-structured focus group and individual interviews were conducted with course participants, leaders and coordinators (n=30) and analyzed thematically. The focus was on the feasibility, satisfaction and course content. RESULTS: In principle, the program seems to have positive value for PMB, may work for them in German, have high relevance for everyday life and give an impetus for social integration. CONCLUSION: The need for and extent of modification of the program for PMB has to be further explored in order to make it more accessible for vulnerable groups.

Impact of migration on illness experience and help-seeking strategies of patients from Turkey and Bosnia in primary health care in Basel.

Migration, particularly among refugees and asylum seekers, poses many challenges to the health system of host countries. This study examined the impact of migration history on illness experience, its meaning and help-seeking strategies of migrant patients from Bosnia and Turkey with a range of common health problems in general practice in Basel, Switzerland. The Explanatory Model Interview Catalogue, a data collection instrument for cross-cultural research which combines epidemiological and ethnographic research approaches, was used in semi-structured one-to-one patient interviews. Bosnian patients (n=36) who had more traumatic migration experiences than Turkish/Kurdish (n=62) or Swiss internal migrants (n=48) reported a larger number of health problems than the other groups. Psychological distress was reported most frequently by all three groups in response to focussed queries, but spontaneously reported symptoms indicated the prominence of somatic, rather than psychological or psychosocial, problems. Among Bosnians, 78% identified traumatic migration experiences as a cause of their illness, in addition to a range of psychological and biomedical causes. Help-seeking strategies for the current illness included a wide range of treatments, such as basic medical care at private surgeries, outpatients department in hospitals as well as alternative medical treatments among all groups. Findings provide a useful guide to clinicians who work with migrants and should inform policy in medical care, information and health promotion for migrants in Switzerland as well as further education of health professionals on issues concerning migrants health.

[Physician-patient interaction from the migrant's viewpoint: suggestions for medical practice]. / Die Arzt-Patienten Interaktion aus der Sicht von MigrantInnen: Vorschläge für die ärztliche Praxis.

The quality of communication between physicians and migrants with psychosocial problems is critical to success of therapy and satisfaction with its course. Recommendations stress the importance of a patient-centered approach including a careful and migration-specific history-taking and of cooperation with colleagues and non-medical professionals, including migrants. These issues should be included in the medical training and in interventions made at the political level.