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Our knowledge of the immigrant patient's experiences and reflections regarding consultations in primary health care where interpreters are used is limited. Thus, the primary aim was to explore these experiences and reflections. The second aim was to study whether demographic and migration-related factors are associated with the patient's satisfaction with the consultation and feeling of consolation given by the general practitioner (GP). The third aim was to analyse whether these feelings are related to the time from the booking to the consultation, to self-reported health, symptoms and the patient's experiences. A questionnaire was distributed to 78 consecutive immigrant patients from Chile, Iran and Turkey at 12 primary healthcare centres around Stockholm. The respondents were asked about their background and health status, while open-ended questions focused on their experiences and comments regarding the consultation and cross-cultural communication in general. Ethical approval was obtained. The respondents consisted of 52 patients, 16 from Chile, nine from Iran and 27 from Turkey. Most of the answers concerned communication problems because of language and cultural differences between the GP and the patient and the GP's ability to listen. Therefore, the importance of having a competent interpreter for a satisfactory consultation was stressed. Many of the respondents also felt that the GP's ability to listen to them and understand them is crucial in the consultation. Background facts, including demographic and migration-related factors, health status and factors related to the consultation, did not seem to be associated with the patient's satisfaction and the feeling of consolation. One limitation is that the sample is small and not equally distributed. The use of authorized interpreters during the consultation is essential. The consultation must be based on a patient-centred strategy and adjusted to the patient's educational level. Cultural competence is needed when meeting immigrant patients.

Aims: To analyse whether there is an association between sex and poor self-reported health (SRH) and psychological distress in Kurdish immigrants., Methods: This cross-sectional study is based on a sample consisting of immigrants, aged 27- 60 years, with self-reported Kurdish ethnicity (n=111, men; n=86, women) in Sweden originating from Iran and Turkey. It is based on data collected in 1996 from the first Swedish National Survey on the living conditions of immigrant groups conducted by Statistics Sweden. The prevalences of reporting poor health, sleeping difficulties, general fatigue and anxiety were estimated by sex. The association between sex and SRH and psychological distress was analysed by an unconditional logistic regression model estimating odds ratios (OR) with 95% confidence intervals. The final model was adjusted for age, marital status, education, housing and employment. Immigrant-specific migration-related variables were used to explore possible reasons for the sex differences., Results: Kurdish men and women had a high prevalence of poor SRH and psychological distress. Age-adjusted odds ratios for anxiety were higher in Kurdish women. Sex differences in anxiety remained even when marital status, education, housing and employment were taken into account., Conclusions: Kurdish men and women report a high prevalence of poor SRH and indicators of psychological distress. Women had a higher risk for anxiety than men. Negative experiences of pre-migration as well as post-migration experiences, such as economic difficulties, preoccupation with the political situation in the home country, perceived discrimination, and feelings of poor control over one's life, were associated with the outcomes.

Objectives: To study whether symptoms of self-reported anxiety, sleeping problems and severe pain are more common among Turkish-born immigrants in Sweden than among Swedes, and whether age and socio-economic status can explain this hypothesised difference., Design: Two random samples were studied -- the Swedish National Board of Health and Welfare Immigrant Survey, and the Swedish Annual Level-of-Living Survey, both from 1996. A total of 526 Turkish-born immigrants in Sweden were compared with 2,854 Swedish controls, all aged between 27 and 60 years. Data were analysed by sex, in an age-adjusted model; and a full model also included age, education, marital status, employment and country of origin (logistic regression)., Results: In the full model, odds ratios were 2.12 (1.43-3.15) for anxiety, 2.60 (1.82-3.72) for sleeping problems, and 2.14 (1.50-3.05) for severe pain among Turkish-born men, and 2.44 (1.69-3.53) for anxiety, 3.01 (2.09-4.33) for sleeping problems, and 2.59 (1.80-3.71) for severe pain among Turkish-born women, using the Swedish controls as references., Conclusions: Being a Turkish-born immigrant in Sweden significantly increases the risks for self-reported anxiety, sleeping problems and severe pain, even after adjusting for age and socio-economic status (education, marital status and employment).

This study explores the association between ethnicity and poor self-reported health and psychological distress, sleeping difficulties, and use of psychotropic drugs among immigrant Kurdish men and native Swedish men, based on data from the first Swedish National Survey of Immigrants and the Swedish Level-of-Living Surveys collected in 1996 by Statistics Sweden. The age-adjusted odds of poor self-reported health and sleeping difficulties among Kurdish men was about 3.5 times higher than among Swedish men. The odds ratio decreased to 2.1 and 2.7 respectively in a model adjusted for age and the other explanatory variables. Yearning for the home country, perceived discrimination and unemployment in the host country seem to be possible explanations for the higher levels of distress among Kurdish immigrants to Sweden.

The aim of this study is to analyse the influence of country of birth on body mass index (BMI) after adjustment for age, educational status, physical activity and smoking habits. Two random samples of men and women, aged 27-60, were used: 1,957 immigrants and 2,975 Swedes, both from 1996. Men and women were analysed in separate models by the use of linear regression. The BMI levels were significantly higher among Polish (0.8 BMI units) and Chilean (0.7 BMI units) men, and Chilean (1.9 BMI units) and Turkish (1.5 BMI units) women than among their Swedish controls, after adjustment for all explanatory variables. Other intermediate risk factors for cardiovascular disease, such as physical inactivity and daily smoking, were also more frequent among almost all the immigrant subgroups. This study shows a strong influence of country of birth on BMI even after adjustment for age, educational status, physical activity and smoking habits.