Noura A. Abouammoh

5.9 Summary

Qualitative methodology was chosen to explore IMGs and patients experiences as cultural issues and deep understanding of the issues under investigation are better explored using this methodology.

A focus group discussion with IMGs and interviews with patients with T2DM from one hospital and interviews with IMGs and patients from eight different PHCCs in Riyadh, SA were conducted. Additionally, follow-up interviews with a number of the IMGs were conducted. Data were analyzed using a thematic approach proposed by Ritchie and Spencer (1994) and based on the principals of grounded theory. Reliability and validity of the data were discussed and established through triangulation, fair presentation, reflexivity and transparency. The following chapter will present the outcome of the data analysis.

Chapter 6

Findings of the study

6.0 Introduction

This chapter begins by presenting the descriptive data of the study participants. The findings from the thematic qualitative analysis are then presented. The data analysed revealed three different themes related to IMGs and patients’ experiences in cross-cultural medical communication, which affect health care provision in SA. These themes are presented in three sections within this chapter:

1- Interaction and rapport-building in cross-cultural medical encounters

2- Providing culturally sensitive lifestyle advice

3- Practical strategies used by IMGs and patients to facilitate communication

6.1 Descriptive Data

6.1.1 IMG characteristics

All the contacted PHCCs agreed to participate in the study. Nineteen IMGs were recruited in the current study (Table 6.1). Eight IMGs were recruited from the hospital, of whom six underwent a focus group discussion. The other two IMGs were interviewed individually, as they had agreed to participate, but were not available at the time of the focus group.

Being in a focus group did not discourage some IMGs from sharing their negative experiences such as their inability to communicate with Saudi patients. The IMGs were keen to share their experiences with the researcher and with each other. The interaction between the focus group participants was apparent through them prompting each other’s responses.

Table 6.1 IMGs’ characteristics

IMG no.	Type of participation	Nationality	Age (years)/gender	Mother tongue	Years of experience in SA/ PHCC	No. of T2DM patients seen/week	Follow-up interview
1	Focus group	Pakistan	46/M	Urdu	9/Hospital	60	-
2	Focus group	Pakistan	56/M	Urdu	4/Hospital	30-35	-
3	Focus group	Kashmir	54/M	Kashmiri	3Y6M/ Hospital	40	-
4	Focus group	Sudan	50/M	Arabic	20/Hospital	75	-
5	Focus group	Sudan	54/M	Arabic	20/Hospital	70-80	-
6	Focus group	Syria	38/M	Arabic	10/Hospital	70	-
7	Face to face	Sudan	32/F	Arabic	9/Hospital	80	-
8	Face to face	Egypt	55/M	Arabic	16/Hospital	125	-
9	Face to face	Pakistan	46/M	Urdu	9y/East1	30	-
10	Telephone interview	India	40/M	Hindi	4y/North1	25	Yes
11	Face to face	Syrian	47/F	Arabic	6y/North2	30-35	Yes
12	Face to face	Sudan	38/F	Arabic	2y4m/East1	30	-
13	Telephone interview	Egypt	50/M	Arabic	8y/East2	25-30	-
14	Face to face	Pakistan	40/F	Urdu	4y/North3	25	-
15	Face to face	Egypt	57/F	Arabic	9y/South1	35	-
16	Face to face	Egypt	32/F	Arabic	4y/West1	25-30	Yes
17	Face to face	Jordan	59/M	Arabic	29y/South1	25	-
18	Face to face	Bangladesh	49/F	Bangla	3y/West2	30	Yes
19	Face to face	Pakistani	51/M	Urdu	20y/West2	35	Yes

Fifteen IMGs were approached and 11 agreed to be interviewed from the PHCCs, both males and females. Three female and a male Arabic speaking IMGs could not find the time and were not willing to be interviewed by phone. Nine interviews took place on the health care premises. Two telephone interviews were conducted based on physicians’ preference, for which consent forms were signed in advance in the PHCCs. The reason given for preferring telephone interviews was due to the IMGs’ busy schedule during working hours. IMG15 was the only participant who refused to be recorded. Reasons for preferring not to be recorded was attributed to fear of being identified, although the anonymity of potential participants had been explained thoroughly. The participant’s wish was followed and notes were taken during and immediately after the interview. No specifically sensitive issues, compared to the other interviews, were raised in this particular interview.

The IMGs were eager to share their experiences with local patients. It seemed that they took the interview as an opportunity to air complaints and sometimes it was difficult to move on with the related topics, as IMGs complained about administrative issues. Some IMGs also expressed their appreciation of the researcher’s effort to deliver their voices and hoped that she could act upon their needs.

Five IMGs were included in the follow-up interviews as four did not respond, one IMG moved to another city, three were on vacation and one IMG was not willing to be included in a follow-up interview.