Introducing a psychological agenda for understanding somatic symptoms--an area of conflict for clinicians in relation to patients in a multicultural community

Cult Med Psychiatry. 2008 Sep;32(3):386-405. doi: 10.1007/s11013-008-9100-8.


Culturally capable care requires that clinicians possess insights into patients' reasoning about illness. It is universally common for emotional distress to be expressed in terms of somatic symptoms. Converting meanings of illness from a somatic to a psychological agenda for understanding distress may be complicated for patients. Objectives of this study were to explore (a) professionals' experiences of encountering patients who use a bodily idiom for emotional distress in a multicultural milieu and their ascriptions of meaning and (b) how professionals impart their agenda of illness meaning to patients. Data were collected by seven focus-group interviews with professionals working in a multicultural suburban area of Stockholm, Sweden, and analyzed in two steps. The first step was content analysis. The second step was an inductive analysis with a revised grounded theory approach. Results showed that the caregivers stressed the importance of constructing a working alliance with the patient. With few exceptions, this did not include a patient-centered approach by the staff for exploring patients' perspectives and understandings of illness. Current knowledge about the importance of gaining insights into patients' perspectives was not implemented. Results of this study point to the importance of implementing new knowledge and according priority to research on the outcomes of that implementation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communication
  • Conflict, Psychological*
  • Cultural Diversity*
  • Humans
  • Mental Disorders / psychology
  • Mental Disorders / therapy
  • Professional-Patient Relations*
  • Psychology / methods*
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / psychology*