Culturally and linguistically diverse patients' views of multimorbidity and general practice care

INTRODUCTION: It is recognised that patients who are culturally and linguistically diverse (CALD) have challenges in accessing health care and understanding health advice or instructions. Those with multimorbidity (MM) are likely to have additional difficulties. In New Zealand, little is known about how this patient group view their health and general practice health care. This study examined the views of multimorbid CALD patients about MM and the health care available in a Very Low Cost Access general practice. METHODS: This qualitative study recruited Samoan, Cook Island Maori, and Cambodian patients with diabetes and more than three other long-term conditions. Two individual interviews and two language-specific focus groups were undertaken to yield themes representing the experience of these CALD patients with MM. FINDINGS: Participants described MM as having considerable impact on their life. They reported feeling responsible for supporting their own health and many detailed self-management techniques. However, they also expressed confusion, lack of information and limited understanding of MM, in particular about managing medication. Not all patients were aware of the range of available general practice services and some described difficulties in accessing general practice care. CONCLUSION: Despite being motivated to self-manage, this patient group report challenges in understanding their conditions and how to manage them, which may also be influenced by health beliefs. Available general practice services are not well known by CALD patients with MM. There is likely to be value in developing a specific structured, yet patient-centred, model of care for this group of patients. KEYWORDS: Access to health care; ethnic groups; focus groups; general practice; health literacy; self care