'We are deaf, though we hear; we are dumb, though we talk; we are blind, though we see' : understanding Iranian late-in-life immigrants' perceptions and experiences of health, illness and culturally appropriate care

Abstract: Despite the fact that elderly immigrants constitute nearly nine percent of the total population over 65-years of age, they have remained conspicuous by their absence in reports that underlie national welfare- and health care decision making in Sweden. The aim of this thesis was to deepen the understanding of Iranian late-in-life immigrants' experiences and perceptions of health, illness and culturally appropriate care. In paper I the findings elucidate the participants' description and explanation of their situation by utilizing phenomenological hermeneutic method. The findings thereby get an insight of the participants' life situation, their experiences of immigration and its effect on their health and social well-being. In paper II by using ethnographic method the culturally appropriate intervention program for senior Iranians and the manner in which the participants considered attending the day care center to be beneficial for their experiences of health was studied. Knowledge gained from this study calls for including culturally appropriate programs in order to meet the clients' needs and concerns for maintaining and/or improving their health and well-being. In paper III by using interpretive phenomenological method participants' perceptions of health and illness are elucidated. Participants in this study consider health as feeling continuity and balance in their life. Social well-being and a well-functioning familial relationship are the core aspects for maintaining and/or promoting health. Knowledge gained from this study opens up a new horizon in considering health and illness from the clients' perspective. In paper IV by utilizing interpretive phenomenological method based on participants' reflections on health and illness a socio-cultural explanatory model of health is developed. This study indicates that the process of maintaining and/or promoting health and participants' interpretation and reflections on health is a dynamic process that is influenced by participants' process of life. The findings presented in this study challenge health providers to consider the socio-cultural meaning of health as a central aspect in influencing clients' possibilities and difficulties in maintaining and/or promoting health and well-being. Paper V, by qualitative secondary-analyzing, challenges the concept of culture as the central, influential aspect for constituting an explanatory model of illness. This study sheds light on the importance of life disruptions and the dynamic process of life changes such as immigration, which confront the cultural understanding of illness. Conclusively this research suggest that in order to give and advocate health and medical services to persons, health professionals need to acquire a broad empathic sensitivity in understanding a person and her/his life-world as the source of healing, recovery, and health promotion possibilities. A socio-cultural awareness of a person, which embraces understanding of her/his cultural, socio-economic, educational, spiritual and environmental circumstances gives access to a person's situated possibilities in health care.