title: Symptom recognition and health care seeking among immigrants and native Swedish patients with heart failure.
abstract: BACKGROUND
  It is not known what patient perceptions or beliefs lead to beneficial decisions or response patterns in symptom interpretation among heart failure (HF) patients, especially immigrants. The aim of this study was to explore and compare symptom recognition and health care seeking patterns among immigrants and native Swedes with HF.
  
  
  METHODS
  The study used a qualitative design. Semi-structured interviews were conducted with 42 patients with HF, of whom 21 were consecutively selected immigrants and 21 were randomly selected Swedish patients. The interviews were analysed using content analysis.
  
  
  RESULTS
  A majority of the immigrant patients sought health care for symptoms and signs, such as breathing difficulties, fatigue and swelling. Twice as many immigrants as Swedes were unaware of "what the illness experience entailed" and which symptoms indicated worsening of HF.
  
  
  CONCLUSIONS
  The symptoms that patients sought care for, were similar among immigrants and Swedes. However, when interpreting symptoms more immigrants were unaware of the connection between the symptoms/signs and their HF condition. More tailored educational interventions might improve recognition of worsening symptoms in immigrant patients with chronic heart failure.
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. azar.hedemalm@gu.se
authors.forename: Azar
authors.initials: A
authors.lastname: Hedemalm
authors.forename: Maria
authors.initials: M
authors.lastname: Schaufelberger
authors.forename: Inger
authors.initials: I
authors.lastname: Ekman