title: Culturally and linguistically diverse patients' views of multimorbidity and general practice care.
abstract: BACKGROUND
  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 Ma¯ori , 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago Wellington, PO Box 7343, Wellington South, Wellington, New Zealand. eileen.mckinlay@otago.ac.nz.
authors.forename: Eileen
authors.initials: E
authors.lastname: McKinlay
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago Wellington, New Zealand.
authors.forename: Stewart
authors.initials: S
authors.lastname: Graham
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago Wellington; Newtown Union Health Service, Newtown, Wellington; Evolve Youth Service, Wellington, New Zealand.
authors.forename: Pauline
authors.initials: P
authors.lastname: Horrill
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D001210:Asia, Southeastern / Q000208:ethnology; D015897:Comorbidity; D018864:Cultural Diversity; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D007802:Language; D009520:New Zealand / Q000453:epidemiology; D036301:Qualitative Research; D012648:Self Care