‘’In Afghanistan, doctors were the smartest.’’ Exploring how experiences of older Afghan ex-refugees shape their trust in general practitioners

Many studies have illustrated that trust is essential in the patient-clinician relationship and for adequate healthcare service delivery because it facilitates access, communication, and cooperation. However, studies suggest that ethnic minorities (e.g., refugees) have lower trust in healthcare than majority groups, leading to inequalities. There is a gap in the current literature on Afghan ex-refugees’ past experiences and how those experiences influence the way they perceive trust in general practitioners (GP). Minority populations such as ex-refugees are a subgroup of the Dutch population and are more vulnerable to ill health than native Dutch citizens and therefore need specific attention. This study aims to reduce societal inequalities by exploring older Afghan ex-refugees’ narratives of past (clinical) experiences and understanding how those experiences shaped their trust in GPs. As such, thirteen semi-structured, narrative-oriented synchronous online interviews were held with Afghan ex-refugees aged 50 years and over. The findings suggest that participant’s past (healthcare) experiences shaped their trust in GPs through a combination of unmet expectations and not fully understanding the Dutch healthcare system. We should consider refugees’ experiences with a (likely) different healthcare system and culture in their home country as an important foundation of establishing trust. Those experiences, alongside dealing with and navigating through a new host country, can make it difficult for this population group to build trust.