Skip to main content

Advertisement

Log in

Communication and Cultural Issues in Providing Reproductive Health Care to Immigrant Women: Health Care Providers’ Experiences in Meeting Somali Women Living in Finland

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

An Erratum to this article was published on 04 June 2011

Abstract

Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives’ communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Khan AA. Non-verbal communication: Fact and Fiction. 2001. http://www.strangehorizons.com/2001/20010226/nonverbal.shtml. Retrieved 06-10.

  2. Samovar LA, Porter RE, Stefani LA. Communication between cultures. Foreign Language Teaching & Research Press/Brooks/Cole/Thomson Learning Asia; 2000.

  3. LeBaron M. Cross-cultural communication. 2003. http://www.beyondintractability.org/essay/cross-cultural_communication/?nid=1188. Retrieved 06-10.

  4. Ting-Toomey S, Chung LC. Understanding intercultural communication. New York: Oxford University Press; 2005.

    Google Scholar 

  5. Hughes PC, Baldwin JR. Communication and stereotypical impressions. The Howard Journal of Communication. 2002;68(1):40–56.

    Google Scholar 

  6. Brown DJ. Ethnic identity in health care: intercultural health communication and physician-patient satisfaction. Thesis in communication studies. Graduate Faculty of Texas Tech University; 2006.

  7. Ulrey KL, Amason P. Intercultural communication between patients and health care providers. An exploration of intercultural communication effectiveness, cultural sensitivity, stress and anxiety. Health Commun. 2001;13(13):449–63.

    Article  PubMed  CAS  Google Scholar 

  8. Lowell A. Communication and cultural knowledge in Aboriginal health care: a review of two subprograms of the Cooperative Research Centre for Aboriginal and Tropical Health’s Indigenous Health and Education Research program. CRCATH; 1998.

  9. Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903–18.

    Article  PubMed  CAS  Google Scholar 

  10. Bruce J. Fundamental elements of quality of care: a simple framework. Stud Fam Plann. 1990;12(2):61–91.

    Article  Google Scholar 

  11. Ashford L, Makinson C. Reproductive health and practice: case studies from Brazil, India, Morocco, and Uganda. Washington, DC: Population Reference Bureau; 1999.

    Google Scholar 

  12. Murphy EM. Best practices in client-provider interactions in reproductive health services: a review of the literature. MAQ Initiative; 2001.

  13. Mi Kim Y, Kols A, Thuo M, Mucheke S, Odallo D. Client-provider communication in family planning: assessing audiotaped consultations from Kenya. The Johns Hopkins School of Public Health. Center for Communication Programs; 1997.

  14. Gabe J, Bury M, Elston MA. Key concepts in medical sociology. London, Thousand Oaks: Sage Publication; 2004.

    Google Scholar 

  15. Harris M. Culture, man, and nature: an introduction to general anthropology. New York: Crowell Corporation; 1971.

    Google Scholar 

  16. Shedlin MG. Assessment of body concepts and beliefs regarding reproductive physiology. Stud Fam Plann. 1979;10:393–7.

    Article  PubMed  CAS  Google Scholar 

  17. Scambler G. Sociology as applied to medicine. 5th edition. London, New York, Philadelphia, St Louis, Sydney, Toronto: Saunders; 2003.

  18. Barry CA, Bradley CP, Britten N, Stevenson FA, Barber N. Patients’ unvoiced agendas in general practice consultations: qualitative study. Brit Med J. 2000;320:1245–50.

    Article  Google Scholar 

  19. Degni F. The social and cultural determinants of the use of contraception among married Somali Women living in Finland. Doctoral thesis. Helsinki: Stakes Research Report 148; 2004.

  20. Andrews MM, Boyle JS. Transcultural concepts in nursing care. 4th ed. Philadelphia, Baltimore, New York, London; Buenos Aires, Hong Kong, Sydney, Tokyo: Lippincott Williams & Wilkind; 2003.

    Google Scholar 

  21. Benagiano G, Shedlin MG. Cultural factors in oral contraceptive compliance. Adv Contracept. 1992;8(1):47–56.

    Article  PubMed  Google Scholar 

  22. Adler NJ. International dimensions of organizational behavior. 3rd ed. Cincinnati, OH: Shout-Western College Publishing 1997. In: Livonen M Analyzing and understanding cultural dimensions: experiences from education in library and information studies. 64th IFLA General Conference; 2009; 16–21.

  23. Statistics Finland. 2009. http://www.stat.fi/tup/suoluk/suoluk_vaesto_en.html#foreigners. Retrieved 06-10.

  24. Population. 2009. http://www.stat.fi/tup/suoluk/suoluk_vaesto_en.html#foreigners. Retrieved 06-10.

  25. Church Member statistics 2011. http://evl.fi/EVLen.nsf/Documents/230282E6EFEF75C6C225730E00426EE1?OpenDocument&lang=EN. Retrieved 06-10.

  26. Lehtonen J, Sajavaara K. The silent Finn. In: Tannen D, Saville-Troike M, Norwood NJ, editors. Perspectives on silence. Norwood, NJ: Abler Publishing; 1985. p. 193–201.

    Google Scholar 

  27. Ahmed AJ. Daybreak is near: literature, clan, and the Nation-State in Somalia. Trenton: The Red Sea Press; 1996.

    Google Scholar 

  28. Sorbye I, Leigh B. Reproductive health: National strategy & action plan 2010–2015. SOMALIA: UNFPA, WHO, UNICEF; 2009.

    Google Scholar 

  29. Asmani LI, Abdi SM. De-linking female genital mutilation/cutting from Islam. New York: Population Council, Frontiers; 2008.

    Google Scholar 

  30. Jaakkola M. Immigrant and ethnic relationships [In Finnish: Maahanmuutto ja etniset suhteet] Työpoliittinen tutkimus 213. Helsinki: Finnish Ministry of Interior; 1990.

  31. Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23:334–40.

    Article  PubMed  CAS  Google Scholar 

  32. Rehnstöm J. Reproductive health and health care in Finland: an overview. Helsinki, Finland: National Research and Development Centre for Welfare and Health; 1997.

    Google Scholar 

  33. Adjadjihoue S, Ali MA. Somali immigrants’ needs and expectations towards health care services in Helsinki metropolitan. Otaniemi, Helsinki: Thesis of Master of Health Care; 2009.

    Google Scholar 

  34. Nour A. The health status of the Somali population in Finland. A survey of Helsinki and Espoo Cities. Unpublished Master’s Thesis. Kuopio, University of Kuopio; 2004.

  35. Hassinen-Ali AT. Terveys ja lapset ovat jumalan lahjoja. Etnografia somalialaisten terveyskäsityksistä ja perhe-elämä hoitokäytännöistä suomalaiseen kulttuurin siirtymävaiheessa. In: English Health and children are God’s gifts. An ethnography of health concepts of Somali people and family life practices in transition into Finnish culture. Kuopio: University of Kuopio Publications number 95; 2002.

  36. Degni F, Ojanlatva A, Essen B. Factors associated with married Iranian women’s contraceptive use in Turku, Finland. Journal of the International Society for Iranian Studies. 2006;43(3):379–90.

    Article  Google Scholar 

  37. Holloway I, Wheeler S. Qualitative research in nursing. Oxford: Blackwell Science; 2002.

    Google Scholar 

  38. Silverman D. Qualitative research: theory, method and practice. 2nd ed. Sage: London; 2004.

    Google Scholar 

  39. Street RL Jr. Gender differences in health care provider-patient communication: are they due to style, stereotypes, or accommodation? Journal of Patient Education and Counseling. 2002;48:201–6.

    Article  Google Scholar 

  40. Fletcher CM. Communication in medicine. London: Nuffield Provincial Hospital Trust; 1971.

    Google Scholar 

  41. Bennett AE. Communication between doctors and patients. London: Nuffield Provincial Hospital Trust; 1976.

    Google Scholar 

  42. Statistics Finland. Foreign in Finland. 2009. http://www.stat.fi/tup/suoluk/suoluk_vaesto_en.html#foreigners. Retrieved 06-10.

  43. Tuominen R, editor. Cultural encounters in health care (Kulttuurien kohtaaminen terveydenhuollossa). Juva: WSOY; 1998.

    Google Scholar 

  44. Hahn SR. Physician symptoms and physician-experienced difficulty in the physician-patient relationship. Ann Intern Med. 2001;134(9):897–905.

    PubMed  CAS  Google Scholar 

  45. Hahn SR, Thompson KS, Wills TA, Stern V, Budner NS. The difficult doctor-patient relationship; personality and psychology. J Clin Epidemiol. 1994;47:647–57.

    Article  PubMed  CAS  Google Scholar 

  46. Lin EH, Katon W, Von Korff M, Bush T, Lipscomb P, Russo J. Frustrating patients: physician and patient perspectives among distressed high users of medical services. JGIM. 1991;6(3):241–6.

    Article  PubMed  CAS  Google Scholar 

  47. Rothschild SK. Cross-cultural issues in primary care medicine. Dis Mon. 1998;44:293–319.

    Article  PubMed  CAS  Google Scholar 

  48. Betancourt JR, Maina AW. The institute of medicine report “Unequal treatment” implications for academic health centers. Mt Sinai J Med. 2004;71:314–21.

    PubMed  Google Scholar 

  49. Bernzweig J, Takayama JI, Phibbs C, Lewis C, Pantell RH. Gender differences in physician-patient communication: evidence from pediatric visits. Arch Pediat Ado Med. 1997;151:586–91.

    Article  CAS  Google Scholar 

  50. Roter DL, Hall JA. Why physician gender matters in shaping the physician-patient relationship. J Womens Health. 1998;7:1093–7.

    Article  PubMed  CAS  Google Scholar 

  51. Roter DL, Geller G, Berhard BA, Larson SM, Doksum T. Effects of obstetrician gender on communication and patient satisfaction. Obstet Gynaecol. 1999;93:635–41.

    Article  CAS  Google Scholar 

  52. Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor U. 1998;9(2):117–25.

    CAS  Google Scholar 

  53. DiMatteo MR. A social psychologist analysis of physician-patient report: toward a science of the art of medicine. J Soc Issues. 1979;35(1):12.

    Article  Google Scholar 

  54. Gámez GG. The nurse-patient relationship as a caring relationship. Nurs Sci Quart. 2009;22(2):126–7.

    Article  Google Scholar 

  55. López E, Vargas R. Interpersonal communication in relation to the ill patient. Nurse IMSS. 2002;10(2):93–102.

    Google Scholar 

  56. Fry S, Johnstone MJ. Ethics in nursing practice. A guide to ethical decision making. Oxford, UK: Wiley; 2008.

    Google Scholar 

  57. Act on Equality between women and men, Ministry of Social Affairs and Health, Gender Equality Brochure 2, Helsinki; 2005.

  58. Finnish Medical Association; 2010. www.medassoc.fi/e. Retrieved 06-10.

  59. Daphne WN. Female education in Somalia: a survey to assess the situation and needs of women. Paris: Unesco; 1987.

    Google Scholar 

  60. Lewis T, Ahmed B, Hussein K. Voices of the Somali community. www.xculture.org/files/SOMALI.pdf. Retrieved 03-11.

  61. Dearborn JL, Victoria PP, Burleson JA, Hornung FE, Waite H, Into FH. Gender affects communication between health care provider and patient. J Am Geriatr Soc. 2006;54(4):637–41.

    Article  PubMed  Google Scholar 

  62. Haegert S. An African ethic for nursing. Nurs Ethics. 2000;7(6):492–502.

    Article  PubMed  CAS  Google Scholar 

  63. Beine K, Fullerton J, Palinkas L, Anders B. Conceptions of prenatal care among Somali women in San Diago. J Nurse-Midwifery. 1995;40:376–81.

    Article  PubMed  CAS  Google Scholar 

  64. Rööst M, Altamirano VC, Liljestrand J, Essén B. Does antenatal care facilitate utilization of emergency obstetric care? A case referent study of near-miss in Bolovia. Acta Obstet Gyn Scan. 2010;89(3):335–42.

    Article  Google Scholar 

  65. Schenker JG, Rabenou V. Contraception: traditional and religious attitudes. Eur J Obstet Gyn. 1993;49(1–2):15–8.

    Article  CAS  Google Scholar 

  66. http://www.med.umich.edu/multicultural/ccp/index.htm. Retrieved Sept 04 2007.

  67. Strasser R. The doctor-patient relationship in general practice. Med J Australia. 1992;156:334–8.

    PubMed  CAS  Google Scholar 

  68. Garcia EA, Lonnie RC, Okada PJ, Perkins SD, Wiebe RA. A comparison of the influence of hospital-trained, ad hoc and telephone interpreters on perceived satisfaction of limited English-proficient parent presenting to a pediatric emergency department. Pediatr Emerg Care. 2004;20:373–8.

    Article  PubMed  Google Scholar 

  69. Betancourt JR, Jacobs EA. Language barriers to informed consent and confidentiality: the impact on women’s health. J Am Med Womens Assoc. 2000;55:294–5.

    PubMed  CAS  Google Scholar 

  70. Green AR, Ngo-Metzger Q, Legedza ATR, Massagli MP, Phillips RS, Lezzoni LI. Interpreter services, language concordance, and health care quality. Experiences of Asian Americans with limited English proficiency. J Gen Inter Med. 2005;20:1050–6.

    Article  Google Scholar 

  71. Betancourt JR, Green AR, Carrillo JE, Firempong AO. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep. 2003;118:293–302.

    PubMed  Google Scholar 

  72. Gilliam ML, Hernandez M. Providing contraceptive care to low income African American Teens: the experience of urban community health. J Commun Health. 2007;32(4):231–44.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Filio Degni.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s10903-011-9486-1.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Degni, F., Suominen, S., Essén, B. et al. Communication and Cultural Issues in Providing Reproductive Health Care to Immigrant Women: Health Care Providers’ Experiences in Meeting Somali Women Living in Finland. J Immigrant Minority Health 14, 330–343 (2012). https://doi.org/10.1007/s10903-011-9465-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-011-9465-6

Keywords

Navigation