Theme 4: Experiences of cultural competency in the Finnish health care service 53

This theme combined the information regarding the experiences of the participants as it relates to cultural competency demonstrated by health care providers.

Sub-theme 1: Comparative views on health care services in Finland and home country

The participants described differences between the health care services in their country and Finnish health care facilities. A common description of the health care services in Finland was that it was better organized.

“To be honest, their respectful behavior and their patience, it was very strange to me because in my home country we don't have this. And that a lot of things are organized, I take time online and, on the phone, to see my doctor, and I see my doctor on a certain time, and sometimes Ido not need to see the doctor at all, and the nurse can do it, these things are very different from the system of my home country” ^(P1).

A common experience among participants was also the lengthy process associated with receiving care. Participants described that not only did they require appointments to get care, but the process of getting specialist care was also long and slow.

“Yeah, because like in my country, it is not like, because obviously, the system in Finland is much more better than what is in my country. But like in my country, we don't have to wait for the appointment if we have to go to the doctor. Because if you have money, then you can go and

have all that treatment, but here like you have to wait for the appropriate time... first they will send you to the nurse and then after that a nurse can come and go to the doctor” (P2).

“Yeah, seeking the medical specialist doctor is really hard in Finland. I even now I don't like it. I'm surprised for it. They just linger you on the General Practitioner (GP) for a long, long time. And the specialist is like cut-off person that you have to pass so many reserves of the GP to reach to the specialist, that they take hell of time” (P11).

Sub-theme 2: Response to cultural needs

The majority of the participants reported no problems concerning response to their cultural needs, primarily because they had no cultural needs on their minds, and they had no

expectations that they would be singled out for a different kind of treatment because of their home cultures. Two participants reported issues regarding culture, one was concerning difficulty describing emotional distress and cause of the depression to a psychologist, while the other was regarding a request to avoid a certain invasive procedure (Transvaginal Ultrasound for

unmarried women).

“…that specialist doctor to call me and maybe I didn't understand, but they didn't follow up.

Because we had cultural problem, I was telling them I cannot do internal Sonography and they were telling, we don’t know other way and they were not ready listen to me” (P1).

Sub-theme 3: What works well in the Finnish health care system

The participants listed many aspects of care they received that were exceptional. A participant stated that received free tests:

“Yeah, cheaper, and then, like, if I had to get some kind of blood tests or something like this laboratory tests, then it was also free” (P2).

“working well, many things. The nurses are well trained. The doctors are good as well. They listen to you, they spoke to you, they obviously, explain you well whenever ask, and especially when you are at a specialist chamber they deal very well” (P1).

Other responses included the demonstration of equity in health care and support from the social insurance institution for persons who cannot pay for care and methodological approach to diagnosis, patient assessment, and service delivery.

Sub-theme 4: Cultural awareness and culture sensitivity among nurses

There were no complaints from participants regarding nurses’ demonstration of cultural competency, primarily because the participants did not expect to be single out for a different kind of treatment based on being foreigners. They expected to be treated like any other patient.

“Honestly, I don’t think so, and it also I feel it is not their job like we cannot learn culture along with medicine, I don’t think so they know” (P13).

“I am not sure they are familiar because they didn't ask, they have not involved. They didn't interact that much with my culture, but with me yes because they asked about all my details personally how what about my health and everything but not about culture” (P12).

Many participants noted that the nurses did not ask them anything about their cultures;

however, the participants themselves also did not expect to be asked anything about their cultures.

Sub-theme 5: Diverse experiences encountered while receiving care

The participants described having good experiences while receiving care, irrespective of challenges that may have occurred such as language barriers. Most of the terms used in describing participant's experiences were “positive”, “overall good”, “good”, “I have no complaints”.

“It is positive, but then can be improved because of language barrier or cultural barrier, if that is removed then it can be the most perfect one. Yes, my experience is positive, some of the thing which I feel I should get used to it then is going to be fine for me, I mean it is not a complain, what I feel actually. So, if slowly I get used to that culture over here, then it is not going to be problem anymore” (P13).

6 Discussion

The result section presented the findings from the data analysis process. This section focuses on the meaning and applicability of these findings. The discussion is presented based on answers to the research questions. New information generated from this work is also presented.