Multicultural encounters in health care

This research project concentrates on multicultural general practice consultations, in which either the physician or the patient is an immigrant. The aims of our study are twofold. First, we aim to provide detailed information about the challenges caused by different cultural and linguistic backgrounds in the doctor–patient interaction. Second, we will examine how the participants manage these problems and how they contribute to shared understanding.

Methodologically, the study is based on conversation analysis. The data consists of 35 video recorded general practice consultations. The data was gathered in three community health centers in Turku in October 2012. The material is transcribed according to the conventions of conversation analysis.

The challenges in the multicultural encounters are not caused solely by linguistic difficulties. Ethnicity, gender and the institutional context, inter alia, can also be significant. Ethnomethodologically put: people interpret the meanings of situations through their cultural competence. For instance, it is common that refugees have encountered traumatic experiences such as torture, and these experiences can affect the orientation towards general practice.

All patients have a considerable need to be heard and understood. Problems caused by different cultural expectations and linguistic difficulties can lead to incorrect diagnoses or cause the patient to question the care instructions given by the physician. Since the number of immigrants in Finland is annually increasing, it is vital to improve multicultural interaction. The results of our research create new knowledge both for the healthcare personnel and for the education of the doctors and nurses with immigrant background. The results can also benefit the development of customer-oriented, cost-effective services, which take patient safety into account. (Funded by University of Turku Graduate School - UTUGS).



MD, PhD Marja-Liisa Honkasalo
University of Turku​

MA Jenny Paananen

University of Turku

MD Maisa Kuusela
City of Turku

MD Valentina Oroza
Turku Immigrant Services