Killien, MarciaNarruhn, Robin Ann2015-05-112015-05-112015Narruhn_washington_0250E_14165.pdfhttp://hdl.handle.net/1773/33220Thesis (Ph.D.)--University of Washington, 2015The purpose of this study was to identify the policies, values and practices in a major medical center regarding the Patient and Family Centered and Culturally Safe reproductive care for women from Somalia. The aims were to identify the policies, values and practices as well as limitations and recommendations that informed care from the perspective of administrators. The design was a single case study. Data sources were interviews and institutional documents. Content analysis and Atlas.ti were used to analyze the data. The major findings were that while Patient and Family Centered Care were endorsed and valued by the institution it did not sufficiently assist health care providers in navigating a conflicted multicultural clinical encounter. Limitations included lack of early engagement and specific policy to guide providers in this specific scenario, a gap in policy regarding the cultural care of individuals and communities, the emergent nature of the scenario, assumptions and dominance of the biomedical culture. Recommendations included pragmatic strategies to manage the emergent nature of this scenario and paradigm changing recommendations. The culture of biomedicine was acknowledged as having influence on this clinical scenario. Conflicting cultural values may contribute to emotional and moral distress in health care providers. Health care providers may be better able to navigate this complex encounter if there are specific policies, practices and trainings designed to assist them.application/pdfen-USCopyright is held by the individual authors.Childbirth; Cultural Safety; Ethics; Global Health; Patient and Family Centered Care; SomaliNursingObstetrics and gynecologyHealth care managementnursing - seattleThesis