Ensuring access to the population they serve is central to the role of health authorities and trusts. Language and communication difficulties are among the most common barriers to access for black and minority ethnic people. The employment of bilingual workers in the health service has been one response to improving access for this section of the population. This review examines some of the available evidence of the effectiveness of such services and puts forward the case for their development within maternity services.
Purpose
There is a recognition in Europe and in the western world of a demographic shift in the ageing population. While the overall ageing of the general population is growing, the numbers of immigrants getting old in their host countries is also increasing, thereby increasing the racial and ethnic proportion of older people in these countries. This changing landscape calls for understanding of issues related to health care provision, policy and research regarding ethnic minorities. Communication is seen as a key factor in understanding the needs of ethnic minority elders (EMEs). The purpose of this paper is to explore health care workers’ (HCWs) perceptions and experiences of communication with EMEs. In this paper the term HCW includes qualified nurses and health care assistants.
Design/methodology/approach
A descriptive qualitative study design using semi-structured interviews was employed. Ten HCWs, who had ethnic minorities in their care were individually interviewed to explore their perceptions and experiences of communication when caring for EMEs.
Findings
Analysis of data revealed that in common with all older people, EMEs experience stereotyped attitudes and difficulties in communication. However, EMEs face particular challenges, including cultural differences, different language and stereotyping of care based on misunderstood needs of EMEs. Facilitators of communication included appropriate training of HCWs and appropriate use of interpreters.
Research limitations/implications
Only homes willing to take part in the study gave permission for their staff to be interviewed. In addition, the HCWs came from various settings. Therefore, views of staff in homes who did not give permission may not be represented.
Practical implications
The diversity of older people needing care in nursing homes and the community calls for training in culturally competent communication for effective provision care provision for EMEs.
Originality/value
Training of health care staff in culturally appropriate communication requires effective practice.
This paper gives the background to a research study which examined and evaluated current practice in relation to the promotion of race equality in the nurse education curriculum. The methodology is described, followed by reflection on the major themes generated. The study was carried out between 1991 and 1993 and had the following objectives: to identify the nature of the underlying philosophies and values which informed institutional approaches; the constraints operating on nurse teachers; the impact of the programmes on students; and the strategies needed to educate and support nurse teachers. Four main themes are discussed: the predominance of a culturalist approach to the subject of race equality; a theory/ practice dichotomy; the need for appropriate teacher preparation; the role and function of black and ethnic minority staff. The relevance of these themes for the future development of nurse education is then considered.
What is known on this subject. The role of managers in implementing equality and diversity policies in the workplace is well established.. There are several reports which show that nurses from minority ethnic backgrounds experience discrimination in the UK National Health Service (NHS).. Discriminatory behaviour can result in stress and loss of confidence in healthcare workers. What this paper adds. Managers observed that discrimination against black African nurses may exist in the UK NHS.. Although all black and minority ethnic (BME) staff are discriminated against with regard to promotion and professional development, this study has shown that black African nurses are at a particular disadvantage, as they suffer more discrimination.. There is a need to promote equality, diversity and inclusion training for managers in the NHS.
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