A qualitative study of cancer care professionals’ experiences of working with migrant patients from diverse cultural backgrounds

Abstract

ObjectivesTo improve the experiences of people from diverse cultural backgrounds, there has been an increased emphasis on strengthening cultural awareness and competence in healthcare contexts. The aim of this focus-group based study was to explore how professionals in cancer care experience their encounters with migrant cancer patients with a focus on how they work with cultural diversity in their everyday practice, and the personal, interpersonal and institutional dimensions therein.DesignThis paper draws on qualitative data from eight focus groups held in three local health districts in major metropolitan areas of Australia. Participants were health professionals (n=57) working with migrants in cancer care, including multicultural community workers, allied health workers, doctors and nurses. Focus group discussions were audio recorded and transcribed in full. Data were analysed using the framework approach and supported by NVivo V.11 qualitative data analysis software.ResultsFour findings were derived from the analysis: (1) culture as merely one aspect of complex personhood; (2) managing culture at the intersection of institutional, professional and personal values; (3) balancing professional values with patient values and beliefs, and building trust and respect; and (4) the importance of time and everyday relations for generating understanding and intimacy, and for achieving culturally competent care.ConclusionsThe findings reveal: how culture is often misconstrued as manageable in isolation; the importance of a renewed emphasis on culture as interpersonalandinstitutional in character; and the importance of prioritising the development of quality relationships requiring additional time and resource investments in migrant patients for enacting effective intercultural care.

‘Can you please hold my hand too, not only my breast?’ The experiences of Muslim women from Turkish and Moroccan descent giving birth in maternity wards in Belgium

“…Nevertheless, our results did show that the cultural context of the women is an essential meaning system that is part of the relational care process, which adds another layer of emotional, moral or symbolic meaning to the interactions between the women and their caregivers as well as to the women’s expectations and interpretations of care. Similar findings regarding this role of culture as an additional layer to the interpersonal negotiation of care between caregivers and patients has been discussed by Broom et al [ 59 ]…”

“…As such, our results confirm the findings of recent international research that discusses the necessity of shifting away from an individualized conceptualization of culture in healthcare. [ 59 , 60 , 61 ]…”

“…Here, the findings add more insight into the importance of a shifting perspective on ‘culture’ from being an ‘individual culture-in-isolation’ towards a notion of culture as being inter-relational and emerging from within the various care interactions with caregivers. [ 59 , 60 , 61 ]…”

The (Co)Production of Difference in the Care of Patients With Cancer From Migrant Backgrounds

“…Of course, this focus on the individual migrant is not without its benefits. For example, such research has highlighted the real need to offer more time and targeted resources to those in greater need (Suphanchaimat, 2015), as well as opportunities to develop culturally competent care strategies (Broom et al, 2013; Broom, Parker, et al, 2019; Pongthavornkamol et al, 2012; van Eechoud et al, 2016). Yet, such paradigms of implicit or explicit patient vulnerability—which can be derived from the premise of migrant-as-different—are somewhat limited in their capacity to capture what occurs via the relational “sense of difference” and its immediate and perhaps more opaque consequences.…”

Nurse Cultural Competence-cultural adaptation and validation of the Polish version of the Nurse Cultural Competence Scale and preliminary research results

“…Together with this influx of foreigners, new challenges arrive in providing healthcare: in communication, acceptance of cultural differences, and a disproportion in healthcare knowledge among migrants. There are a number of problems related to providing adapted and culturally diverse care by healthcare professionals [ 3 , 4 ].…”