Challenges of healthcare professionals in providing care to South Asian ethnic minority patients in Hong Kong: A qualitative study

Abstract

Ethnic minorities across the globe encounter disparities in healthcare. While a great deal of research has been conducted on the experiences of these patients, studies focusing on the perspectives of healthcare professionals are limited, particularly in the context of Asia. This study explores the perceptions of and challenges faced by Hong Kong healthcare professionals in the provision of culturally appropriate care to South Asian ethnic minority patients. Taking a qualitative approach, interviews were conducted with 22 healthcare professionals. Two main themes were identified: ‘lack of support’ at the healthcare system level and ‘dysfunctional relationship with South Asian ethnic minority patients’ at the interpersonal level. Challenges at the healthcare system level include information outreach, cultural competency, utilisation of available resources and time and workload, whereas challenges at the interpersonal level include patient–provider interaction, patient–provider perceptions of illness and care and patient–provider sociocultural discordance. Intercultural care was found to be influenced by both the healthcare system and interpersonal characteristics. The study highlights the need for healthcare professional education and training in cultural competency, in order to improve the provision of intercultural care. Identifying the challenges faced by healthcare professionals and the implications of these challenges for the provision of healthcare to South Asian ethnic minority patients will help practitioners, policy makers and care provider agencies to improve quality of care and health outcomes for culturally diverse patients.

The perspectives of health professionals and patients on racism in healthcare: A qualitative systematic review

“…The age of participants ranged from 24 to 89 years old. The included studies were conducted in 6 different countries: 15 in the United States [ 8 , 26 – 39 ], 3 in the United Kingdom [ 40 – 42 ], 2 in Australia [ 43 , 44 ], 1 in Canada [ 45 ], Spain [ 46 ] and Hong Kong [ 47 ] respectively. 11 studies reported findings from the African American community, 2 each from the Pakistani, Indigenous Australian and South Asian communities and 1 each from the African Caribbean, Latin American, Native American, Roma and Iranian communities.…”

“…Minority patients reported that healthcare providers ignored or rushed them during their clinical interactions [ 32 , 40 , 41 , 44 , 47 ]. Some patients further stated that they received less priority and were unfairly skipped over by patients of perceived privileged races [ 29 , 31 , 32 , 34 , 38 ].…”

“…Healthcare providers professed that they were less empathetic towards minority patients [ 27 , 33 , 35 ], even losing their temper more easily [ 47 ], because they were less able to connect to patients of a different race [ 27 ]. This is further exacerbated by the time constraint these providers face [ 33 , 35 ], pressuring them to limit their interactions with minority patients unintentionally [ 27 ].…”

“…They acknowledged their failure to understand the differing needs of minority patients to administer individualized care [ 8 , 35 , 36 , 40 ]. Instances of overt racism were also reported by providers who observed that racial minorities were sometimes referred to using racially derogatory labels [ 47 ]. These discriminatory healthcare encounters can perpetuate racial fault lines which are currently unobvious problems that can eventually result in further tension and conflicts between the minority and majority population.…”

“…Providers should strive to avoid labelling of patients as it has been reported that they often overapply such population statistics to individual patients [ 51 ], even if the stereotypes were grounded on epidemiology. Additionally, minority patients perceived less empathy from healthcare providers [ 31 , 32 , 34 , 37 , 46 ], which corresponded to providers’ perspective on the differential treatment of minority patients [ 8 , 27 , 33 , 35 , 36 , 40 , 42 , 47 ]. These two themes have a causal relation where providers were less able to put themselves in the shoes of minority patients to vicariously experience their circumstances, resulting in them being less able to connect to minority patients and express empathy towards them.…”