Health professional perspectives on translation of cultural safety concepts into practice: A scoping study

Abstract

People from unique and diverse populations, (i.e., social groupings excluded by the dominant majority by, for example, ethnicity, gender, age, sexual orientation, disability or even rurality), experience dissimilar health outcomes. Members of such populations who have long-term health conditions experience further health disparities through inefficient management and treatment. This remains a significant hindrance to achieving equity in health outcomes. Being responsive and acting upon the cultural needs of unique and diverse populations within health services is pivotal in addressing health disparities. Despite provision of professional training to health professionals, cultural competency remains an elusive goal. This scoping study summarized available literature about what helped health professionals translate cultural safety concepts into practice. We searched electronic databases using MeSH terms and keywords for English language articles and reference lists of potentially included studies. Quality appraisal was undertaken using Joanna Briggs Institute critical appraisal tools. Data were charted, with a descriptive numerical summary and thematic analysis of study findings undertaken. Twelve qualitative studies with n = 206 participants were included. Learning through and from direct experience, and the individual qualities of professionals (i.e., individual capacity for relational skills and intentionality of engagement with one's own values and biases) facilitated translation of cultural safety concepts into practice. Also important was the need for cultural training interventions to address both issues of content and process within course design. Doing this would take into consideration the benefits that can come from learning as a part of a collective. In each of these themes was evidence of how health professionals needed the ability to manage emotional discomfort as part of the process of learning. A dearth of information exists exploring professionals' perspectives on translating cultural safety concepts into practice. There may be merit in designing educational interventions that look beyond the classroom. We also suggest that nurturing people's relational skills likely holds benefits to growing culturally safe practice as does increasing health professional's capacity to sit with the discomfort that occurs when paying attention to one's own and others values and biases.

Disabled People or Their Support Persons’ Perceptions of a Community Based Multi-Sensory Environment (MSE): A Mixed-Method Study

“…Creating a space that is welcoming for all and that is considered culturally safe by Indigenous peoples (in NZ, that is Māori) is suggested to assist in addressing health disparities [45]. In this study, the MSE space was identified as unwelcoming for Māori users and potentially others who struggled with the booking and payment systems, as well as accessing the room itself.…”

Undergraduate physiotherapy students’ perspectives on optimising the curriculum for supported self-management education

“…Why far less Māori, and no Pacific Island, students participated in our study is not known. However, one reason could be that self-management of health is of itself a cultural artefact, largely driven by white Western, neoliberal philosophies (Wilson et al, 2022), and for many cultural groups that value collectivism, such as Māori and Pacific Island cultures, "self"-management may be incongruent with their ways of being. This concept suggests that culture not only possibly impacts on how we teach SSM but that the concept in itself needs further in-depth exploration and understanding in a country such as New Zealand.…”

Supported self-management in long-term conditions in an African context

“…Many would contend that the philosophy of focusing on the ‘self’ is problematic in and of itself (Ould Brahim 2019 ). Wilson, Wilkinson and Tikao ( 2022 ) argue that:…”

“…Conversely, with collectivism, where the groups people belong to, such as family and community, are highly valued, the ‘self’ becomes less prominent (Realo 2003 ) and thereby incongruent with the concept of ‘self-management’ of health. Such debates are evolving in nations where the ideologies of collectivism stand out (Basurrah, Al-Haj Baddar & Di Blasi 2022 ; Wilson et al 2022 ). So, what of the African viewpoint?…”