How do ethnic minority patients experience the intercultural care encounter in hospitals? A systematic review of qualitative research

Abstract

BackgroundIn our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients.MethodsA systematic search was conducted for papers published between 2000 and 2015. Analysis and synthesis were guided by the critical interpretive synthesis approach.ResultsFifty one articles were included. Four dimensions emerged, describing the intercultural care encounter as (1) a meeting of two different cultural contexts of care, (2) in a dynamic and circular process of (3) balancing between the two cultural contexts, which is (4) influenced by mediators as concepts of being human, communication, family members and the hospital’s organizational culture.ConclusionsThis review provides in-depth insight in the dynamic process of establishing intercultural care relationships in the hospital. We call for a broader perspective towards cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way.Electronic supplementary materialThe online version of this article (doi:10.1186/s12910-016-0163-8) contains supplementary material, which is available to authorized users.

Comparison of short- and mid-term outcomes of Italian- and German-speaking patients after an interdisciplinary pain management programme in Switzerland: A prospective cohort study

“…In addition to language barriers, cultural barriers have been shown to have a negative impact on the recovery process (35): "Cultural differences may result in diverging and conflicting representations of health, illness and therapy, and this may hinder the healing process or even cause its failure". Four mediating factors in intercultural care have been identified to facilitate or hinder the care relationship and, by that, the rehabilitation process: (i) humanity in care, (ii) communication, (iii) the role of the family, and (iv) the hospital's organizational culture (40). Adapting the therapy content in combination with specific intercultural competence training of all involved medical personal might enhance the treatment effect in the IPMP by implementing a comprehensive "cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way" (40).…”

“…Four mediating factors in intercultural care have been identified to facilitate or hinder the care relationship and, by that, the rehabilitation process: (i) humanity in care, (ii) communication, (iii) the role of the family, and (iv) the hospital's organizational culture (40). Adapting the therapy content in combination with specific intercultural competence training of all involved medical personal might enhance the treatment effect in the IPMP by implementing a comprehensive "cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way" (40).…”

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

“…However, in United States, it has been found that when HPs delivered services to ethnically and culturally diverse patients, they lacked adequate understanding of the patients' needs and were uncomfortable in playing the role of healthcare provider (Leininger, ). Moreover, HPs may face challenges in establishing therapeutic relationships with culturally diverse patients, resulting in reduced sharing of health information and limited patient participation in the medical decision‐making process (Almutairi, Dahinten, & Rodney, ; Casillas et al, ; Degrie, Gastmans, Mahieu, Casterl, & Denier, ). Such high levels of uncertainty and doubt when crossing cultural boundaries have been found to result in stress and anxiety among HPs (Markey, Tilki, & Taylor, ).…”

“…Levesque, Harris and Russell () conceptualise five dimensions of accessibility: approachability, acceptability, availability & accommodation, affordability and appropriateness. When both the healthcare provider and the patient come from different cultural background, the care process is known as intercultural care (Degrie et al, ). Culture is created by people involving ideas, beliefs, values, assumptions and behaviours about health and life, which can be uphold across generations (Ulrey & Amason, ).…”

“…Moreover, the patient's involvement in the treatment and decision‐making process may be restricted. As a result, the therapeutic relationship between the patient and healthcare provider, which is a fundamental part of the treatment process, cannot be established, leading to adverse impacts on the patient's health outcomes (Degrie et al, ; Van Osch, van Dulmen, van Vliet, & Bensing, ).…”