Looking through racism in the nurse–patient relationship from the lens of culturally congruent care: A scoping review

Abstract

Aim: This review aimed to identify the nature of racism in the nurse-patient relationship and summarize international research findings about it.Design: A scoping review of the international literature. Data sources: The search process encompassed three main online databases of PubMed (including MEDLINE), Scopus and Embase, from 2009 until 2021. Review methods: The scoping review was informed by the Levac et al.'s framework to map the research phenomenon and summarize current empirical research findings.Also, the review findings were reflected in the three-dimensional puzzle model of culturally congruent care in the discussion section. Results:The search process led to retrieving 149 articles, of which 10 studies were entered into data analysis and reporting results. They had variations in the research methodology and the context of the nurse-patient relationship. The thematical analysis of the studies' findings led to the development of three categories as follows: bilateral ignition of racism, hidden and manifest consequences of racism and encountering strategies. Conclusion:Racism threatens patients' and nurses' dignity in the healthcare system.There is a need to develop a framework of action based on the principles of culturally congruent care to eradicate racism from the nurse-patient relationship in the globalized context of healthcare.Impact: Racism in the nurse-patient relationship has remained a relatively unexplored area of the nursing literature. It hinders efforts to meet patients' and families' needs and increases their dissatisfaction with nursing care. Also, racism from patients towards nurses causes emotional trauma and enhances job-related stress among nurses. Further research should be conducted on this culturally variant phenomenon. Also, the participation of patients and nurses should be sought to prohibit racism in healthcare settings.

Self-Assessment of Health Professionals’ Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care

“…Regarding the question about the recognition of the participants’ lack of knowledge and their positive intention to learn more, the results point in the direction of other recent studies that come to similar results [ 17 , 18 , 19 ]. The answers given about the willingness of the participants to listen before asking questions or about the fact that individual differences are an important part of people’s identities were satisfactory.…”

“…The questions about recognizing the fact that there can be cultural differences over time were also satisfactory. However, their knowledge of history was largely incomplete among all specialties within the sample, something which is not mentioned in other recent studies about racism in health care [ 18 ].…”

“…An awareness that stereotypical attitudes and discriminatory actions can dehumanize and even encourage violence against individuals because of their membership in groups that are different from themselves was reported as high by the majority of the participants. Aligned to the previous satisfactory high percentages is the response that participants know their family’s story of immigration and assimilation into Cyprus and they continue to develop their capacity for assessing areas where there are gaps [ 17 , 18 , 20 ].…”

Fostering Race-Based Conversations in Nursing

“…In a 2022 review that evaluated the impact of racism on the nurse-patient relationship, a thematic analysis of the findings led to the development of three categories: bilateral ignition of racism, hidden and manifest consequences of racism, and encountering strategies. 2 Bilateral ignition of racism is when both patients and nurses hold racist beliefs and stereotypes that influence their behaviors and negatively impact their interactions. Racism perpetuated by nurses is often rooted in implicit bias and stereotypical attitudes toward patients of color or those with limited language skills, substance dependencies, or mental illness.…”

“…The National Commission to Address Racism in Nursing defines racism as “assaults on the human spirit in the form of actions, biases, prejudices, and an ideology of superiority based on race that persistently causes moral suffering and physical harm of individuals and perpetuates systemic injustices and inequities.”1 Those who experience racism and discrimination are often patients with poor access to health care, who have poor health care outcomes, and who suffer from mental health issues. In a 2022 review that evaluated the impact of racism on the nurse–patient relationship, a thematic analysis of the findings led to the development of three categories: bilateral ignition of racism, hidden and manifest consequences of racism, and encountering strategies 2…”