Mental well-being of patients from ethnic minority groups during critical care: a qualitative ethnographic study

Abstract

ObjectivesTo investigate the state of the mental well-being of patients from ethnic minority groups and possible related risk factors for the development of mental health problems among these patients during critical medical situations in hospital.DesignQualitative ethnographic design.SettingOneintensive care unit (ICU) of a multiethnic urban hospital in Belgium.Participants84 ICU staff members, 10 patients from ethnic-minority groups and their visiting family members.ResultsPatients had several human basic needs for which they could not sufficiently turn to anybody, neither to their healthcare professionals, nor to their relatives nor to other patients. These needs included the need for social contact, the need to increase comfort and alleviate pain, the need to express desperation and participate in end-of-life decision making. Three interrelated risk factors for the development of mental health problems among the patients included were identified: First, healthcare professionals’ mainly biomedical care approach (eg, focus on curing the patient, limited psychosocial support), second, the ICU context (eg, time pressure, uncertainty, regulatory frameworks) and third, patients’ different ethnocultural background (eg, religious and phenotypical differences).ConclusionsThe mental state of patients from ethnic minority groups during critical care is characterised by extreme emotional loneliness. It is important that staff should identify and meet patients’ unique basic needs in good time with regard to their mental well-being, taking into account important threats related to their own mainly biomedical approach to care, the ICU’s structural context as well as the patients’ different ethnocultural background.

Preventing Conflicts Between Nurses and Families of a Multi-ethnic Patient Population During Critical Medical Situations in a Hospital

“…The strategies are predominantly based on the results of an ethnographic fieldwork study in an ICU of a multi-ethnic urban hospital in Belgium (Van Keer et al, 2015;Van Keer et al, 2017) and on additional research on communication during critical care and in multi-ethnic health care settings. These studies were found in the electronic database PubMed.…”

“…This information should also include the hospitals' most important regulations, multicultural health care services and advanced care planning. Information can be provided both within the hospital, for example by nurses and intercultural mediators, and outside the hospital, by general practitioners or migrant organizations (Van Keer et al, 2015;Van Keer et al, 2017).…”

“…have a negative impact on the quality of health care provision and can provoke ethnocultural polarization in society (Van Keer, Deschepper, Huyghens, & Bilsen, 2017;Van Keer et al, 2015).…”

Cultural alienation: A concept analysis

“…The presence of bilingual nurses also decreases the burden on clients' relatives, ensures that information is more accurately exchanged, and increases trust between staffers and families 37 . There are more possibilities for culturally centered nursing care when providing information to ethnic minority groups both within and outside the hospital regarding multicultural health care services, care planning, and mental well‐being 38 . Nurses should tailor communication skills at the patient or family's level and give them a safe space to think about decisions for themselves.…”

Relational Spirituality and Transgenerational Obligations: The Role of Family in Lay Explanatory Models of Post-traumatic Stress Disorder in Male Cameroonian Asylum Seekers and Undocumented Migrants in Europe

“…Contacting the participants required anthropological work by the first author FG. Purposive sampling was utilized in order to approach participants during ethnographic fieldwork in suburban areas of Paris and urban areas of Southern Germany, where asylum seekers are commonly located in accommodation facilities (59)(60)(61). This gave the researcher the opportunity to immerse herself into her study field (60).…”