Swedish experts' understanding of active aging from a culturally sensitive perspective – a Delphi study of organizational implementation thresholds and ways of development

Abstract

BackgroundInternational migration and aging populations make for important trends, challenging elderly care regimes in an increasingly globalized world. The situation calls for new ways of merging active aging strategy and cultural sensitivity. This study aim to illuminate the gap between cultural sensitivity and active aging to identify perceived thresholds by Swedish municipal officials in the understanding of older late-in-life-immigrants situation.MethodsDelphi methodology in three rounds. Twenty-three persons in municipal decision-making positions participated and generated 71 statements, of which 33 statements found consensus.ResultsThe 33 statements show that the decision makers prefer not to use cultural sensitivity as a concept in their work, but rather tailor interventions based on individual preferences that may or may not be present in a certain culture. However, as the complexity of care increases, emphasis drifts away from personal preferences toward text-book knowledge on cultures and activity.

Culturally sensitive active ageing seen through the lens of the welfare theory of health: assistant nurses’ views

“…On the other hand, when the VLGs are hard to achieve, as with the vignettes of Rima and Hannah, the professionals focus on fixed factors rather than personal preferences to understand the VLGs. These results align with Johansson et al’s (2022) study where professionals in decision-making positions described a wish to base decisions on individual preferences, but began focusing on fixed cultural factors as the older adults’ needs became more complex. Thus, it is argued that cultural sensitivity supported by the WTH is a viable path forward to balance between the othering risk (see Torres, 2006 ) and individual preferences (see Johansson et al, 2021 ).…”

The Culturally Competent Healthcare Professional: The RESPECT Competencies from a Systematic Review of Delphi Studies

“…Experts clarified the content of the knowledge that healthcare professionals should have to work effectively with diverse populations. The most dominant content related to social determinants of health, social and cultural factors influencing health, and knowledge of the various cultures [16,17,[28][29][30][31][32][33][34][35][36][37]. Other studies highlighted the importance of having knowledge of more aspects.…”

“…They also need to develop the competency to critically self-reflect. Apart from general self-reflection [16,26], this competency involved reflection on own beliefs and ideas [16,32], biases, prejudice, stereotypes [17,32,33], practices, behaviours, habits, and contexts [17]. While self-reflection has been identified as a necessary competency for healthcare professionals, it was Hordijk et al's [16] study that found that critical reflection on one's own beliefs was the behaviour that achieved the highest score of consensus among experts.…”

“…Other relevant competencies were politeness [17], communicating sensitively [30,37], ensuring trust [37], participating in or seeing the practices of other cultures [27,28,31,36], accepting gender and sexual diversity [18], ensuring equality and justice, and promoting health literacy [33]. Furthermore, Chae et al [30] presented experts' opinions about the importance of exploring and valuing the patients' ideas, while Johansson et al [32], Ziegler, Michaëlis, and Sørensen [17], and Deardorff [27] talked about active listening, and Forkhzadian et al [33], Jirwe et al [29], and Deardorff [27] talked about the importance of being curious and asking questions. Experts in Deardorff's [27] study agreed on the importance of openness in regard to to learning from other cultures.…”

“…In addition, the experts thought that healthcare professionals should work with patients to understand any religious impacts on the expression of symptoms. Johansson et al [32] also presented more competencies, such as making information accessible to all patients, creating opportunities for support and active ageing, providing individually adjusted care, enabling active ageing for older people, and working with relatives for the benefit of the patient. Hart et al [34] presented the agreed competencies of obtaining consent and collaboration with the patient, taking into account the cultural context while providing care to patients, and establishing support mechanisms for the patient.…”