Older South Asian patient and carer perceptions of culturally sensitive care in a community hospital setting

Abstract

This study describes the application of grounded theory to establish older, south Asian patient and carer views of service delivery in the UK. The purpose of the study was to inform the development of culturally sensitive services by defining the concept of cultural sensitivity from a user/carer perspective. The study took place in two community hospitals providing nurse-led intermediate care to a culturally diverse inner city population. Fifty-five per cent of the inner city population is of south Asian origin. Admissions to intermediate care, however, do not reflect the demography. Recent reports commissioned by the Department of Health highlight the failure of the National Health Service in England to provide culturally sensitive services to black and Asian patients. The Department of Health is trying to redress this inequality providing policy guidance for improving access and cultural sensitivity in the British health care system. There is little existing empirical evidence, however, to clarify the concept of culturally sensitive care. Patients and carers in this study described culturally appropriate care as that which respects individuality, creates mutual understanding, caters for spiritual need and maintains dignity. Older south Asian patients and their carers identified respect, understanding, spirituality and dignity as central to their conceptualization of cultural sensitivity. Their focus was on the nature of human relationships and their ability to interact in a positive way with staff. The findings of this small piece of empirical research are limited by the sample size (four patients and three carers), but illustrate that cultural sensitivity, although complex, can be defined. This then provides a basis for developing appropriate care strategies. One universal principle explicit in this research was that to be sensitive to culture staff must challenge their own assumptions and develop an understanding of the many layers of culture and subculture with which they are dealing. The starting point for any service is to understand the expectations of its users and to seek out and manage areas of conflict between organizational values and individuals' cultural requirements.

Experiences of health and care when growing old in Norway - From the perspective of elderly immigrants with minority ethnic backgrounds

“…Cultural diversities in relation to language, religion, dietary preferences, family structures, and beliefs related to health and care have impact on care-giving situations [5,6] .There have been several studies carried out from the caregivers' perspective which show that language obstacles are perceived as the main barrier to the contact between older immigrants and the health-care system. Nurses have described that many later-in-life immigrants only speak the language of their native country, though despite this, professional interpreters are seldom used in the care of older foreign-born patients [7,8] .…”

Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare

“…Using a grounded theory approach, the third paper identified evaluated the perceptions of four patients and three relatives to culturally sensitive care were examined 38 . Although the study was limited in sample size the results indicated that patient and relatives viewed culturally sensitive care as a practice that respects individuality, maintains dignity and cares of the spiritual needs of the diverse groups.…”

Expériences des immigrantes d’Asie du Sud en matière de respect dans les milieux de traitement du cancer

“…L'étude de Browne (1995) auprès d'une population autochtone vient confirmer les résultats selon lesquels un rapport entre les attitudes et le comportement des prestataires de soins envers les femmes autochtones et l'incidence d'interactions cliniques respectueuses créaient des sentiments d'égalité et de dignité. Clegg (2003) a signalé que le concept de respect pour un individu était influencé en termes globaux par des interprétations politiques, sociales, économiques et religieuses.…”

“…Quoique la plupart des femmes originaires du Canada sont confrontées aux divers défis associés au cancer, ces défis prennent habituellement une ampleur accrue chez les immigrantes qui font peut-être face à des enjeux de migration et d'établissement, notamment aux défis associés au maintien de leurs propres croyances et pratiques tout en apprenant de nouvelles façons de se donner une vie stable dans leur nouveau pays (Gupta, Kumar & Stewart, 2002; Hilton et coll., 2001). Par exemple, les immigrantes doivent composer non seulement avec le diagnostic de cancer mais encore avec des enjeux liés à leur établissement au Canada tels que le fait d'avoir laissé leur famille étendue dans leur pays d'origine ou de prendre soin de membres de la famille et de s'adapter à la vie au Canada (Hilton et coll., 2001;Clegg, 2003;Singh, 2002).…”

“…Quoique la plupart des femmes originaires du Canada sont confrontées aux divers défis associés au cancer, ces défis prennent habituellement une ampleur accrue chez les immigrantes qui font peut-être face à des enjeux de migration et d'établissement, notamment aux défis associés au maintien de leurs propres croyances et pratiques tout en apprenant de nouvelles façons de se donner une vie stable dans leur nouveau pays (Gupta, Kumar & Stewart, 2002; Hilton et coll., 2001). Par exemple, les immigrantes doivent composer non seulement avec le diagnostic de cancer mais encore avec des enjeux liés à leur établissement au Canada tels que le fait d'avoir laissé leur famille étendue dans leur pays d'origine ou de prendre soin de membres de la famille et de s'adapter à la vie au Canada (Hilton et coll., 2001;Clegg, 2003;Singh, 2002).Les disciplines du domaine de la santé comme les soins infirmiers, la médecine, le travail social et les professions liées au conseil font toutes du respect un principe éthique central qui oriente la pratique clinique (Beauchamp & Childress, 1994;Morris, 1997). Bien que le fondement, les principes et valeurs des soins infirmiers comme l'autonomie, la dignité et l'intégrité reposent tous sur le concept de respect (Klutgen, 1995; Widäng, Fridlund & Mårtensson, 2007), ces concepts sont utilisés à titre de synonymes de respect dans la litté-rature afin d'expliquer la dimension éthique du respect (Peters, 1961;Rokeach, 1979).…”