Article Author, year Country
Sample Main results
1 Suurmond et al.
Cultural competencies needed for working with asylum seekers:
- Knowledge
Knowledge of the political and humanitarian situation in countries of origin
Knowledge of epidemiology and the manifestation of diseases in asylum seekers’ countries of origin
Knowledge of effect of refugee hood on health - Attitudes
Awareness of the juridical context of the host country in which asylum seekers live
Awareness of how culture shapes individual behaviour and thinking
Awareness of one's own prejudices and tendency to stereotype - Skills
Ability to develop a trustful relationship with an asylum seeker Ability to ask delicate questions about traumatic events, personal problems
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Ability to explain what can be expected from health care (in order to develop a trustful relationship)
2 Festini et al.
Nurses working in a third-level regional Paediatric hospital in Italy
Nurses mainly used gestures or called a volunteer cultural mediator when facing communication difficulties
Positive factors:
Knowing at least one foreign language Negative factors:
Communication problems; language barrier Different nutrition and eating habits Different perception of personal hygiene Different attitude regarding painful procedures:
- foreign children have a higher pain tolerance - parents have a more tolerant attitude towards their
child’s pain)
Problems because of religious practices or habits
Difficulties when supporting foreign parents during their grief Different opinion about the role of the nurse :
- Foreign patients have a lower opinion about nurses than native patients
- Difficulties with Muslim men accepting female nurses) Feeling embarrassed or uncomfortable during care due to several reasons because of patients’:
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- Religious and worship habits - Eating habits
- View on personal hygiene
Feeling disapproval for the behaviours or habits of parents of foreign children because of differences in:
- Personal hygiene
- Eating habits a lack of respect towards nurses 3 Taylor & Alfred for the delivery of culturally
Nurses sometimes used colleagues, patients or interpreters to improve the communication with their patients.
Positive factors
Passion for culturally competent care Being open minded
Being sensitive to cultural differences Being aware of personal biases
Working effectively with family members
The availability of adequate, translated health education materials
Negative factors:
Communication difficulties:
- Not being able to communicate with patients - Lack of adequate interpreter services
- The wait for interpreters to arrive
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- Concerns about the accuracy of the interpretation Lack of knowledge of cultural differences
Lack of exposure to patients from different cultures Lack of tolerance of patients who do not speak English Differences in the perception of health and illness Differences in the perception of pain
Expectation of the role of the patient Gender preferences
Different practices related to dying
Lack of administrative support from the organization Lack of recognition of the need by management of the organization
General lack of support for culturally competent care from the organization
Lack of adequate training on culture 4 Degni et al.
Nurses understanding the history, culture, religion and changes in patients’ lives in the hosting country
Negative factors
Communication problems between patients and health care providers
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Different perception about male staff (female patients not wanting to be treated by male staff)
Husbands of female patients wanting to make the decisions for her
General lack of professional medical interpreters 5 Matteliano & health clinics in the USA
Positive factors
Having altruistic motivations Probing for root causes
Using a holistic approach to patient care Establishing partnerships with patients
Willingness to share personal information about themselves Willingness to learn important patient cultural practices Having patience
Formal training in cultural competence Negative factors
Lack of available written guidelines
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A feeling of one’s own inadequate cultural knowledge Language difficulties:
- Not having direct communication with children and parents
- Not knowing if healthcare advice is fully understood by the parents
To convey knowledge to parents concerning children’s health and development
Challenges related to interpreters:
- To be independent of the interpreter,
- A feeling of insecurity about the interpreters’ translations - The interpreters talk takes a lot of time from other tasks A feeling of being provoked that parents did not learn to speak Swedish despite many years of stay in the country
Having professional experience within the PCHC services for more than 20 years
Being responsible for more than 50% of children of foreign origin 7 Jones (2008)
Speaking Spanish to the patient Negative factors
Language barrier
60 hospital in the USA
- Concern about the accuracy of translation from sources other than the hospital translators
- Concern about the accuracy in translation over the phone Limited cultural knowledge staff in somatic and psychiatric
Difficulties related to different cultural behaviours:
- Difficulties in assessing the seriousness of illness because of the different behaviour
- Limited knowledge about behaviours related to different cultures
- Problems in treatment related to patients being passive - Difficulties in motivating cooperation in the treatment - Appear more emotional and loud
- Different behaviours related to cultural ceremonies Difficulties related to gender roles :
- Women are not allowed to act because of the husband - Same gender on caregiver and patient
Complicating organizational factors :
- Trouble in finding interpreters as the main problem - Migrants having limited knowledge about the Swedish
health care system
Communication barriers (language)
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Hierarchical view of health care staff 9 Pergert et al. Loss of information control Cultural and religious obstacles:
- Different views and practices of gender roles, - Different views on family roles
- Different views on health care staff roles - Odours/cooking smells
- Differences in emotional expressions (expression of grief or anger) which can lead to misunderstandings
- Truth-telling differences Social obstacles:
- Differences in social situation - Differences in identities - Differences in status - Racism and prejudice Organizational obstacles:
- Unadjusted policies and routines 10 Dogan et al.
(2009)
To describe the problems in
Qualitative study Turkish patients, German nurses and
Some nurses used spouses, children, relatives or friends to translate
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Education programme about different values and habits of foreign patients
Having empathy Having compassion Being sincere
Openness to different cultural values Being sensitive to foreign patients Negative factors
Poor communication because of language barriers
Patients having the feeling that their complaints or the health care staff’s suggestions were lost in translation
Difference of habits based on culture (eating, hygiene) Religious differences
Other patients were sometimes used as translators between the nurse and the patient
Positive factors
Training on how immigrants experience health and illness Negative factors
Lack of training in intercultural care resulting in a lack of skills in intercultural care
Language barrier
63 preventing
effective communication and care.
Prejudicing and stereotyping by nurses
12 Foley (2005) and to examine the cultural and and health centres in Philadelphia.
Negative factors Language barriers
Nurses often relied on children, friends or relatives to translate Difficulty finding translators for medical appointments
Difficulties with communicating effectively with patients who have little or no formal education and limited fluency in English or French
Patients being unfamiliar with biomedicine and the organization of the health care system
Lack of understanding in American medicine
Health care providers having little understanding of the
sociocultural context of HIV/AIDS in Africa, and how lack of ARV treatment and high mortality rates in their home countries shapes Africans’ attitudes to testing and treatment in the US.
Non-disclosure of patients with HIV
Health care providers having insufficient resources Health care providers lacking compassion for the African population (racism and discrimination)
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Immigrant patients lacking information about HIV