What do non-English-speaking patients value in acute care? Cultural competency from the patient's perspective: a qualitative study.
OBJECTIVE
The purpose of this research was to locate cultural competence within the experiential domain of the non-English-speaking patient.


METHODS
Seven language-specific focus groups were held with 59 hospital patients and carers of patients with limited English to better understand their experience and to identify critical factors leading to their constructions of care. Grounded theory analysis within a constructivist perspective was undertaken.


RESULTS
While the majority of patients were positive about their hospital experience, the theme of powerlessness appeared central to many patient experiences. Language facilitation was the most common issue. Inattention to specific cultural mores and racism in some instances contributed to negative experiences. Patients primarily valued positive engagement, information and involvement, compassionate, kind and respectful treatment, and the negotiated involvement of their family.


CONCLUSIONS
Because of the specific nature of each patient-provider interaction within its particular social and political environment, culturally competent behaviour in one context may be culturally incompetent in another. We propose a model of cultural empowerment that reflects the phenomenological basis of cultural competence in that cultural competence must be consistently renegotiated with any particular patient in a particular healthcare context. Similarly, ongoing community consultations are needed for health services and organisations to retain cultural competence.
Simpson Centre for Health Services Research, Liverpool Health Service, University of NSW, Sydney, Australia. Pam.Garrett@sswahs.nsw.gov.au
Pamela Wish
PW
Garrett
Hugh Grant
HG
Dickson
Anna Klinken
AK
Whelan
Roberto-Forero
D000208:Acute Disease; D002983:Clinical Competence; D003142:Communication; D003258:Consumer Behavior; D054521:Cultural Competency; D018864:Cultural Diversity; D003469:Culture; D017144:Focus Groups; D006801:Humans; D007802:Language; D008962:Models, Theoretical; D005791:Patient Care; D017060:Patient Satisfaction; D010865:Pilot Projects; D036301:Qualitative Research