title: Health care providers' perspectives of providing culturally competent care in the NICU.
abstract: OBJECTIVE
  To examine the experiences and perceptions of health care providers caring for new immigrant families in the neonatal intensive care unit (NICU).
  
  
  METHODS
  Qualitative design using grounded theory methodology.
  
  
  METHODS
  Two tertiary-level NICUs of two large metropolitan hospitals in western Canada.
  
  
  METHODS
  Fifty eight (58) health care providers from multiple disciplines.
  
  
  METHODS
  Health care providers were interviewed during seven focus groups. We recorded and transcribed focus group data. We analyzed transcripts via line-by-line coding, categorization of codes, concept saturation, and theme generation assisted through NVIVO software.
  
  
  RESULTS
  Health care providers identified the nuanced construct of fragile interactions that is embedded within care of the new immigrant family in the NICU. During crisis, decision making, differing norms and beliefs, and language and communication are barriers that affected the fragile nature of interactions. During transition home, fragile interactions were affected by unintentional stereotyping, limited time for intangible activities, and lack of intuitive perceptions of the needs of new immigrant families. Health care providers employed caring and culturally competent strategies to overcome the fragile nature of interactions.
  
  
  CONCLUSIONS
  Within the premise of providing family-centered care is the concept of honoring cultural, ethnic, and socioeconomic diversity; it is imperative that culturally competent care be considered and implemented as a separate stand-alone aspect when caring for new immigrant families.
authors.forename: Leonora
authors.initials: L
authors.lastname: Hendson
authors.forename: Misty D
authors.initials: MD
authors.lastname: Reis
authors.forename: David B
authors.initials: DB
authors.lastname: Nicholas
mesh_terms: D003144:Communication Barriers; D054521:Cultural Competency; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D017283:Neonatal Nursing / Q000379:methods*; D009723:Nurse-Patient Relations; D018802:Patient-Centered Care; D011368:Professional-Family Relations; D036301:Qualitative Research
keywords: NICU; culture/cultural competence; grounded theory; health care professionals; immigrants/migrants; patient-provider; relationships