title: Culture and language differences as a barrier to provision of quality care by the health workforce in Saudi Arabia.
abstract: OBJECTIVE
  To identify, synthesize, and summarize issues and challenges related to the culture and language differences of the health workforce in Saudi Arabia.
  
  
  METHODS
  A comprehensive systematic review was conducted in May 2014 to locate published articles. Two independent researchers in consultation with several experts used 4 electronic databases (ISI Web of Knowledge, Science Direct, PubMed, and Cochrane) to scrutinize articles published from January 2000 - March 2014. Each of the studies was given a quality assessment rating of weak, moderate, or strong, and was evaluated for methodological soundness using Russell and Gregory's criteria.
  
  
  RESULTS
  The online literature search identified 12 studies that met the inclusion criteria. Lack of knowledge of non-Muslim nurses or culture in Saudi Arabia, difficulties in achieving cultural competence, and culture shock were documented as cultural difference factors. Issues in language difference include the clarity of language use by health care providers in giving information and providing adequate explanation regarding their activities.
  
  
  CONCLUSIONS
  The available information provided by this review study shows that there is a communication barrier between patients and health care workers such as healthcare workers demonstrate low cultural competency. Despite the fact that the government provides programs for expatriate healthcare workers, there is a need to further improve educational and orientation programs regarding the culture and language in Saudi Arabia.
authors.affiliation: Department of Community Health Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. assem21@hotmail.com.
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Almutairi
mesh_terms: D003144:Communication Barriers; D054521:Cultural Competency; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007514:Islam; D007802:Language; D009726:Nurses / Q000523:psychology; D011787:Quality of Health Care; D012529:Saudi Arabia
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