“Who are they? What does that mean for care?”: An exploratory descriptive study of clinicians’ experiences of caring for patients and family members from culturally diverse backgrounds

INTRODUCTION: Cultural diversity is a broad term used to encompass ethnic and racial diversity, multiculturalism, diverse languages, religions, practices, beliefs and identities of people. In ICU, people who are culturally diverse are at increased risk of marginalisation, sub-optimal care, higher morbidity and mortality. Ethnocultural biases and stereotypical assumptions can negatively influence ICU care. AIM: To explore the experiences of nurses, physicians and allied health professionals (clinicians) in caring for patients and their family members from culturally diverse backgrounds. METHODS: Ethical approval was granted for an exploratory descriptive study. Convenience sampling was used to recruit clinicians involved in patient care, from two ICUs in Australia. Semi-structured individual interviews were undertaken to gather data, with interviews audio recorded and auto-transcribed. Data were analysed using inductive content analysis. FINDINGS: Twenty clinicians participated, with interviews lasting 26 min (mean). Analysis revealed four main themes: (i) Cultural sensitivity and responsiveness, which describes the importance of cultural sensitivity and responsiveness in care; (ii) Complexities of communication, which includes descriptions of strategies to overcome communication barriers; (iii) At the end of life, which describes end-of-life care challenges, particularly in the context of brain death and organ donation; and (iv) The way forward, offering suggestions for optimising care for patients and family members who were culturally diverse. CONCLUSIONS: Cultural diversity complicates patient and family care and communication in the ICU. These findings emphasise the importance of clinicians' sensitivity and openness to difference, and that it is clinicians' responsibility to overcome cultural and linguistic differences, not the critically ill patient or their family. IMPLICATIONS FOR CLINICAL PRACTICE: Achieving greater openness and awareness requires ICU and healthcare leaders to promote the use of professional interpreters to their full scope of expertise, development of culturally-specific resources and creation of a wider community network of cultural representatives to bridge cultural gaps.