Clinicians' Experiences in Care Delivery to Culturally and Linguistically Diverse Patients in the Emergency Department: A Social Ecological Perspective

Aims:
To explore the influence of broader cultural and social factors on clinicians' care delivery to patients from culturally and linguistically diverse backgrounds in the emergency department.

Design:
A qualitative exploratory study.

Methods:
A social ecological perspective drawn from a Social Ecological Model was used to guide the study. Clinicians from two public hospital emergency departments in Southeast Queensland, Australia were recruited with purposive and snowballing sampling strategies. Semi-structured interviews were undertaken between October 2022 and September 2023. Data were analysed using a content analysis approach.

Results:
Seventeen clinicians participated in the interviews: nine nurses and eight doctors. Nine participants were born in a country outside of Australia. Three main themes were generated from the interview data: (i) cultural and religious diversity and challenges in care delivery; (ii) social interactions and communication in clinical care; and (iii) perception about care delivery, services and supports.

Conclusion:
Findings from this study offer insight into clinicians' experiences and perspectives regarding the influence of cultural and religious diversity as well as cross-cultural communication and prejudice in care delivery. Social interactions and communication in clinical care were found to facilitate care delivery process and navigate challenges. Cultural competency training and multicultural services and resources can help support clinicians in providing culturally appropriate care in the emergency department.

Implications for the Profession and Patient Care:
The findings of this study may help inform the development of practical guidelines and strategies to support clinicians in care delivery. Appropriate training regarding cultural competency is essential to promote culturally appropriate care. Developing a tailored multicultural service and targeted resources in the emergency department is recommended in clinical practice.

Reporting Method:
The consolidated criteria for reporting qualitative research checklist was used.

Patient and Public Involvement:
A health consumer representative was involved to provide advice on the study conceptualization and data interpretation.