Enhancing culturally responsive care in perioperative settings for older adult patients: A qualitative interview study

IF 7.5 1区 医学 Q1 NURSING International Journal of Nursing Studies Pub Date : 2024-10-11 DOI:10.1016/j.ijnurstu.2024.104925
Charmaine G. Bonus , Deborah Hatcher , Tiffany Northall , Jed Montayre
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Abstract

Background

Older adults aged over 65 are increasingly admitted to hospital for acute care reasons, including surgical procedures. In multicultural societies, the diversity of an ageing population has significant implications for the planning and delivery of culturally responsive perioperative care for older adults from ethnically diverse backgrounds, who are admitted to hospital for surgical intervention.

Objective

To explore the perspectives and experiences of perioperative staff when caring for older adult patients from ethnically diverse backgrounds.

Design

Exploratory qualitative methodology.

Setting(s)

Staff working in Australian perioperative care settings were recruited for semi-structured interviews.

Participants

Purposive sampling was used to recruit 15 perioperative staff members, who had experience with caring for older adult patients from ethnically diverse backgrounds during their surgical procedure.

Methods

Individual, semi-structured interviews were conducted with perioperative staff. Reflexive thematic analysis was used to identify key themes.

Results

Two themes were identified. These were ‘Organisational barriers in delivering safe and culturally responsive care’, and ‘Staff experiences in navigating the challenges of providing culturally responsive care’. Staff reported that safety protocols often overshadowed patient-specific needs, especially for patients requiring additional linguistic or cultural support. The lack of formal interpreter services and the pressure to meet efficiency targets were cited as major barriers to delivering culturally responsive care.

Conclusions

Delivering culturally responsive care in the fast-paced, high-risk environment of the operating theatre presents complex challenges, as perioperative staff must navigate competing priorities of patient safety, organisational efficiency, and cultural nuances. This article highlights how the emphasis on efficiency can compromise culturally responsive care for older adults, with staff often frustrated by the lack of formalised organisational support, especially those for facilitating effective communication. Current approaches tend to treat cultural care as an “add-on” rather than integrating it into perioperative safety measures. A shift towards pre-emptive planning, with an organisational culture change that embeds culturally responsive care into the broader safety framework, is essential. This proactive approach would enhance both patient outcomes and staff readiness, fostering a perioperative environment where safety and cultural care are synonymous.
Tweetable abstract: Embedding culturally responsive care into safety protocols is essential for enhancing perioperative experiences among older migrant patients.
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在围手术期加强对老年患者的文化关怀:定性访谈研究。
背景:越来越多的 65 岁以上的老年人因急症(包括外科手术)入院治疗。在多元文化社会中,人口老龄化的多样性对规划和提供针对不同种族背景的老年人的围手术期护理具有重要影响:探讨围手术期工作人员在护理来自不同种族背景的老年患者时的观点和经验:设计:探索性定性方法:招募在澳大利亚围手术期护理机构工作的人员进行半结构化访谈:方法:采用有目的的抽样方法招募 15 名围手术期工作人员,他们都有在手术过程中护理来自不同种族背景的老年患者的经验:对围术期工作人员进行了个人半结构式访谈。结果:确定了两个主题:结果:确定了两个主题。结果:确定了两个主题,分别是 "提供安全和文化适应性护理的组织障碍 "和 "员工应对提供文化适应性护理挑战的经验"。工作人员报告称,安全协议往往会掩盖病人的具体需求,尤其是需要额外语言或文化支持的病人。缺乏正规的口译服务和达到效率目标的压力被认为是提供文化敏感性护理的主要障碍:在手术室这种快节奏、高风险的环境中提供文化适应性护理是一项复杂的挑战,因为围手术期工作人员必须在患者安全、组织效率和文化细微差别这些相互竞争的优先事项中游刃有余。这篇文章强调了对效率的重视会如何影响对老年人的文化关怀,而缺乏正式的组织支持(尤其是促进有效沟通的支持)往往会让工作人员感到沮丧。目前的方法倾向于将文化护理作为一种 "附加",而不是将其纳入围手术期安全措施中。转变为先发制人的计划,同时改变组织文化,将文化关怀纳入更广泛的安全框架中,是至关重要的。这种积极主动的方法将提高患者的治疗效果和员工的准备程度,营造一个安全和文化关怀同义的围手术期环境。Tweetable 摘要:将文化关怀纳入安全协议对于提高老年移民患者的围手术期体验至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
15.00
自引率
2.50%
发文量
181
审稿时长
21 days
期刊介绍: The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).
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