Conectar
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.
A qualitative exploratory study.
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.
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.
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.
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.
The consolidated criteria for reporting qualitative research checklist was used.
A health consumer representative was involved to provide advice on the study conceptualization and data interpretation.
To review primary research reporting the inclusion of informal carers in caring for older people in the emergency department.
An integrative review employing Whittemore and Knafl's updated integrative review methodology.
A systematic search was undertaken between November 2023 and September 2024. Ten articles met the inclusion criteria of primary research reporting the inclusion of carers in the care of older adults in the emergency department. Exclusion criteria included studies conducted outside of the emergency department, not carer-related, and those not restricted to carers of older adults. The Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the articles.
Medline @ Ovid, EBSCO, Wiley Online Library, Cochrane, EMBASE and SCOPUS.
Thematic analysis produced two reoccurring themes: Carers as advocates and Carers as outsiders. Through sharing of information and support of the older adult, carers can act as advocates. Restrictive admission policies, exclusion from decision-making processes, and failure to be heard by the healthcare professional resulted in carers feeling like outsiders.
Including carers is essential to support the care of vulnerable older adults in the emergency department. Care partnerships between healthcare professionals and carers can be enhanced with education on effective and respectful communication processes and support of carer well-being.
This review highlights the essential nature of care partnerships involving informal carers in the emergency department for providing high-quality care to older adults with complex care needs. An appropriate carer inclusion programme could support emergency department clinicians, carers and older adults.
The PRISMA 2020 checklist was used to ensure adherence to review processes.
No patient or public contribution.
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