Table 2 Summary of the included articles, ordered chronologically, from most to least recent, and alphabetically within years
Ref | Author/Year | Type of study | Setting | Sample | Aims | Relevant findings |
|---|---|---|---|---|---|---|
[26] | Hughson, Marshall, Daly, Woodward-Kron, Hajek & Story (2018) | Qualitative | Medicine - Maternity | 7 midwives, 5 obstetricians, 5 physiotherapists, 1 social worker and 1 occupational therapist working with CALD service users | Identify health literacy issues when providing maternity care to CALD women, and the strategies needed for health professionals to collaboratively address these issues | Health professionals reported a lack of certainty as to whether the information they were trying to communicate was adequately comprehended, low health literacy of the service users and competing cultural models of health barriers to effective culturally responsive communication |
[27] | Jennings, Bond & Hill (2018) | Systematic review | Non-specific healthcare | 65 reports on Indigenous healthcare access | Explore Indigenous narrative accounts of healthcare access within qualitative research papers, to better understand Indigenous views on culturally safe healthcare and health communication represented in that literature | Indigenous service users valued informal ‘talk’ and the use of simplified language within healthcare interactions as it fostered feelings of trust, strengthened engagement and produced positive outcomes |
[28] | Mollah, Antoniades, Lafeer & Brijnath (2018) | Qualitative | Mental health | 4 counsellors, 6 psychologists, 5 nurses and 2 social workers working with CALD communities | Document frontline mental health practitioners understanding of cultural competence and to identify, from their perspective, what helped or hindered them to deliver culturally competent mental healthcare in their daily practice | Healthcare providers reported not achieving effective cross-cultural communication was due to a lack of access to, reliability of and use of interpretive services. Among the participants who felt they were achieving culturally responsive communication, many of the communication styles described tended to homogenize ethnic differences between practitioner and patient but highlighted ethnic differences from the mainstream community |
[29] | Xiao, Willis, Harrington, Gillham, De Bellis, Morey & Jeffers (2018) | Qualitative | Nursing – Aged care | 56 aged care workers and 30 Culturally And Linguistically Diverse (CALD) aged care residents and their family members | Critically examine how staff and residents initiated effective cross-cultural communication and social cohesion that enabled positive changes to occur | Cultural humility, a collaborative approach and organizational support is critical to achieving effective cross-cultural communication |
[30] | Smith, Fatima & Knight (2017) | Mixed methods | Non-specific healthcare | 24 healthcare providers and 54 Aboriginal service users | Explore the views of key stakeholders on cultural appropriateness of primary healthcare services for Aboriginal people | A practice level gap exists between healthcare workers and Aboriginal service users’ perceptions for the provision of culturally sensitive services delivery |
[12] | Truong, Gibbs, Paradies & Priest (2017) | Qualitative | Allied health | 14 community healthcare providers working with CALD communities | Explore the multi-level aspects of cultural competence from the perspectives of healthcare service providers in the community health context | Reflexivity at both individual and organizational levels is necessary in order to deliver services that are responsive to local community needs |
[31] | Truong, Gibbs, Paradies, Priest & Tadic (2017) | Qualitative | Allied health | 27 CALD community health service users | Explore the positioning of cultural competence within community health from multiple perspectives | Healthcare professionals reported barriers to achieving effective cross-cultural communication as the services users’ level of English-speaking proficiency and their understanding the language of the ‘health system’. Service user participants did not feel as though they experienced any language difficulties and were offered interpreters as needed, however found it easier to communicate with staff that shared a similar cultural background |
[32] | Watts, Meiser, Zilliacus, Kaur, Taouk, Butow, Kissane, Hale, Perry, Aranda & Goldstein (2017) | Qualitative | Medicine - Oncology | 12 medical oncologists, 5 radiation oncologists and 21 oncology nurses working with CALD cancer patients | Identify the systemic barriers encountered by oncology health professionals working with patients from ethnic minorities to guide the development of a communication skills training program | Health professionals expressed a need for training in cultural awareness and communication skills with a preference for face-to-face delivery. A lack of funding, a culture of “learning on the job”, time constraints and the belief that any single culture was too diverse for cultural training to be beneficial were systemic barriers to training |
[33] | Henderson, Barker & Mak (2016) | Qualitative | Nursing | 19 clinical facilitators, 5 clinical nurses and 10 nursing students working with CALD communities | Explore the experiences of clinical nurses, nurse academics and student nurses regarding intercultural communication challenges | Strategies participants used to mitigate challenges included resorting to cultural validation through alliance building, proactively seeking clarification and acquiring cultural awareness knowledge |
[34] | Olaussen & Renzaho (2016) | Systematic review | Allied health | 11 papers reviewed – reporting on migrants with disabilities | Examine the challenges of providing service to migrants with disability, healthcare providers level of cultural competence and document components of the cultural competence framework required to reduce disability-related health inequalities | Healthcare professionals perceived themselves as being culturally competent, whereas migrants with disabilities and their families felt as though their needs were not being adequately addressed due to cultural misunderstandings and disrespect of cultural values |
[35] | Valibhoy, Kaplan & Szwarc (2016) | Qualitative | Mental health | 16 young people from refugee backgrounds | Explore the perceptions of young people from refugee backgrounds how they accessed mental health services, disclosing personal problems, barriers and facilitators to engagement with clinicians and recommendations to improve services | Participants valued accessible practitioners who combined content expertise with interpersonal qualities to make the person feel listened to, responded to and recognized |
[36] | Watt, Abbott & Reath (2016) | Qualitative | Medicine – General Practitioner (GP) Registrars | 43 GPs & Registrars working with CALD Aboriginal and CALD clients | Explore the ways in which GP registrars are currently developing cultural competence | Registrars report there is no common approach to cross-cultural training. Exposure to diversity appears to be an important way in which cultural competency is developed |
[37] | O’Connor, Chur-Hansen &Turnbull (2015) | Qualitative | Mental health | 8 psychologists working with Aboriginal clients | Identify the professional skills and personal competencies that enable effective service delivery for Indigenous clients, particularly those aged 12–25 | Professional skills needed to achieve culturally responsive service delivery with Aboriginal service users are collaboration, flexibility, commitment to ongoing learning and community engagement and consultation. Personal characteristics include self-reflection, welcoming nature, openness and cultural understanding |
[38] | Von Doussa, Power, McNair, Brown, Schofield, Perlesz, Pitts & Bickerdike (2015) | Qualitative | Allied health | 32 healthcare workers and 13 same-sex attracted parents | Explore barriers and facilitators to healthcare access for same-sex attracted parents and their children | Healthcare workers and same-sex attracted parents agreed that the workers lacked confidence and knowledge using appropriate and inclusive language to acknowledge the persons family situation |
[39] | Wilson, Magarey, Jones, O’Donnell & Kelly (2015) | Qualitative | Allied health | 35 non-Aboriginal health professionals working with Aboriginal services users | Explore the attitudes and characteristics of non-Aboriginal health professionals working in Aboriginal health | The attitudes and characteristics of non-Aboriginal health professionals working in Aboriginal health vary and can be considered across a range of groups. Self-reflection is critical for health professionals to address their own assumptions and bias that |
[40] | Abbott, Reath, Gordon, Dave, Harnden, Hu, Kozianski & Carriage (2014) | Qualitative | Medicine – GP | 71 GP supervisors and 4 medical educators working with Aboriginal service users | Examine the confidence and skills of non-Indigenous GP supervisors in providing feedback to a GP Registrar consulting with an Aboriginal patient | GP supervisors lacked confidence in providing guidance on cross-cultural communication with Aboriginal service users. GP registrars and supervisors felt they lacked specific training and relied on generic communication and consultation skills |
[41] | Farley, Askew & Kay (2014) | Qualitative | Non-specific healthcare | 20 GPs, 5 practice nurses and 11 administrative staff working with newly arrived refugees | Explore the experiences of primary healthcare providers working with newly arrived refugees in Brisbane | Healthcare providers identified lack of funding, appropriate resources and language barriers as the reason for not achieving effective culturally responsive communication. Healthcare providers reported trying to overcome these barriers by learning basic greetings, making longer appointment times and accessing external supports, such as language classes |
[42] | Kendall & Barnett (2014) | Qualitative | Allied health | 34 Indigenous health workers and community elders and 5 non-Indigenous health workers | Explore the factors contributing to the underutilization of health services by Aboriginal people | Services users often described the healthcare providers communication styles as an abrupt series of questions or demands followed by the rapid transfer of incomprehensible medical knowledge. Effective and respectful communication allowed Indigenous service users to feel informed and empowered to make knowledgeable decisions |
[43] | Nielsen, Foster, Henman & Strong (2013) | Qualitative | Medicine | 20 service users diagnosed with chronic pain | Examine the healthcare experiences of people with chronic pain and focuses discussion on the impact that institutional and cultural factors can have on individual experience | Problematic patient-provider communication, such as speaking too ‘clinically’ and ‘talking at’ rather than to can negatively affect the care received and health outcomes of a person living with chronic pain |
[44] | Woolley, Sivamalai, Ross, Duffy & Miller (2013) | Qualitative | Medicine – Graduate | 13 Indigenous health professionals, Elders and community members | Explore Indigenous peoples’ perspectives regarding desired attributes they would want to see in graduate doctors who choose to practice in their remote community | Effective communication with Indigenous service users and in remote communities required graduate doctors to have appropriate clinical skills, medical knowledge, knowledge about how local health systems operate and familiarity with significant Indigenous health issues |
[45] | Gill & Babacan (2012) | Qualitative | Non-specific healthcare | Number and type of participants not specified | Report findings of a major review of one of Australian state health systems cultural and linguistic diversity, cultural competence requirements, minimum standards and benchmarks | The concept of cultural competence was not well defined. A whole-organization approach at all levels of the system is needed to achieve culturally competent communication and care |
[46] | Komaric, Bedford & van Driel (2012) | Qualitative | Allied health | 50 CALD service users and 14 healthcare providers | Describe the challenges people from CALD communities and their treating healthcare providers face regarding treating and preventing chronic disease and what barriers they experience and perceive with regard to access to health services | The provision of adequate interpretive services was identified by healthcare providers and services users as a means to increase satisfaction with care, however recognized it as an overly simplistic solution |
[47] | Mitchison, Butow, Aldridge, Hui, Vardy, Eisenbruch, Iedema & Goldstein (2012) | Qualitative | Medicine - Oncology | 73 CALD cancer patients and their relatives | Explore communication of prognosis with migrant cancer patients and their families | Services users from all ethnicities preferred their prognostic information to be delivered in a caring and personalised manner from an authoritative oncologist |
[48] | Kaur (2009) | Qualitative | Social work | 66 child protection caseworkers working with CALD communities | Examine caseworker perceptions of ‘culturally sensitive’ practice when working with CALD communities | Recognition and acknowledgement of the persons cultural identity, cultural values, languages, community and religion are critical to achieving effective communication |
[49] | Johnstone & Kanitsaki (2008) | Qualitative | Non-specific healthcare | 145 healthcare workers self-identified as being from different ethno cultural backgrounds | Explores the idea that racial and ethnic disparities in healthcare may be expressive of un-acknowledged practices of cultural racism | The language difference and English language proficiency of the service user was used as a social marker to classify and categorise patients and had a significant influence on how they were treated by attending staff. This language prejudice was found as a profound failure in and a barrier to communication |
[50] | Renzaho (2008) | Qualitative | Allied health | 50 healthcare workers and 100 CALD service users | Document how service providers identify and develop services to meet the needs of CALD communities and assess CALD clients’ experiences with the service providers | Service providers have limited approaches to the provision of CALD services, tending to adopt a “one-size-fits-all” models of delivery |