Background
Methods
Definitions
Selection criteria
Search strategy
Analysis
Results
Study | Rehabilitation field | Location | Design | No. Of Participants | Study goals |
---|---|---|---|---|---|
Al Busaidy and Borthwick 2012 [48] | OT | Oman | Interviews | 11 Practitioners | Inquired about service provision experiences |
Centeno 2009 [33] | SLP | USA | Surveys | 33 Practitioners | Inquired about service provision experiences |
Dogan et al 2009 [34]a | PT | Turkey | Surveys | 50 Practitioners | Inquired about service provision and reception experiences |
Dressler and Pils 2009 [35] | PT, SLP, OT | Austria | Interviews | 28 Practitioners: 1 SLP, 2 OTs, 1 PT; 24 others | Examines practitioners perception of cross-cultural communication experiences |
Drolet et al. 2014 [32] | OT, SLP | Canada | Focus groups | 43 Practitioners: 21 in healthb, 22 in social services | Inquired about service provision experiences |
Guiberson and Atkins, 2012 [36] | SLP | USA | Survey | 154 Practitioners | Inquired about practitioners backgrounds, training, and experiences with service delivery |
Jaggi and Bithell 1995 [44] | PT | Bangladesh | Survey | 68 Practitioners | Inquired about practitioners experiences, knowledge, and attitudes regarding service delivery |
OT | Glasgow | Survey | 94 Practitioners | Inquired about practitioners perceptions, experiences, knowledge, and attitudes regarding service delivery | |
Kinebanian and Stomph 1992 [46] | OT | Netherlands | Interview | 25 Practitioners | Inquired about service provision experiences |
Kirkham et al. 2009 [57] | Aud | USA | Survey | 103 Practitioners | Inquired about perceptions of speech and language outcome disparities and recommendations to reduce disparities |
Kirsh, Trentham and Cole 2006 [61] | OT | Canada | Interviews | 14 Consumers | Inquired about minorities’ experiences with receiving services |
Kohnert et al. 2003 [38] | SLP | USA | Survey | 104 Practitioners | Inquired about service provision experiences |
Kramer-Roy 2012 [62] | OT | United Kingdom | Interviews | 6 caregivers | Inquired about the service needs of Pakistani families with disabled children |
Kummerer and Lopez-Reyna 2006 [60] | SLP | USA | Interviews | 14 caregivers | Explored the views and beliefs of language development, disabilities, therapy experiences of Mexican immigrant mothers |
Lee, Sullivan and Lansbury 2006 [58] | PT | Australia | Interviews & Observations | 6 Practitioners | Explored practitioners strategies with service delivery |
Lindsay et al. 2012 [12] | OT, PT | Canada | Interviews & Focus Groups | 13 Practitioners & coordinators: 2 PTs, 2 OTs, 9 others | Inquired about service provision experiences |
Lindsay et al. 2014 [39] | OT | Canada | Interviews | 17 Practitioners | Explored practitioners strategies with service delivery |
Maul, 2010 [54] | SLP | USA | Interviews | 9 Practitioners | Explored cultural competency skills in practitioners |
Munoz 2007 [55] | OT | USA | Interviews | 12 Practitioners | Explored practitioners’ perceptions of culturally competent service delivery |
Nelson and Allison 2007 [43] | OT | Australia | Part 1: Interviews & focus groups Part 2: Surveys | Part 1: 25 Stakeholders including 8 caregivers Part 2: 50 Practitioners | Explored practitioners’ perceptions of culturally competent service delivery |
Nelson, Allison, and Copley 2007 [49] | OT | Australia | Part 1: Survey Part 2: Focus groups & Interviews | Part 1: 50 Practitioners Part 2: 25 Stakeholders including 8 caregivers | Inquired about service provision and reception experiences |
Nelson et al. 2011 [56] | OT | Australia | Survey & Workshop discussion | 41 Practitioners | Inquired about service provision experiences |
Phipps 1995 [40] | OT | Australia | Survey | 65 Practitioners | Inquired about service provision experiences |
Phoon and Maclagan 2009 [50] | SLP | Malaysia | Survey | 38 Practitioners | Explored practitioners experiences with using assessments |
Roseberry-McKibbon and Eicholtz 1994 [41] | SLP | USA | Survey | 1145 Practitioners | Inquired about service provision experiences |
Roseberry-Mckibbon, Brice and O’Hanlon, 2005 [42] | SLP | USA | Survey | 1736 Practitioners | Inquired about service provision experiences |
Stedman and Thomas 2011 [51] | OT | Australia | Interviews | 7 Practitioners | Inquired about service provision experiences |
Watts and Carlson, 2002 [52] | OT | Australia | Interviews | 8 Practitioners | Inquired about practitioners’ experiences, perspectives and recommendations regarding service provision |
Williams and McLeod 2012 [45] | SLP | Australia | Survey | 128 Practitioners | Inquired about practitioners’ experiences and perspectives regarding service provision |
Yang et al. 2006 [47] | OT | Singapore | Interviews | 9 Practitioners | Explored the applicability of OT frameworks in Oman context |
Yeowell 2010 [59] | PT | England | Interviews | 6 Patients | Inquired about the service needs of Pakistani women |
Study characteristics
Field | # of health care practitioners | # of patients/caregivers |
---|---|---|
Occupational therapy | 343 | 28 |
Audiology | 103 | N/A |
Speech language pathology | 3348 | 14 |
Physiotherapy | 127 | 6 |
Practitioner perspectives
OT HCP | OT PTs | PT HCP | PT PTs | SLP HCP | SLP PTs | Aud HCP | AUD PTs | |
---|---|---|---|---|---|---|---|---|
Barriers | ||||||||
Language barriers | ✔ | ✔ | ✔ | ✔ | ✔ | ✖ | ✖ | ✖ |
Limited resources | ✔ | ✖ | ✔ | ✔ | ✔ | ✖ | ✖ | ✖ |
Influence of cultural difference | ✔ | ✖ | ✔ | ✖ | ✔ | ✖ | ✖ | ✖ |
Facilitators | ||||||||
Cultural awareness amongst practitioners | ✔ | ✔ | ✖ | ✔ | ✔ | ✔ | ✖ | ✖ |
Cultural awareness in services | ✔ | ✔ | ✔ | ✔ | ✔ | ✖ | ✔ | ✖ |
Explanations of health care systems | ✔ | ✔ | ✔ | ✔ | ✖ | ✔ | ✖ | ✖ |
Barriers reported by practitioners
Primary barriers to culturally competent care | Areas of health care service delivery/reception affected |
---|---|
Language barriers | • Practitioner-patient/caregiver communication • Establishment of rapport • Information provision and instruction • Engagement in intervention/therapy |
Cultural barriers | • Practitioner-patient/caregiver communication • Establishment of rapport • Diagnosis • Decision-making on treatment • Engagement in intervention/therapy |
Limited resources | • Practitioner-patient/caregiver communication • Establishment of rapport • Diagnosis • Assessments • Engagement in intervention/therapy |
The effect of language barriers
The influence of cultural differences on service delivery
“Some recommendations you’ll give a child for safety concerns or you provide a child with equipment so they’re better supported so feeding could be more successful and more in a safe way and yet they still have a lot of [difficulty] culturally [with] their food, they want to be feeding that even though a different food is suggested”. Lindsay et al. [12], pp. 2011.
Limited resources to facilitate culturally competent care
Facilitators reported by practitioners
Primary facilitators to culturally competent care | Impact on health care service delivery/reception |
---|---|
Cultural awareness amongst practitioners | • Helped establish rapport • Helped with provision of appropriate care/therapy • Helped to tailor care/therapy when needed • Helped with understanding patient/caregiver health-related goals |
Cultural awareness in services | • Improved practitioner-patient/caregiver communication • Helped establish rapport • Increased attendance and compliance • Helped to learn about patients’/caregivers’ values and needs • Helped diminish negative experiences • Created a comfortable atmosphere • Helped support patients/caregivers with long-term treatment management |
Explanations of health care systems | • Increased patient/caregiver understanding of available services and resources • Increased patient/caregiver understanding of available funding • Increased patient/caregiver understanding of available support networks • Increased patient/caregiver understanding of benefits of treatment and compliance |
Increasing cultural awareness
Fostering a culturally competent work environment
Explaining healthcare to minority culture patients
Patient/caregiver perspectives
Barriers reported by patients/caregivers
The effects of language and cultural barriers
The effects of limited resources in services
Facilitators reported by patients/caregivers
Cultural awareness amongst practitioners
Cultural awareness in services
“If I’m talking English and you’re speaking English, I’ve got to take it in as English, but if I don’t speak good English, when you’re speaking in English I’ve got to take it in and translate it in my head and translate it into your language and then back into English to speak it. Yes. So I think you need to give them space and check they’ve understood before they go on to the next sentence. That would help.” Yeowell [59], pp. 261.