OBJECTIVE:The purpose of this research was to locate cultural competence within the experiential domain of the non-English-speaking patient. DESIGN:Seven language-specific focus groups were held with 59 hospital patients and carers of patients with limited English to better understand their experience and to identify critical factors leading to their constructions of care. Grounded theory analysis within a constructivist perspective was undertaken. RESULTS:While the majority of patients were positive about their hospital experience, the theme of powerlessness appeared central to many patient experiences. Language facilitation was the most common issue. Inattention to specific cultural mores and racism in some instances contributed to negative experiences. Patients primarily valued positive engagement, information and involvement, compassionate, kind and respectful treatment, and the negotiated involvement of their family. CONCLUSION:Because of the specific nature of each patient-provider interaction within its particular social and political environment, culturally competent behaviour in one context may be culturally incompetent in another. We propose a model of cultural empowerment that reflects the phenomenological basis of cultural competence in that cultural competence must be consistently renegotiated with any particular patient in a particular healthcare context. Similarly, ongoing community consultations are needed for health services and organisations to retain cultural competence.

译文

目的:本研究的目的是将文化能力定位于非英语患者的体验领域。
设计:针对59个医院患者和英语水平有限的患者的护理人员举行了七个针对特定语言的焦点小组,以更好地了解他们的经验并确定导致其护理结构的关键因素。在建构主义视角下进行了扎根的理论分析。
结果:尽管大多数患者对他们的住院经历持肯定态度,但无能为力的主题似乎是许多患者经历的核心。语言便利化是最常见的问题。在某些情况下,对特定文化习俗和种族主义的不重视造成了负面的经历。患者主要重视积极的参与,信息和参与,富有同情心,友善和尊重的治疗以及家人的协商参与。
结论:由于每种患者与提供者之间在特定的社会和政治环境中互动的特殊性,在一种情况下具有文化能力的行为在另一种情况下可能在文化上不适合。我们提出了一种文化授权模型,该模型可以反映文化能力的现象学基础,因为文化能力必须与特定医疗环境中的任何特定患者重新协商。同样,卫生服务和组织需要进行持续的社区磋商以保持文化才能。

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