Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2019 Jul 30;14(7):e0219971. doi: 10.1371/journal.pone.0219971. eCollection 2019.
Culturally and linguistically diverse patients access healthcare services less than the host populations and are confronted with different barriers such as language barriers, legal restrictions or differences in health beliefs. In order to reduce these disparities, the promotion of cultural competence in healthcare organizations has been a political goal. This scoping review aims to collect components and strategies from evaluated interventions that provide culturally competent healthcare for culturally and linguistically diverse patients within healthcare organizations and to examine their effects on selected outcome measures. Thereafter, we aim to organize identified components into a model of culturally competent healthcare provisions.
A systematic literature search was carried out using three databases (Pubmed, PsycINFO and Web of Science) to identify studies which have implemented and evaluated cultural competence interventions in healthcare facilities. PICO criteria were adapted to formulate the research question and to systematically choose relevant search terms. Sixty-seven studies implementing culturally competent healthcare interventions were included in the final synthesis. Identified strategies and components of culturally competent healthcare extracted from these studies were clustered into twenty categories, which were organized in four groups: Components of culturally competent healthcare-Individual level; Components of culturally competent healthcare-Organizational level; Strategies to implement culturally competent healthcare and Strategies to provide access to culturally competent healthcare. A model integrating the results is proposed. The overall effects on patient outcomes and utilization rates of identified components or strategies were positive but often small or not significant. Qualitative data suggest that components and strategies of culturally competent healthcare were appreciated by patients and providers.
This scoping review used a bottom-up approach to identify components and strategies of culturally competent healthcare interventions and synthesized the results in a model of culturally competent healthcare provision. Reported effects of single components or strategies are limited because most studies implemented a combination of different components and strategies simultaneously.
文化和语言多样化的患者接受医疗保健服务的比例低于当地居民，并且面临着不同的障碍，如语言障碍、法律限制或健康观念的差异。为了减少这些差异，促进医疗保健组织的文化能力已成为一个政治目标。本范围综述旨在收集评估干预措施中为医疗保健组织内的文化和语言多样化患者提供文化上合适的医疗保健的组成部分和策略，并检查它们对选定的结果测量指标的影响。此后，我们旨在将确定的组成部分组织到文化上合适的医疗保健提供模型中。
使用三个数据库（Pubmed、PsycINFO 和 Web of Science）进行了系统的文献检索，以确定在医疗保健设施中实施和评估文化能力干预措施的研究。采用 PICO 标准来制定研究问题，并系统地选择相关搜索词。最终综合分析了 67 项实施文化能力干预措施的研究。从这些研究中提取的文化能力医疗保健的策略和组成部分被聚类为二十个类别，这些类别被组织成四个组：文化能力医疗保健的组成部分-个人层面；文化能力医疗保健的组成部分-组织层面；实施文化能力医疗保健的策略和提供文化能力医疗保健的策略。提出了一个整合结果的模型。确定的组成部分或策略对患者结果和利用率的总体影响是积极的，但往往较小或不显著。定性数据表明，患者和提供者都欣赏文化能力医疗保健的组成部分和策略。
本范围综述采用自下而上的方法来确定文化能力医疗保健干预措施的组成部分和策略，并将结果综合到文化能力医疗保健提供模型中。单一组成部分或策略的报告效果有限，因为大多数研究同时实施了不同组成部分和策略的组合。
