Immigrants with long-term residency perceive some paternalistic attitudes from the nurses who care for them
A study by IDIAPJGol highlights power imbalances and a lack of understanding between nurses and immigrant patients, caused by communication and cultural differences
A qualitative study led by the Multidisciplinary Research Group on Health and Society (GREMSAS), an interinstitutional group from the Jordi Gol Institute for Research in Primary Care (IDIAPJGol) and the Autonomous University of Barcelona (UAB), examines intercultural communication in primary care from the perspective of nurses, long-term immigrant residents, and cultural mediators. The authors of the study, published in the journal Nursing Open, point out that “immigrant patients perceive a power imbalance in the care relationship and a paternalistic attitude from nurses.” Although these same patients acknowledge the empathy and professionalism of the nurses, communication and cultural differences exacerbate the mutual lack of understanding in the care relationship.
This study underscores the importance of integrating diverse perspectives into healthcare practices and implementing training programs in communication skills. The GREMSAS research team calls for closer collaboration between patients, healthcare professionals, and mediators to achieve more equitable and culturally sensitive care.
A Global Issue
The phenomenon of international migration, which affects over 272 million people worldwide, is an increasingly complex reality with significant cultural, social, and political implications. Immigrant populations, especially those who have been in their host country for over five years, continue to face social, healthcare, and cultural barriers, even when they have mastered the host country’s language. Perceptions of bias, lack of empathy, or difficulty establishing close and humanized relationships with healthcare professionals are some of the persistent challenges negatively impacting their experience with the healthcare system and the care of their health.
Cultural Mediation
In Catalonia, the introduction of cultural mediation services in the 1990s helped address these differences and foster mutual understanding. However, according to the authors, it remains essential to delve deeper into the experiences of both patients and healthcare professionals to improve the quality of care. This study responds to this need by considering not only the perspectives of patients and nurses but also those of cultural mediators as external observers of the dynamics of intercultural communication. In this regard, Francesc Ramos emphasizes that “it is necessary to strengthen communication skills, promote dialogic learning, and build stronger connections between immigrant communities and the healthcare system.” He also recommends actively involving cultural mediators and communities in health decision-making processes.
A Qualitative Study
The study combines qualitative data from two previous investigations with the results of a focus group involving cultural mediators. Methods include semi-structured interviews, focus groups, and secondary data analysis using Charmaz’s grounded theory approach. The results identify two main categories: the role of culture in communication and the degree of cultural sensitivity in care. Immigrant patients value informal dialogue as a key tool for building trust, while nurses request more training to address cultural complexities.
Reference to the article
Ramos-Roure F, Feijoo-Cid M, Manresa-Dominguez JM, Segura-Bernal J, García-Sierra R, Fernández-Cano MI, Arreciado Marañón A, Moreno-Gabriel E, Flamarich Gol C, Toran-Monserrat P. A Comparative Study of the Perspectives of Long-Stay Immigrants, Nurses and Cultural Mediators on Intercultural Communication: A Secondary Qualitative Analysis. Nurs Open. 2024 Nov;11(11):e70074. doi: 10.1002/nop2.70074. PMID: 39558517; PMCID: PMC11573725.
