Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis

doi:10.1186/s12875-024-02630-y

. 2024 Oct 23;25(1):381.

doi: 10.1186/s12875-024-02630-y.

Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis

Robin Vandecasteele¹, Lenzo Robijn², Sara Willems^{2

3

4}, Stéphanie De Maesschalck^{2

3}, Peter A J Stevens⁵

Affiliations

¹ Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium. robin.vandecasteele@ugent.be.
² Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium.
³ Centre for the Social Study of Migration and Refugees, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
⁴ Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Quality & Safety Ghent, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium.
⁵ Department of Sociology, Faculty of Political and Social Sciences, Ghent University, Sint- Pietersnieuwstraat 41, Ghent, 9000, Belgium.

PMID: 39443846
PMCID: PMC11515484
DOI: 10.1186/s12875-024-02630-y

Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis

Robin Vandecasteele et al. BMC Prim Care. 2024.

. 2024 Oct 23;25(1):381.

doi: 10.1186/s12875-024-02630-y.

Authors

Robin Vandecasteele¹, Lenzo Robijn², Sara Willems^{2

3

4}, Stéphanie De Maesschalck^{2

3}, Peter A J Stevens⁵

Affiliations

¹ Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium. robin.vandecasteele@ugent.be.
² Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium.
³ Centre for the Social Study of Migration and Refugees, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
⁴ Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Quality & Safety Ghent, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium.
⁵ Department of Sociology, Faculty of Political and Social Sciences, Ghent University, Sint- Pietersnieuwstraat 41, Ghent, 9000, Belgium.

PMID: 39443846
PMCID: PMC11515484
DOI: 10.1186/s12875-024-02630-y

Abstract

Background: This study investigated the perceived barriers and potential facilitators for culturally sensitive care among general practitioners in Flanders. Understanding these dynamics is crucial for improving healthcare quality and equity.

Methodology: Twenty-one in-depth interviews were conducted with Flemish GPs. Braun and Clarke's reflexive thematic analysis was employed to develop and interpret themes that elucidate shared underlying meanings and capture the nuanced challenges and strategies related to cultural sensitivity in healthcare.

Results: Two core themes were generated: GPs' uncertainty and opposition. These themes manifest in emotional responses such as frustration, miscomprehension, and feelings of helplessness, influencing relational outcomes marked by patient disconnect and reduced motivation for cultural sensitivity. The barriers identified are exacerbated by resource scarcity and limited intercultural contact. Conversely, facilitators include structural elements like interpreters and individual strategies such as engagement, aimed at enhancing GPs' confidence in culturally diverse encounters. A meta-theme of perceived lack of control underscores the challenges, particularly regarding language barriers and resource constraints, highlighting the critical role of GPs' empowerment through enhanced intercultural communication skills.

Conclusion: Addressing GPs' uncertainties and oppositions can mitigate related issues, thereby promoting comprehensive culturally sensitive care. Essential strategies include continuous education and policy reforms to dismantle structural barriers. Moreover, incentivizing culturally sensitive care through quality care financial incentives could bolster GP motivation. These insights are pivotal for stakeholders-practitioners, policymakers, and educators-committed to advancing culturally sensitive healthcare practices and, ultimately, for fostering more equitable care provision.

Keywords: Barriers and facilitators; Culturally sensitive care; General practitioners; Health equity; Intercultural communication; Reflexive thematic analysis.

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Conflict of interest statement

The authors declare no competing interests.

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[1] Napier AD, Ancarno C, Butler B, Calabrese J, Chater A, Chatterjee H, et al. Culture and health. Lancet. 2014;384(9954):1607–39. - PubMed

[2] Napier AD, Ancarno C, Butler B, Calabrese J, Chater A, Chatterjee H, et al. Culture and health. Lancet. 2014;384(9954):1607–39. - PubMed

[3] Drewniak D, Krones T, Sauer C, Wild V. The influence of patients’ immigration background and residence permit status on treatment decisions in health care. Results of a factorial survey among general practitioners in Switzerland. Soc Sci Med. 2016;161:64–73. - PubMed

[4] Drewniak D, Krones T, Sauer C, Wild V. The influence of patients’ immigration background and residence permit status on treatment decisions in health care. Results of a factorial survey among general practitioners in Switzerland. Soc Sci Med. 2016;161:64–73. - PubMed

[5] Lorant V, Van Oyen H, Thomas I. Contextual factors and immigrants’ health status: double jeopardy. Health Place. 2008;14(4):678–92. - PubMed

[6] Lorant V, Van Oyen H, Thomas I. Contextual factors and immigrants’ health status: double jeopardy. Health Place. 2008;14(4):678–92. - PubMed

[7] Paternotte E, Scheele F, Seeleman CM, Bank L, Scherpbier AJ, van Dulmen S. Intercultural doctor-patient communication in daily outpatient care: relevant communication skills. Perspect Med Educ. 2016;5:268–75. - PMC - PubMed

[8] Paternotte E, Scheele F, Seeleman CM, Bank L, Scherpbier AJ, van Dulmen S. Intercultural doctor-patient communication in daily outpatient care: relevant communication skills. Perspect Med Educ. 2016;5:268–75. - PMC - PubMed

[9] Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666. - PMC - PubMed

[10] Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666. - PMC - PubMed

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Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis

Affiliations

Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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