Improving communication key to better culturally safe hospital care

A study led by the Communicate Study Partnership from Menzies School of Health Research has unveiled critical insights into the experiences of First Nations people in Australian hospitals, spotlighting the urgent need for culturally safe care.

The research, published in the Journal of Racial and Ethnic Health Disparities, reveals that poor communication often leads to experiences of racism and poorer health outcomes for First Nations patients. Participants reported incidents of confusion, aggression, and resistance from healthcare providers to shared decision-making.

Stuart Yiwarr McGrath, a Gumatj man of the Yolŋu nation, aboriginal health practitioner, and study author, emphasised the study’s unique approach: “This paper highlights solutions rather than deficits to better inform clinical care, linguistically, culturally and a pragmatic approach to have equal perspectives while delivering biomedical knowledge to our mob coming from remote areas.”

The study, which involved interviews with 11 in-patients and caregivers from diverse First Nations backgrounds, identified key priorities for improving cultural safety in hospitals:

1. Providing training programs for health care providers that focus on intercultural communication and anti-racism.
2. Ensuring patients receive information in ways that promote genuine understanding and trust.
3. Revising consent processes to respect First Nations protocols, with a focus on involving family members in the consent process.
4. Developing an appropriate mechanism for patients to make complaints without fear of retribution.

Dorothy, a Yolŋu Elder and study participant, articulated the need for co-designed solutions: “If they help us, we can help them. Create the solutions together. But they have to do the work first, and open pathways for us because that place [the hospital] is full of complicated foreign things and a lot of different systems.”

The study highlights that the consequences of culturally unsafe communication are far-reaching, potentially leading to angry staff and patients, missed appointments, clinical mistakes, and premature self-discharge.

McGrath noted the importance of conducting interviews in native languages: “The qualitative interviews I conducted were in Yolngu Matha, which made a huge difference. You are more likely to express yourself articulately in the language you think and dream in.”

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