We are hugely grateful to all those people who take part in our research and want to give participants the opportunity to be updated on the outcomes of the studies they have been involved with.
To do this we are building a library of short articles summarising completed studies and their outcomes (see below).
This resource will be added to regularly over the coming months so please check back later for further updates.
A recently published article in the International Review of Psychiatry states the results from the CoACtION study (Cultural Adaptations in Clinical Interactions). This was a multi-site survey study to assess what cultural adaptations are made by clinicians in different settings. The aims were to identify what interactions that are culturally influenced are used by clinicians in England and how these interactions are experienced by patients who are from a Non-White or Non-Western Background.
Those who completed the surveys were clinicians working in Mental Health in 25 areas of England and patients in those areas who were of a Non-White or non-Western background. A total of 2805 participants took part in the study between 1st April and 30th June 2018, 87% Clinicians and 13% Patients. Questionnaires were written in English and support was available from carers or staff members for those who needed it. Only those with capacity and those willing to complete the questionnaires took part.
Participants generally came from NHS community mental health teams or inpatient services. The most common role for clinicians was that of nurse with most clinicians working 1 – 5 years in their role. Most patients had been with services for over 10 years. In terms of gender, those that completed the questionnaires were mainly female clinicians and male patients (55%). The majority of the clinicians were white and a majority reported they had less than 40% of their practice population from minority cultures. 67% of the patient participants spoke English as their first language.
The results of the questionnaire when analysed showed that often the opinions of the clinicians and the patients differed except to most often agree that a culturally specific assessment tool was never used and that levels of acculturation were most of the time or always considered. Disagreement though was recorded around other factors (whether the setting of interaction was culturally appropriate, whether preferred language, migration history, barriers to accessing services, influence of religion, alternative pathways to care and cultural values relating to goals and social support networks were discussed). Clinicians most often felt these factors were always or most of the time taken into account, but patients felt that they were rarely or never taken into account. So a disconnect was shown to exist. Other questions given solely to clinicians showed that they considered the areas of cultural importance mentioned ‘most of the time’ or ‘always’ and most felt they were attending to cultural needs. In comparison those questions just answered by patients showed the majority of patients received care from someone of a different cultural background and that ‘often’ their cultural needs were not met, however some reported that their cultural needs were addressed.
Using some statistical tests on the answers to the questionnaires it was possible to see that Clinicians are more likely to feel cultural needs were being met if they had been working in their role for more than 10 years, had specific training to work with cultural groups and they had a high percentage of their patients come from minority cultural groups.
The results of this study are in line with other research done previously, showing a disconnect between how clinicians rate their communication skills and how patients report these as not satisfactory. This study shows that within the sphere of cultural competence the clinicians’ assessment of their perceived cultural competence and the patients view that their cultural needs are not being met points to a disparity between the two viewpoints. This must be addressed going forward.
This research was funded by the Pakistan Association of Cognitive Therapists (PACT) and sponsored by Southern Health NHS Foundation Trust. The Chief Investigator was Professor Shanaya Rathod. The full article can be read here:
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