Uneingeschränkter Zugang

Advancing Cultural Competence in Healthcare System: Insights on Barriers and Required Measures

,  und   
23. Mai 2025

Zitieren
COVER HERUNTERLADEN

Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., & Normand, J. (2003). Culturally competent healthcare systems: A systematic review. American Journal of Preventive Medicine, 24(3), 68-79. https://doi.org/10.1016/S0749-3797(02)00657-8. Search in Google Scholar

Assarroudi, A., Heshmati Nabavi, F., Armat, M. R., Ebadi, A., & Vaismoradi, M. (2018). Directed qualitative content analysis: the description and elaboration of its underpinning methods and data analysis process. Journal of Research in Nursing, 23(1), 42-55. https://doi.org/10.1177/1744987117741667 Search in Google Scholar

Betancourt, J. R., Green, A. R., & Carrillo, J. E. (2002). Cultural competence in health care: Emerging frameworks and practical approaches (Vol. 576). New York, NY: Commonwealth Fund, Quality of Care for Underserved Populations. Search in Google Scholar

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Park, E. R. (2005). Cultural competence and health care disparities: key perspectives and trends. Health Affairs, 24(2), 499-505. https://doi.org/10.1377/hlthaff.24.2.499 Search in Google Scholar

Bofulin, M., Farkaš-Lainščak, J., Gosenca, K., Jelenc, A., Keršič-Svetel, M., Lipovec Čebron, U., ... & Zaviršek, D. (2018). Kulturne kompetence in zdravstvena oskrba: priročnik za razvijanje kulturnih kompetenc zdravstvenih delavcev [Cultural Competence and Healthcare: Manual for cultural competence development of healthcare workers]. Nacionalni inštitut za javno zdravje. Search in Google Scholar

Bradshaw, C., Atkinson, S., & Doody, O. (2017). Employing a qualitative description approach in health care research. Global Qualitative Nursing Research, 4. https://doi.org/10.1177/2333393617742282 Search in Google Scholar

Brown, E. A., Bekker, H. L., Davison, S. N., Koffman, J., & Schell, J. O. (2016). Supportive care: communication strategies to improve cultural competence in shared decision making. Clinical Journal of the American Society of Nephrology, 11(10), 1902-1908. https://doi.org/10.2215/CJN.13661215 Search in Google Scholar

Cai, D. Y. (2016). A concept analysis of cultural competence. International Journal of Nursing Sciences, 3(3), 268-273. https://doi.org/10.1016/j.ijnss.2016.08.002 Search in Google Scholar

Chae, D., Kim, J., Kim, S., Lee, J., & Park, S. (2020). Effectiveness of cultural competence educational interventions on health professionals and patient outcomes: A systematic review. Japan Journal of Nursing Science, 17(3), e12326. https://doi.org/10.1111/jjns.12326 Search in Google Scholar

Chassin, M. R., & Loeb, J. M. (2013). High‐reliability health care: getting there from here. The Milbank Quarterly, 91(3), 459-490. https://doi.org/10.1111/1468-0009.12023 Search in Google Scholar

Chiarenza, A. (2012). Developments in the concept of cultural competence. In Inequalities in health care for migrants and ethnic minorities, 2, 66-81. Antwerp: Ga-rant.check Search in Google Scholar

Constantinou, C. S., Andreou, P., Nikitara, M., & Papa-georgiou, A. (2022). Cultural competence in healthcare and healthcare education. Societies, 12(6), 178. https://doi.org/10.3390/soc12060178 Search in Google Scholar

Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches. Los Angeles: Sage Publication Inc. Search in Google Scholar

Cross, T. L., Bazron, B.J., Dennis, K.W., and Isaacs M.R. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. Washington DC: CASSP Technical Assistance center, Georgetown University Child Development Center. Search in Google Scholar

Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S. J., & Reid, P. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. International Journal for Equity In Health, 18, 1-17. https://doi.org/10.1186/s12939-019-1082-3 Search in Google Scholar

Lipovec Čebron, U., & Huber, I. (2020). Cultural Competence and Healthcare. Experiences from Slovenia. Etnološka tribina, (43), 68-88. https://doi.org/10.15378/1848-9540.2020.43.02 Search in Google Scholar

Davidson, E. M., Liu, J. J., Bhopal, R. A. J., White, M., Johnson, M. R., Netto, G., ... & Sheikh, A. (2013). Behavior change interventions to improve the health of racial and ethnic minority populations: a tool kit of adaptation approaches. The Milbank Quarterly, 91(4), 811-851. https://doi.org/10.1111/1468-0009.12034 Search in Google Scholar

De-María, B., Topa, G., and López-González, M. A. (2024). Cultural competence interventions in European healthcare: a scoping review. Healthcare, 12(10), 1040. https://doi.org/10.3390/healthcare12101040 Search in Google Scholar

Delphin-Rittmon, M. E., Andres-Hyman, R., Flanagan, E. H., & Davidson, L. (2013). Seven essential strategies for promoting and sustaining systemic cultural competence. Psychiatric Quarterly, 84, 53-64. https://doi.org/10.1007/s11126-012-9226-2 Search in Google Scholar

Diamond, L., Izquierdo, K., Canfield, D., Matsoukas, K., & Gany, F. (2019). A systematic review of the impact of patient–physician non-English language concordance on quality of care and outcomes. Journal of General Internal Medicine, 34, 1591-1606. https://doi.org/10.1007/s11606-019-04847-5 Search in Google Scholar

Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x Search in Google Scholar

Engebretson, J., Mahoney, J., & Carlson, E. D. (2008). Cultural competence in the era of evidence-based practice. Journal of Professional Nursing, 24(3), 172-178. https://doi.org/10.1016/j.profnurs.2007.10.012 Search in Google Scholar

Flynn, P. M., Betancourt, H., Emerson, N. D., Nunez, E. I., & Nance, C. M. (2020). Health professional cultural competence reduces the psychological and behavioral impact of negative healthcare encounters. Cultural Diversity & Ethnic Minority Psychology, 26(3), 271–279. https://doi.org/10.1037/cdp0000295 Search in Google Scholar

Giacomini, M. K., Cook, D. J., Evidence-Based Medicine Working Group, & Evidence-Based Medicine Working Group. (2000). Users‘ guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid?. Jama, 284(3), 357-362. https://doi.org/10.1001/jama.284.3.357 Search in Google Scholar

Government of Republic of Slovenia. (2020). Državno poročilo o stanju varstva pacientovih pravic za leto 2019 [State report on the patients’ rights protection for year 2019]. https://www.gov.si/assets/ministrstva/MZ/DO-KUMENTI/Drzavno-porocilo-o-stanju-varstva-pacientovih-pravic-za-leto-2019.pdf Search in Google Scholar

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PloS one, 14(7), e0219971. https://doi.org/10.1371/journal.pone.0219971 Search in Google Scholar

Harrison, R., Walton, M., Chauhan, A., Manias, E., Chit-kara, U., Latanik, M., & Leone, D. (2019). What is the role of cultural competence in ethnic minority consumer engagement? An analysis in community heal-thcare. International Journal for Equity in Health, 18, 1-9. https://doi.org/10.1186/s12939-019-1104-1 Search in Google Scholar

Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community, 26(4), 590-603. https://doi.org/10.1111/hsc.12556 Search in Google Scholar

Hickson, S. V. (2024). Healthcare disparities. Clinics in Integrated Care, 22, 100181. https://doi.org/10.1016/j.intcar.2023.100181 Search in Google Scholar

Hui, A., Latif, A., Hinsliff-Smith, K., & Chen, T. (2020). Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: Illustrative cases from the UK heal-thcare system. Health Policy, 124(3), 298-302. https://doi.org/10.1016/j.healthpol.2020.01.003 Search in Google Scholar

Jongen, C., McCalman, J., Bainbridge, R., & Clifford, A. (2018). Cultural Competence in Health: a Review of the Evidence. Singapore: Springer. Search in Google Scholar

Johnson, J. L., Adkins, D., & Chauvin, S. (2020). A review of the quality indicators of rigor in qualitative research. American Journal of Pharmaceutical Education, 84(1), 7120. https://doi.org/10.5688/ajpe7 Search in Google Scholar

Kavčič, M., Pahor, M., & Domajnko, B. (2015). User involvement in Slovenian healthcare. Journal of Health Organization and Management, 29(5), 595-610. https://doi.org/10.1108/JHOM-06-2014-0095 Search in Google Scholar

Kanengoni-Nyatara, B., Watson, K., Galindo, C., Charania, N. A., Mpofu, C., & Holroyd, E. (2024). Barriers to and recommendations for equitable access to healthcare for migrants and refugees in Aotearoa, New Zealand: An integrative review. Journal of Immigrant and Minority Health, 26(1), 164-180. https://doi.org/10.1007/s10903-023-01528-8 Search in Google Scholar

Kapilashrami, A., Hill, S., & Meer, N. (2015). What can health inequalities researchers learn from an intersectionality perspective? Understanding social dynamics with an inter-categorical approach?. Social Theory & Health, 13, 288-307. https://doi.org/10.1057/sth.2015.16 Search in Google Scholar

Kumar, P., Bera, S., Dutta, T., & Chakraborty, S. (2018). Auxiliary flexibility in healthcare delivery system: An integrative framework and implications. Global Journal of Flexible Systems Management, 19(2), 173-186. https://doi.org/10.1007/s40171-018-0183-y Search in Google Scholar

Lichon, M., Kavcic, M., & Masterson, D. (2015). A comparative study of contemporary user involvement within healthcare systems across England, Poland and Slovenia. Journal of Health Organization and Management, 29(5), 625-636. https://doi.org/10.1108/JHOM-05-2014-0088 Search in Google Scholar

Lin, M. H., & Hsu, H. C. (2020). Effects of a cultural competence education programme on clinical nurses: A randomised controlled trial. Nurse Education Today, 88, 104385. https://doi.org/10.1016/j.nedt.2020.104385 Search in Google Scholar

Lundin, C., Hadziabdic, E., & Hjelm, K. (2018). Language interpretation conditions and boundaries in multilingual and multicultural emergency healthcare. BMC International Health and Human Rights, 18, 1-14. https://doi.org/10.1186/s12914-018-0157-3 Search in Google Scholar

McCalman, J., Jongen, C., & Bainbridge, R. (2017). Organisational systems’ approaches to improving cultural competence in healthcare: a systematic scoping review of the literature. International journal for equity in health, 16, 1-19. https://doi.org/10.1186/s12939-017-0571-5 Search in Google Scholar

Mews, C., Schuster, S., Vajda, C., Lindtner-Rudolph, H., Schmidt, L. E., Bösner, S., ... & Knipper, M. (2018). Cultural competence and global health: Perspectives for medical education–Position paper of the GMA committee on cultural competence and global health. GMS Journal for Medical Education, 35(3). https://doi.org/10.3205/zma001174 Search in Google Scholar

Mitchell, J. I., Graham, I. D., & Nicklin, W. (2020). The unrecognized power of health services accreditation: more than external evaluation. International Journal for Quality in Health Care, 32(7), 445-455. https://doi.org/10.1093/intqhc/mzaa063 Search in Google Scholar

Mubarak, F., & Suomi, R. (2022). Elderly forgotten? Digital exclusion in the information age and the rising grey digital divide. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 59, 00469580221096272. https://doi.org/10.1177/00469580221096272 Search in Google Scholar

Napier, A. D., Depledge, M., Knipper, M., Lovell, R., Ponarin, E., Sanabria, E., & Thomas, F. (2017). Culture matters: using a cultural contexts of health approach to enhance policy making. World Health Organization. Regional Office for Europe. Search in Google Scholar

O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine, 89(9), 1245-1251.. https://doi.org/10.1097/ACM.0000000000000388 Search in Google Scholar

Okolo, C. A., Ijeh, S., Arowoogun, J. O., Adeniyi, A. O., & Omotayo, O.(2024). Healthcare Manageŕs role in Adressing Health Disparities: A review of strategies. International Journal of Applied Research in Social Sciences, 6(4), 518-531. https://doi.org/10.51594/ijarss.v6i4.989 Search in Google Scholar

Paternotte, E., van Dulmen, S., van der Lee, N., Scherpbier, A. J., & Scheele, F. (2015). Factors influencing intercultural doctor–patient communication: A realist review. Patient education and counseling, 98(4), 420-445. https://doi.org/10.1016/j.pec.2014.11.018 Search in Google Scholar

Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. BMJ, 320(7227): 114–116. https://doi.org/10.1136/bmj.320.7227.114 Search in Google Scholar

Powell, D. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 22(1): 5–10. https://doi.org/10.1891/1078-4535.22.1.5 Search in Google Scholar

Ramšak, M., Orzechowski, M., Bielińska, K., Chowaniec, A., Doričić, R., Nowak, M., ... & Steger, F. (2023). Diversity awareness, diversity competency and access to healthcare for minority groups: perspectives of healthcare professionals in Croatia, Germany, Poland, and Slovenia. Frontiers in Public Health, 11, 1204854. https://doi.org/10.3389/fpubh.2023.1204854 Search in Google Scholar

Rechel, B., Mladovsky, P., Ingleby, D., Mackenbach, J. P., & McKee, M. (2013). Migration and health in an increasingly diverse Europe. The Lancet, 381(9873), 1235-1245. https://doi.org/10.1016/S0140-6736(12)62086-8 Search in Google Scholar

Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC. http://data.europa.eu/eli/reg/2016/679/oj Search in Google Scholar

Reese, D. J., Buila, S., Cox, S., Davis, J., Olsen, M., & Jurkowski, E. (2017). University–community–hospice partnership to address organizational barriers to cultural competence. American Journal of Hospice and Palliative Medicine, 34(1), 64-78. https://doi.org/10.1177/1049909115607295 Search in Google Scholar

Saeed, S. A., & Masters, R. M. (2021). Disparities in health care and the digital divide. Current Psychiatry Reports, 23, 1-6. https://doi.org/10.1007/s11920-021-01274-4 Search in Google Scholar

Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275-1285. https://doi.org/10.1016%2Fs0027-9684(15)31505-4 Search in Google Scholar

Schenk, L., Sonntag, P. T., Beck, P., Khan, Z., Peppler, L., & Schouler-Ocak, M. (2022). Organisational and staff-related effects on cultural competence in the hospital setting: a cross-sectional online survey of nursing and medical staff. BMC Health Services Research, 22(1), 644. https://doi.org/10.1186/s12913-022-07947-x Search in Google Scholar

Schiaffino, M. K., Ruiz, M., Yakuta, M., Contreras, A., Akhavan, S., Prince, B., & Weech-Maldonado, R. (2020). Culturally and linguistically appropriate hospital services reduce Medicare length of stay. Ethnicity & Disease, 30(4), 603-610. https://doi.org/10.18865/ed.30.4.603 Search in Google Scholar

Singh, I. (2023). Understanding of cultural competence is essential for the delivery of compassionate, fair, and proportionate medical regulations. The Lancet, 402(10400), 434-435. https://doi.org/10.1016/S0140-6736(23)00524-X Search in Google Scholar

Sparks, C. (2013). What is the “digital divide” and why is it important?. Javnost-The Public, 20(2), 27-46. https://doi.org/10.1080/13183222.2013.11009113 Search in Google Scholar

Škraban, J. 2020. Uvod k slovenski izdaji [Introduction to the Slovenian Edition]. In Verrept, H., & Coune, I. Standardi medkulturne mediacije v zdravstvu [Guide for intercultural mediation in healthcare] (J.Škraban, trans.). Ljubljana: Nacionalni inštitut za javno zdravje. Search in Google Scholar

Taylor, R. (2005). Addressing barriers to cultural competence. Journal for Nurses in Professional Development, 21(4), 135-142. Search in Google Scholar

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC Health Services Research, 14, 1-17. https://doi.org/10.1186/1472-6963-14-99 Search in Google Scholar

Van Gool, F. W. R., Theunissen, N. C. M., Bierbooms, J. J. P. A., & Bongers, I. M. B. (2017). Literature study from a social ecological perspective on how to create flexibility in healthcare organisations. International Journal of Healthcare Management, 10(3), 184-195. https://doi.org/10.1080/20479700.2016.1230581 Search in Google Scholar

Weech-Maldonado, R., Dreachslin, J. L., Epané, J. P., Gail, J., Gupta, S., & Wainio, J. A. (2018). Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for health-care leadership diversity demonstration project. Health Care Management Review, 43(1), 30-41. https://doi.org/10.1097/HMR.0000000000000128 Search in Google Scholar

WHO (World Health Organization). 2021. The Global Health Observatory. Health equity monitor: About the Health Equity Monitor. Search in Google Scholar

Yong-Hing, C. J., & Khosa, F. (2023). Provision of culturally competent healthcare to address healthcare disparities. Canadian Association of Radiologists Journal, 74(3), 483-484.2023;74(3):483-484. https://doi:10.1177/08465371231154231 Search in Google Scholar

Yousef, K. (2024). Intercultural Communicative Competence in Virtual and Face-to-Face Teamwork: A Quantitative Analysis of Culturally Diverse Teams. Organizacija, 57(2), 139-150. https://doi.org/10.2478/orga-2024-0010 Search in Google Scholar

Železnik, D., Kokol, P., & Blažun Vošner, H. (2017). Adapting nurse competence to future patient needs using Checkland’s Soft Systems Methodology. Nurse Education Today 48: 106–110. https://doi.org/10.1016/j.nedt.2016.09.015 Search in Google Scholar