Literature Review: Table of Evidence on Cultural Barriers in Healthcare for Indigenous Australians

This literature review provides evidence on the cultural barriers faced by Indigenous Australians when seeking healthcare from mainstream healthcare settings. It includes strategies for cultural respect, barriers to cultural respect, and interventions to improve cultural competency in healthcare.

Literature Review: Table of Evidence
Student Name:
Describe the barrier or issue in health care that you want to address for your Capstone Project Paper (two or three sentences):
© 2015. Grand Canyon University. All Rights Reserved.
Indigenous Australians experience many challenges when seeking healthcare from mainstream healthcare settings. In this regard,
cultural barrier has been identified as a problem that most Aboriginal people face when seeking health care services.

Criteria Article 1 Article 2 Article 3 Article 4
Author, Journal (Peer-
Reviewed), and
Permalink or Working
Link to Access Article
Author(s): Toby
Freeman, Tahnia
Edwards, Fran
Baum, Angela
Lawless, Gwyn
Jolley, Sara
Javanparast, and
Theresa Francis
Journal: Australian
and New Zealand
Journal of Public
Health
Link: doi:
10.1111/1753-
6405.12231
Author(s): Elizabeth F.,
Rix, Lesley Barclay,
Janelle Stirling, Allison
Tong, and Shawn
Wilson.
Journal: Hemodialysis
International
Link: doi:
10.1111/hdi.12201
Author(s): Renata FI
Meuter, Cindy
Gallois, Norman S.
Segalowitz, Andrew
G. Ryder, and Julia
Hocking
Journal: BMC health
services research
Link: doi:
10.1186/s12913-015-
1024-8
Author(s): Khalid M. Almutairi
Journal: Saudi Medical Journal
Link: doi:
10.15537/smj.2015.4.10133
Article Title and Year
Published
Title: Cultural
respect strategies
in Australian
Aboriginal primary
health care
services: beyond
education and
training of
practitioners
Year: 2014
Title: The perspectives
of Aboriginal patients
and their healthcare
providers on improving
the quality of
hemodialysis services:
A qualitative study
Year: 2015
Title: Overcoming
language barriers in
healthcare: A
protocol for
investigating safe and
effective
communication when
patients or clinicians
use a second
language
Year: 2015
Title: Culture and language
differences as a barrier to the
provision of quality care by the
health workforce in Saudi
Arabia
Year: 2015
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Aim: To asses
cultural respect
techniques, patient
Aim: To elucidate and
explore the viewpoint
of Indigenous
Aim: To investigate
miscommunication as
well as language
Purpose: To establish, assess and
summarize problems associated
with language and culture
2

Purposes/Aim of Study experience and
inhibitor of
cultural respect.
Australians’ and
healthcare staff’s
experience of renal
service.
barriers that are likely
to occur in hospitals
between physicians
and patients.
differences among healthcare
providers in Saudi Arabia.
Design (Quantitative,
Qualitative, or other)
Qualitative Qualitative Qualitative and
quantitative
Qualitative
Setting/Sample -6 PHC services
-21 clients in PHC
-18 Aboriginal patients
-29 healthcare
providers
80 interactions
between physicians
and patients
12 secondary studies
Methods:
Intervention/Instruments
Interviews Interviews -Questionnaire
-Video recording
Systematic review
Analysis Thematic analysis Thematic analysis -Content analysis
- Discursis analysis
Content analysis
Key Findings Strategies for
cultural respect
are:
-Social perception
of health
-Focusing on the
social determinants
of health
-Hiring Aboriginal
workers
-Barriers to
cultural respect
are:
-communication
difficulties
-Racism and
discrimination
-External programs
Crisis can be avoided
by:
-Adaptable family-
focused care
-Engaging a patient
early
-Addressing the fear of
services
-Focus on culture when
delivering services
-Cultural barriers
influence
communications
between patients and
healthcare providers.
-Lack of knowledge of culture
resulted in culture shock and
culture incompetence
-Language differences affected
the provision of clear
instructions in healthcare
settings.
3

Recommendations The Aboriginal
workforce should
be supported to
enhance cultural
respect the health
system
-Service redesigning is
required to address
Aboriginal needs
-Healthcare providers
should improve the
relationship with
patients
There is a need to
develop appropriate
techniques to address
the aspect of cultural
differences because it
might affect the
quality of healthcare.
The government should offer
educational programs about
culture and language.
Explanation of How the
Article Supports Your
Identified Barrier or
Issue in Health Care
This article will
help me to
determine the
barriers to
culturally
competent care
and possible
solutions.
This article is helpful
because it focuses on
two main themes
including cultural
competence and
cultural awareness
training.
This source is good
for the topic because
it confirms that
cultural difference
influences the quality
of healthcare.
Although this study is done
outside Australia, it offers
information on the effects and
how other countries in the world
are dealing with the issue of
cultural and language
differences in healthcare
settings.
Criteria Article 1 Article 2 Article 3 Article 4
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Author(s): Jessica
Conway, George
Tsourtos, and
Sharon Lawn
Journal: BMC
health services
research
Link: doi:
10.1186/s12913-
017-2265-5
Author(s):
Shaouli Shahid,
Angela Durey,
Dawn Bessarab,
Samar M.
Aoun, and
Sandra C.
Thompson
Journal: BMC
health services
research
Link: doi:
Author(s): Pippa Waterworth,
Melanie Pescud, Rebecca Braham,
James Dimmock, and Michael
Rosenberg
Journal: PloS one
Link:
https://doi.org/10.1371/journal.pone.
0142323
Author(s): Anton Clifford,
Janya McCalman, Roxanne
Bainbridge, and Komla Tsey
Journal: International Journal
for Quality in Health Care
Link:
https://doi.org/10.1093/intqhc/
mzv010
4

10.1186/1472-
6963-13-460
Article Title and
Year Published
Title: The
barriers and
facilitators that
indigenous health
workers
experience in
their workplace
and communities
in providing self-
management
support: a
multiple case
study.
Year: 2017
Title:
Identifying
barriers and
improving
communication
between cancer
service
providers and
Aboriginal
patients and
their families:
the perspective
of service
providers
Year: 2013
Title: Factors influencing the health
behaviour of indigenous Australians:
Perspectives from support people.
Year: 2015
Title: Interventions to improve
cultural competency in health
care for Indigenous peoples of
Australia, New Zealand,
Canada, and the USA: a
systematic review
Year: 2015
Research Questions
(Qualitative)/Hypot
hesis (Quantitative),
and Purposes/Aim
of Study
Aim: To examine
indigenous health
workers (IHWs)
views of the
efficacy and
suitability of the
Flinders Closing
the Gap Program
(FCTGP).
Purpose: To
report cancer
service
providers’
(CSPs)
viewpoint
regarding the
elements
inhibiting
communication
and provide
techniques for
appropriate
communication
Aim: To interview persons who offer
support to aboriginal populations to
get an understating of their
perceptions on aspects affecting
health behaviors among aboriginal
populations.
Purpose: To discuss the
attributes and review the
quality of interventions created
to enhance cultural competence
in health care for indigenous
persons in different countries
including the U.S., New
Zealand, Canada, and
Australia.
5

with Aboriginal
patients.
Design
(Quantitative,
Qualitative, or
other)
Qualitative Qualitative Qualitative Qualitative
Setting/Sample 5 IHWs 62 indigenous
and non-
indigenous
(CSPs)
29 people -16 review studies
Methods:
Intervention/Instru
ments
Interviews Interviews Interview Systematic review
Analysis Thematic
analysis
Thematic
analysis
Thematic analysis Content analysis
Key Findings -Barriers to the
provision of
FCTGP included
negative
experience within
most mainstream
health services.
-CSPs do not
have
knowledge
about the needs
of indigenous
people with
cancer
-Indigenous
people with
cancer do not
have
knowledge of
western
medicine.
- The main factors that were
identified include social networks,
culture, racism, psychological
distress, and history.
The interventions that have
developed in the countries are
the employment of indigenous
staff, the introduction of
culturally competent programs
and training programs for staff.
Recommendations Improve support
for IHWs to
-More
aboriginal staff
Indigenous people can form
community coalitions to enhance
Researchers should pay
attention to the effectiveness of
6

foster the
provision of
FCTGP.
should be
recruited to
bridge the gap
in cultural
differences
health behavior, which will reduce
health inequalities and empower the
community.
the existing methods to address
cultural competence in
healthcare.
Explanation of How
the Article Supports
Your Identified
Barrier or Issue in
Health Care
The article is
helpful because it
involves
indigenous
healthcare
providers who
explain the
problems that
patients
experience in
mainstream
healthcare
services mainly
due to cultural
differences.
The article is
suitable
because it
investigates the
effects of
cultural
differences for
a single illness
and offers a
practical
solution.
Even though this article has
identified many factors that affect
health behaviors among indigenous
populations, it has highlighted
culture as aim important element,
which is the focus on the topic under
study.
This article supports the
selected health issue because it
presents a review of multiple
strategies to address the issue.
7

References
Almutairi, K. M. (2015). Culture and language differences as a barrier to provision of quality
care by the health workforce in Saudi Arabia. Saudi Medical Journal, 36(4), 425.
Clifford, A., McCalman, J., Bainbridge, R., & Tsey, K. (2015). Interventions to improve cultural
competency in health care for Indigenous peoples of Australia, New Zealand, Canada and
the USA: a systematic review. International Journal for Quality in Health Care, 27(2),
89-98.
Conway, J., Tsourtos, G., & Lawn, S. (2017). The barriers and facilitators that indigenous health
workers experience in their workplace and communities in providing self-management
support: a multiple case study. BMC health services research, 17(1), 319.
Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S., & Francis, T.
(2014). Cultural respect strategies in Australian Aboriginal primary health care services:
beyond education and training of practitioners. Australian and New Zealand Journal of
Public Health, 38(4), 355-361.
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming
language barriers in healthcare: A protocol for investigating safe and effective
communication when patients or clinicians use a second language. BMC health services
research, 15(1), 371.
Rix, E. F., Barclay, L., Stirling, J., Tong, A., & Wilson, S. (2015). The perspectives of A
boriginal patients and their health care providers on improving the quality of
hemodialysis services: A qualitative study. Hemodialysis International, 19(1), 80-89.
© 2015. Grand Canyon University. All Rights Reserved.

Shahid, S., Durey, A., Bessarab, D., Aoun, S. M., & Thompson, S. C. (2013). Identifying barriers
and improving communication between cancer service providers and Aboriginal patients
and their families: the perspective of service providers. BMC health services research,
13(1), 460.
Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors
influencing the health behaviour of indigenous Australians: Perspectives from support
people. PloS one, 10(11), e0142323.
9