Literature Review - Research Process :: Step by Step

Running head: HEALTHCARE ADMIN CAPSTONE
CULTURALLY SENSITIVE COMMUNICATION
Name of the Student:
Name of the University:
Author Note:

1LITERATURE REVIEW
Introduction
Communication is an effective approach that helps healthcare providers or healthcare
professionals in understanding the needs of the patients. However, diversity in culture
becomes a barrier to developing effective communication among healthcare professionals and
patients. Healthcare professionals should be able to understand the needs, circumstances, or
pain of the people that belong from the common nation, cultural heritage, or race to improve
effective culturally sensitive communication with the patients (Kourkouta, & Papathanasiou,
2014). Therefore, it is important for healthcare providers or healthcare professionals should
be aware of cultural knowledge along with cultural skills. Communication is important as it
helps in building trust and avail of efficient information from the patients. Besides, patients
and their families would also be benefited from effective communication regarding the
current health status or possible health outcomes. Nursing professionals are the advocate of
patients, and culturally sensitive communication would enable the nurses to deliver along
with administering quality care. Many kinds of the literature suggest the implementation of
culturally sensitive communication strategies or practices among healthcare professionals to
provide effective care to patients and families.
Background of Culturally Diversity Communication
Globalization has resulted in increased cultural diversity at the national and
international levels. According to Crawford, Candlin, & Roger (2017), communication is
complicated and, therefore, suggests that building a strong relationship with patients and their
families would ease the communication. Successful healthcare professionals would
effectively communicate with the help of effective communication that results in the ability
to empathize and associate with patients. Cultural diversity communication refers to the
communication where the healthcare professionals would reflect their perspectives and

2LITERATURE REVIEW
culture along with understanding the culture and perspectives of patients and their families.
Thus, it is essential to provide culturally sensitive communication in the framework of
patient-centered care as the structure works on the perspective of patients. Reflecting on the
needs and demands of patients by engaging the culture and their beliefs.
Barriers in Communication
According to Hart & Mareno (2014), nursing professionals find it difficulties in
availing education along with remembering the preferences and beliefs of multiple cultures.
Further, nurses also shared their views that the blending of multiple cultures makes it difficult
to understand the exact expectation and opinions of patients. Therefore, the major barrier to
communication is great diversity. There is a vast number of cultures and numerous ethnic
groups. In healthcare settings or hospitals, people visit from diversely cultural backgrounds.
Healthcare professionals often find difficulties in addressing their viewpoints. Person-
centered care needs to deliver care in accordance with the preferences and needs of the
patients. Thus, the diversity of culture may obstruct the delivery of quality care services to
patients and families. The increased diversity has also influenced the stress on the healthcare
professionals in delivering services (Purnell & Fenkl, 2019). Many culturally diverse people
often find reluctance in specific treatment or procedures; they tend to avail of traditional
home treatment.
Another major barrier is the lack of resources in healthcare settings or hospitals for
effective, culturally sensitive communication. According to Hart & Mareno (2014), there is a
lack of knowledgeable people or persons who would help the healthcare professionals in
delivering the specific answer about a particular population or particular ethnic group. It is
difficult for a single person to hold knowledge about every cultural group. Apart from
experience, nursing professional also finds a lack of time. Time is another valuable resource;

3LITERATURE REVIEW
nursing professionals work in a team and are under huge pressure (Enns & Sawatzky, 2016).
They are responsible for multiple daily activities starting from assisting patients in assisting
physicians in delivering effective care. The cultural diversity has resulted in consuming more
time in understanding the needs of the patients. The nursing professionals find it difficult to
assess interpreters or to understand the traditional treatment procedures within the time
constraint.
The major barrier of practicing culturally sensitive communication by the nursing
professionals and other healthcare professionals is the inadequacy of effective training on
culturally competent communication. It has been found that nursing professionals who have
received training in cultural competence communication are also lacking in effective
communication (Horvat et al., 2014). Thus, the training module should involve enough
knowledgeable and evidence based approaches that healthcare professionals can practice.
However, it has been found that only training would not improve culturally sensitive
communication; the nursing professionals or nursing staff must be exposed to the culturally
diverse population in gaining adequate knowledge about the diverse cultures. The language is
another barrier, and thus the training should also consider providing the relevant training in
improving the language barrier among the healthcare professionals in delivering the care to
the patients. The nurses who would communicate with a similar language as the patients tend
to build a strong relationship with the patients (Almutairi, 2015). Thus, resulting in effective,
culturally sensitive communication.
The prejudices and biasness also act as a barrier in communicating with the
consideration of culturally sensitive. It has been found that sometimes nursing professionals
do not communicate with culturally sensitive towards the patients visiting from different
countries or different ethnic backgrounds (Hart & Mareno, 2014).

4LITERATURE REVIEW
Relationship between communication and health outcome
Communication is an effective tool in developing the health outcomes of the patients.
The communication can be either verbal or non-verbal; however, there are multiple barriers
in communication. The major is culturally sensitive communication, due to numerous factors
and elements, there is a lack of effective communication. Several researchers have found that
effective communication is a significant key element in developing positive health outcomes.
Communication helps in making relevant clinical decisions on health outcomes. According to
Brown et al. (2016), communication would improve the self-efficacy among the patients and
helps in providing complex information about the health status of the patients. Patients are
best in providing their previous medical history, and it can only be done with the help of
multiple effective practices. Thus, there is a strong relationship between health outcomes and
effective, culturally sensitive communication.
Evidence-based practice to increase the communication
Evidence-based practice is the most approachable problem-solving tool. The
implementation of evidence-based practice would result in effective outcomes to the problem.
The evidence-based practice is effective and adequate training for healthcare professionals to
increase culturally sensitive communication (Portney, 2020). The nursing institute or schools
must include a subject on foreign language or workshops to gain communication skills. The
training can be provided in the hospital or any healthcare settings regarding the best practice
of communication for delivering quality care. The skills such as active listening must be
practice by the nursing staff to understand the needs along with emphasizing the patients.
According to Bodenheimer (2018), teach-back communication is a strategy for developing
effective, culturally sensitive communication between the patient and healthcare
professionals. This strategy of teach-back involves the assessment of the patient. The
recommendation or instructions given by the healthcare professionals need to be repeated by

5LITERATURE REVIEW
the patients in their own words. Therefore, this process is also known as closing the loop, and
it would help in a clear understanding of the mind of patients regarding their health status.
Another major evidence-based practice is developing two-way communication, and it would
help in generating shared decision based on the belief and culture of the patients along with
families (Cheng, 2017).
Conceptual Framework
Figure 1: Conceptual framework
Source: (Created by the author)
The above figure is the conceptual figure that describes the major concepts for
delivering and developing effective, culturally sensitive communication among patients and
healthcare providers. According to Kastanakis & Voyer (2014), the major drivers of
communications are attitudes of healthcare professionals, implementation of evidence-based
practices, and increasing the skill sets of healthcare professionals.
Skills
Evidence
-based
Practices
Cultural
sensitive
communica
tion
Attitude
Building relationship
Building rapport
Improves
communication skills
Willingness to interact,
empathy and emotional
self-regulation
Awareness of
the cultural
diversity, taking
perspective,
communication
strategy

6LITERATURE REVIEW
Literature Review Cycle
A literature review cycle is an efficient tool to provides information on multiple types
of research and articles. It helps in understanding the previous pieces of evidence and
researches on the topic. This cycle helps in understanding details about the problem area and
provides information about previous findings (Hart, 2018).
Figure 2: Literature Review cycle
Source: Created by Author
Conclusion
From the above analysis and discussion, the researcher would find the relevant in-
depth information and knowledge of culturally sensitive communication. Communication in
Identified the
problem area
Searched the
necessary
literature
Written
relevant
reviews based
on the
literatures
Critically
analyzed the
references
Managed
references

7LITERATURE REVIEW
healthcare needs to be effective as it involves information about treatment or any clinical
procedures. Besides, the diversity in the cultural activities acts as a major barrier in delivering
effective communication to the patients. Therefore, major necessary strategies or theories
need to be implemented as an action plan for reducing the problem area of effective
communication. Based on multiple pieces of literature and articles, the major barriers have
been identified for delivering culturally sensitive communication. The literature has also
proven that there is an existing relationship between the effective communication and health
outcomes of the patients and families. Thus, it is important for implementing evidence-based
practices to improve culturally sensitive communication.

8LITERATURE REVIEW
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.
Bodenheimer, T. (2018). Teach-back: a simple technique to enhance patients’
understanding. Family practice management, 25(4), 20-22.
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.
Cheng, D. (2017). “Communication is a two-way street”: Instructors’ perceptions of student
apologies. Pragmatics, 27(1), 1-32.
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural
diversity in nurse–patient communication. Collegian, 24(1), 63-69.
Enns, C. L., & Sawatzky, J. A. V. (2016). Emergency nurses’ perspectives: Factors affecting
caring. Journal of Emergency Nursing, 42(3), 240-245.
Hart, C. (2018). Doing a literature review: Releasing the research imagination. Sage.
Hart, P. L., & Mareno, N. (2014). Cultural challenges and barriers through the voices of
nurses. Journal of clinical nursing, 23(15-16), 2223-2233.
Horvat, L., Horey, D., Romios, P., & Kis‐Rigo, J. (2014). Cultural competence education for
health professionals. Cochrane database of systematic reviews, (5).
Kastanakis, M. N., & Voyer, B. G. (2014). The effect of culture on perception and cognition:
A conceptual framework. Journal of Business Research, 67(4), 425-433.

9LITERATURE REVIEW
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia
socio-medica, 26(1), 65.
Portney, L. G. (2020). Foundations of Clinical Research: Applications to Evidence-Based
Practice. FA Davis.
Purnell, L. D., & Fenkl, E. A. (2019). Transcultural diversity and health care. In Handbook
for Culturally Competent Care (pp. 1-6). Springer, Cham.