Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis

• Published in: BMC family practice 2024-10, Vol.25 (1), p.381-17, Article 381
• Main Authors: Vandecasteele, Robin, Robijn, Lenzo, Willems, Sara, De Maesschalck, Stéphanie, Stevens, Peter A J
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Attitude of Health Personnel; Barriers and facilitators; Behavior; Belgium; Communication Barriers; Cultural competence; Cultural differences; Cultural identity; Culturally Competent Care; Culturally sensitive care; Culture; Decision making; Ethnicity; Evaluation; Family medicine; Female; Gender; General Practice; General practitioners; General Practitioners - psychology; Health aspects; Health care disparities; Health care reform; Health disparities; Health equity; Humans; Intercultural communication; Interviews as Topic; Language; Male; Management; Medical care; Middle Aged; Minority & ethnic groups; Multiculturalism; Multiculturalism & pluralism; Patient satisfaction; Perceptions; Physician-Patient Relations; Physicians (General practice); Primary care; Qualitative Research; Quality management; Reflexive thematic analysis
• ISSN: 2731-4553; 2731-4553; 1471-2296
• DOI: 10.1186/s12875-024-02630-y

This study investigated the perceived barriers and potential facilitators for culturally sensitive care among general practitioners in Flanders. Understanding these dynamics is crucial for improving healthcare quality and equity. Twenty-one in-depth interviews were conducted with Flemish GPs. Braun and Clarke's reflexive thematic analysis was employed to develop and interpret themes that elucidate shared underlying meanings and capture the nuanced challenges and strategies related to cultural sensitivity in healthcare. Two core themes were generated: GPs' uncertainty and opposition. These themes manifest in emotional responses such as frustration, miscomprehension, and feelings of helplessness, influencing relational outcomes marked by patient disconnect and reduced motivation for cultural sensitivity. The barriers identified are exacerbated by resource scarcity and limited intercultural contact. Conversely, facilitators include structural elements like interpreters and individual strategies such as engagement, aimed at enhancing GPs' confidence in culturally diverse encounters. A meta-theme of perceived lack of control underscores the challenges, particularly regarding language barriers and resource constraints, highlighting the critical role of GPs' empowerment through enhanced intercultural communication skills. Addressing GPs' uncertainties and oppositions can mitigate related issues, thereby promoting comprehensive culturally sensitive care. Essential strategies include continuous education and policy reforms to dismantle structural barriers. Moreover, incentivizing culturally sensitive care through quality care financial incentives could bolster GP motivation. These insights are pivotal for stakeholders-practitioners, policymakers, and educators-committed to advancing culturally sensitive healthcare practices and, ultimately, for fostering more equitable care provision.