RECOGNISING AND RESPONDING TO PATIENTS’ CULTURAL CARE NEEDS AND PREFERENCES IN HAEMODIALYSIS: AN OBSERVATIONAL STUDY

 

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RECOGNISING AND RESPONDING TO PATIENTS’ CULTURAL CARE NEEDS AND PREFERENCES IN HAEMODIALYSIS: AN OBSERVATIONAL STUDY

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Sara
Aryal
Sara Aryal sara.aryal@griffithuni.edu.au Griffith University School of Nursing and Midwifery Brisbane Australia *
Paul Bennett paul.bennett@griffith.edu.au Griffith University School of Nursing and Midwifery Brisbane Australia -
Areum Hyun a.hyun@griffith.edu.au Griffith University School of Nursing and Midwifery Brisbane Australia -
Rochelle Wynne r.wynne@deakin.edu.au School of Nursing & Midwifery, Deakin University Centre for Quality & Patient Safety Research in the Institute for Health Transformation Geelong Australia -
Melissa Bloomer m.bloomer@griffith.edu.au School of Nursing and Midwifery, Griffith University and Intensive Care Unit, Princess Alexandra Hospital, Brisbane Australia -
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Patients with diverse cultural characteristics often have unique care needs, and when these are unmet, their healthcare experiences may be negatively affected. Recognising the cultural needs and preferences of patients receiving haemodialysis is vital to improving care. However, adapting care to respond to patients’ needs and preferences can be challenging for clinicians. It is important to understand if and how clinicians provide culturally responsive care.

Non-participant observation was used to collect data across 24 observation episodes involving 46 clinician participants. Data were collected at two haemodialysis centres in Australia during May and June 2025. Each observation episode lasted between 1.5 and 3.5 hours totalling approximately 56 hours of observation. Informal conversations were occasionally held to clarify observed actions and contextualise behaviours. Data were analysed using inductive content analysis.


Three themes were identified: (i) recognition of cultural care needs and preferences (ii) staff allocation by shared cultural or linguistic background (iii) adapting communication. Clinicians’ responses to patients’ cultural needs and preferences were reactive, initiated in response to specific needs identified during care, rather than being part of routine haemodialysis care. To overcome communication challenges, clinicians used simplified language, repeated short phrases, gestures, visual aids, and translation apps. In addition, clinicians were allocated to match patients’ cultural or linguistic background and preferred language. Culturally specific commitments such as attending funerals or community and church events were recognised and accommodated through flexible dialysis scheduling.


Cultural care needs were recognised, but responses were often situational and dependent on immediate circumstances. While attempts to address language and communication barriers were commonly recognised and addressed, other potential cultural care needs such as culturally specific food preferences and traditional health beliefs were rarely identified or discussed. This suggests that some culturally significant aspects of patients’ lives may remain unacknowledged and unmet in haemodialysis care. Implementing cultural assessment tools and protocols, culturally tailored resources and opportunities for staff education may assist in promoting consistent, equitable, and person-centred care, improving patient experiences.

Kewords