Abstract
Background: Conflicts during communication inmulti-ethnichealthcare settings is an increasing point ofconcern as a result of societies’increased ethno-culturaldiversity.We can expect that conflicts are even more likely to arise insituations where difficult medical decisions have to be made, such as critical medical situations in hospital. However, in-depth research on this topic is rather scarce. During critical care patients are oftenunable to communicate. We have therefore investigated factors contributing to conflicts between healthcare professionals and family membersfrom ethnic minority groups in critical medical situations in hospital.
Methods: Ethnographic fieldwork was donein one intensive care unit of a multi-ethnic urban hospital in Belgium over 6months (January 2014 to June 2014). Data were collected through negotiated interactive observation, patients’ in-depth interviews with healthcare professionals,from medical records,and by making notes ina | logbook. Data | were | analysed | by using | grounded | theory | procedures. | | | | | ————- | —- | ——– | ——– | ——– | —— | ———– | — | — | — |
Results: Conflicts were essentially related to differences inparticipants’views onwhat constitutes ‘goodcare’based professionals’views ondifferent care approaches. Healthcare ongoodcare were based predominantlyon a biomedical care model, whereas families’views ongoodcare were mainly inspired by a holistic lifeworld-oriented approach. Giving good care, from thehealthcare professionals’point of view, included great attention to regulations, structured communication, and central decisionmaking.Ontheother hand, goodcare from the families’ point of view included seeking exhaustive information, and participating inend-of-life decisionmaking. professionals’biomedical Healthcare views on offering good care were strengthened by the features of the critical care context whereas families’holistic views onofferinggood care were reinforced by the specific characteristicsof families’ ethno-familialcare context, including their different ethno-cultural backgrounds. However, ethno-cultural differences between participants onlycontributed to conflicts inconfrontation with a triggeringcritical care context.
Conclusions: Conflicts cannot be exclusively linked to ethno-cultural differences as structural, functional characteristics of critical care substantially contribute to the development ofconflicts.Therefore, effective conflict prevention should not onlyfocus on ethno-culturaldifferentnessbut should alsotake the structural organizational | characteristics | of | thecritical | care context | sufficiently | | into account. | | | | | ————— | — | ———– | ———— | ———— | — | ————- | — | — | — |