The Effectiveness of Culturally-Focused Interventions in Increasing Satisfaction of Hospitalized Adult Asian Patients

Abstract

Culturally competent care has gained global attention as a key element to improving quality and eliminating racial and ethnic disparities in health care. This has been at the forefront of global health considerations because of the increase in population diversity, which presents a challenge that needs to be addressed from a multicultural perspective. The Asian population in the United States is increasing at a significant rate, from 4.8% in 2010 to 9.2% in 2050. It is important to understand the needs of the Asian inpatient, in order to implement culturally-focused services that will lead to increase patient satisfaction.

Patient satisfaction is a driving force for health care organizations to enhance their services, as well as to ensure private and public funding. Improving the inpatient experience of multicultural ethnic groups is a health care challenge that needs to be addressed across all health care settings.  To date, the evidence has not been systematically evaluated to determine if culturally-focused interventions for adult Asian inpatients may have a positive impact on their hospitalization experience.

A systematic review of the literature was performed to determine if culturally-focused interventions would have an effect on satisfaction of hospitalized adult Asians. A search of MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Educational Research Information Clearinghouse (ERIC), the Cochrane Library, the Joanna Briggs Institute Library of Systematic Reviews, Scopus, Excerpta Medical Databases (Embase), and Academic Search Premier was conducted, followed by a reference search of relevant studies and a grey literature search of  the Virginia Henderson Library, Google scholar,  Mednar, conference proceedings, and websites.

This review first considered randomized controlled trials (RCT), non-randomized controlled trials, and quasi-experimental studies. There was an insufficient number of RCTs, non-randomized controlled trials, and quasi-experimental studies. The reviewers considered before and after studies, cohort studies, and case control studies for inclusion. This review also considered descriptive study designs including case series, individual case reports and descriptive cross sectional studies related to the adult Asian population in acute-care hospital settings. A search of both published and unpublished studies in over 13 databases and several professional conference proceedings revealed two descriptive studies and one interventional non-experimental pilot study that met predetermined search criteria and methodological quality. Based on these three studies, the results suggest culturally competent communication with patients by physicians and registered nurses, quietness of the room, information about treatments and procedures, and cultural foods are associated with increased satisfaction among hospitalized adult Asian patients. Based on the results, the evidence also suggests that communication between healthcare providers (physicians and registered nurses) and patients may improve satisfaction among adult Asian inpatients (Level 3, Joanna Briggs Institute-JBI Levels of Evidence). Culturally-focused interventions tailored to individual patient needs may be an appropriate strategy in enhancing hospital care in addition to the comprehensive standards of hospital care practice.