Healthcare providers as cultural guests of patients and their loved ones: trust in the icu

Introduction: In the stressful environment of the ICU, cultural differences between healthcare providers and patients’ loved ones can prevent the establishment of trust. Healthcare providers can address this barrier by respecting cultural practices utilized as comfort mechanisms by patients and their loved ones. The objective of this research is to determine how healthcare providers can be genuine cultural guests of patients and their loved ones in the ICU setting. Methods: We used a qualitative descriptive design with 22 family caregivers who had participated in a randomized clinical trial testing an intervention aimed at addressing gaps in quality palliative care to improve patient, family, and system outcomes. Semi-structured, audio-recorded phone interviews were conducted in 2021, with caregivers whose family member had been in the ICU between May 2019 and Aug 2020. We employed a conventional and directed qualitative content analysis to code interviews, and developed a formative categorization matrix, and theoretical labeling of categories. Results: Four key pillars were identified to support the ICU team to act as cultural guests: form genuine connection, build trust, establish expectations, and respect culture. Formation of genuine connection entails healthcare provider investment. Building trust requires the healthcare providers engage in frequent communication with the family, avoiding medical jargon. In order to establish expectations, healthcare providers must assess the culture of patients and their loved ones in order to learn how to best support the needs during their ICU stay. Respect of cultural practices can allow healthcare providers to create a sense of collaboration with patients and their families, who may feel that the healthcare providers are on an opposing team. Conclusions: Patients and loved ones often utilize culture as a mechanism to maintain a sense of comfort and familiarity when navigating the foreign environment of the ICU. In this study, we identified 4 key pillars allowing healthcare providers to act as cultural guests when working on building a collaborative relationship with a patient’s loved ones. Implementing these practices, healthcare providers can provide medical services in a way that complement patients’ culture, enhancing the patient and caregivers ICU experience.