Older people from Culturally and Linguistically Diverse (CALD) backgrounds are increasingly admitted to hospital for acute care reasons, such as surgical procedures. However, there is limited evidence on the perioperative (surgical) experiences and needs of ethnically diverse older adults.
To synthesise evidence about the perioperative experiences of older adults from ethnically diverse backgrounds.
An integrative review methodology.
Eighteen articles were included in the review. Three main themes emerged from the review of the literature; (i) Culturally related factors as drivers to decision-making preoperatively; (ii) Providing culturally responsive and appropriate perioperative information; and (iii) Culturally related considerations for effective self-management postoperatively.
The perioperative needs of ethnic groups are contextualised or informed by culture, ethnicity and linguistics. These needs are not necessarily exclusive to those of ethnically diverse backgrounds. For example, the perceived need for understandable information to make an informed decision would be considered as an essential aspect of perioperative care for any patient. However, the need for understandable information and the complexities of effective communication in perioperative settings are compounded by nuances of culture and language.
There needs to be culturally appropriate perioperative processes of care, which build on the standard practice. While patient needs are addressed by universal processes, there is a need to expand and utilise approaches that are culturally and linguistically responsive to older adult patients and their family caregivers. The availability of appropriate mechanisms to engage with healthcare in a culturally meaningful way has the potential to reduce health inequities and improve patient experience.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Collegian
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The Perioperative Toolkit.2016https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0010/342685/The_Perioperative_Toolkit.pdf#:∼:text=The%20Perioperative%20Toolkit%20is%20designed%20to%20aid%20in,the%20multidisciplinary%20perioperative%20team%20for%20patient%20centred%20care
- Ethnic barriers to utilization of total joint arthroplasty among Chinese immigrants in the United States.Journal of Arthroplasty. 2016; 31 (.e1872): 1873-1877https://doi.org/10.1016/j.arth.2016.02.046
- Theoretical reflections of Leininger's cross-cultural care in the context of Covid-19.Revista Gaúcha de Enfermagem. 2021; : 42https://doi.org/10.1590/1983-1447.2021.20200209
- Can routine preoperative data predict adverse outcomes in the elderly? Development and validation of a simple risk model incorporating a Chart-Derived Frailty score.Journal of the American College of Surgeons. 2014; 219: 684-694https://doi.org/10.1016/j.jamcollsurg.2014.04.018
- Ethnic differences in the perception of prayer and consideration of joint arthroplasty.Medical Care. 2002; 40: 471-476https://doi.org/10.1097/00005650-200206000-00004
- Collective terminology to describe the minority ethnic population.Sociology. 2002; 36: 803-816https://doi.org/10.1177/003803850203600401
- Ethnic/racial terminology as a form of representation: a critical review of the lexicon of collective and specific terms in use in Britain.Genealogy. 2020; 4: 87https://doi.org/10.3390/genealogy4030087
- Older Australia at a glance.2018
- Determinants of racial and ethnic disparities in surgical care. 32. 2008: 509-515https://doi.org/10.1007/s00268-007-9344-4
- Postoperative pain management in the non-Hispanic white and Mexican American older adult.Seminars in Perioperative Nursing. 1999; 8: 7-11
- Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups.BMC Medical Research Methodology. 2014; 14: 42https://doi.org/10.1186/1471-2288-14-42
- Chinese speaking patients' understanding of information and consent related to their surgical experience.The Journal of Stomal Therapy Australia. 2021; 41: 16-21https://doi.org/10.33235/jsta.41.3.16-21
- How do ethnic minority patients experience the intercultural care encounter in hospitals? A systematic review of qualitative research.BMC Medical Ethics. 2017; 18https://doi.org/10.1186/s12910-016-0163-8
- Racial and ethnic postoperative outcomes after surgery: the Hispanic paradox.Journal of Surgical Research. 2018; 232: 88-93https://doi.org/10.1016/j.jss.2018.05.074
Federation of Ethnic Communities’ Councils of Australia (FECCA). (2015). Review of Australian research on older people from culturally and linguistically diverse backgrounds. doi:https://doi.org/10.4225/55/59dee30b8a176.
- Preferences for arthritis care among urban African Americans: “I don't want to be cut”.Health Psychology. 2004; 23: 324-329https://doi.org/10.1037/0278-622.214.171.1244
- A qualitative study of breast reconstruction decision-making among Asian immigrant women living in the United States.Plastic Reconstructive Surgery. 2017; 139: 360E-368Ehttps://doi.org/10.1097/PRS.0000000000002947
- Ethnicity and patient's perception of risk in joint replacement surgery.Journal of Rheumatology. 2008; 35: 1664-1667
- A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders.American Journal of Public Health. 2014; 104: e16-e31https://doi.org/10.2105/ajph.2013.301706
- Key stakeholders’ views on the quality of care and services available to frail seniors in Canada.BMC Geriatrics. 2018; : 18https://doi.org/10.1186/s12877-018-0969-y
- Racial disparities in readmissions and site of care for major surgery.Journal of the American College of Surgeons. 2014; 218: 423-430https://doi.org/10.1016/j.jamcollsurg.2013.12.004
- We are doing it together”; the integral role of caregivers in a patients’ transition home from the medicine unit.PLoS One. 2018; 13e0197831https://doi.org/10.1371/journal.pone.0197831
- Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors.Journal of the American College of Surgeons. 2013; 216 (.e412): 482-492https://doi.org/10.1016/j.jamcollsurg.2012.11.014
- Understanding ethnic differences in the utilization of joint replacement for osteoarthritis: the role of patient-level factors.Medical Care. 2002; 40: I44-I51
- Critical Appraisal Tools.2020
- What do adult surgical patients speaking primarily Cantonese, Italian, or Portuguese really want to know about pain and pain management?.Pain Management Nursing. 2020; 21: 462-467https://doi.org/10.1016/j.pmn.2020.02.003
- What do adult surgical patients really want to know about pain and pain management?.Pain Management Nursing. 2009; 10: 22-31https://doi.org/10.1016/j.pmn.2008.08.006
- "Keep on truckin'" or “It's got you in this little vacuum”: race-based perceptions in decision-making for total knee arthroplasty.Journal of Rheumatology. 2007; 34: 1069-1075
- Influence of ethnicity and socioeconomic factors on outcome after total hip replacement: Influence of ethnicity and socioeconomic factors.Scandinavian Journal of Caring Sciences. 2013; 27: 139-146https://doi.org/10.1111/j.1471-6712.2012.01013.x
- Preoperative information provided to Swedish and immigrant patients before total hip replacement.Medicinski Arhiv. 2012; 66: 399-404https://doi.org/10.5455/medarh.2012.66.399-404
- Poor patient-reported outcome after hip replacement, related to poor perception of perioperative information, commoner in immigrants than in non-immigrants.Acta Orthopaedica. 2016; 87: 218-224https://doi.org/10.3109/17453674.2015.1135664
- Hospital discharge preparedness for patients with limited English proficiency: a mixed methods study of bedside interpreter-phones.Patient Education and Counseling. 2018; 101: 25-32https://doi.org/10.1016/j.pec.2017.07.026
- Increased access to professional interpreters in the hospital improves informed consent for patients with limited English proficiency.Journal of General Internal Medicine: JGIM. 2017; 32: 863-870https://doi.org/10.1007/s11606-017-3983-4
- Overview of the theory of culture care with the ethnonursing research method.Journal of Transcultural Nursing. 1997; 8: 32-52https://doi.org/10.1177/104365969700800205
- Willingness to participate in health research among community-dwelling middle-aged and older adults: does race/ethnicity matter?.Journal of Racial and Ethnic Health Disparities. 2021; 8: 773-782https://doi.org/10.1007/s40615-020-00839-y
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Journal of Clinical Epidemiology. 2009; 62: 1006-1012
- Arab American women's lived experience with early-stage breast cancer diagnosis and surgical treatment.Cancer Nursing. 2012; 35: 302-311https://doi.org/10.1097/NCC.0b013e318231db09
- The influence of race and ethnicity on complications and mortality after orthopedic surgery: a systematic review of the literature.Medical Care. 2014; 52: 842-851https://doi.org/10.1097/MLR.0000000000000177
- Caregiving for older adults with limited english proficiency: transitioning from hospital to home.Journal of General Internal Medicine: JGIM. 2019; 34: 1744-1750https://doi.org/10.1007/s11606-019-05119-y
- Ethnic variation in knee replacement: patient preferences or uninformed disparity?.Archives of Internal Medicine (1960). 2005; 165: 1117-1124https://doi.org/10.1001/archinte.165.10.1117
- Negative health care experiences of immigrant patients: a qualitative study.BMC Health Services Research. 2011; 11: 10https://doi.org/10.1186/1472-6963-11-10
- The integrative review: updated methodology.Journal of Advanced Nursing. 2005; 52: 546-553
- Do patient preferences contribute to racial differences in cardiovascular procedure use?.Journal of General Internal Medicine: JGIM. 1997; 12: 267-273https://doi.org/10.1007/s11606-006-5062-0
- Caring for the surgically anxious patient: a review of the interventions and a guide to optimizing surgical outcomes.The American Journal of Surgery. 2016; 212: 151-159https://doi.org/10.1016/j.amjsurg.2015.03.023
- Exploring the ‘patient experience’ of individuals with limited english proficiency: a scoping review.Journal of Immigrant and Minority Health. 2018; https://doi.org/10.1007/s10903-018-0816-4
Published online: August 21, 2022
Accepted: July 16, 2022
Received in revised form: June 28, 2022
Received: May 4, 2022
© 2022 Australian College of Nursing Ltd. Published by Elsevier Ltd.