Background:
Asthma outcomes are generally worse for ethnic minority children. Cultural competencetraining is an instrument for improving healthcare for ethnic minority patients. To developeffective training, we explored the mechanisms in paediatric asthma care for ethnic minoritypatients that lead to deficiencies in the care process.
Methods:
We conducted semi-structured interviews on care for ethnic minority children with asthma(aged 4-10 years) with paediatricians (n = 13) and nurses (n = 3) in three hospitals. Interviewswere analysed qualitatively with a framework method, using a cultural competence model.
Results:
Respondents mentioned patient non-adherence as the central problem in asthma care. Theyrelated non-adherence in children from ethnic minority backgrounds to social context factors,difficulties in understanding the chronic nature of asthma, and parents’ language barriers.Reactions reported by respondents to patients’ non-adherence included retrieving additionalinformation, providing biomedical information, occasionally providing referrals for socialcontext issues, and using informal interpreters.
Conclusions:
This study provides keys to improve the quality of specialist paediatric asthma care to ethnicminority children, mainly related to non-adherence. Care providers do not consciouslyrecognise all the mechanisms that lead to deficiencies in culturally competent asthma carethey provide to ethnic minority children (e.g. communicating mainly from a biomedicalperspective and using mostly informal interpreters). Therefore, the learning objectives ofcultural competence training should reflect issues that care providers are aware of as well asissues they are unaware of.