Nursing strategies to enhance culturally sensitive patient care in a metropolitan community: Western Cape, South Africa

Abstract

Background: Globally, more than 80% of people consult indigenous healers before seeking mainstream healthcare, indicating the influence of cultural beliefs on health-seeking behaviours. This presents challenges for fair, high-quality treatment in multicultural settings such as metropolitan Western Cape, South Africa. To address these challenges, one must consider culturally sensitive patient care, which respects and incorporates diverse cultural backgrounds. Purpose: The study explored the perspectives of nurses, patients and community members on the integration of cultural beliefs and practices in healthcare. It strove to develop and validate nursing strategies that enhance culturally sensitive patient care in the Western Cape, South Africa, guided by Leininger’s Sunrise Theory. Methods: A qualitative, multiphase design was employed using semi-structured interviews, focus groups and observations. A total of thirty-seven participants took part, including eleven nurses, one focus group comprising seven nurses, twelve patients and seven community members, all representing a range of qualifications and experiences. Data saturation was achieved after 6 interviews from each group however, additional interviews were conducted to confirm saturation, consistency of emerging themes and to enhance the credibility. Focus group discussions were included to complement the data and were incorporated into the final analysis. Data was analysed using Braun and Clarke’s (2006) six-step thematic analysis, supported by ATLAS.ti 25 software. Results: The findings show that meaningful progress towards culturally sensitive integrative healthcare in South Africa requires moving beyond both biomedical dismissal of traditional healing practices and superficial multiculturalism that tolerates cultural practices if they do not interfere with biomedical protocols. Seven strategic domains emerged: education and training, policy development, resource allocation, effective communication, integration of indigenous knowledge, professional support, and patient partnership. Validation results indicated strong agreement among experts regarding the relevance, clarity and feasibility of the proposed strategies. Conclusion: The study concludes that implementing validated nursing strategies grounded in empirical findings can enhance culturally sensitive patient care by promoting collaboration between healthcare providers, patients and communities. True transformation requires reimagining healthcare as culturally plural, where biomedicine coexists with other healing systems on equal footing and advancing the WHO’s vision for inclusive health systems and strengthening patient-centered care in South Africa’s diverse metropolitan communities. The study recommends incorporation of culturally sensitive care into nursing education, development of institutional guidelines, and ongoing stakeholder engagement to support implementation.