Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland

Phenomenon: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patientsespecially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. Approach: A survey on cross-cultural care was mailed to Lausanne University hospital's front-line healthcare providers: clinical nurses and resident physicians at our institution. Preparedness items asked How prepared do you feel to care for ... ? (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of 4 - well/5 - very well prepared and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. Findings: Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients whose religious beliefs affect treatment (22%). After adjustment, working in a sensitized department ( = 0.21, p = .01), training on the history/culture of a specific group ( = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations ( = 0.25, p = .004) and (b) inadequate cross-cultural training ( = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness ( = -0.26, p = .01; = -0.22, p = .01). Insights: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for improvement. Our study points toward institutional strategies to improve preparedness: notably, making sure departments are sensitized to cross-cultural care resources and increasing provider diversity to reflect the changing Swiss demographic.