Abstract

Background: A substantial body of research evidence suggests that inequalities in health linked to ethnicity exist. People from minority ethnic groups suffer discrimination and have poorer access to health care services, however, the influence of health professionals in relation to these health inequalities is under researched. Health professionals are expected to deliver a high standard of culturally appropriate health care to a diverse, changing and complex population. Educational packages in the area of cultural care have flourished, but there is a paucity of research that seeks to explore the experience of health professionals themselves. This research explores the opportunities and barriers experienced by health visitors in the North East of England when working with clients who are from another culture. The findings from the study are developed into a substantial theory which conceptualises this work.
Methodology: Grounded Theory methodology was used and 21 semi-structured interviews were conducted with practicing health visitors in the North East of England between May 2008 and September 2009. All participants described themselves as white.
Findings and conceptual theory: When health visitors talk about their work with people from cultures they identify as different to their own, there are three areas which are important to them. These are, first, in
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relation to relationship building; second, a metaphorical ‘cross cultural terrain’; and finally, and most importantly, in managing emotions. The complex ways in which these three areas intersect with each other is what shapes professional engagement across cultures. The theory ‘emotional encounters through cross cultural terrain: shaping relational journeys through culture’ was developed to conceptualise this work.
Conclusion: Emotions have the power to shape professional practice in health care, influencing (dis)engagement with clients across cultures. The ways in which this happens have implications for practice, theory and education.