Interventions to enhance cross-cultural competence in oncology: A meta-analysis of effectiveness studies and a qualitative review

Michael Rost; Eva De Clercq; Louisa Arnold; Milenko Rakic

doi:10.1016/j.ejon.2023.102277

Interventions to enhance cross-cultural competence in oncology: A meta-analysis of effectiveness studies and a qualitative review

Eur J Oncol Nurs. 2023 Jun:64:102277. doi: 10.1016/j.ejon.2023.102277. Epub 2023 Feb 10.

Authors

Michael Rost¹, Eva De Clercq², Louisa Arnold³, Milenko Rakic²

Affiliations

¹ Institute for Biomedical Ethics, University of Basel, 4056, Switzerland. Electronic address: michael.rost@unibas.ch.
² Institute for Biomedical Ethics, University of Basel, 4056, Switzerland.
³ Institute of Psychology, Friedrich-Schiller-University of Jena, 07743, Germany.

PMID: 36944274
DOI: 10.1016/j.ejon.2023.102277

Abstract

Purpose: Cross-cultural competence of healthcare providers is crucial to create a culturally safe environment. Cancer poses special challenges to cross-culturally competent communication and decision-making. Yet, no research synthesis on cross-cultural competence interventions has focused specifically on oncology.

Methods: We conducted a meta-analysis and qualitative review of literature on the effectiveness of cross-cultural competence interventions in oncology. No limitations were placed on publication date, language, oncology setting, or geographic region. Of 1.565 citations identified, 15 articles met the inclusion criteria. Information on study design, samples, measured outcomes, and effectiveness statistics were coded. Average weighted effects were calculated applying meta-analysis methodology.

Results: Studies were published between 2000 and 2020; more than half in the last seven years; two thirds in the USA. Overall study quality was at a low to moderate level, notably only one study provided a control-group-design. In sum, nurses constituted the largest occupational group among participants. Results of the meta-analysis indicate that cross-cultural competence interventions have differential effects. While the overall effect of cross-cultural competence interventions was not statistically significant, results showed that the cross-cultural competence dimensions of knowledge and behavior did improve. Effects beyond that remain unclear.

Conclusions: We provide valuable information on research gaps. The lack of studies and insufficient methodological rigor of available studies show that more research is needed to support the claim that interventions actually improve the various dimensions of cross-cultural competence in oncology. To build a stronger evidence base, it is necessary to include patient-reported outcomes and to center their experiences in future research.

Keywords: Cross-cultural competence; Effectiveness; Intervention; Literature review; Meta-analysis; Oncology.

Publication types

Meta-Analysis
Review

MeSH terms

Cultural Competency*
Forecasting
Health Personnel
Humans
Neoplasms* / therapy