Enhancing culturally responsive care in perioperative settings for older adult patients: a qualitative interview study

Background: Older adults aged over 65 are increasingly admitted to hospital for acute care reasons, including surgical procedures. In multicultural societies, the diversity of an ageing population has significant implications for the planning and delivery of culturally responsive perioperative care for older adults from ethnically diverse backgrounds, who are admitted to hospital for surgical intervention. Objective: To explore the perspectives and experiences of perioperative staff when caring for older adult patients from ethnically diverse backgrounds. Design: Exploratory qualitative methodology. Setting(s): Staff working in Australian perioperative care settings were recruited for semi-structured interviews. Participants: Purposive sampling was used to recruit 15 perioperative staff members, who had experience with caring for older adult patients from ethnically diverse backgrounds during their surgical procedure. Methods: Individual, semi-structured interviews were conducted with perioperative staff. Reflexive thematic analysis was used to identify key themes. Results: Two themes were identified. These were 'Organisational barriers in delivering safe and culturally responsive care', and 'Staff experiences in navigating the challenges of providing culturally responsive care'. Staff reported that safety protocols often overshadowed patient-specific needs, especially for patients requiring additional linguistic or cultural support. The lack of formal interpreter services and the pressure to meet efficiency targets were cited as major barriers to delivering culturally responsive care. Conclusions: Delivering culturally responsive care in the fast-paced, high-risk environment of the operating theatre presents complex challenges, as perioperative staff must navigate competing priorities of patient safety, organisational efficiency, and cultural nuances. This article highlights how the emphasis on efficiency can compromise culturally responsive care for older adults, with staff often frustrated by the lack of formalised organisational support, especially those for facilitating effective communication. Current approaches tend to treat cultural care as an "add-on" rather than integrating it into perioperative safety measures. A shift towards pre-emptive planning, with an organisational culture change that embeds culturally responsive care into the broader safety framework, is essential. This proactive approach would enhance both patient outcomes and staff readiness, fostering a perioperative environment where safety and cultural care are synonymous. Tweetable abstract: Embedding culturally responsive care into safety protocols is essential for enhancing perioperative experiences among older migrant patients.