Nurses’ perceptions of communicating with minority parents in a neonatal nursery: a communication accommodation theory approach

Background: Communication is a central part of providing family centred care in neonatal nurseries and is associated with a range of positive outcomes for families. However, previous research has indicated that communication is more problematic between health professionals and minority groups of patients and families, although much of this research is atheoretical. The current study used communication accommodation theory to examine nurses’ perceptions of effective and ineffective interactions with typical parents, culturally and linguistically diverse parents (CALD), and adolescent parents in neonatal nurseries. Method: We conducted semi-structured interviews with nurses from two tertiary hospitals in Australia. Twelve nurses from one hospital were asked about interactions with typical parents, and twenty-nine nurses from the other hospital were asked about interactions with CALD and adolescent parents. Interviews were coded for communication strategy and accommodative stance, using a coding system based on communication accommodation theory. Results: Descriptions of interactions with typical parents (who were perceived as Anglo-Australian) differed from those with CALD and adolescent parents. Interactions with CALD parents focused mostly on comprehension and cultural differences, with limited mention of other strategies. Interactions with adolescent parents were regarded as particularly problematic, and involved greater focus on face management than for other groups of parents. Generally, interactions with minority groups were based on a narrower range of strategies, and were more intergroup than interpersonal in focus. Conclusions: Our findings show the importance of studying health professionals’ perceptions of interactions with people from different minority groups. We discuss the implications for our understanding of communicating with diverse patients and families, and educating health professionals, including the utility of communication accommodation theory as a guiding framework for training.