Critical Care Nurses' Encounters With Multicultural Patients and Families in Saudi Arabia: A Qualitative Study.

aimTo examine the perceptions and experiences of local and expatriate critical care nurses when interacting with multicultural patients and their families in Saudi healthcare settings.

designA descriptive qualitative exploratory design was employed to gain an in-depth understanding using purposive sampling.

methodsData were collected through semi-structured interviews, conducted in English, with 18 nurses from intensive care, cardiac care, burn and emergency units. We operationally defined multicultural patients and families as those whose nationality, language, religion, or cultural background differed from that of the treating nurse (see Section 1 for the full definition). Interviews explored nurses' perceptions and encounters with multicultural patients and families. Transcribed data were analysed using thematic analysis.

resultsFour major themes emerged. Communication barriers, particularly language differences, were the most frequently reported and, according to participants, the most immediately consequential challenge, since language determined whether basic clinical information could be exchanged at all; cultural and religious beliefs, limited health literacy and organisational constraints shaped how well that information was received and acted upon. Nurses employed adaptive strategies, including teamwork, translation technologies and institutional support (e.g., embassies, social workers), largely in the absence of formal interpreter services. Nurses described a strong personal and professional commitment to diversity, equity and inclusion; however, most reported little or no structured training in cultural competence, relying instead on informal, experience-based learning and identified specific system-level gaps in interpreter provision and culturally adapted policy.

conclusionCritical care nurses face substantial challenges in caring for multicultural patients. Enhancing cultural competence requires tailored training, adequate resources and system-level support. These findings underscore the importance of organisational policies and infrastructure that promote culturally sensitive, patient-centred care. IMPLICATIONS: Structured cultural competence training and access to system-level resources, including professional interpreters and culturally adapted policies, are essential. These measures enable nurses to communicate effectively, respect patients' cultural and religious practices, and deliver equitable, patient-centred care. IMPACT: The study highlights key communication barriers and effective strategies for culturally competent care in post-Vision 2030 Saudi healthcare settings. Findings may inform education, policy and practice and support efforts to strengthen patient-family-nurse interactions and culturally responsive care. REPORTING

methodWe adhered to the relevant EQUATOR Network reporting guidance using the Consolidated Criteria for Reporting Qualitative Research (COREQ); the completed COREQ checklist is provided in Table S1. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.