{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:48:43Z","timestamp":1791866923993,"version":"4.3.4"},"reference-count":88,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the perceptions and experiences of local and expatriate critical care nurses when interacting with multicultural patients and their families in Saudi healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive qualitative exploratory design was employed to gain an in\u2010depth understanding using purposive sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected through semi\u2010structured 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\u00a01 for the full definition). Interviews explored nurses' perceptions and encounters with multicultural patients and families. Transcribed data were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four 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\u2010based learning and identified specific system\u2010level gaps in interpreter provision and culturally adapted policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Critical care nurses face substantial challenges in caring for multicultural patients. Enhancing cultural competence requires tailored training, adequate resources and system\u2010level support. These findings underscore the importance of organisational policies and infrastructure that promote culturally sensitive, patient\u2010centred care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Structured cultural competence training and access to system\u2010level 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\u2010centred care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>The study highlights key communication barriers and effective strategies for culturally competent care in post\u2010Vision 2030 Saudi healthcare settings. Findings may inform education, policy and practice and support efforts to strengthen patient\u2013family\u2013nurse interactions and culturally responsive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>We 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\u00a0S1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70877","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:29:57Z","timestamp":1791865797000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Critical Care Nurses' Encounters With Multicultural Patients and Families in Saudi Arabia: A Qualitative Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-9545","authenticated-orcid":false,"given":"Maha","family":"Almarhabi","sequence":"first","affiliation":[{"name":"Faculty of Nursing King Abdulaziz University  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3794-4158","authenticated-orcid":false,"given":"Sharfuddin","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Mater Misericordiae University Hospital University College Dublin  Dublin Ireland"},{"name":"School of Health Professions University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1230-5680","authenticated-orcid":false,"given":"Sahar","family":"Aljadani","sequence":"additional","affiliation":[{"name":"King Abdullah Medical Complex  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"3","key":"e_1_2_15_2_1","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1108\/ER-05-2017-0104","article-title":"Organizational Policies and Diversity Management in Saudi Arabia","volume":"41","author":"Abaker M. 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