Electronic Thesis and Dissertation Repository

Thesis Format



Master of Science




Garnett, Anna


Background: Home- and community-based services (HCBS) are beneficial for clients; however, clients experiencing marginalization face unique barriers to using HCBS that include negative experiences with healthcare providers. Therefore, this study explored how healthcare professionals working in HCBS develop therapeutic relationships with clients experiencing marginalization.

Methods: This interpretive description study was informed by the theory of cultural humility. We completed semi-structured interviews with 13 healthcare professionals working in HCBS between March and August 2023.

Findings: Findings are organized into the themes of self-awareness and growth, honouring clients’ personhood, navigating the home environment, setting and negotiating expectations, and resource availability and impact.

Conclusion: Findings include practical approaches to support strong therapeutic relationships with clients experiencing marginalization. This paper offers insights on how the theory of cultural humility may be applied to practice, education, policy, and research to foster therapeutic relationships and improve the quality of care for clients experiencing marginalization.

Summary for Lay Audience

Healthcare services that are delivered in a client’s home or community can be helpful for clients’ health. However, sometimes healthcare providers treat clients who face marginalization poorly, which can stop them from using these services. The researcher wanted to know more about how healthcare professionals who visit clients in their home or community develop trust and rapport with clients who face marginalization in society. Understanding this would help improve the quality of care we offer to clients facing marginalization and improve health equity.

The researcher studied this problem using a theory that explains how healthcare professionals can use cultural humility in their practice. Acting with cultural humility means the healthcare provider respects their client’s culture and tries to understand their client’s views. The researcher spoke to thirteen healthcare professionals who provide care in the home or community setting. This study’s results show that healthcare professionals who work in the home or community can build strong relationships with clients facing marginalization by acting with cultural humility. The researchers also realised that developing self-awareness, honouring who clients are, being mindful of the client’s home environment, and setting expectations help healthcare professionals build trust and rapport with their clients. Findings from this study show that the resources available to healthcare professionals impact the relationships healthcare professionals can build with their clients. This study gives us insights into how to develop better policies and education programs and offers strategies for healthcare professionals to build relationships with clients facing marginalization.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Available for download on Friday, December 20, 2024