Exploring cultural safety and person- and patient-centred care in general practice: voices of Aboriginal and Torres Strait Islander peoples

Aboriginal and Torres Strait Islander peoples in Australia continue to experience significant health disparities rooted in the ongoing impacts of colonisation, systemic racism, and cultural disconnection. While patient-centred care (PCC) is widely promoted as a gold standard for high quality and respectful healthcare, its application to meet the unique needs of Aboriginal and Torres Strait Islander patients in general practice remains poorly understood. Instead, cultural safety has been offered as a contextually grounded approach to care, one that critically examines power imbalances, cultural identity, and the historical forces shaping healthcare experiences. To examine the alignment between Aboriginal and Torres Strait Islander peoples’ perspectives on interacting with general practitioners (GPs) and the principles of PCC and culturally safe care. A mixed method-approach was employed, beginning with a survey and followed by qualitative interviews that underwent thematic analysis. Aboriginal and Torres Strait Islander adults with experiences of general practice care were invited to participate. Seventy Aboriginal and Torres Strait Islander people participated. Findings highlight the centrality of a trusting and caring relationships, effective communication, respect for diverse Indigenous identities, individualised care, clinical competence and the GP’s attitude. Key enablers of culturally safe care included adequate time, continuity of care, genuine engagement, informed consent, confidentiality, privacy, and a physically welcoming environment. Our study found significant diversity in participant perspectives, reinforcing that a ‘one-size fits all’ approach is inappropriate. The principles of PCC support culturally safe care through adaptability and respect for patient values.