Exploring the Associations of Cultural Sensitivity, Technology, and Patient Empowerment with Patient-Centered Care: A Mixed-Methods Study in UAE Rehabilitation Healthcare Centers

Abstract

Background

Patient-centered care is a healthcare priority, particularly in diverse settings like the United Arab Emirates. Understanding the factors influencing its delivery is essential for effective care.

Objective

This study examines the association between cultural sensitivity, technology, and patient empowerment with patient-centered care in UAE rehabilitation healthcare centers.

Design

A mixed-methods approach was employed, integrating quantitative and qualitative data collection. Quantitative data was analyzed using correlation and regression analyses, while qualitative data was explored through thematic analysis to identify key patterns.

Participants

The study involved 100 healthcare providers (internists, nurses, rehabilitation therapists) working in licensed rehabilitation healthcare centers in the UAE. Additionally, 200 patients recruited through purposive sampling from both inpatient and outpatient settings. Patients, aged 18–54, represented diverse socio-economic backgrounds and health conditions, including musculoskeletal, neurological, and chronic illnesses.

Approach

Quantitative data was collected using a structured questionnaire comprising 12 items measured on a 5-point Likert scale, focusing on healthcare providers’ and patients’ perceptions of cultural sensitivity, technology integration, and patient empowerment. Qualitative data from semi-structured interviews was transcribed, coded, and analyzed to explore detailed perspectives on how cultural practices, technological tools, and empowerment strategies influence care delivery.

Key Results

Cultural sensitivity demonstrated a strong positive correlation with patient-centered care (PCC) (r = 0.938, p < 0.001), as did patient empowerment (r = 0.965, p < 0.001). Regression analysis revealed that patient empowerment was the most influential factor (B = 0.800, p < 0.001), followed by cultural sensitivity (B = 0.110, p = 0.041). Thematic analysis of qualitative data highlighted the significance of cultural practices, adaptability of technology, and patient-driven strategies in shaping positive care experiences.

Conclusion

The findings align with existing research, underscoring the importance of cultural competence, technological integration, and patient empowerment in delivering effective patient-focused care.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11606-025-09401-0.

INTRODUCTION

“Patient-or person-centered care,” “person-directed care,” or “person-focused care” are phrases that are often used interchangeably to refer to a concept that aims at providing decision-making through patient self-determination.¹ This concept requires input of the patient’s preferences, values, and beliefs into the process of providing care, leading to an appropriate and meaningful treatment plan. It supports the participation of patients and their active and informed decisions rather than them being passive customers of healthcare services.²

Respect for patient autonomy has been a cornerstone of healthcare ethics for decades and is widely recognized as a fundamental principle in medical practice and training.³ However, there has been a renewed emphasis on integrating patient-directed preferences into clinical decision-making processes, reflecting an evolving focus on shared decision-making and personalized care models.⁴ This shift highlights the growing importance of empowering patients to actively participate in their healthcare journeys, aligning treatment plans with their values, beliefs, and preferences.

Rehabilitation care, in particular, plays a significant role in the continuum of healthcare, as it addresses the long-term recovery and quality of life of patients who have experienced major medical conditions, surgeries, or chronic illnesses. It requires a comprehensive, patient-centered approach due to the diversity of individual needs and goals during recovery. Unlike acute care settings, rehabilitation focuses on empowering patients to regain autonomy and functionality, making the integration of patient-centered care (PCC) practices especially significant. Cultural sensitivity, advanced technological tools, and strategies to enhance patient empowerment are essential to overcome barriers, such as resource limitations and cultural resistance, that often hinder the effective delivery of rehabilitation services.

Cultural sensitivity is an essential component of patient-centered care, especially in multicultural settings such as the UAE. The UAE is home to a highly diverse population, with expatriates making up approximately 88% of its residents, representing over 200 nationalities. This diversity extends to the healthcare workforce, which comprises professionals from various cultural and linguistic backgrounds. Such diversity necessitates culturally sensitive healthcare practices that account for differing values, beliefs, and expectations. Providers must demonstrate cultural competence to ensure that care is equitable and tailored to patients’ unique needs, thereby reducing health disparities and enhancing trust.

Rogan et al. (2020) highlighted the use of ICU diaries as a framework for enhancing PCC and reducing psychological morbidity among ICU patients. The study emphasized the importance of institutional factors, including culture, which pertains to the attitudes, values, and norms influencing healthcare practices; resources, referring to the availability of staff, equipment, and funding necessary to implement ICU diary projects; training, which emphasizes the need for educating healthcare staff on the proper use and benefits of ICU diaries; policy, which involves establishing formal guidelines and regulations to support the adoption of this practice; and privacy, which ensures the confidentiality and appropriate handling of sensitive patient information. The strategies suggested, such as staff development, management support, interdisciplinary integration, piloting programs, and policy formulation, aim to address these institutional factors. By doing so, they provide a healthcare environment that prioritizes patient preferences, facilitates effective communication, and empowers patients and families in the recovery process. These efforts emphasize on the potential of ICU diaries to positively impact both patient outcomes and healthcare practices, providing a model for broader application in PCC initiatives.⁵

In recent years, the Fourth Industrial Revolution (4IR) has played a significant role in transforming various sectors, including healthcare. The 4IR refers to the rapid technological advancements that are blending the digital, physical, and biological worlds, driven by innovations such as artificial intelligence (AI), the Internet of Things (IoT), big data, and blockchain. These technologies have the potential to revolutionize healthcare by enabling more personalized, efficient, and patient-centered care. For instance, AI and big data analytics improve decision-making processes, while IoT devices allow for continuous patient monitoring, fostering a more proactive and empowered healthcare experience.

Additionally, 4IR has the ability to enhance healthcare governance and delivery, particularly in the context of the United Arab Emirates (UAE)’s rehabilitation healthcare system. As Bodolica and Spraggon (2021) highlighted, technologies such as AI, IoT, and big data are improving information flow within healthcare systems, supporting better patient management and decision-making. However, challenges such as data privacy, cost, and the adaptation of healthcare professionals remain crucial issues that must be addressed for these technological advancements to be fully integrated into healthcare practices.⁶

As healthcare systems increasingly rely on technologies from the 4IR, data privacy becomes a critical concern. The collection, storage, and sharing of sensitive patient data through digital platforms must comply with strict privacy regulations to protect individuals’ rights. Data breaches or misuse of patient information could lead to significant ethical and legal implications, undermining public trust in these technologies. Therefore, safeguarding data privacy is not only a technical challenge but also a cornerstone of maintaining the integrity of PCC in the digital age.

This study examines the association between cultural sensitivity, technology, and patient empowerment on PCC in UAE-accredited rehabilitation healthcare. This study aims to explore cultural sensitivity’s role in establishing healthcare practices responsive to patients’ needs, evaluate how technology improves care through advanced tools, and analyze patients’ empowerment contribution to PCC management. The significance of this study lies in its practical implications for UAE healthcare policymakers and providers, offering strategies to improve care delivery. Furthermore, it enriches academic literature by providing insights into the interplay between these factors and patient-centered care in a multicultural context.

LITERATURE REVIEW

Patient-Centered Care (PCC) in Rehabilitation Healthcare

The research conducted by Yu et al. (2023) focused on investigating how PCC affects the outcomes of inpatient treatment. According to their analysis of inpatient surveys and medical records done through cross-section, the authors discovered that PCC is closely linked with better health results such as improved patient contentment, superior clinical findings, augmented communication, enhanced adherence to treatment regimes, and decreased incidents of harm caused by medical care. These results show the significance of including PCC in hospitalization care to enhance the quality as well as the cost-effectiveness of healthcare delivery systems. They, therefore, propose that providers should give more priority to this approach when dealing with inpatients while at the same time suggesting that policymakers should make it among their top agendas towards achieving effective overall health outcomes.⁷

Fernandes et al. (2022) researched the difficulties that the rehabilitation workforce encounters when they want to provide person-centered care (PCC). After conducting surveys and interviews, they came up with five main obstacles: lack of resources, insufficient training, organizational barriers, heavy workload, and cultural resistance to change. The authors recommend that PCC to be effective in such settings, these challenges need to be addressed through investing in resources, training staff members, and making changes within organizations, as well as shifting cultures.⁸

Culture Sensitivity in Healthcare

In the article, Tanaka and Arakida (2019) examined the concept of cultural sensitivity in healthcare workers. The study finds that cultural sensitivity encompasses three main components: cultural facts, cultural competencies, and cultural awareness, all of which are essential for theory-practice advancement. This emphasizes the role of cultural sensitivity in bridging gaps within PCC by ensuring healthcare providers address racial, ethnic, and linguistic barriers. They also highlight the importance of educational interventions to enhance cultural competencies among healthcare professionals, facilitating better implementation of PCC.⁹

Stubbe (2020) states the importance of cultural competence and humility for healthcare providers taking care of people from different cultures. Providers should respect and understand other cultures, ensure effective communication, and customize care according to individual needs. This study stresses the need for continuous self-examination coupled with receptivity towards learning diverse perspectives as it seeks to improve cultural competence and humility within medical practice. Cultural competence complements PCC by enabling providers to personalize care effectively across diverse cultural settings, reducing health disparities.¹⁰

Role of Technology in Healthcare

Technology can be described as the use of science to solve practical problems, improve human environments, or utilize knowledge to alter surroundings.¹¹ Ruiz Morilla et al. (2017) explored the process of integrating technology into healthcare services from practitioners’ perspectives. Their findings revealed that while authorities acknowledged the benefits of technological integration, barriers such as resistance to change, patient privacy concerns, and lack of training and support persist. Effective change management was highlighted as critical to securing staff involvement and overcoming challenges that hinder the successful adoption of computerized systems in clinical practice.¹²

Stellefson et al. (2020) emphasized the growing role of social media in health promotion and the responsibilities of health education specialists. Social media platforms enable health education through wider audience reach, targeted community engagement, and cost-effectiveness. Key roles include content creation, moderation, community participation, and managing ethical concerns.¹³ Despite challenges such as misinformation and privacy issues, social media remains a powerful tool for public health improvement. Integrating social media into PCC empowers patients to access real-time health information and interact with healthcare providers, enhancing self-management and satisfaction.¹⁴

Patient Empowerment

Empowerment is a complex process of discovering and developing potential that enables an individual to take control of his/her life. Patient self-management strategies, as explored by Atinga and Baku (2022), emphasize discovering this potential to improve patient outcomes.¹⁵

Barbosa et al. (2021) focused on behavior change interventions for chronic disease patients. Strategies such as education/training, self-applied strategies, motivational interviewing, planning, and peer support were found to empower patients, promoting positive behavioral change and improving disease management. This complements PCC by ensuring patients are active participants in their care plans, leading to better adherence and outcomes. Based on the findings of this study, it is suggested that the above-stated strategies be integrated into routine patient care practice and that patients should be evaluated and managed considering their distinct resource self-sufficiency and health literacy. Altogether, these findings portray the significance of empowering, based intervention models on chronic illnesses to enhance patients’ quality of life and minimize barriers to the effective handling of chronic disease.¹⁶

Similarly, Ludwig et al. (2020) analyzed global trends in multiple myeloma care and discussed notable disparities that are explained by differences in healthcare accessibility, quality, and financial revenues, as well as empowered patients’ opportunities. The analysis identifies greater occurrences in “developed” states, but lower mortality as a result of better health facilities and treatment. High mortality is observed in “developing” states due to lack of resources. The study reveals the need to enhance the quality of patient care, increase support to health facilities, and improve patient engagement in their treatment since patients with higher health literacy who are actively involved in the decision-making process have a better prognosis. According to the authors, greater focus should be placed on enhancing all healthcare systems and patient advocacy worldwide in order to decrease mortality and increase survival rate for multiple myeloma patients.¹⁷

Integration in Culture Sensitivity, Technology, and Patient Empowerment in Patient-Centered Care

The integration of cultural sensitivity, technology, and patient empowerment is essential for effective patient-centered care. For instance, Stubbe (2020) highlights how cultural competence ensures that diverse patients receive personalized care,¹⁰ while Stellefson et al. (2020) show how technology facilitates patient empowerment through tools like social media. These interconnected factors collectively enhance PCC by addressing disparities, fostering engagement, and enabling individualized healthcare.¹⁴

In the UAE, rehabilitation care reflects these principles but faces unique challenges due to cultural diversity and technological integration. Alkhaibari et al. (2023) examined PCC in the Middle East and North Africa (MENA). This concept can be useful in a number of ways, such as increasing patient satisfaction and improving their health status. However, this study revealed that there are several factors that hinder the implementation of the strategic plan, including cultural issues, lack of resources, and training of the employees on the implementation process. Patients and their careers should be educated to improve training programs, and a culturally sensible and patient PCC model should be integrated into the health policies. The review also comes with a proposal for a follow-up, more comprehensive empirical study, which is needed to monitor and chart the advances of PCC in the MENA region.¹⁸

Similarly, Abdulmohsin’s review delves into implementing affected PCC in primary healthcare practices in Qatar, emphasizing strategies, challenges, and outcomes. It discusses initiatives such as staff training, patient education, and integrating electronic health records for better PCC delivery. Cultural considerations along with resource constraints are the difficulties encountered and their potential solutions provided, as well. By integrating these strategies, UAE rehabilitation care can enhance patient satisfaction, improve outcomes, and ensure international standards of PCC are met.¹⁹

CONCEPTUAL FRAMEWORK

The interaction between cultural sensitivity, technology, and patient empowerment is crucial for improving patient-centered care outcomes. The three key concepts are illustrated in Figure 1, with arrows showing the influence of each on the other and how these collectively impact PCC. Cultural sensitivity ensures that care is tailored to the patient’s needs, enhancing the effectiveness of technological interventions, while empowering patients enables them to take an active role in their care, leading to better adherence and satisfaction. This synergistic relationship is fundamental in creating a healthcare environment that prioritizes the patient’s experience and well-being.

Figure 1.

Conceptual model of the interactions between cultural sensitivity, technology, and patient empowerment in patient-centered care.

METHODOLOGY

Research Design

This study employed a sequential explanatory mixed-methods design, integrating quantitative data from structured questionnaires, alongside qualitative data from semi-structured interviews. This combination utilizes the strengths of both methods to provide a comprehensive understanding of PCC in the UAE’s multicultural healthcare setting, ensuring the findings are strong and applicable to research, policy, and clinical practice.

Quantitative data was used to identify trends and relationships between variables such as cultural sensitivity, technology integration, and patient empowerment, while qualitative interviews enriched the findings by exploring individual experiences and contextual influences. This sequential approach allowed for the validation and triangulation of results, enhancing the study’s reliability and applicability.

Participants

Healthcare providers and patients were purposively sampled from 10 licensed rehabilitation centers across all seven emirates of the UAE: Abu Dhabi, Dubai, Sharjah, Ajman, Umm Al-Quwain, Ras Al Khaimah, and Fujairah. The distribution of facilities was as follows: Abu Dhabi (3), Dubai (3), Sharjah (2), and one center each in Ras Al Khaimah and Fujairah. These centers were selected to ensure geographic and demographic representation across the UAE's healthcare landscape. This purposeful selection aligned with the study’s objectives by focusing on participants who could provide rich and meaningful insights into rehabilitation care.

Sample Size and Distribution

• Healthcare providers: 100 (doctors, nurses, therapists)

• Patients: 200, representing diverse demographics and health conditions

This sampling strategy ensured the inclusion of participants with varying characteristics such as age, gender, socio-economic status, and health conditions (e.g., musculoskeletal, neurological, and chronic illnesses) and ability to provide informed consent. By strategically selecting participants from multiple regions and healthcare backgrounds, the study aimed to capture a wide range of experiences and perspectives reflective of the UAE’s healthcare diversity, thus enhancing the study’s representativeness and transferability. Additionally, the inclusion of healthcare providers with at least 3 years of professional experience ensured the reliability of data on PCC practices.

Inclusion and Exclusion Criteria

Inclusion Criteria

• Patients aged 18–54 years.

• Receiving care at one of the selected centers.

• Diagnosed with musculoskeletal, neurological, or chronic illnesses.

• Able to provide informed consent.

Exclusion Criteria

• Patients with language barriers in English or Arabic.

• Those experiencing acute mental health crises.

• Unwilling to participate.

These criteria ensured participants were representative of the study’s focus and capable of contributing meaningful insights.

Data Collection

Quantitative data were collected through a structured questionnaire distributed both online and in person to maximize response rates and inclusivity. A total of 400 surveys were distributed (100 to healthcare providers and 300 to patients), and 300 completed responses were received (75% overall response rate). Specifically, 100 responses were received from healthcare providers, achieving a response rate of 100%, while 200 responses were obtained from patients, corresponding to a 67% response rate. This high response rate among healthcare providers ensured comprehensive representation of professional perspectives, whereas the patient response rate provided a strong sample size to reflect diverse patient experiences across the UAE’s rehabilitation centers.

Qualitative data were gathered through semi-structured interviews with a subset of 30 participants (10 healthcare providers and 20 patients). The interviews were conducted by a team of trained research assistants and audio-recorded with participant consent. Field notes were also taken during the interviews to document non-verbal communication and context. These interviews were then transcribed verbatim for analysis.

Quantitative Component

The structured questionnaire included 12 items rated on a 5-point Likert scale, addressing key study variables. The online surveys were shared via secure email links, while in-person surveys were administered during patient visits and staff meetings at the selected rehabilitation centers. Clear instructions and confidentiality assurances were provided to encourage participation and honest responses.

Independent Variables

• Cultural Sensitivity: It is defined as the ability of healthcare providers to understand, respect, and effectively respond to cultural differences. This includes components such as cultural competence, cultural awareness, and adaptation of care practices to meet patients’ cultural needs.⁹ It was measured through participants’ perceptions of how cultural practices influenced care delivery and the extent to which healthcare providers demonstrated cultural competence.

• Technology Integration: It refers to the adoption and use of technological tools and platforms in healthcare delivery. It encompasses aspects such as accessibility, usability, and perceived impact on care quality.¹² Specific measures included the availability of electronic healthcare records, telemedicine capabilities, and the integration of IoT devices in patient management.

• Patient Empowerment: It is the process by which patients gain control over their healthcare decisions, supported by information, encouragement, and resources.¹⁶ It was assessed based on factors such as patient engagement in decision-making, self-management of chronic conditions, and the extent to which healthcare providers facilitated patient autonomy.

Dependent Variable

• Patient-Centered Care (PCC): Assessed using composite measures of satisfaction with care delivery, perceived responsiveness to patient needs, and overall care quality.

Survey items were adapted from previously validated instruments, including the Cultural Competence Assessment Instrument (CCA), Technology Acceptance Model (TAM)-based items, and the Patient Activation Measure (PAM). These instruments demonstrated strong psychometric properties (Cronbach’s α > 0.85).

The rationale for using these validated instruments is to ensure that the study captures comprehensive and reliable data on important factors influencing PCC. Cultural sensitivity, technology integration, and patient empowerment are critical elements of healthcare delivery, especially in a multicultural setting such as the UAE, where healthcare providers and patients come from diverse backgrounds. These questionnaires were chosen based on their strong psychometric properties, ensuring high internal consistency (Cronbach’s α > 0.80 for all scales) and their relevance to the research objectives. This approach allows for a comprehensive understanding of the dynamics between these variables and their impact on patient care, thereby enhancing the validity of the study’s findings. Survey questionnaire is attached in the Appendix.

Data Analysis

Quantitative data was analyzed using SPSS, employing descriptive (mean, frequency, standard deviation) and inferential statistics (Pearson correlation, regression analysis) to explore relationships between cultural sensitivity, technology integration, patient empowerment, and PCC.

Regression Analysis

• Type of Regression: Multiple linear regression was conducted to determine the predictive power of independent variables (cultural sensitivity, technology integration, and patient empowerment) on the dependent variable (patient-centered care).

• Variable Inclusion: Variables were added hierarchically to the regression models to examine their incremental contributions. The process involved:

  1. Entering demographic control variables (age, gender, socio-economic status) in the initial model.
  2. Adding the independent variables in subsequent steps, guided by theoretical and empirical considerations.

• Model Adjustment: Models were adjusted for potential confounding factors, including age, gender, and socio-economic status, to isolate the specific effects of the primary variables of interest.

• Conceptual Framework: The variable selection and model hierarchy were guided by Donabedian’s framework of healthcare quality, which posits that structure (technology), process (cultural sensitivity), and outcome (patient-centered care) are interconnected.

The regression model demonstrated high significance (F = 1369.941, p < 0.001), explaining 93.3% of the variance in PCC (R² = 0.933). Among the predictors, patient empowerment emerged as the most influential factor (B = 0.800, p < 0.001), followed by cultural sensitivity (B = 0.110, p = 0.041).

Qualitative Component

Semi-structured interviews explored participants’ perceptions and experiences related to cultural sensitivity, technology integration, and patient empowerment. Questions included:

• Can you share an example of how cultural practices influenced your healthcare delivery?

• How has technology impacted the way you provide or receive care?

• In what ways are patients empowered to make decisions about their care, and how does this affect their satisfaction with services?

Thematic Analysis

Qualitative data were analyzed using Braun and Clarke’s (2006) framework:

1. Familiarization: All transcripts were read multiple times to immerse in the data.

2. Coding: Initial codes were generated to capture meaningful segments of the data.

3. Theme Development: Codes were grouped into themes reflecting the participants’ perspectives on cultural sensitivity, technology integration, and patient empowerment.

4. Review and Refinement: Themes were iteratively refined to ensure they were distinct and adequately represented the data.

Ethical Considerations

The study received approval from the Institutional Review Board (IRB) and all participants provided informed consent before participation. Additionally, all ethical guidelines related to confidentiality, voluntary participation, and the right to withdraw at any time without consequence were strictly followed.

Results

The study provides comprehensive demographic profiles of participants, with emphasis on age, gender, and socio-economic classifications. Regarding the age distribution of respondents, the largest group (72.8%) was represented by respondents aged 25–34 years, followed by those aged 35–44 years (16.4%), 18–24 years (9.3%), and 45–54 years (5.3%), as shown in Figure 1.

Concerning gender, 61.8% of participants identified as male, 34.9% were female, and 3.3% preferred not to disclose their gender, as shown in Figure 2. Moreover, the analysis of socio-economic status revealed the following distribution:

• High Socio-Economic Status (SES) (20%): Individuals in this group possess advanced educational qualifications, hold prestigious occupations, and have significant financial resources. They often have access to private healthcare services and premium medical facilities.

• Middle Socio-economic Status (SES) (50%): This group includes participants with moderate income levels and education. They generally utilize standard healthcare services, balancing affordability with quality, but may lack access to luxury options.

• Low Socio-economic Status (SES) (30%): Participants in this group face financial constraints, often have limited educational attainment, and rely heavily on public healthcare or basic medical services.

Figure 2.

Age demographics.

The study employed a total of 300 participants. These findings provide a foundational understanding of the sample demographics, offering critical insights into the variability across age, gender, and socio-economic classifications.

Figure 2 illustrates the Pareto chart based on the provided age demographic data. The blue bars represent the individual age group percentages, while the orange line shows the cumulative percentages. This visual highlights the dominance of the 25–34 age group and the cumulative contribution of all groups. ​

Figure 3 illustrates a Pareto chart for the gender distribution. The blue bars represent the percentages for each category, and the red line shows the cumulative percentage. This chart helps visualize the relative contribution of each category and highlights the dominant one (male).

Figure 3.

Gender demographics.

Figure 4 illustrates a Pareto chart based on the socioeconomic status: Bars (light green) represent the percentage of respondents for each socioeconomic class. Line (orange) shows the cumulative percentage. The chart highlights the dominance of the middle SES, followed by the low SES and then the high SES, with cumulative percentages reflecting their contributions to the total population.

Figure 4.

Socioeconomic status.

Table 1 provides a demographic and professional overview of patients (n=200) and providers (n=100). Patients primarily fall in the 25–34 age range (72.8%) with a mean age of 32 years, while providers are older, averaging 42 years. Male participants dominate both groups (61.8% of patients, 50% of providers). Most patients (60%) reside in urban areas and are middle-income (50%), with 70% employed. Providers, all employed, have an average of 12 years of experience, with 70% being doctors. Healthcare settings differ, with patients primarily visiting outpatient clinics (80%), while providers work exclusively in hospitals.

Table 1.

Sample Characteristics for Patients and Providers

Characteristic	Patients (n=200)	Providers (n=100)
Age
Mean (SD)	32 (±6)	42 (±8)
Min-Max	18–54	30–54
Age distribution
18–24	9.3% (19)	N/A
25–34	72.8% (146)	30–34: 50% (50)
35–44	16.4% (33)	35–44: 30% (30)
45–54	5.3% (11)	45–54: 20% (20)
Gender
Male	61.8% (124)	50% (50)
Female	34.9% (70)	50% (50)
Prefer not to disclose	3.3% (6)	0% (0)
Socioeconomic status
Low SES	30% (60)	20% (20)
Middle SES	50% (100)	60% (60)
High SES	20% (40)	20% (20)
Employment status
Employed	70% (140)	100% (100)
Unemployed	30% (60)	N/A
Education level
High school	10% (20)	N/A
College	60% (120)	40% (40)
Graduate	30% (60)	60% (60)
Health conditions
Chronic illness	40% (80)	N/A
No chronic illness	60% (120)	N/A
Region of residence
Urban	60% (120)	100% (100)
Rural	40% (80)	N/A
Healthcare setting		Hospital (100%)
Outpatient	80% (160)	N/A
Inpatient	20% (40)	N/A
Hospital	N/A	100% (100)
Years of experience (for providers)	N/A	3–20 years (mean 12 years)
Role/occupation	N/A	Doctors (70%), nurses (20%), and therapists (10%)
Average length of visit	20 min (±5)	30 min (±10)

Table 2 presents descriptive statistics for key variables in healthcare practices, including cultural sensitivity, technology’s role, patient empowerment, and PCC. The mean scores indicate moderate perceptions of cultural sensitivity (3.07) and PCC (3.13), suggesting a recognition of their importance in enhancing healthcare delivery. Technology’s impact is also acknowledged, with a mean of 3.26 for virtual technology benefits. However, lower scores in empowerment approaches (2.98) reveal challenges in fully engaging patients in their care decisions. Overall, these findings highlight areas for improvement in healthcare practices.

Table 2.

Descriptive Statistics for Key Variables in Healthcare Practices

Variable	Statement	Mean	Std Dev
Cultural sensitivity	Cultural competence and humility for healthcare providers	3.07	1.39
	Providers should customize care to offer fairer remedies	2.93	1.43
	Patients who perceived better cultural sensitivity reported more satisfaction	2.86	1.36
Role of technology	Social media as a method of health advertising receives extra importance	2.98	1.45
	IT systems can improve scientific decision-making and enhance outcomes	3.01	1.47
	The benefits of virtual technology include improved access and communication	3.26	1.47
Patient empowerment	Empowerment-oriented approaches enhance patient outcomes	2.98	1.51
	Empowering patients through decision-making improves healthcare delivery	2.91	1.38
	Empowerment programs improve mental health and self-efficacy	2.91	1.40
Patient-centered care	Patient-centered care affects inpatient treatment outcomes	3.13	1.40
	Including PCC enhances quality and cost-effectiveness of healthcare	2.81	1.43
	PCC principles enhance outcomes in adult physical rehabilitation	3.02	1.46

Table 3 presents t-test comparisons of healthcare practices based on demographic variables, specifically gender and age. Significant differences were found in cultural sensitivity and technology’s role between males and females, with p-values of 0.0003 and 0.0422, respectively, indicating a strong likelihood that these differences are not due to chance. Additionally, younger individuals demonstrated significantly higher perceptions of cultural sensitivity and technology’s role compared to older individuals, with p-values of 0.0002 and 0.0031, respectively, highlighting generational differences in these areas.

Table 3.

t-Test Comparisons of Healthcare Practices by Demographic Variables

Comparison	t-statistic	p-value
Cultural sensitivity (male vs. female)	−3.67	0.0003
Role of technology (male vs. female)	−2.04	0.0422
Cultural sensitivity (younger vs. older)	−3.76	0.0002
Role of technology (younger vs. older)	−2.99	0.0031

Correlation Analysis

The correlation analysis revealed that the variables culture sensitivity, role of technology, patient empowerment, and PCC have a significant positive correlation. However, a comparison of each pair of measures resulted in a Pearson correlation exceeding 0.92, indicating a high level of association. For instance, culture sensitivity demonstrated a very high correlation with the role of technology (r =0.958, p < 0.001) while the correlation between culture sensitivity and patient empowerment was equally strong (r = 0. 962, p < 0.001) followed by a correlation between culture sensitivity and PCC also showing a significant correlation (r = 0.938, p < 0. 001).

These results, summarized in Table 4, emphasizes on the interconnected nature of the examined variables, suggesting that improvements in one domain often lead to enhancements in others.

Table 4.

Correlations

Variables		Culture sensitivity	Role of technology	Patient empowerment	Patient-centered care
Culture sensitivity	Pearson correlation	1.000	0.958**	0.962**	0.938**
	Sig. (2-tailed)		.000	.000	.000
	N	301	301	301	301
Role of technology	Pearson correlation	0.958**	1	0.958**	0.929**
	Sig. (2-tailed)	.000		.000	.000
	N	301	301	301	301
Patient empowerment	Pearson correlation	0.962**	0.958**	1	0.965**
	Sig. (2-tailed)	.000	.000		.000
	N	301	301	301	301
Patient-centered care	Pearson correlation	0.938**	0.929**	0.965**	1
	Sig. (2-tailed)	.000	.000	.000
	N	301	301	301	301

**Correlation is significant at the 0.01 level (2-tailed)

Regression Analysis

The regression analysis examined the relationship between cultural sensitivity, the role of technology, and patient empowerment with patient-centered care. The model was highly significant (F=1369.941, p<0.001), accounting 93.3% of the variance in PCC (R² = 0.933) as shown in Table 5.

Table 5.

ANOVA Results for the Regression Model Predicting Patient-Centered Care Using Cultural Sensitivity, Role of Technology, and Patient Empowerment as Predictors

ANOVAa
Model	Sum of squares	df	Mean square	F	Sig.
Regression	221.216	3	73.739	1369.941	0.000b
Residual	15.986	297	0.054
Total	237.203	300

^aDependent variable: patient-centered care

^bPredictors: (constant), patient empowerment, role of technology, culture sensitivity

Regression coefficients as represented in Table 6 revealed that patient empowerment was the strongest predictor (B =0.800, 95% CI [0.682, 0.918], p < 0.001), indicating a substantial positive contribution to patient-centered care. Cultural sensitivity also demonstrated a positive but smaller effect (B = 0.110, 95% CI [0.004, 0.216], p = 0.041). However, the role of technology was not significantly associated with PCC (B = 0.004, 95% CI [–0.100, 0.108], p = 0.947). The constant (intercept) was 0.342 (95% CI [0.271, 0.413], p < 0.001), representing the baseline level of PCC when all predictors are at 0.

Table 6.

Coefficients of the Regression Model Predicting Patient-Centered Care, Showing Unstandardized Coefficients (B), Standard Errors, 95% Confidence Intervals (CI), Standardized Coefficients (Beta), t-Values, and p-Values for Each Predictor

Coefficients
Predictor	Unstandardized coefficients			Standardized coefficients	t	p-value
	Coefficients (B)	Std. Error	95% CI	Beta
(Constant)	0.342	0.036	[0.271, 0.413]	-	9.532	<0.001
Culture sensitivity	0.110	0.054	[0.004, 0.216]	0.128	2.051	0.041
Role of technology	0.004	0.053	[−0.100, 0.108]	0.004	0.067	0.947
Patient empowerment	0.800	0.060	[0.682, 0.918]	0.838	13.424	< 0.001

^aDependent variable: patient-centered care

Thematic Analysis

Transcript coding was conducted using a thematic analysis approach, identifying main themes: cultural sensitivity, technology integration, and patient empowerment. Each theme was further enriched with sub-themes derived from the participants’ responses and aligned with relevant scholarly studies. These themes outline the significant dimensions of PCC within UAE rehabilitation healthcare settings, providing insights into the interplay of cultural, technological, and empowerment factors in enhancing care outcomes. Table 7 outlines the main themes, sub-themes, and associated keywords derived from thematic analysis.

Table 7.

Themes, Sub-themes, and Keywords from Thematic Analysis on Patient-Centered Care in UAE Rehabilitation Healthcare

Theme	Sub-themes	Keywords
Cultural sensitivity		Cultural competence, humility, respecting diverse norms, integrating preferences, trust, patient adherence
	Cultural practices integration	Dietary restrictions, religious practices, family structure, cultural preferences
	Language and communication	Use of interpreters, overcoming language barriers, culturally sensitive communication
Technology integration		Telemedicine, electronic health records, IoT devices, data privacy, accessibility, communication
	Advantages	Improved accessibility, treatment precision, streamlined processes, virtual consultations
	Challenges	Data privacy concerns, patient tech literacy, equitable access
Patient empowerment		Patient involvement, education, autonomy, adherence, satisfaction, collaborative healthcare
	Empowerment through education	Disease information, treatment plans, self-management, informed decision-making
	Outcomes of empowerment	Improved health outcomes, treatment adherence, trust, patient responsibility
Integration and synergy in PCC		Collaboration, trust-building, inclusive care, technology-assisted culturally sensitive tools

Cultural Sensitivity

Cultural sensitivity emerged as a foundation for effective PCC, emphasizing the importance of respecting diverse cultural norms, beliefs, and practices. Healthcare providers consistently highlighted the significance of cultural intelligence in promoting trust, satisfaction, and adherence to treatment plans. Healthcare providers described efforts to integrate cultural preferences, such as dietary restrictions and religious practices, into care delivery, supported by the use of translators to overcome language barriers. For instance, provider A noted,

We make sure that we are culturally intelligent and understanding hence take time to understand different cultures before responding to them in a manner that is deemed acceptable so that people can cooperate.

Similarly, provider B explained,

Cultural aspects include diet, religion, and family configuration; respecting these factors ensures patient compliance and satisfaction.

Patients also emphasized the importance of cultural sensitivity in improving their healthcare experiences. Patient A shared,

I treat my doctor and he always asks me about my cultural preferences and never dismisses them, which I appreciate because they make me feel valued.

These findings are consistent with Stubbe (2020), who emphasized that cultural competence and humility are important for personalizing care and reducing disparities in healthcare delivery.¹⁰ The integration of cultural preferences not only enhances patient adherence but also promotes stronger patient-provider relationships.

Technology Integration

The integration of advanced technology in UAE rehabilitation healthcare settings was highlighted as both a facilitator and a challenge in PCC. Providers and patients noted that technologies such as telemedicine and electronic health records streamlined processes communication, enhance accessibility, and improve treatment precision. Provider A remarked,

Telemedicine has been incredible, especially for follow-up consultations, as it ensures care delivery while avoiding inconveniences.

Patient A confirmed,

From a patient perspective, there are advantages to the use of telemedicine – patients are, for instance, able to get follow-up appointments without having to travel much.

However, concerns were raised regarding data privacy and patient tech literacy, particularly among elderly patients. Provider C explained,

Often the patients have issues with the technology, especially the elderly; but more help and training is offered to the patients.

These findings align with Ruiz Morilla et al. (2017), who highlighted transformative potential of technology in healthcare delivery, alongside the need for robust privacy safeguards and patient training programs to ensure equitable benefits.¹²

Patient Empowerment

Empowering patients was identified as a critical driver of PCC, with both healthcare providers and patients emphasizing the role of education and active involvement in care decisions. Provider A stated,

Patient participation therefore leads to high levels of patient compliance and positive health outcomes because a patient follows strictly the health management plan.

Patient C noted,

This is why I became an emancipated patient so that I can listen to my doctor, take the prescribed medication, as well as enroll in treatment as I do know my condition.

Empowered patients demonstrated greater adherence to treatment plans, higher satisfaction, and improved health outcomes. Provider C highlighted the role of education, stating,

Patient education is one of the most vital interventions when it comes to the process of helping a patient to be empowered.

These findings correspond with Barbosa et al. (2021), who emphasized the role of empowerment-oriented strategies in enhancing patient engagement and achieving better healthcare outcomes.¹⁶ The involvement of patients in decision-making fosters a collaborative healthcare environment that promotes trust and accountability.

Integration and Synergy

The interplay between cultural sensitivity, technology integration, and patient empowerment emphasizes the comprehensive nature of PCC. For instance, culturally sensitive practices facilitate the adoption of technological tools, such as translation apps, while empowered patients are better equipped to engage with these technologies. Patient B stated,

I assume I am okay after being furnished with particulars concerning a specific state, and getting help on how it could impact me, I believe I understand my health status.

This synergy amplifies the overall impact on PCC, as described by Bodolica and Spraggon (2021), who highlighted the interconnected roles of these factors in creating inclusive and effective healthcare systems.⁶

These findings collectively provide actionable insights for healthcare policymakers and practitioners in the UAE, emphasizing the need for culturally intelligent, technologically proficient, and empowerment-focused strategies to optimize PCC in UAE rehabilitation healthcare settings.

DISCUSSION

The results of this study indicated the close connection between cultural sensitivity, technology, patient involvement, and a patient-oriented approach within the healthcare system. The Pearson correlation coefficients established that a powerful relation exist between these variables. More precisely, a very close relationship exists between cultural sensitivity, role technology use, patient power, and patient-dedicated care, respectively. From the findings of this study, it can be concluded that cultural competence has a positive relationship with other factors implying change, like the use of technology and patient engagement, resulting in optimal patient-oriented care. Previous studies have emphasized the importance of patient-centered, culturally sensitive healthcare to increase patient engagement and satisfaction through inclusive and effective care.^20–22

The study findings highlight that cultural sensitivity, technology, and patient empowerment are key factors that contribute to PCC. These factors emphasize the importance of interventions aimed at enhancing patient autonomy, involvement in clinical decision-making processes, and self-responsibility for health. Past studies highlight the importance of effective communication, patient empowerment, and people-centered approaches in healthcare. They provide insights and recommendations to improve interactions between medical practitioners and patients, increase trust, and enhance the overall patient experience.^23–25

Furthermore, the findings from Table 3 highlight the significant impact of demographic factors such as gender and age on cultural sensitivity and the role of technology in healthcare practices. Specifically, females demonstrated greater sensitivity to cultural factors, while younger individuals were more inclined to value the role of technology in care delivery. These differences highlight the importance of tailoring interventions to demographic variables to enhance PCC. For instance, recognizing these demographic disparities can guide strategies to improve cultural responsiveness in male patients and promote technological literacy among older populations, ensuring more equitable and effective healthcare practices.

The findings of this study also highlight the importance of cultural change and patient empowerment in sustainable patient care. Cultural sensitivity positively affects patient care (p = 0.041), although to a lesser extent than patient empowerment. This highlights the need for health professionals to be culturally responsive and sensitive to patient needs. However, the age skew in the study sample predominantly patients aged 25–34 years may limit the generalizability of these results to older or younger populations. Selection bias due to the age distribution has been identified as a limitation and should be considered a potential confounder. Interestingly, although technological and cultural changes are closely related to patient empowerment, they do not directly affect patient care. This finding warrants further exploration, especially regarding regional variations in healthcare settings, as these factors could influence the applicability of these results across diverse regions.

These findings enhance our understanding of health and provide recommendations for improving patient care. The impact of gender and age on outcomes should also be considered, as these demographic factors likely influence patient experiences and the effectiveness of patient-centered care. These studies emphasize the importance of patient engagement, cultural responsiveness, and technological advances for health promotion. Insights are offered into the dynamic nature of patient engagement, the importance of adapting interventions for diverse populations, and the potential of AI in transforming healthcare delivery.^26–28

The response highlights the importance of healthcare vendors in UAE rehabilitation centers being culturally intelligent. They emphasize the need to admire cultural norms, use translators, and incorporate cultural practices into remedy plans. This method is discovered to supplement affected persons’ trust, pride, and treatment adherence, ultimately enhancing patient-focused care. This aligns with the findings from a current examination by,²⁹ exploring cultural competence and patient satisfaction in Saudi Arabian healthcare settings, and a study by Bodolica and Spraggon, (2019) testing cultural sensitivity’s role in improving PCC in the United Arab Emirates.³⁰ However, selection bias with the small sample size limits the ability to generalize these results.

The responses show that the integration of the modern era, along with telemedicine and electronic health data, in UAE rehabilitation healthcare settings can support the delivery of patient-focused care by enhancing accessibility, communication, and remedy precision. However, the study does not account for regional differences in healthcare systems across the UAE, which may influence the findings. Further research is recommended to assess regional disparities and their impact on healthcare delivery in institutional settings. This study aligns with findings from a study by³¹ investigating the limitations and facilitators of telehealth adoption in Saudi Arabian healthcare settings and a study by³² exploring the impact of digital health information on PCC in Kuwaiti hospitals.

Patient empowerment in UAE rehabilitation healthcare facilities notably influences the quality of patient-focused care. Empowered patients involved in decision-making and knowledgeable about their health demonstrate better treatment adherence, improved satisfaction, and better health outcomes. This finding aligns with the research by Amin et al. (2020), on patient empowerment and healthcare outcomes in Saudi hospitals³³ and a study by Ahmad et al. (2020) investigating patient engagement impact on PCC in the United Arab Emirates.³⁴ However, further adjustments for age and gender distribution are recommended to refine outcome analyses.

Patients emphasized that healthcare vendors recognizing cultural preferences, including nutritional restrictions and spiritual practices, and using interpreters, notably enhances their satisfaction and adherence to treatment. Providers concurred, noting that cultural sensitivity fosters trust and compliance. This alignment between patient and provider perspectives highlights that cultural competence is crucial for effective patient-centered care. Recent studies support this view, showing that culturally sensitive practices improve patient satisfaction and health outcomes.^35,36 However, the results may not be generalizable due to the limited sample size and potential selection bias. Future studies should consider addressing this limitation.

Patients stated that advanced technology like telemedicine, digital fitness statistics, and wearable gadgets enhanced accessibility, communication, and remedy precision. However, challenges such as data privacy and patient tech literacy remain. Providers echoed these sentiments, highlighting that while technology improves care delivery, privacy concerns must be carefully managed, and all patients must benefit equitably. Recent studies corroborate these findings, indicating that technology complements patient engagement and care but must balance innovation with robust safeguards.^37,38

Empowering patient through education and involvement in decision-making drastically affects their adherence to treatment plans, satisfaction, and overall fitness consequences. Both patients and vendors mentioned that empowered patients are more motivated, compliant, and confident. This empowerment fosters a collaborative environment for effective patient-focused care. Past studies strengthened these insights, demonstrating that person empowerment leads to better health outcomes and improved patient-provider relationships.^39,40 Together, these factors demonstrate the multifaceted strategies needed for optimal patient outcomes in diverse healthcare settings.

CONCLUSION

In conclusion, this study demonstrates the relationship between cultural sensitivity, technology, and patient empowerment to enhance PCC. The findings emphasize on the interconnectedness of these three concepts, where cultural sensitivity promotes trust and inclusivity, patient empowerment strengthens decision-making and treatment adherence, and technology improves accessibility and communication. These elements do not act independently but rather interact synergistically to shape the outcome of PCC. For instance, technology can facilitate culturally sensitive communication through translation tools, while empowered patients are better equipped to engage with healthcare technologies, amplifying their impact on care delivery.

Supplementary Information

Below is the link to the electronic supplementary material.

Declarations:

Conflict of Interest:

The author declares that he does not have a conflict of interest.