Assessment of cultural competence in Texas nursing faculty

Cultural competence and associated factors among nurses working in public hospitals of South Wollo zone, Northeast Ethiopia: a multi-center cross-sectional study

BACKGROUND

Enhancing cultural competence stands as a cornerstone in the realm of clinical nursing. Consequently, nurses engaging with culturally diverse communities encounter significant challenges. In Ethiopia, nurses providing care often prioritize physical well-being, the therapeutic journey, and medical interventions, while overlooking the critical cultural dimensions of patient care. Therefore, this study aims to assess the level of cultural competence and its determining factors among nurses employed in public hospitals located in the South Wollo Zone of northeastern Ethiopia.

METHODS

A multicenter, institution-based cross-sectional study was conducted, involving 629 nurses employed in public hospitals across northeastern Ethiopia. Participants were selected using a simple random sampling method. Data were gathered using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire (NCCSQ), and subsequently entered into Epi-data 4.6 for analysis. Statistical analysis was performed using SPSS version 26, employing multiple linear regression analysis to identify determining factors.

RESULT

The participants' overall mean score for cultural competence was 3.198 [95% CI: 3.161, 3.234]. Specifically, factors such as being a female nurse (β = 0.089, CI: 0.019-0.159), having a diploma level of education (β = -0.084, CI: -0.101 to -0.007), having 11-20 years of work experience (β = 0.412, CI: 0.090-0.815), a 1:15 nurse-to-patient ratio (β = 0.081, CI: 0.010-0.162), experience with caring for culturally and ethnically diverse patients (β = 0.362, CI: 0.248-0.476), comprehensive hospital level (β = 0.699, CI: 0.496-0.903), and attending cultural training (β = 0.002, CI: 0.234-0.931) were predictors of the mean score for cultural competence.

CONCLUSION

In this study, the level of cultural competence was found to be at a moderate level and need more effort. Factors such as gender, years of work experience, nurse-to-patient ratio, experience in caring for culturally and ethnically diverse patients, hospital level, educational attainment, attendance of cultural training, and the presence of a feedback system for cultural competence were identified as predictors of cultural competence level. Sharing experiences from higher-level hospitals to lower-level ones and strengthening cultural competence training sessions for nurses can significantly enhance cultural competence within clinical settings.

Assessment of Nursing Faculty Members' Knowledge Toward Research: A Cross-Sectional Study

Background and aim In the context of contributing to healthcare and the well-being of a nation and its communities, nursing research plays a vital role in advancing the discipline of nursing science. Nursing research is essential for improving the quality of nursing care. This study aims to examine the research knowledge level of faculty members at the College of Nursing, University of Raparin, Kurdistan Region, Iraq. Methods We conducted a cross-sectional study involving 43 nursing faculty members at the University of Raparin. The survey was distributed using convenience sampling in April 2024. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (released 2019, IBM Corp., Armonk, NY). Continuous variables were analyzed using mean and standard deviation, while categorical variables were analyzed using frequency and percentage distributions. The association between knowledge scores and demographics was tested using Mann-Whitney, Kruskal-Wallis, Chi-square, and post-hoc tests. Stepwise multiple regression analysis was used to determine the variables that influence the knowledge score. Significance was set at p < 0.05. Results A total of 43 participants were enrolled in this study. The mean age was 32.56 ± 4.75, with 69.8% of participants being male. In terms of educational attainment, 48.8% held master's degrees, 39.5% held bachelor's degrees, and only 11% possessed PhDs. The mean work experience was 5.40 ± 4.04 years, and the mean knowledge score toward research was 3.09 ± 1.97 out of 7. Demographic variables, such as age, marital status, and gender, showed no significant associations with knowledge levels (p > 0.05). However, significant associations were found for education level (p = 0.004) and years of experience (p = 0.011). In the stepwise regression analysis, we observed a significant positive correlation between the level of education and knowledge score (F =10.787, p = 0.002). However, variables, such as age, gender, marital status, years of experience, and participation in research courses, did not demonstrate statistical significance (p-values > 0.05). Conclusion This study highlights a significant lack of research expertise among nursing faculty members, emphasizing the urgent need for targeted interventions and instructional activities in nursing education programs. It is crucial to address this knowledge gap in order to support the professional growth of faculty members and promote the advancement of nursing research and evidence-based practice. Policymakers should also consider implementing mentorship programs that strategically pair less experienced faculty members with seasoned researchers. This initiative aims to cultivate a collaborative learning environment and enhance research skills.

Investigation the relationship between xenophobic attitude and intercultural sensitivity level in nurses

OBJECTIVE

The level of intercultural sensitivity is important for nurses to approach the individual's culture in care and treatment without prejudice. In this study, it was aimed to determine the effect of nurses' intercultural sensitivity level on xenophobic attitude.

METHODS

This quantitative cross-sectional study was conducted at Van Training and Research Hospital between January and June 2022. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. SPSS-25 package program and R programming language 4.1.3 are used.

RESULTS

This study was conducted with 235 nurses. According to the findings obtained in our study, the regression model determine the effect of intercultural sensitivity on xenophobia level was found to be F(1,233) = 69.857, p = 0.001, and 23.1 % (R2 = 0.231) of the variance in the dependent variable was explained by the independent variable. Intercultural sensitivity has a negative and significant effect on the level of xenophobia (β = -0.480; t (233) = -8.358, p = 0.001). When comparing the performance of all variables with machine learning algorithms for the prediction model, the best performing algorithm was found to be Random Forest (RF). The contributions of these variables to the model were calculated with Shapley Additive Explanations (SHAP) values. The most important variables that should be included in the model to predict the xenophobia variable are the respect for cultural differences sub-dimension and intercultural sensitivity variables.

CONCLUSION

It was determined that as the level of intercultural sensitivity of the nurses increased, their xenophobic attitudes decreased. Longitudinal studies on xenophobic attitude in nurses are recommended. It is recommended to make predictions with different machine learning models.

Cultural competence and associated factors among nurses working in public health institutions in the Assosa zone, Benishangul Gumuz regional state, Ethiopia, 2022

BACKGROUND

Cultural competence is one of the principal foundations of clinical nursing. In Ethiopia, nurses in nursing care still focus more on physical needs, the healing process, and treatment and less on the cultural aspects of the patient.

OBJECTIVE

This study aims to assess the cultural competence and associated factors among nurses working in public health institutions found in the Assosa Zone, West Ethiopia, in 2022.

METHODS

An institution-based cross-sectional study design was conducted on 362 nurses who were selected by simple random sampling. Data was collected using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire for Nurses. The data were entered into Epi Data version 3.1 and exported to SPSS version 25. Linear regression analysis was used to identify factors statistically significantly associated with the cultural competence of nurses at a p-value < 0.05.

RESULT

Overall The mean score of cultural competence of participants was 113 (CI, 111.7-115.7), with a mean item score of 3.2 (CI, 3.15-3.26). Nurse-to-patient ratio (B;.93, CI;.59_1.3), experience with previously working in a primary hospital than the current health institution (B; -11.1, CI; -18_-4.2), and experience with previously working in a health center than the current health institution (B; -11.5, C;-18.5_-4.8), being diploma education level (B; -23.2, CL;-32_-14.8), being BSC education level (B;-20.3, CI;-28_-12.3), and the presence of a feedback system in a health facility (B; 13.5, CI; 9.5_17.5) were identified as predicted factors of cultural competences.

CONCLUSION

The overall mean score of the cultural competencies of the participants was moderate. To improve the cultural competence of nurses, it is typically necessary to provide educational opportunities to raise their educational level and establish a feedback system in all health institutions across the nation.

A virtual training program for improving cultural competence among academic nurse educators

BACKGROUND

Everyday, nursing students interact with culturally diverse clients. Nursing education recognizes that cultural competence is a necessary outcome of nursing programs. Nurse educators expect all nursing students to provide culturally congruent care to multicultural clients. Therefore, nurse educators must be culturally competent in order to prepare culturally competent nursing students for clinical practice. This study aimed to evaluate the effect of virtual training program on the cultural competence of academic nurse educators.

METHODS

This randomized controlled study included nurse educators working in six nursing schools affiliated with medical universities of Kerman province in southeastern Iran. Sixty-nine nurse educators were randomly assigned to the intervention (n = 35) and control (n = 34) groups. The training program consisted of three 2-hour sessions for a month. Cultural Diversity Questionnaire for Nurse Educators Revised (CDQNE-R) was used to evaluate the cultural competence of educators before and one month after the virtual training program.

RESULTS

Both the intervention (3.29 ± 0.58) and control (3.24 ± 0.58) groups demonstrated a similar level of cultural competence before the training program (t = 0.05, p = 0.95). After the training, the intervention group showed a significant increase in cultural competence (3.80 ± 0.7) compared to the control group (3.23 ± 0.67). This improvement resulted in culturally competent participants becoming culturally proficient, as evidenced by a large effect size (t = -4.76, p = 0.001).

CONCLUSION

The virtual training program had a positive impact on the cultural competence of nurse educators. Given the importance of cultural competence in nursing education, continuing education programs that focus on strengthening the cultural competence of nurse educators should be prioritized. The experiences gained from implementing virtual training programs can serve as a valuable resource for nurse educators seeking to enhance their cultural competence.

Cultural competence of nursing educators at medical universities of 2nd regional planning in Iran

BACKGROUND

One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals' health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran.

METHODS

The current research was a descriptive and survey study framed within Campinha-Bacote's cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software.

RESULTS

The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates' interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants' responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants' responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73.

CONCLUSIONS

The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran.

Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence: An Integrated Systematic Review

PURPOSE

The COVID-19 pandemic revealed a global urgency to address health care provision disparities, which have largely been influenced by systematic racism in federal and state policies. The World Health Organization recommends educational institutions train clinicians in cultural competence (CC); however, the mechanisms and interacting social structures that influence individuals to achieve CC have received little attention. This review investigates how postgraduate health and social science education approaches CC and how it accomplishes (or not) its goals.

METHOD

The authors used critical realism and Whittemore and Knafl's methods to conduct a systematic integrated review. Seven databases (MEDLINE, CINAHL, PsycINFO, Scopus, PubMed, Web of Science, and ERIC) were searched from 2000 to 2020 for original research studies. Inclusion criteria were: the use of the term "cultural competence" and/or any one of Campinha-Bacote's 5 CC factors, being about postgraduate health and/or social science students, and being about a postgraduate curriculum or a component of it. Thematic analysis was used to reveal the mechanisms and interacting social structures underlying CC.

RESULTS

Thirty-two studies were included and 2 approaches to CC (themes) were identified. The first theme was professionalized pedagogy, which had 2 subthemes: othering and labeling. The second theme was becoming culturally competent, which had 2 subthemes: a safe CC teaching environment and social interactions that cultivate reflexivity.

CONCLUSIONS

CC conceptualizations in postgraduate health and social science education tend to view cultural differences as a problem and CC skills as a way to mitigate differences to enhance patient care. However, this generates a focus on the other, rather than a focus on the self. Future research should explore the extent to which insight, cognitive flexibility, and reflexivity, taught in safe teaching environments, are associated with increasing students' cultural safety, cultural humility, and CC.

Preparing nursing students for diverse populations

AIM

To improve undergraduate nursing students and educator intercultural knowledge and competencies by implementing an academic systems change.

BACKGROUND

Many organizations have diversity and inclusion guidelines and initiatives for healthcare providers to consider in determining culturally competent care, which has a direct impact on the care given, received, and overall outcomes.

DESIGN

1. Assess student's mindset at the beginning and the end of an undergraduate nursing course. 2. Ensure diversity and inclusion content was provided to faculty through a continuing education program. 3. Review all undergraduate courses for diversity and inclusion content.

METHODS

The Intercultural Development Inventory®, a 50-item cross-cultural, theory-based assessment tool was used in a pre- and post-test design (n = 61 intervention; n = 56 control) to determine undergraduate nursing student's mindset and assists the student's in developing a personalized Intercultural Development Plan. The effectiveness of faculty diversity and inclusion education was evaluated using a post program evaluation. Curricular blueprinting of all undergraduate nursing courses for diversity and inclusion content was completed.

RESULTS

The results demonstrated a statistically significant difference in the post-test between the intervention and control groups.

CONCLUSION

While evidence is lacking in specificity of how to best implement diversity and inclusion content in curriculum, these results provided some excellent baseline data that can be tracked while continued changes occur.

Continuing professional development among social- and health-care educators

Future social- and health-care educators will be required to have versatile competence in educating professionals that reflects both the constantly changing health-care environment and delivery of high-quality patient care. Continuing professional development can be defined as a process that aims to increase educators' competence and well-being, along with the effectiveness of an organisation. This study aimed to describe educators' continuing professional development and clarify the contribution of continuing education. The research applied a qualitative approach as only limited information about social- and health-care educators' professional development currently exists.' Data were collected by group interviews of 35 experienced social- and health-care educators from six institutions of higher education and two vocational schools across Finland. An inductive content analysis yielded 39 subcategories, 11 categories and three main categories, namely, educators' approaches for developing professional competence, barriers to continuing education, and educators' continuing education needs. The educators reported that they maintain and develop their competence in versatile ways; for example, continuing professional development takes place through both formal continuing education and informal collaboration at daily work. Regarding barriers to continuing education, the educators most often cited the lack of planning and a lack of resources, for example, scheduling and financial factors. The continuing education needs of social- and health-care educators are highly individual and should not only reflect organisational goals. The fact that this study only included experienced educators can be considered a limitation, as a sample that also included novice educators may have yielded different perceptions of continuing education and professional development. The results of the research can be utilised when designing the continuing professional development of educators at the individual, group or organisational level.

European intensive care nurses' cultural competency: An international cross-sectional survey

OBJECTIVES

To determine the level of cultural competence of European critical care nurses.

DESIGN

A multi-country survey performed in 2017 as a part of the European project Multicultural Care in European Intensive Care Units.

METHOD

Online survey of critical care nurses in 15 European countries (n = 591) using the Healthcare Provider Cultural Competence Instrument consisting of 49 items divided into five subscales: awareness and sensitivity, behaviour, patient-centred orientation, practice orientation and self-assessment. Descriptive and correlational analyses were performed.

RESULTS

Critical care nurses scored highest for 'awareness and sensitivity' (M = 5.09, SD = 0.76), and lowest for 'patient-centred communication' (M = 3.26, SD = 0.94). Nurses from northern and southern Europe scored higher across all subsets of the cultural competence instrument (all subsets, p < 0.001) than nurses from central Europe. Speaking other languages significantly correlated with higher scores in all subscales (all > 0.05) except 'practice orientation'. Previous education on multicultural nursing significantly correlated with higher scores in all subscales (all > 0.01) except patient-centred communication; and visits to other countries was negatively correlated with all subscales (all, p > 0.001) except patient-centred communication.

CONCLUSION

Being exposed to cultural diversity in different ways, like living in a multicultural country, speaking a second language and visiting other countries may influence development of cultural competence. Therefore, programmes which facilitate multicultural clinical practice are strongly recommended in nursing education.

Cultural Competence of Baccalaureate Nurse Faculty: Relationship to Cultural Experiences

BACKGROUND

Introducing and fostering cultural competence development in nursing students only may occur with well-qualified, committed nurse faculty who are self-aware of their own cultural values and beliefs, unfortunately, there is limited research on the factors that influence the development of nurse faculty cultural competence.

PURPOSE AND METHODS

This descriptive, correlational study examined cultural experiences of 118 full-time nurse faculty in the United States (U.S.). Marianne Jeffreys' Cultural Competence and Confidence (CCC) model was used to examine cultural experiences and transcultural self-efficacy (TSE), or confidence. Jeffrey's Transcultural Self-Efficacy Tool (TSET) was used to measure nurse faculty cognitive, affective, and practical nursing skills as influenced by cultural experiences.

RESULTS

Results indicate that nurse faculty are most confident about their attitudes (8.61), and least confident about their transcultural knowledge (7.39). Study results identified nurse faculty TSE as influenced by cultural experiences within the U.S. (r_s = 0.23, p < .01), teaching transcultural nursing care concepts in courses (r_s = 0.35, p < .01), and formalized preparation in training and workshops (r_s = 0.30, p < .01). In addition, nurse faculty lacked international experiences abroad, teaching transcultural nursing care concepts, and formalized education training and workshops.

CONCLUSIONS

Nurse faculty are most confident about their attitudes and least confident about their transcultural knowledge. The results of this study indicate that nurse faculty cultural experiences within the U.S., development in teaching cultural nursing care concepts, and preparation in training and workshops influence nurse faculty TSE and overall cultural competence.