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Dursun Ergezen F, Aydın R. The relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students: A descriptive and multi-centric study. NURSE EDUCATION TODAY 2024; 144:106443. [PMID: 39383659 DOI: 10.1016/j.nedt.2024.106443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 08/04/2024] [Accepted: 09/29/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND Xenophobia plays a pivotal role in influencing the delivery of culturally competent care. Nevertheless, the relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students remains undetermined. AIM This study aimed to determine the relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students. METHODS AND PARTICIPANTS The study involved 1045 nursing students from six universities in Türkiye. Data were collected using the "Participant Information Form," the "Intercultural Sensitivity Scale," the "Ethnocentrism Scale," and the "Xenophobia Scale." Multiple linear regression was employed for the analysis. RESULTS Intercultural sensitivity (β = -0.09; p = 0.028) emerged as a negative predictor of xenophobia levels in students, while ethnocentrism (β = 0.17; p = 0.000) was identified as a positive predictor of xenophobia levels. Additionally, socio-demographic characteristics, including age, living in an extended family, academic year, participation in intercultural nursing courses, and interaction with immigrant neighbors, were established as significant predictors of xenophobia. CONCLUSION This study revealed a direct correlation between higher intercultural sensitivity and reduced xenophobia, whereas an increase in ethnocentrism was linked to elevated levels of xenophobia. These results offer valuable insights for educators and policymakers to combat xenophobia and design targeted interventions.
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Affiliation(s)
- Fatma Dursun Ergezen
- Akdeniz University, Nursing Faculty, Fundamentals of Nursing Department, Antalya, Türkiye.
| | - Ruveyde Aydın
- Ondokuz Mayıs University, Health Sciences Faculty, Nursing Department, Maternity and Gynaecological Nursing Department, Samsun, Türkiye
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Mert-Karadas M, Kovanci MS, Ocalan S, Uslu-Sahan F, Ozdemir L. The tendency and affecting factors of nursing students' Xenophobia toward refugees from the perspective of ecological systems theory: A convergent parallel mixed method study. Nurse Educ Pract 2024; 78:104013. [PMID: 38879910 DOI: 10.1016/j.nepr.2024.104013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/04/2024] [Accepted: 05/30/2024] [Indexed: 06/18/2024]
Abstract
AIM This study aims to develop a comprehensive understanding of nursing students' xenophobic tendencies toward refugees and affecting factors from the perspective of Ecological Systems Theory. BACKGROUND Nursing students' xenophobia toward refugees may negatively affect their care for patients. To effectively prevent xenophobia, it is essential to identify its underlying factors. DESIGN A convergent parallel mixed method. METHODS This study was conducted with third and fourth-grade nursing students at a university in Turkey. In the quantitative phase, online surveys were used, employing convenience sampling, with 227 participants. In the qualitative phase, purposive sampling was used and data were collected through in-depth interviews with 17 participants on the Zoom platform. Data were obtained using the Participant Information Form, Xenophobia Scale and Semi-Structured Interview Form. RESULTS Nursing students who are male, in their third year, have low economic status, lack immigrant friends, lack immigrants in the family members, receive information about immigrants from social media and live in regions with a high concentration of immigrants have higher levels of xenophobia (p<0.05). In the qualitative phase, our study results showed that negative experiences with refugees, economic and social worries, perception of security threats, cultural conflicts and negative media messages toward refugees can lead to xenophobia. In addition, students stated that lessons about immigrants and caring for them in clinics can improve their ability to empathize with immigrants. CONCLUSION Nursing curriculums should cover immigrant care and interaction to combat xenophobia, which can improve empathy skills and raise awareness.
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Affiliation(s)
- Merve Mert-Karadas
- Hacettepe University, Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Ankara, Turkey.
| | - Mustafa Sabri Kovanci
- Hacettepe University, Faculty of Nursing, Department of Psychiatric Nursing, Ankara, Turkey
| | - Sinem Ocalan
- Hacettepe University, Faculty of Nursing, Department of Psychiatric Nursing, Ankara, Turkey
| | - Fatma Uslu-Sahan
- Hacettepe University, Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Ankara, Turkey
| | - Leyla Ozdemir
- Hacettepe University, Faculty of Nursing, Department of Internal Medicine Nursing, Ankara, Turkey
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Berşe S, Dirgar E, Tosun B, Tanriverdi D, Atay E. Cultural humility among nursing students in a multicultural setting. Work 2024:WOR230268. [PMID: 38943417 DOI: 10.3233/wor-230268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Given the importance of cultural diversity in healthcare, the shift from "cultural competence" to "cultural humility" has become crucial. This transition is particularly relevant for nursing students in multiethnic regions, such as Southeastern Anatolia, Turkey, where diverse cultural interactions can significantly impact their professional development and practice. OBJECTIVE This study was conducted to determine the cultural humility levels of nursing students. METHODS This descriptive study was carried out with nursing students in two universities in the Southeastern Anatolia region, where the immigrant population is dense, in Turkey. RESULTS In this study, the total mean score of the Cultural Humility Scale of the students participating in the research was 70.03±16.01. A significant difference was found between the Cultural Humility scale mean scores of the students and their gender, nationality, native language, experience of going abroad, desire to live in another country, and enjoying spending time with people from different cultures (p < 0.05). Significant positive correlations were determined between the average scores provided by the students on a 0-10 scale, indicating the importance they placed on cultural diversity in nursing education, and both the total score of the Cultural Humility Scale and the mean score of its sub-dimensions (p < 0.01, r = 0.273). CONCLUSION This study found that the cultural humility level of nursing students living and studying with people from various cultures is sometimes exhibited.
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Affiliation(s)
- Soner Berşe
- Department of Nursing, Faculty of Health Sciences, Gaziantep University, Turkey
| | - Ezgi Dirgar
- Department of Midwifery, Faculty of Health Sciences, Gaziantep University, Turkey
| | - Betül Tosun
- Faculty of Nursing, Hacettepe University, Turkey
| | - Derya Tanriverdi
- Department of Nursing, Faculty of Health Sciences, Gaziantep University, Turkey
| | - Eda Atay
- Department of Nursing, Faculty of Health Sciences, Hasan Kalyoncu University, Turkey
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Köse Tosunöz İ, Öztürk Çopur E. The relationship between ethnocentrism and xenophobia level and predictors: A descriptive and correlational study of nurses working in two cities where refugees live intensively in Turkey. Nurs Health Sci 2024; 26:e13107. [PMID: 38566443 DOI: 10.1111/nhs.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/08/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024]
Abstract
Determining the ethnocentrism and xenophobia levels of nurses contributes to nurses' awareness regarding their attitudes on the issue and providing quality care. This descriptive and correlational study aimed to determine the relationship between ethnocentrism and xenophobia levels of nurses working in hospitals located in two different border regions where refugees live intensively in Turkey. The study was conducted with 386 nurses who were working in two different hospitals located in two cities in the south of Turkey. Data were collected using the "Personal Information Form," "Ethnocentrism Scale," and "Xenophobia Scale." About half of the nurses did not want to care for foreign patients. There was a positive and statistically significant relationship between mean scores of the Ethnocentrism Scale and the Xenophobia Scale (p < 0.05). The regression analysis indicated that the level of ethnocentrism explains the level of xenophobia by 9%. Nurses had a high level of xenophobia and moderate ethnocentric attitudes. The level of xenophobia increased as the ethnocentrism level of nurses increased. It is recommended to conduct further studies to determine different predictors of xenophobia among nurses.
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Affiliation(s)
- İpek Köse Tosunöz
- Nursing Department, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ebru Öztürk Çopur
- Department of Nursing, Yusuf Şerefoğlu Health Sciences Faculty, Kilis 7 Aralık University, Kilis, Turkey
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Güner S, Gökçe İsbir G, Aydın Beşen M. Midwives' Intercultural Effectiveness Levels and Influencing Factors. J Transcult Nurs 2024; 35:189-198. [PMID: 38380448 DOI: 10.1177/10436596241229479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Due to globalization, countries around the world are starting to notice diversity in their populations. It is crucial that midwives be able to communicate effectively with women from a variety of cultures to provide them with culturally effective health care. METHOD This cross-sectional study was conducted with 394 midwives who work in seven different regions of Türkiye. Data on the intercultural effectiveness and intercultural communication competence of midwives were collected. Data analysis was performed using descriptive statistics, t-tests, analysis of variance, and regression analysis. RESULTS Midwives' intercultural effectiveness was influenced by their foreign language proficiency, experiences abroad, having friends from different cultures, following social media platforms in different languages and cultures, providing care to individuals from diverse cultures, and their willingness to do so. DISCUSSION Findings suggest that exposure to different cultures enhances the level of intercultural effectiveness. Consequently, it is recommended to make plans to support midwives to have positive experiences with different cultures.
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Tosun B. Cultural competence in nursing education: examining the nexus of cultural sensitivity and effectiveness among nursing students. Evid Based Nurs 2024; 27:74. [PMID: 38050028 DOI: 10.1136/ebnurs-2023-103863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Betül Tosun
- Faculty of Health Sciences, Department of Nursing, Hasan Kalyoncu Universitesi, Gaziantep, Turkey
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Korkmaz Aslan T, Sönmezer Öcal H. Investigation of differences in xenophobia, prosociality level, and sociodemographic characteristics in nursing students. Brain Behav 2023; 13:e3277. [PMID: 37822190 PMCID: PMC10726838 DOI: 10.1002/brb3.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023] Open
Abstract
AIMS This study aimed to examine differences in xenophobia, prosocial behavior tendency, and sociodemographic characteristics among nursing students. MATERIALS & METHODS The participants were 227 nursing students (29.1% male, 70.9% female) attending the nursing department in the spring semester of the 2019-2020 academic year. We used a personal identification form, xenophobia scale, and prosocial behavior tendency scale to collect the data. RESULTS Among the participants, 24.7% were in first year, 30.4% were in second year, 21.6% were in third year, and 23.3% were in fourth year. Female students had higher prosocial behavior disposition, altruistic, and submissive scores than their male counterparts. The second-year students' prosocial behavior scores were higher than those of the third-year students. The male students' hatred, humiliation, and xenophobia scores were higher than those of the female students. DISCUSSION The xenophobia scores were higher in those with two living parents and lower in those whose mothers had secondary education. We used the Kolmogorov-Smirnov test, Shapiro-Wilk test, and graphical assessments to test the quantitative data's compliance with normal distribution. We also employed the Student's t-test and one-way analysis of variance for data showing a normal distribution and Mann-Whitney U and Kruskal-Wallis tests for data showing non-normal distribution. To evaluate the relationships among variables, we used the Pearson correlation analysis for normally distributed variables and Spearman's correlation analysis for non-normally distributed variables. CONCLUSION Women's prosocial behavior tendency total score was higher than men's, and men's xenophobia total score was higher than women's. There was a weak negative correlation between the positive behavior tendency and xenophobia total scores.
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Affiliation(s)
- Tuba Korkmaz Aslan
- Department of NursingNecmettin Erbakan University Seydişehir Kamil Akkanat Faculty of Health SciencesSeydişehirTurkey
| | - Hacer Sönmezer Öcal
- Department of NursingKaramanoglu Mehmetbey University Faculty of Health SciencesKaramanTurkey
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Özdemir S, Sevinç S. Correlation between cultural competence, xenophobia, and attitudes towards brain drain in nursing students. NURSE EDUCATION TODAY 2023; 131:105963. [PMID: 37734367 DOI: 10.1016/j.nedt.2023.105963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/24/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023]
Abstract
This study aimed to determine the correlation between cultural competence, xenophobia, and attitudes to brain drain in nursing students. Individuals with high levels of intercultural competence have more successful social and emotional interactions with people from various cultural backgrounds. A cross-sectional and correlational design was used. This study was conducted on 473 nursing students from two different provinces neighboring the Syrian border between October 28th and December 28th, 2021. An information form and nurse cultural competence, xenophobia, and attitude scales for brain drain were used to collect data. A negative nonsignificant correlation between cultural competence and xenophobia and a positive nonsignificant correlation between cultural competence and attitude towards brain drain were found. The students had high levels of cultural competence and positive attitudes towards brain drain, and a moderate level of xenophobia. Socio-demographic characteristics affected cultural competence, xenophobia, and attitudes towards brain drain.
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Affiliation(s)
- Serap Özdemir
- Department of Nursing, Yusuf Serefoglu Faculty of Health Sciences, Kilis 7 Aralik University, Kilis, Turkey.
| | - Sibel Sevinç
- Department of Nursing, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
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Çetin Y, Savaş M. Does the cultural awareness of nurses affect brain drain and xenophobia? J Adv Nurs 2023; 79:4348-4355. [PMID: 37209393 DOI: 10.1111/jan.15702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/29/2023] [Accepted: 04/30/2023] [Indexed: 05/22/2023]
Abstract
AIM Turkey is on the transit route of immigrants as it is located between countries where poverty and wars are intense and European countries. Therefore, there are countless immigrants from different countries in Turkey. Migrations affect every sector, especially the health sector. The aim of this study was to determine how cultural awareness of nurses, who are the cornerstone of the health system, affects brain drain and xenophobia. The problem of health care is not only on the agenda of immigrants, but also on the agenda of health service providers in their countries due to economic and working conditions. DESIGN This research was designed as descriptive and relationship-seeking. METHODS The data of the research were collected through Google Forms between December 5 and 26, 2022. A total of 231 nurses working in a public hospital in south-east Turkey participated in the study. Data were evaluated with descriptive statistics as well as reliability, t-test, ANOVA, Pearson correlation and linear regression analysis. RESULTS It was determined that the attitudes of the participants towards brain drain were moderate, their cultural awareness was low and their xenophobic attitudes were high. In addition, it was determined that 44% of the change in the total score obtained from the intercultural awareness scale was explained by the scores obtained from the xenophobia and brain drain scales. CONCLUSIONS In this context, it may be possible to reduce xenophobic attitudes by giving intercultural awareness trainings to nurses. In addition, it is important to provide working conditions and economic support by health policy makers to prevent the brain drain of nurses. IMPACT Nurses may need to provide care for individuals from different cultures due to the regions in which they live. For this reason increasing their cultural awareness and reducing xenophobia may ensure that they provide improved care to their patients.
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Affiliation(s)
- Yasin Çetin
- Department of Nursing Management, Faculty of Health Sciences, Adıyaman University, Adıyaman, Turkey
| | - Mümin Savaş
- Department of Public Health Nursing, Faculty of Health Sciences, Adıyaman University, Adıyaman, Turkey
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Kardas U, Yilmaz Sahin S. Investigation of the relationship between cultural sensitivity and effectiveness levels among nursing students. Nurse Educ Pract 2023; 72:103773. [PMID: 37703766 DOI: 10.1016/j.nepr.2023.103773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/29/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023]
Abstract
AIM The aim of this study is to investigate the relationship between cultural sensitivity and effectiveness levels among nursing students. BACKGROUND The world is changing and globalizing, and societies are becoming increasingly multicultural. Therefore, nurses, who play an important role in health service delivery, are expected to be competent in interacting with patients from different cultures and to develop cultural sensitivity during their education. DESIGN The design of this study is a prospective descriptive study. METHODS The research was conducted with 284 nursing students in the faculty of nursing at a university in Ankara. The data collection process of this study was conducted at the end of the spring semester of the 2019-2020 academic year between 20 and 30 June 2020. The Sociodemographic Characteristics Form, Intercultural Sensitivity Scale, and Intercultural Effectiveness Scale were used to collect data. Descriptive statistics, parametric and nonparametric tests were used for data analysis. RESULTS The mean age of the students was 20.80 ± 1.64, and 82% of the students were female. The mean scores on the Intercultural Sensitivity and Intercultural Effectiveness Scales were 92.56 ± 11.98 and 53.87 ± 6.28, respectively. A positive, moderate, and statistically significant correlation was found between the scores on the two scales. In the study, it was determined that females have higher cultural sensitivity and cultural effectiveness level than males, and students who could not understand and speak English have lower cultural sensitivity and cultural effectiveness level than students who could understand and speak English. CONCLUSION In this study, it was evaluated that the nursing students had high cultural sensitivity and moderate cultural effectiveness levels, and cultural sensitivity levels were found to increase in line with cultural effectiveness levels. It is recommended to review the educational curricula to improve cultural communication competence and organize programs to improve English speaking and conduct more studies examining the cultural effectiveness of students.
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Affiliation(s)
- Ulker Kardas
- Department of Surgical Nursing, Gulhane Faculty of Nursing, University of Health Sciences, Ankara, Turkey
| | - Sibel Yilmaz Sahin
- Department of Surgical Nursing, Hamidiye Faculty of Nursing, University of Health Sciences, İstanbul, Turkey.
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Yıldız M, Yildirim MS, Elkoca A, Varol E, Aydin MA, Dege G. Investigation of the Relationship Between Xenophobic Attitude and Intercultural Sensitivity Level in Health Education Students. J Transcult Nurs 2023; 34:238-246. [PMID: 36927307 DOI: 10.1177/10436596231158136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Intercultural sensitivity and xenophobia levels of health education students can affect the care they give to the patient. It is important to know the level of intercultural sensitivity and xenophobia of students receiving health education and to determine the relationship between them. The purpose of the study was to examine the relationship between xenophobic attitudes and intercultural sensitivity among university students. METHODS This quantitative cross-sectional research was conducted in between January and June 2022 with health education students. The study conducted with health education students at Gumushane University and Agri Ibrahim Cecen University. Child Development, Nursing, Emergency Management Services/Technicians, Nutrition and Dietetics, Elderly care, Social services, Medical Laboratory Techniques, and Disabled Care studying at these universities were included in the study. Students who received health education and wanted to participate voluntarily in the study were included. Students aged 18 and over, studying in the health education department of the university, studying in the 1, 2, 3, 4th classes and volunteering to participate in the study were included in the study. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. RESULTS This study was conducted with 789 students. According to our study, a significant negative correlation was found between the students' xenophobia scale and the intercultural sensitivity scale total score means (p < .05). Intercultural sensitivity has a negative and significant effect on the level of xenophobia (β = -0.116; t (787) = -3.283, p = .001). A significant difference was found between the students' Xenophobia Scale total score mean and gender, department, and grade (p < .05) as was the case between Intercultural Sensitivity Scale total score mean and gender, department, grade, immigrant acquaintance, and foreign language knowledge (English language) level (p < .05). DISCUSSION Intercultural sensitivity has a negative and significant effect on the level of xenophobia. It can negatively affect the level of caregiving of students receiving health education. It is thought that intercultural sensitivity will be developed by including course content in the curriculum to increase students' intercultural effectiveness and awareness levels and to reduce xenophobic prejudices.
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Affiliation(s)
| | | | - Ayşe Elkoca
- Gaziantep Islamic Science and Technology University, Turkey
| | - Ela Varol
- Agri Ibrahim Cecen University, Turkey
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Karadas MM, Bilgin A, Sahan FU, Ozdemir L. Determining the predictors of nursing students' xenophobic tendency toward refugees. NURSE EDUCATION TODAY 2023; 122:105722. [PMID: 36709522 DOI: 10.1016/j.nedt.2023.105722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/19/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Xenophobia is an important role in affecting the professional development of nursing students and the health of refugees. However, factors contributing to xenophobia levels in nursing students remain undetermined. AIM To determine the predictors and levels of xenophobia in nursing students toward refugees. METHOD Our cross-sectional descriptive study included nursing students (n = 265) from Turkey. Data were collected using the "Participant Information Form", "Xenophobia Scale", "Ethnocentrism Scale", and "Intergroup Social Contact Scale". Structural equation modeling and regression analysis were used for data analysis. RESULTS 86.0 % of the participants were female and students' xenophobia scale mean score was 50.89 (SD = 9.59) at a high level. Nursing students living in the city center showed a higher level of xenophobia than those living in the village/town (β = 3.327). Nursing students with an immigrant family member displayed a lower level of xenophobia than those who did not (β = 3.461). Both ethnocentrism and intergroup social contact exerted a direct effect on xenophobia. Ethnocentrism (β = 0.193, p < 0.001) was found to be a positive predictor of xenophobia levels in students. Intergroup social contact (β = -0.400, p < 0.001) was found to be a negative predictor of xenophobic levels in students. CONCLUSION This study showed that ethnocentrism and intergroup social contact exerted direct effects on the xenophobic levels in nursing students. Our study also revealed that living in the city center and having an immigrant family member affected the level of xenophobia in such a sample.
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Affiliation(s)
- Merve Mert Karadas
- Hacettepe University, Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Ankara, Turkey.
| | - Aylin Bilgin
- Sakarya University of Applied Sciences, Faculty of Health Sciences, Nursing Department, 54400, Sakarya, Turkey
| | - Fatma Uslu Sahan
- Hacettepe University, Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Ankara, Turkey
| | - Leyla Ozdemir
- Hacettepe University, Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
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