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Díaz DA, Martínez VC, López Castillo H. Considerations for Culturally Congruent Healthcare for Simulation in Bedside Clinical Practice. Nurs Clin North Am 2024; 59:371-381. [PMID: 39059856 DOI: 10.1016/j.cnur.2024.01.009] [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: 07/28/2024]
Abstract
This article provides practical recommendations for creating and implementing culturally appropriate and culturally congruent healthcare simulation applications for bedside providers that adhere to best practices and reporting standards. Framed within the 11 criteria for simulation design outlined in the Healthcare Simulation Standards of Best Practice, the article provides a summary of these criteria, highlighting the lessons learned from their application in a Health Resources and Services Administration-sponsored public health grant 6 U4EHP46217-01-01, Public Health Simulation-Infused Program.
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Affiliation(s)
- Desiree A Díaz
- Department of Nursing Practice, College of Nursing, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA.
| | - Valerie C Martínez
- Department of Nursing Practice, College of Nursing, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Humberto López Castillo
- Department of Health Sciences, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA; Department of Population Health Sciences, College of Medicine, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
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Kunnen KEE, Miller K, Oh Y. Minority Student Perspectives of Barriers, Supports, and Christian Virtues in an Undergraduate Christian Nursing Program. J Christ Nurs 2024; 41:152-159. [PMID: 37199726 DOI: 10.1097/cnj.0000000000001089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
ABSTRACT Diversity and inclusion are critical priorities in nursing education programs. Literature has focused on minority student experiences of barriers and supports-but not through a Christian worldview. This qualitative study using a phenomenological-hermenuetic approach gave voice to the experiences of 15 self-identified minority student graduates from a Christian baccalaureate nursing program. Data analysis revealed opportunities for growth in providing a supportive climate within the program and how Christian virtues of hospitality, humility, and reconciliation can be employed to achieve this goal.
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Compton-McBride S, Andrews A, Reed A. Seek to Understand: Cultural Humility in Undergraduate Nursing Students and Faculty. Nurs Educ Perspect 2024; 45:233-235. [PMID: 37824428 DOI: 10.1097/01.nep.0000000000001194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
ABSTRACT There exists a critical knowledge deficit in undergraduate nursing students when caring for multiculturally diverse clients. A mixed-methods study was conducted with a sample of undergraduate nursing faculty and students. Foronda's Cultural Humility Scale was used, along with a survey about cultural experiences in undergraduate nursing education. The study found that to provide opportunities for psychologically safe conversations and simulated cultural encounters, concepts related to cultural humility should be considered when redesigning nursing curricula.
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Affiliation(s)
- Sheri Compton-McBride
- About the Authors Sheri Compton-McBride, DNP, RN; Angela Andrews, PhD, RN; and Amy Reed, PhD, RN, are faculty at Southern Illinois University Edwardsville School of Nursing, Edwardsville, Illinois. The authors acknowledge and express gratitude to Dr. Cynthia Foronda for her feedback and expertise and for allowing them to utilize her cultural humility tool. For more information, contact Dr. Compton-McBride at
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Schneidewind M. Implementing LGBTQ Culturally Appropriate Affirmation Training in the Southern United States: An Evidence-Based Practice Project. J Contin Educ Nurs 2024; 55:121-129. [PMID: 38063797 DOI: 10.3928/00220124-20231130-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND The lesbian, gay, bisexual, transgender, or queer (LGBTQ) community is diverse, and members have a shared need for culturally competent health care (CCH). Best practices show that culturally appropriate affirmation training (CAAT) bridges the sociocultural knowledge gap between patient and provider, resulting in increased access to CCH. METHOD The pre-/posttest project design used validated tools to measure group changes in knowledge, attitude, and skills before and after delivery of LGBTQ CAAT. The sample included staff interacting with or making decisions on behalf of patients (n = 11) at a nonprofit clinic in the southern United States. RESULTS A Wilcoxon signed-rank test showed an increase in health care team scores for knowledge, attitude, and skills (knowledge, p = .006, r = -.59; attitude, p = .123, r = -.33; skills, p = .005, r = -.60). Qualitative analysis (thematic analysis) (a) showed that participants explored sensitive subjects in a nonjudgmental way; (b) connected the dots between minority stress, bias, and patient-provider trust; and (c) showed increased staff confidence in providing care to LGBTQ patients. CONCLUSION As staff undergo LGBTQ CAAT, access to CCH will increase, health outcomes will improve, and LGBTQ health disparities will decrease. [J Contin Educ Nurs. 2024;55(3):121-129.].
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Graham-Perel A. Cultural Humility and Diversity in Nursing Academia: Understanding History to Create a "Brave Space" Culture in the Classroom. Nurs Clin North Am 2024; 59:11-19. [PMID: 38272577 DOI: 10.1016/j.cnur.2023.11.003] [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: 01/27/2024]
Abstract
Nursing academicians are positioned at a critical juncture to mold the future generations of nursing with the skills of cultural humility, starting with fostering humility in the classroom. The dynamic culture of nursing education, with consideration of the diversity of nursing students and faculty, commands attention before the exploration of what is taught about the culture of patients. Classroom cultural humility must become the "brave space" of nursing academia. This is possible with strategic approaches and revisiting the history of the culture of nursing education before trying to shape its future.
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Affiliation(s)
- Ashley Graham-Perel
- Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA.
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Johanson L, Urso PP, Bemker MA, Sullivan D. A Cultural Humility Approach to Inclusive and Equitable Nursing Care. Nurs Clin North Am 2024; 59:97-108. [PMID: 38272586 DOI: 10.1016/j.cnur.2023.11.008] [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: 01/27/2024]
Abstract
The nursing workforce does not represent the diversity of patients in their care. Nursing students historically have been taught cultural competence, with a core value for diversity, equity, and inclusion, but health inequities remain a problem. Cultural humility goes beyond cultural competency, offering nurses a perpetual learning role from the individual patients in their care. The concept of cultural humility also offers bedside nurses a way to overcome implicit and explicit bias through self-awareness and active listening, but it may not be well understood.
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Affiliation(s)
- Linda Johanson
- Walden University, College of Nursing, 100 Washington Avenue South, Suite 1210, Minneapolis, MN 55401, USA
| | - Patti P Urso
- Walden University College of Nursing, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA
| | - Mary A Bemker
- Walden University College of Nursing, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA
| | - Debra Sullivan
- Walden University College of Nursing, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA.
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Robinson-Barella A, Takyi C, Chan HKY, Lau WM. Embedding cultural competency and cultural humility in undergraduate pharmacist initial education and training: a qualitative exploration of pharmacy student perspectives. Int J Clin Pharm 2024; 46:166-176. [PMID: 38063997 PMCID: PMC10830727 DOI: 10.1007/s11096-023-01665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/24/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Emphasis has been placed upon embedding equity, diversity and inclusion within the initial education and training of healthcare professionals, like pharmacists. Yet, there remains limited understanding of how best to integrate cultural competency and cultural humility into undergraduate pharmacy student training. AIM This qualitative study explored the views of pharmacy students to understand perspectives on, and identify recommendations for, embedding cultural competency and cultural humility within pharmacy education and training. METHOD Undergraduate pharmacy students from one UK-based School of Pharmacy were invited to participate in an in-person, semi-structured interview to discuss cultural competency in the pharmacy curriculum. Interviews were conducted between November 2022 and February 2023 and were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Newcastle University Ethics Committee. RESULTS Twelve undergraduate pharmacist students, across all years of undergraduate training, were interviewed. Three themes were developed from the data, centring on: (1) recognising and reflecting on cultural competency and cultural humility; (2) gaining exposure and growing in confidence; and (3) thinking forward as a culturally competent pharmacist of the future. CONCLUSION These findings offer actionable recommendations to align with the updated Initial Education and Training standards from the United Kingdom (UK) pharmacy regulator, the General Pharmaceutical Council; specifically, how and when cultural competency teaching should be embedded within the undergraduate pharmacy curriculum. Future research should further explore teaching content, learning environments, and methods of assessing cultural competency.
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Affiliation(s)
- Anna Robinson-Barella
- School of Pharmacy, King George VI Building, Newcastle University, Newcastle, NE1 7RU, UK.
- Population Health Sciences Institute, Newcastle University, Newcastle, UK.
| | - Christopher Takyi
- School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Hayley K Y Chan
- School of Pharmacy, King George VI Building, Newcastle University, Newcastle, NE1 7RU, UK
| | - Wing Man Lau
- School of Pharmacy, King George VI Building, Newcastle University, Newcastle, NE1 7RU, UK
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Suntai Z, Noh H, Lee L, Bell JG, Lippe MP, Lee HY. Quality of Care at the End of Life: Applying the Intersection of Race and Gender. THE GERONTOLOGIST 2024; 64:gnad012. [PMID: 36786381 DOI: 10.1093/geront/gnad012] [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: 08/30/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Research on racial and gender disparities in end-of-life care quality has burgeoned over the past few decades, but few studies have incorporated the theory of intersectionality, which posits that membership in 2 or more vulnerable groups may result in increased hardships across the life span. As such, this study aimed to examine the intersectional effect of race and gender on the quality of care received at the end of life among older adults. RESEARCH DESIGN AND METHODS Data were derived from the combined Round 3 to Round 10 of the National Health and Aging Trends Study. For multivariate analyses, 2 logistic regression models were run; Model 1 included the main effects of race and gender and Model 2 included an interaction term for race and gender. RESULTS Results revealed that White men were the most likely to have excellent or good care at the end of life, followed by White women, Black men, and Black women, who were the least likely to have excellent or good care at the end of life. DISCUSSION AND IMPLICATIONS These results point to a significant disadvantage for Black women, who had worse end-of-life care quality than their gender and racial peers. Practice interventions may include cultural humility training and a cultural match between patients and providers. From a policy standpoint, a universal health insurance plan would reduce the gap in end-of-life service access and quality for Black women, who are less likely to have supplemental health care coverage.
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Affiliation(s)
- Zainab Suntai
- Diana R. Garland School of Social Work, Baylor University, Waco, Texas, USA
| | - Hyunjin Noh
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - Lewis Lee
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - John Gregory Bell
- College of Community Health Sciences, University of Alabama, Tuscaloosa, Alabama, USA
| | - Megan P Lippe
- The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
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Ogunlana MO, Oyewole OO, Aderonmu JA, Onyeso OK, Faloye AY, Govender P. Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals. BMC MEDICAL EDUCATION 2023; 23:933. [PMID: 38066501 PMCID: PMC10709888 DOI: 10.1186/s12909-023-04910-0] [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: 09/15/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Being culturally competent would enhance the quality of care in multicultural healthcare settings like Nigeria, with over 200 million people, 500 languages, and 250 ethnic groups. This study investigated the levels of training and practice of cultural competence among clinical healthcare professionals in two purposively selected Nigerian tertiary hospitals. METHODS The research was a cross-sectional study. A multi-stage sampling technique was used to recruit participants who completed the adapted version of Cultural Competence Assessment Instrument (CCAI-UIC). Data were analysed using descriptive statistics, Pearson's correlation, ANOVA, and multivariate linear regression. RESULTS The participants were mainly women (66.4%), aged 34.98 ± 10.18 years, with ≤ 5 years of practice (64.6%). Personal competence had a positive weak correlation with age (p < 0.001), practice years (p = 0.01), training (p = 0.001), practice (p < 0.001), and organisational competence (p < 0.001). There were significant professional differences in the level of training (p = 0.005), and differences in training (p = 0.005), and personal competence (p = 0.015) across levels of educational qualifications. Increasing practise years (p = 0.05), medical/dental profession relative to nursing (p = 0.029), higher personal (p = 0.013), and organisational (p < 0.001) cultural competences were significant predictors of the level of training. Male gender (p = 0.005), higher years in practice (p = 0.05), local language ability (p = 0.037), rehabilitation professionals relative to nursing (p = 0.05), high culturally competent practice (p < 0.001), higher training opportunities (p = 0.013), and higher organisational competence (p = 0.001) were significant predictors of higher personal competence. CONCLUSION About a third of the participants had no formal training in cultural competence. Incorporating cultural competence in the Nigerian healthcare professionals' education curricula may enhance the quality of care in the multicultural setting.
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Affiliation(s)
- Michael O Ogunlana
- Department of Physiotherapy, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria.
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa.
| | - Olufemi O Oyewole
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Joseph A Aderonmu
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Ogochukwu Kelechi Onyeso
- Population Studies in Health, Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Ayobamigbe Y Faloye
- Unit of Planning Research and Statistics, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria
| | - Pragashnie Govender
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
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Ličen S, Prosen M. The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study. BMC MEDICAL EDUCATION 2023; 23:819. [PMID: 37915004 PMCID: PMC10621240 DOI: 10.1186/s12909-023-04800-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia. METHODS A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05. RESULTS The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge. CONCLUSIONS The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.
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Affiliation(s)
- Sabina Ličen
- Department of Nursing, Faculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia.
| | - Mirko Prosen
- Department of Nursing, Faculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia
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Frie K, Timm J. Developing Cultural Humility Through an Interprofessional Clinical Education Experience. Nurse Educ 2023; 48:E153-E157. [PMID: 36807285 DOI: 10.1097/nne.0000000000001379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND An interprofessional clinical education model operating student-led, faculty-guided clinics partnered with rural Midwest American communities lacking health care access. PURPOSE To evaluate how an internship, guided by the Theory of Cultural Humility, during the COVID-19 pandemic supported development of cultural humility in interprofessional health profession students. APPROACH Nursing, exercise science, public health, and social work participants completed an internship during early phases of the COVID-19 pandemic, despite many experiences being suspended. Quantitative evaluation using pre-/postadministration of Foronda's Cultural Humility Scale was completed across 3 periods measuring change in cultural humility. RESULTS Total scores of Foronda's Cultural Humility Scale increased for all 3 periods (n = 11, n = 74, and n = 44), demonstrated by aggregate data and statistical analysis. The largest change occurred in the first period. CONCLUSIONS Engaging interprofessional students in experiential learning during real-life, real-time public health events creates reflection of complex practice issues while developing cultural humility.
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Affiliation(s)
- Kathryn Frie
- Associate Professor (Dr Frie), Department of Undergraduate Nursing, and Associate Professor (Dr Timm), Department of Graduate Nursing, Winona State University, Winona, Minnesota
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Singh H, Haghayegh AT, Shah R, Cheung L, Wijekoon S, Reel K, Sangrar R. A qualitative exploration of allied health providers' perspectives on cultural humility in palliative and end-of-life care. BMC Palliat Care 2023; 22:92. [PMID: 37434238 DOI: 10.1186/s12904-023-01214-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Cultural factors, including religious or cultural beliefs, shape patients' death and dying experiences, including palliative and end-of-life (EOL) care preferences. Allied health providers must understand their patients' cultural preferences to support them in palliative and EOL care effectively. Cultural humility is a practice which requires allied health providers to evaluate their own values, biases, and assumptions and be open to learning from others, which may enhance cross-cultural interactions by allowing providers to understand patients' perceptions of and preferences for their health, illness, and dying. However, there is limited knowledge of how allied health providers apply cultural humility in palliative and EOL care within a Canadian context. Thus, this study describes Canadian allied health providers' perspectives of cultural humility practice in palliative and EOL care settings, including how they understand the concept and practice of cultural humility, and navigate relationships with patients who are palliative or at EOL and from diverse cultural backgrounds. METHODS In this qualitative interpretive description study, remote interviews were conducted with allied health providers who currently or recently practiced in a Canadian palliative or EOL care setting. Interviews were audio-recorded, transcribed, and analyzed using interpretive descriptive analysis techniques. RESULTS Eleven allied health providers from the following disciplines participated: speech-language pathology, occupational therapy, physiotherapy, and dietetics. Three themes were identified: (1) Interpreting and understanding of cultural humility in palliative and EOL care (i.e., recognizing positionality, biases and preconceived notions and learning from patients); (2) Values, conflicts, and ethical uncertainties when practicing cultural humility at EOL between provider and patient and family, and within the team and constraints/biases within the system preventing culturally humble practices; (3) The 'how to' of cultural humility in palliative and EOL care (i.e., ethical decision-making in palliative and EOL care, complexities within the care team, and conflicts and challenges due to contextual/system-level factors). CONCLUSIONS Allied health providers used various strategies to manage relationships with patients and practice cultural humility, including intra- and inter-personal strategies, and contextual/health systems enablers. Conflicts and challenges they encountered related to cultural humility practices may be addressed through relational or health system strategies, including professional development and decision-making support.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
| | - Arta Taghavi Haghayegh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Riya Shah
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sachindri Wijekoon
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Kevin Reel
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- Ethics Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ruheena Sangrar
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
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Zhao Y, Shannon K, Buxton JA, Ti L, Genovy TA, Braschel M, Pick N, Kestler M, Deering K. Precarious Housing Associated with Unsuppressed Viral load, sub-optimal Access to HIV Treatment and Unmet Health care Needs, Among Women Living with HIV in Metro Vancouver, Canada. AIDS Behav 2023; 27:2271-2284. [PMID: 36729293 PMCID: PMC10564463 DOI: 10.1007/s10461-022-03957-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 02/03/2023]
Abstract
We investigated associations between (1) housing status (four categories measuring housing stability) and outcomes along the HIV care continuum (not currently on antiretroviral therapy [ART]; sub-optimal ART adherence [< 95% in the last 3-4 weeks]; unsuppressed viral load [> 200 copies/ml], median CD4 < 200 in the last six months), and (2) housing status and unmet primary, dental and mental health care needs in the last six months among WLWH. Housing status was defined according to the Canadian Definition of Homelessness and had four categories: unsheltered (i.e., living in ≥ 1 unsheltered location [e.g., street, abandoned buildings]), unstable (i.e., living in ≥ 1 unstable location [e.g., shelter, couch surfing]), supportive housing (i.e., only living in supportive housing), and stable housing (i.e., only living in one's own housing; reference). At baseline, in the last six months, 47.3% of participants reported unstable housing, followed by 24.4% unsheltered housing, 16.4% stable housing, and 11.9% supportive housing. Overall, 19.1% of the full sample (N = 336, 2010-2019) reported not currently on ART; among participants on ART, 28.0% reported sub-optimal ART adherence. Overall, 32.1% had recent unsuppressed viral load. Among a subsample (n = 318, 2014-2019), 15.7% reported unmet primary care needs, 26.1% unmet dental care needs, and 16.4% unmet mental health care needs. In adjusted models, being unsheltered (vs. stable housing) was associated with not currently on ART, unsuppressed viral load, and unmet primary and dental care needs. Housing and health services need to be developed with and for WLWH to address structural inequities and fulfill basic rights to housing and health.
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Affiliation(s)
- Yinong Zhao
- Centre for Gender and Sexual Health Equity, University of British Columbia, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, University of British Columbia, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jane A Buxton
- Centre for Gender and Sexual Health Equity, University of British Columbia, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Lianping Ti
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Theresa Anne Genovy
- Centre for Gender and Sexual Health Equity, University of British Columbia, Vancouver, Canada
| | - Melissa Braschel
- Centre for Gender and Sexual Health Equity, University of British Columbia, Vancouver, Canada
| | - Neora Pick
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | - Mary Kestler
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | - Kathleen Deering
- Centre for Gender and Sexual Health Equity, University of British Columbia, Vancouver, Canada.
- Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Eden A, Cominos N, Fleet JA. Agency in change: Learning experiences of international midwifery students in South Australia. Women Birth 2023; 36:143-150. [PMID: 36494305 DOI: 10.1016/j.wombi.2022.11.014] [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: 08/31/2022] [Revised: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
PROBLEM While literature reports broadly on the experiences of international students of health professions in higher education, the experience of students undertaking an undergraduate midwifery program outside their country of origin has not previously been reported. BACKGROUND Midwifery studies incorporate distinct clinical practice and discipline-specific therapeutic relationships which can challenge students familiar with the health system, so it is necessary to understand their impact on the learning needs of international students, who contribute to the diversity of our workforce. AIM To explore learning experiences of international students of an undergraduate midwifery program to identify their perceptions and personal strategies which impacted their participation in the program. METHODS A qualitative descriptive study, with a purposive sample of nine current international students and recent graduates of a midwifery program at a South Australian university. Participants attended a focus group or individual phone interview to explore their learning experiences, and data were thematically analysed. FINDINGS Five themes and sub-themes were identified, built around a core concept of the international midwifery student experience as agency in change: language and culture, teaching and learning, isolation and integration, services and support, and motivation and resilience. Studying abroad was associated with personal and professional growth. Continuity of care for women presented challenges and produced learnings unique to this cohort. CONCLUSION Tailored support, such as specialized clinical facilitation and organized peer networking, is required for international midwifery students in Australia. Additionally, effective approaches to facilitate bilingualism to support language concordant care are needed.
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Affiliation(s)
- Amye Eden
- Clinical and Health Sciences, University of South Australia, City East Campus, Corner North Terrace and Frome Road, Adelaide, SA 5000, Australia.
| | - Nayia Cominos
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia.
| | - Julie-Anne Fleet
- Rosemary Bryant AO Research Centre, University of South Australia, City East Campus, Corner North Terrace and Frome Road, Adelaide, SA 5000, Australia.
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Wei H, Price Z, Evans K, Haberstroh A, Hines-Martin V, Harrington CC. The State of the Science of Nurses' Implicit Bias: A Call to Go Beyond the Face of the Other and Revisit the Ethics of Belonging and Power. ANS Adv Nurs Sci 2023; 46:121-136. [PMID: 36728370 DOI: 10.1097/ans.0000000000000470] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This article summarizes the current state of nurses' implicit bias and discusses the phenomenon from Levinas' face of the Other and ethics of belonging, Watson's human caring and unitary caring science, and Chinn's peace and power theory. Nurses' implicit bias is a global issue; the primary sources of nurses' implicit bias include race/ethnicity, sexuality, health conditions, age, mental health status, and substance use disorders. The current research stays at the descriptive level and addresses implicit bias at the individual level. This article invites nurses to go beyond "the face of the Other" and revisit the ethics of belonging and power.
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Affiliation(s)
- Holly Wei
- East Tennessee State University College of Nursing, Johnson City, Tennessee (Dr Wei); Physician Services, Novant Health, Winston-Salem, North Carolina (Dr Price); Atrium Health, Charlotte, North Carolina (Ms Evans); Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina (Dr Haberstroh); and Office of Community Engagement and Diversity Inclusion (Dr Hines-Martin), University of Louisville School of Nursing (Dr Harrington), Louisville, Kentucky
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Chu H, Kirby L, Booth A, Klepper M, Sherman ADF, Bower KM, Wright EM. Providing gender affirming and inclusive care to transgender men experiencing pregnancy. Midwifery 2023; 116:103550. [PMID: 36423562 PMCID: PMC9850418 DOI: 10.1016/j.midw.2022.103550] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES AND DESIGN Information about providing professional and appropriate perinatal care to transgender men in the perinatal setting is scarce, and healthcare providers often have insufficient knowledge or skills to provide this care. In response, a quality improvement educational program for nursing staff was developed and implemented, with the goal of evaluating the impact of this intervention on nurses' knowledge, skills, and attitudes when caring for pregnant transgender men. SETTING AND PARTICIPANTS The training was offered to nursing staff of a 24-bed inpatient perinatal unit at a large, private academic medical center in a major East Coast city during the unit's quarterly staff meeting in March 2020. INTERVENTION The training covered the provision of affirming and inclusive perinatal care for transgender men. The content of the training was based on recommendations in the literature and reviewed by content experts. MEASUREMENTS Pre-test (N = 55) and post-test (N = 23) online self-administered surveys assessed nursing staff's knowledge of, comfort, and interest in providing gender affirming care for transgender men. Mann-Whitney U and Fischer's exact tests were used to determine significant changes in knowledge and attitudes over time. FINDINGS Findings suggest the training improved nursing staff's self-reported knowledge and skills in providing gender affirming care to pregnant transgender men over time, with participants demonstrating improved knowledge about communication around pronouns, gender identity, reproductive systems, and obstetric history. Awareness of resources for both professional development and to refer transgender patients also improved. However, persistent deficits in other knowledge, skills, and attitudes remained, suggesting that nurses would likely benefit from further support and training in transgender-specific health issues. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings support the utility of unit-based training in improving affirming and inclusive care in the perinatal setting. This highlights opportunities for supporting nurses' professional practice of caring for transgender patients experiencing pregnancy and may be adapted for use in other specialty units.
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Affiliation(s)
- Hillary Chu
- Johns Hopkins School of Nursing, 525N. Wolfe Street, Baltimore, MD 21205, United States.
| | - Lee Kirby
- Johns Hopkins School of Nursing, 525N. Wolfe Street, Baltimore, MD 21205, United States.
| | - Ashley Booth
- Johns Hopkins School of Nursing, 525N. Wolfe Street, Baltimore, MD 21205, United States.
| | - Meredith Klepper
- Johns Hopkins School of Nursing, 525N. Wolfe Street, Baltimore, MD 21205, United States.
| | - Athena D F Sherman
- The Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd., Atlanta, GA 30322, United States.
| | - Kelly M Bower
- Johns Hopkins School of Nursing, 525N. Wolfe Street, Baltimore, MD 21205, United States.
| | - Erin M Wright
- Johns Hopkins School of Nursing, 525N. Wolfe Street, Baltimore, MD 21205, United States.
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Garrett SB, Simon MA. The Social Contexts of Birthing People with Public- and Private-Payer Prenatal Care: Illuminating an Understudied Aspect of the Patient Experience. Health Equity 2022; 6:898-908. [PMID: 36636111 PMCID: PMC9811847 DOI: 10.1089/heq.2021.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose In pursuit of more equitable and person-centered health care, patients and professional medical societies increasingly call for better clinician understanding of patients' perspectives and social contexts. A foundational but understudied aspect of patients' social contexts are the ideas they encounter about health-related behaviors. We investigated this aspect of the social contexts of birthing people, comparing those with public versus private insurance to discover setting-specific insights. Methods Based on ethnographic fieldwork, we created an original survey featuring 29 statements about 12 prenatal, perinatal, and postpartum health behaviors (e.g., drinking alcohol, epidural use, breastfeeding). Participants were 248 individuals receiving prenatal care in Northern California in 2009-2011, split evenly between public- and private-payer coverage. Participants reported whether they were familiar or unfamiliar with each statement. Results Ninety-eight percent of all participants had heard contradictory ideas about ≥1 health behavior (mean=3.9 behaviors for public- and 5.4 for private-coverage respondents). For 20 of the 29 behavior-related ideas, exposure varied significantly by coverage type. Among other differences, public-coverage respondents were much more familiar with ideas related to risk and constrained autonomy (e.g., that serious perinatal complications are common; that new mothers should try to breastfeed even if they do not want to). Conclusions Birthing people are exposed to a wide range of ideas about health behaviors, many of which vary by the structural systems in which they are embedded. Understanding and engaging this complexity can help clinicians to provide more respectful, person-centered, and equitable maternity care.
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Affiliation(s)
- Sarah B. Garrett
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA.,*Address correspondence to: Sarah B. Garrett, PhD, Philip R. Lee Institute for Health Policy Studies, 490 Illinois Street, Floor 7, San Francisco, CA 94158, USA,
| | - Melissa A. Simon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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18
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Goodall KR, Wofford LG. Pedagogical strategies of LGBTQIA+ education in pre-licensure nursing: An integrative review. NURSE EDUCATION TODAY 2022; 119:105547. [PMID: 36122533 DOI: 10.1016/j.nedt.2022.105547] [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: 02/12/2022] [Revised: 08/23/2022] [Accepted: 09/08/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Previous research suggests that information about providing culturally sensitive care to patients of the LGBTQIA+ population has been lacking among pre-licensure nursing programs. This is due, in part, to a lack of faculty preparation and knowledge regarding LGBTQIA+ issues. The purpose of this integrative review is to examine pedagogical strategies of LGBTQIA+ content integration in pre-licensure nursing programs in the United States. DATA SOURCES The literature search was conducted by searching CINAHL, the Cochrane Database, PubMed, MEDLINE, Google Scholar, and PsychINFO for peer-reviewed articles that were written in the English language and completed in an educational setting. REVIEW METHODS The search was conducted by a single independent reviewer. Inclusion and exclusion criteria were applied to articles identified by the databases. Eighteen articles met all identified criteria. Articles were appraised using resources from the Joanna Briggs Institute and one article was excluded from further consideration after appraisal. Seventeen articles were analyzed for themes. RESULTS Three themes emerged from the review: lecture and dialogue, experiential learning, and reading and writing. CONCLUSIONS Based on the review of the literature, there is a myriad of evidence-based pedagogies to incorporate LGBTQIA+ content into pre-licensure nursing programs. Students were successful in achieving learning outcomes and interventions were well-received. The studies in this review may assist in mitigating a lack of faculty preparedness in teaching LGBTQIA+ content by providing examples of pedagogical strategies that can be adapted to fit their particular course or program.
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Affiliation(s)
- Kaysi R Goodall
- College of Nursing, Belmont University, 1900 Belmont Blvd., Nashville, TN 37212, United States of America.
| | - Linda G Wofford
- College of Nursing, Belmont University, 1900 Belmont Blvd., Nashville, TN 37212, United States of America.
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Gautier L. Towards CR 2 evaluation: Culturally -reflexive and -responsive evaluation in crises times and beyond. Int J Health Plann Manage 2022; 37 Suppl 1:32-36. [PMID: 36114618 DOI: 10.1002/hpm.3579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 07/13/2022] [Accepted: 09/06/2022] [Indexed: 12/31/2022] Open
Abstract
More than ever, health services evaluators are in high demand. In such context, evaluation deliverables are time- and/or culturally-sensitive. For the target communities or for those with an interest in the evaluation, the priority is to make sure their voice is prominently featured in evaluation deliverables. This priority coincides with a context where evaluators need to negotiate their positionality, in a context where evaluation deliverables are time- and/or culturally-sensitive. Beyond the mere inclusion of health service users as evaluation stakeholders, how do evaluators position themselves in these discussions? How do they meaningfully navigate this new paradigm in health services evaluation? This issue refers to intangible processes, which can be supported through both natural predisposition and the acquisition of specific skills. Core competencies for credentialled evaluators now all feature the importance of self-awareness and reflexive thinking; as well as the demonstration of appropriate and respectful verbal and non-verbal communication skills, and the capacity to identify practice communities' needs and capacity to participate, while recognising, respecting, and responding to aspects of diversity. Culturally-responsive evaluation is a promising approach to reconcile the world of evaluators and diverse practice communities. Recently, the concept of cultural humility-a reflexive learning process initially designed for frontline workers-has also gained important traction. In this perspective paper, we reflect on the added-value of combining these two approaches (hence, CR2 evaluation-reflexive and responsive) to fulfil the promise of patient and community-centeredness in health service evaluation.
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Affiliation(s)
- Lara Gautier
- Département de Gestion, d'Évaluation et de Politique de Santé, École de Santé Publique de l'Université de Montréal, Montreal, Quebec, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada.,Institut universitaire SHERPA, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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Ślusarska B, Marcinowicz L, Blaževičienė A. Cultural competencies in Polish and Lithuanian nurses: A cross‐sectional comparative study. Scand J Caring Sci 2022; 37:444-457. [PMID: 36329572 DOI: 10.1111/scs.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/07/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cultural competencies are known as a multidimensionalconstruct; however, they usually refer to an individual's sensitivity orcultural attitudes, cultural awareness, knowledge, and skills. AIM The aim of the study was to compare the cultural competences of nurses in Poland and Lithuania based on an adaptation of the Nurse Cultural Competence Scale (NCCS). DESIGN The design was a comparative cross-sectional study. METHODS A total of 383 Polish nurses and 184 Lithuanian nurses took part in the study. The questionnaires of the NCCS-Polish version (NCCS-v.PL) and the NCCS-Lithuanian version (NCCS-v.L) were used after linguistic adaptation and an evaluation of psychometric properties. RESULTS As a result of the comparative analysis, a higher general level of cultural competences (based on the NCCS) was found in the Lithuanian group M-148.09 (SD = 22.85). The results show statistically significant differences among the respondents in the subscale of Nurse Cultural Competence Scale-Cultural Knowledge (NCCS-CK; p ˂ 0.001); higher competences of the nurses were found in the Group LT (M = 31.05; SD = 6.75) than in the Group PL (M = 28.82; SD = 7.82). In the group of Polish nurses (Group PL), the intensity of cultural competences was found to increase along with age (NCCS-v.P r = 0.157, p < 0.05); this, however, was not observed in the Group LT (NCCS-v.LT, p > 0.05). CONCLUSIONS Both the nurses in Poland and in Lithuania are characterised by an average level of cultural competences. Diversity in the level of cultural competences was found in both groups depending on age, education and work experience.
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Affiliation(s)
- Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences Medical University of Lublin Lublin Poland
| | - Ludmiła Marcinowicz
- Department of Obstetrics, Gynaecology and Maternity Care Medical University of Bialystok Bialystok Poland
| | - Aurelija Blaževičienė
- Department of Nursing, Faculty of Nursing, Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania
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Luctkar-Flude M, Ziegler E, Foronda C, Walker S, Tyerman J. Impact of Virtual Simulation Games to Promote Cultural Humility Regarding the Care of Sexual and Gender Diverse Persons: A Multi-Site Pilot Study. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
BACKGROUND Diversity, equity, and inclusion (DEI) are increasingly recognized as core values for nursing education and practice. PURPOSE The purpose of this article is to offer teaching tools and strategies to integrate cultural humility within the nursing curriculum and create a more inclusive learning environment. APPROACH Various teaching tools, methods, and strategies are presented. OUTCOMES Use of ground rules, an environmental assessment, examination of the curriculum landscape and teaching materials, bias awareness activity, modified privilege walk, Modified Monopoly, simulation, low-income community experiences, study abroad, debriefing, and evaluation with valid and reliable tools are suggested. CONCLUSIONS By threading cultural humility concepts throughout the curriculum, nurse educators have the potential to shape learner perspectives to better appreciate and value diversity.
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Affiliation(s)
- Cynthia Foronda
- Professor of Clinical (Dr Foronda) and Assistant Professor of Clinical (Dr Prather), University of Miami School of Nursing and Health Studies, Coral Gables, Florida; Assistant Professor of Nursing (Dr Baptiste), Johns Hopkins University School of Nursing, Baltimore, Maryland; and Associate Professor (Dr Luctkar-Flude), Queen's University, Kingston, Ontario, Canada
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Singh H, Sangrar R, Wijekoon S, Nekolaichuk E, Kokorelias KM, Nelson MLA, Mirzazada S, Nguyen T, Assaf H, Colquhoun H. Applying 'cultural humility' to occupational therapy practice: a scoping review protocol. BMJ Open 2022; 12:e063655. [PMID: 35906054 PMCID: PMC9345050 DOI: 10.1136/bmjopen-2022-063655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Cultural humility is becoming increasingly important in healthcare delivery. Recognition of power imbalances between clients and healthcare providers is critical to enhancing cross-cultural interactions in healthcare delivery. While cultural humility has been broadly examined in healthcare, knowledge gaps exist regarding its application in occupational therapy (OT) practice. This scoping review protocol aims to: (1) describe the extent and nature of the published health literature on cultural humility, including concepts, descriptions and definitions and practice recommendations, (2) map the findings from objective one to OT practice using the Canadian Practice Process Framework (CPPF), and (3) conduct a consultation exercise to confirm the CPPF mapping and generate recommendations for the practice of cultural humility in OT. METHODS AND ANALYSIS We will search Ovid Medline, Ovid Embase, Ovid PsycINFO, Ebsco CINAHL Plus, ProQuest ASSIA, ProQuest Sociological Abstracts, ProQuest ERIC, WHO Global Index Medicus, and Web of Science databases. Published health-related literature on cultural humility will be included. There will be no restrictions on population or article type. Following deduplication on Endnote, the search results will undergo title, abstract, and full-text review by two reviewers working independently on Covidence. Extracted data will include descriptors of the article, context, population, and cultural humility. After descriptive extraction, data describing cultural humility-related content will be descriptively and interpretively analysed using an inductive thematic synthesis approach. The data will also be mapped to OT practice through deductive coding using the CPPF. Occupational therapists and clients will be consulted to further critique, interpret and validate the mapping and generate practice recommendations. ETHICS AND DISSEMINATION Ethics approval was not required for this scoping review protocol. We will disseminate the findings, which can enhance understanding of cultural humility in OT, facilitate cross-cultural encounters between occupational therapists and clients and improve care outcomes through publications and presentations.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ruheena Sangrar
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sachindri Wijekoon
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Erica Nekolaichuk
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Kristina Marie Kokorelias
- Department of Medicine, Geriatrics Program, Sinai Health and University Health Network, Toronto, Ontario, Canada
| | - Michelle L A Nelson
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sofia Mirzazada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Tram Nguyen
- March of Dimes Canada, Toronto, Ontario, Canada
| | - Holly Assaf
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Confronting Racism in Pain Research: A Call to Action. THE JOURNAL OF PAIN 2022; 23:878-892. [PMID: 35292201 PMCID: PMC9472374 DOI: 10.1016/j.jpain.2022.01.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/11/2022]
Abstract
Racism is an established health determinant across the world. In this 3-part series, we argue that a disregard of how racism manifests in pain research practices perpetuates pain inequities and slows the progression of the field. Our goal in part-1 is to provide a historical and theoretical background of racism as a foundation for understanding how an antiracism pain research framework - which focuses on the impact of racism, rather than "race," on pain outcomes - can be incorporated across the continuum of pain research. We also describe cultural humility as a lifelong self-awareness process critical to ending generalizations and successfully applying antiracism research practices through the pain research continuum. In part-2 of the series, we describe research designs that perpetuate racism and provide reframes. Finally, in part-3, we emphasize the implications of an antiracism framework for research dissemination, community-engagement practices and diversity in research teams. Through this series, we invite the pain research community to share our commitment to the active process of antiracism, which involves both self-examination and re-evaluation of research practices shifting our collective work towards eliminating racialized injustices in our approach to pain research. PERSPECTIVE: We call on the pain community to dismantle racism in our research practices. As the first paper of the 3-part series, we introduce dimensions of racism and its effect on pain inequities. We also describe the imperative role of cultural humility in adopting antiracism pain research practices.
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The racial and cultural ecology of home and community-based services for diverse older adults. J Aging Stud 2022; 61:101023. [DOI: 10.1016/j.jaging.2022.101023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/19/2022]
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El-Gazar HE, Zoromba MA, Zakaria AM, Abualruz H, Abousoliman AD. Effect of humble leadership on proactive work behavior: The mediating role of psychological empowerment among nurses. J Nurs Manag 2022; 30:2689-2698. [PMID: 35596235 DOI: 10.1111/jonm.13692] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Abstract
AIM This study was designed to determine the effect of humble leadership on nurses' proactive behaviors at work through psychological empowerment. BACKGROUND Nurse leaders' humility has a profound effect on enhancing nurses' proactive work behavior; yet, the mechanism underlying this pattern of effect remains unknown. METHODS A descriptive cross-sectional study was conducted in all nine Universal Health Insurance hospitals in Port Said, Egypt. Using scales for assessing leader humility, sychological empowerment, and proactive behavior at work, 316 nurses were surveyed. Regression analyses and structural equation models were used to examine the study hypothetical model. RESULTS The results revealed that humble leadership, psychological empowerment, and proactive work behavior were significantly positively correlated. Psychological empowerment fully mediated the relationship between humble leadership and proactive work behavior. CONCLUSION This study emphasized the value of humble leadership in psychologically empowering nurses, which results in greater proactive work behavior. IMPLICATION FOR NURSING MANAGEMENT Nurse managers should lead their nursing staff with humility, which could increase the level of nurses' psychological empowerment and proactive behaviors at work, which will be reflected positively on the staffs and the organization.
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Affiliation(s)
- Heba E El-Gazar
- Nursing Administration, Faculty of Nursing, Port Said University, Egypt
| | - Mohamed A Zoromba
- Psychiatric Nursing and Mental Health, Faculty of Nursing, Mansoura University, Egypt
| | | | - Hasan Abualruz
- Alghad International Colleges for Applied Medical Sciences, Najran, Saudi Arabia
| | - Ali D Abousoliman
- Nursing Administration, Faculty of Nursing, Kafr Elsheikh University, Egypt
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Climate, knowledge, comfort related to LGBTQ+ health and healthcare. TEACHING AND LEARNING IN NURSING 2022. [DOI: 10.1016/j.teln.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bookhart LH, Anstey EH, Kramer MR, Perrine CG, Reis‐Reilly H, Ramakrishnan U, Young MF. A nation‐wide study on the common reasons for infant formula supplementation among healthy, term, breastfed infants in US hospitals. MATERNAL & CHILD NUTRITION 2022; 18:e13294. [PMID: 34905644 PMCID: PMC8932686 DOI: 10.1111/mcn.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
In‐hospital infant formula supplementation of breastfed infants reduces breastfeeding duration, yet little is known about common reasons for infant formula supplementation. We examined the three most common reasons for in‐hospital infant formula supplementation of healthy, term, breastfed infants in the US reported by hospital staff. Hospital data were obtained from the 2018 Maternity Practices in Infant Nutrition and Care survey (n = 2045), which is completed by hospital staff. An open‐ended question on the top three reasons for in‐hospital infant formula supplementation was analyzed using thematic qualitative analysis and the frequencies for each reason were reported. The top three most common reasons for in‐hospital infant formula supplementation reported by hospital staff included medical indications (70.0%); maternal request/preference/feelings (55.9%); lactation management‐related issues (51.3%); physical but non‐medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%) and medical staff/institutional practices (4.7%). These findings suggest that a variety of factors should be considered to address unnecessary infant formula supplementation. Lactation management support delivered in a timely and culturally sensitive manner and targeted to mother‐infant dyads with potential medical and physical indications may reduce unnecessary in‐hospital infant formula supplementation. The three most commonly reported reasons by hospital staff for infant formula supplementation were found to be related to medical indications (70.0%); maternal request/preference/feelings about breastfeeding such as frustration or lack of confidence (55.9%); lactation management‐related issues (51.3%); physical but non‐medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%); and medical staff/institutional practices (4.7%). Underlying many of the reported three most common reasons for infant formula supplementation is potentially lack of lactation management support that considers the social influences (e.g. from family and friends) and that is culturally relevant. These findings suggest that a variety of factors should be considered to address unnecessary infant formula supplementation.
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Affiliation(s)
- Larelle H. Bookhart
- Hubert Department of Global Health, Doctoral Program in Nutrition and Health Sciences, Laney Graduate School Emory University Atlanta Georgia USA
| | - Erica H. Anstey
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta Georgia USA
| | - Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA
| | - Harumi Reis‐Reilly
- Maternal and Child Health National Association of County and City Health Officials Washington District of Columbia USA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Doctoral Program in Nutrition and Health Sciences, Laney Graduate School Emory University Atlanta Georgia USA
- Hubert Department of Global Health Emory University Atlanta Georgia USA
| | - Melissa F. Young
- Hubert Department of Global Health, Doctoral Program in Nutrition and Health Sciences, Laney Graduate School Emory University Atlanta Georgia USA
- Hubert Department of Global Health Emory University Atlanta Georgia USA
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Turkson-Ocran RAN, Nkimbeng M, Erol D, Hwang DA, Aryitey AA, Hughes V. Strategies for Providing Culturally Sensitive Care to Diverse Populations. J Christ Nurs 2022; 39:16-21. [PMID: 34860764 PMCID: PMC9976714 DOI: 10.1097/cnj.0000000000000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
ABSTRACT Nurses are called to care for patients and families from many backgrounds and cultural groups. This article discusses the key strategies of cultural humility, conscientious practice, and establishing trust that promotes cultural sensitivity as well as congruence with Christian values. When implemented, these strategies can facilitate the provision of quality, culturally sensitive patient care that conforms to a biblical worldview.
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Undoing Racism and Mitigating Bias Among Healthcare Professionals: Lessons Learned During a Systematic Review. J Racial Ethn Health Disparities 2021; 9:1990-2000. [PMID: 34480317 PMCID: PMC8415190 DOI: 10.1007/s40615-021-01137-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Research indicates that the implicit biases and racist attitudes of healthcare workers are fundamental contributing factors to race-based health inequities. However, few studies and reviews appear to have examined the provision and effects of anti-racist education and training on post-licensure healthcare workers. The purpose of this systematic literature review was to explore what research methods are being used to ascertain the training healthcare workers are receiving post-licensure and to identify the goals and outcomes of this training. METHODS Using PubMed, CINAHL, and Google Scholar databases, peer-reviewed articles meeting inclusion criteria were identified and reviewed by the authors from March through October of 2020 in alignment with the renewed national focus on anti-racism and racial justice. Studies or initiatives involving students were excluded as were commentaries on studies and studies not specific to racism or anti-racism. RESULTS Eleven articles were identified as meeting stipulated inclusion criteria. Few were outcome studies (n = 3), and many articles did not clearly delineate training methods, content, or outcomes assessed. Identified methods included group discussion, case studies, and online modules. Reported outcomes included increased self-awareness of implicit biases and racism. Only two studies focused specifically on nurses, with the majority of studies centering on physicians (n = 5). CONCLUSIONS A considerable knowledge gap exists regarding effective methods, tools, and outcomes to use for undoing racism and mitigating bias in healthcare professionals. Nothing less than a seismic paradigm shift is called for, one in which an anti-racist perspective informs all healthcare education, research, and practice.
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Markey K, Prosen M, Martin E, Repo Jamal H. Fostering an ethos of cultural humility development in nurturing inclusiveness and effective intercultural team working. J Nurs Manag 2021; 29:2724-2728. [PMID: 34309969 DOI: 10.1111/jonm.13429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
AIM To discuss the importance of fostering an ethos of cultural humility development in cultivating inclusiveness and effective intercultural team working. BACKGROUND Widening cultural and ethnic diversity of the health care workforce enriches the working environment and encourages a broader perspective on health care services and delivery. However, the intricacies of learning to work effectively within intercultural health care teams and adapting to new ways of working are often under estimated and thus overlooked. EVALUATION In adopting a framework for cultural humility development (Hughees et al., 2020, 10.1016/j.profnurs.2019.06.005), this paper proposes some practical suggestions for nurturing intrapersonal, interpersonal and system level cultural humility simultaneously. KEY ISSUES Fostering an ethos of cultural humility development within the workplace can support inclusiveness and better intercultural team working relationships. Nurses need support in developing awareness of their own cultural beliefs, whilst examining perceptions of cultural difference. CONCLUSION Examining cultural factors that influence intercultural working relationships will help in identifying structures, supports and approaches required for integration and inclusiveness. IMPLICATIONS FOR NURSING MANAGEMENT Nurturing ways of supporting interpersonal, intrapersonal and systems levels cultural humility development inspires the self-awareness, openness and respect for cultural difference required. Developing culturally responsive leadership styles and prioritizing their own cultural humility development is critical.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Mirko Prosen
- Department of Nursing, Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Emer Martin
- Chief Executive Officer; Hospital Administration and Management, St John's Hospital, Limerick, Ireland
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Dickins KA, Malley A, Bartels SJ, Baggett TP, Looby SE. Barriers, facilitators, and opportunities to optimize care engagement in a diverse sample of older low-income women: A qualitative study. Geriatr Nurs 2021; 42:965-976. [PMID: 34256156 DOI: 10.1016/j.gerinurse.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/01/2022]
Abstract
The growing population of aging women in the United States is disproportionately at-risk for adverse physical, behavioral, mental, and psychosocial health conditions. Engagement with preventive care is critical to address these risk factors. A qualitative descriptive approach was used to explore patterns of healthcare use, facilitators, barriers, and opportunities to optimize primary/preventive care engagement among low-income midlife and older women. Themes were deductively derived from the Behavioral Model for Vulnerable Populations. Categories were inductively determined: barriers to care engagement; facilitators of care engagement; opportunities to optimize primary/preventive care engagement. Themes emerging from this study suggest that experiences related to discrimination, psychological health, trauma, and prioritizing care of others negatively influence care engagement; while respect, continuity, and clinician gender and racial/ethnic concordance enhance care participation. Efforts aiming to engage low-income aging women in care should focus on addressing barriers, building on facilitators, and leveraging contemporary telehealth-outreach solutions.
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Affiliation(s)
- Kirsten A Dickins
- Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, 125 Nashua Street, Suite #7632, Boston, Massachusetts 02114, United States.
| | - Ann Malley
- Massachusetts General Hospital, Division of Critical Care and Pulmonary Medicine, United States; University of Massachusetts, Lowell, United States
| | - Stephen J Bartels
- Mongan Institute, Massachusetts General Hospital, Harvard Medical School, United States
| | - Travis P Baggett
- Mongan Institute, Massachusetts General Hospital, Harvard Medical School, United States; Massachusetts General Hospital, Division of General Internal Medicine, United States; Boston Health Care for the Homeless Program, United States
| | - Sara E Looby
- Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, 125 Nashua Street, Suite #7632, Boston, Massachusetts 02114, United States; Metabolism Unit, Massachusetts General Hospital, Harvard Medical School, United States
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Sherman ADF, McDowell A, Clark KD, Balthazar M, Klepper M, Bower K. Transgender and gender diverse health education for future nurses: Students' knowledge and attitudes. NURSE EDUCATION TODAY 2021; 97:104690. [PMID: 33279814 PMCID: PMC8049084 DOI: 10.1016/j.nedt.2020.104690] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/12/2020] [Accepted: 11/23/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Compared to cisgender peers, transgender and gender diverse (TGD) people experience significant health disparities associated with discrimination and limited access to appropriate care in healthcare settings. Nurses represent the largest segment of the United States (US) healthcare workforce; however, US nursing programs only dedicate approximately 2.12 h to Lesbian, Gay, Bisexual, and TGD (LGBT)-related content. OBJECTIVES/DESIGN/SETTING/PARTICIPANTS To fill the gap in TGD-related nursing education, the Transgender Curriculum Integration Project (TCIP) developed and integrated an evidence-based curriculum specific to TGD health into the pre-licensure accelerated Bachelor's in Nursing Science (BSN) program at Johns Hopkins School of Nursing. The purpose of this study was to assess the preliminary efficacy and feasibility (i.e., attrition, engagement, acceptability) of the TCIP in improving the TGD-related health knowledge and attitudes among a sample of pre-licensure nursing students. METHODS TCIP utilized a self-administered online survey to assess students' knowledge and attitudes about TGD health prior to (time point 1) and following (time points 2 and 3) the integration of TGD-specific content into five nursing pre-licensure courses. Rank-based nonparametric testing using Kruskal-Wallis H and Mann-Whitney U were conducted to determine if there were statistically significant differences in responses between the three time points. Thematic content analysis was used to determine themes present among short answers. RESULTS Findings indicate TGD-specific content improved student's gender sensitivity overtime, with improvements in self-reported skills in providing care for TGD people and knowledge of additional TGD-specific resources. However, gender sensitivity remains low among student's and students requested more TGD content suggesting room for further improvement. CONCLUSIONS Findings support the efficacy of TCIP and highlight complexities of curricular change that can guide future curricular integration and evaluation in nursing programs nation-wide.
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Affiliation(s)
- Athena D F Sherman
- Emory University, The Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd., Atlanta, GA 30322, United States of America.
| | - Alex McDowell
- Mongan Institute for Health Policy, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA 02114, United States of America.
| | - Kristen D Clark
- University of California, San Francisco, School of Nursing, 2 Koret Way, San Francisco, CA 94143, United States of America.
| | - Monique Balthazar
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd., Atlanta, GA 30322, United States of America.
| | - Meredith Klepper
- Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States of America.
| | - Kelly Bower
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America.
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Abstract
We herein, describe the rationale, content, methodology and evaluation of a health humanities module in the new competency-based curriculum, and share our experience of the same. Providing training in health humanities to the healthcare trainees will definitely go a long way in having a professional and responsive Indian medical graduate, who is able to provide empathetic and holistic healthcare to all sections of the society.
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Affiliation(s)
- Satendra Singh
- Health Humanities Group, University College of Medical Sciences (University of Delhi) and GTB Hospital, Delhi, India. Correspondence to: Dr Satendra Singh, Department of Physiology, University College of Medical Sciences, Delhi 110 095, India.
| | - Upreet Dhaliwal
- Health Humanities Group, University College of Medical Sciences (University of Delhi) and GTB Hospital, Delhi, India
| | - Navjeevan Singh
- Health Humanities Group, University College of Medical Sciences (University of Delhi) and GTB Hospital, Delhi, India
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Zghal A, El-Masri M, McMurphy S, Pfaff K. Exploring the Impact of Health Care Provider Cultural Competence on New Immigrant Health-Related Quality of Life: A Cross-Sectional Study of Canadian Newcomers. J Transcult Nurs 2020; 32:508-517. [PMID: 33095098 PMCID: PMC8404719 DOI: 10.1177/1043659620967441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: New immigrants underutilize health care because of multiple barriers. Although culturally competent health care improves access, it is typically assessed by providers, not newcomers whose perceptions matter most. Methodology: Surveys that included measures of cultural competence and health-related quality of life (QOL) were completed by 117 new immigrants in Windsor, Ontario, Canada. A series of stepwise linear regression analyses were conducted to identify independent predictors of QOL and its four domains: physical health, psychological, social relationships, and environment. Results: Our adjusted results suggest that experiences of discrimination was negatively associated with overall QOL (β = −.313; p < .001) and its psychological (β = −.318; p < .001), social (β = −.177; p = .048), and environmental (β = −.408; p < .001) domains. Discussion: Discrimination negatively influences new immigrant QOL. Provider cultural competency training should emphasize the influence of provider discrimination on immigrant health and explore learners’ values and biases.
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Affiliation(s)
- Afef Zghal
- University of Windsor, Windsor, Ontario, Canada
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Chicca J, Shellenbarger T. Fostering Inclusive Clinical Learning Environments Using a Psychological Safety Lens. TEACHING AND LEARNING IN NURSING 2020. [DOI: 10.1016/j.teln.2020.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ventres W. Toward a New Ethic in Global Health Practice: Perspectives from Central America. South Med J 2020; 113:374-377. [PMID: 32747964 DOI: 10.14423/smj.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- William Ventres
- From the Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock
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Grauerholz KR, Fredenburg M, Jones PT, Jenkins KN. Fostering Vicarious Resilience for Perinatal Palliative Care Professionals. Front Pediatr 2020; 8:572933. [PMID: 33134232 PMCID: PMC7579417 DOI: 10.3389/fped.2020.572933] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/26/2020] [Indexed: 01/17/2023] Open
Abstract
Background: The demands on healthcare professionals caring for families grappling with a life-limiting condition in an unborn or newly born child can be overwhelming. Clinicians working in emergency/trauma, hospice, and pediatric settings are already at high risk for burnout and compassion fatigue, which can leave healthcare institutions increasingly vulnerable to poor retention, absenteeism, and waning quality of care. The provision of exemplary palliative care requires a cohesive interdisciplinary team of seasoned professionals resilient to daily challenges. In September 2019, the American College of Gynecology, in a committee opinion, published standard of care guidelines for perinatal palliative care. This has created an impetus for exceptional caregiving and a greater demand for both physician and interdisciplinary healthcare provider education, training, and ongoing support that promotes truly beneficent care for pregnant patients confronted with life-limiting fetal conditions. Methods: A scoping review of the research literature was conducted in order to distinguish the barriers and facilitators of professional resiliency in perinatal palliative care. PubMed, Medline, CINAHL, and EBSCO Psychology & Behavioral Sciences Collections were systematically reviewed. Because of the paucity of studies specific to perinatal palliative care, several interviews of nurses and physicians in that field were conducted and analyzed for content distinctly pertaining to personal practices or workplace factors that support or hinder professional resiliency. Results: The research indicated that medical professionals often cite a lack of knowledge, inexperience using effective communication skills related to perinatal palliative care and bereavement, challenges with interdisciplinary collaboration, misconceptions about the role and function of palliative care in the perinatal or neonatal settings, moral distress, and workload challenges as encumbrances to professional satisfaction. Strategic implementation of facility-wide bereavement care training, effective communication modalities, and evidenced-based practical applications are critical components for a thriving perinatal palliative care team. Authentic formal and informal debriefing, peer mentoring, adequate caseloads, robust provider self-care practices, exceptional relational efficacy, and cultural and spiritual humility can foster personal growth and even vicarious resilience for perinatal palliative care professionals. Conclusions: Support should be strategic and multifaceted. The onus to implement salient measures to cultivate resilience in the perinatal palliative caregiver should not be only upon the individuals themselves but also upon prevailing regulatory governing bodies and healthcare institutions.
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Affiliation(s)
| | | | - Premala Tara Jones
- Life Perspectives, San Diego, CA, United States.,Counseling and Testing Center, University of Akron, Akron, OH, United States
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