An analysis of the cultural problems encountered during caregiving by the nurses working in two different regions of Turkey

Determining the effect of an intercultural nursing course on empathic skill and intercultural sensitivity levels: An intervention study

BACKGROUND

Providing culturally sensitive healthcare services requires to command on content and concepts. Moreover, it is essential to train nurses who are sensitive toward cultural values and beliefs and who can provide holistic and individual nursing care in an increasingly diverse population.

OBJECTIVE

This study determined the effect of the Intercultural Nursing Course on the empathic skill and intercultural sensitivity levels of nursing students in Turkey.

DESIGN

This study was an interventional study that adopted a pretest-posttest design with a control group.

PARTICIPANTS

The participants of the study were 165 nursing students from a school of health; these students were completing their fourth year of studies and in the spring term of the 2017-2018 academic year. However, the sample group comprised 113 students who agreed to participate in the study and completely filled out the administered forms. The intervention group consisted of 84 students admitted to Intercultural Nursing Course, whereas the control group consisted of 29 students who were not admitted to Intercultural Nursing Course.

METHODS

Intercultural Nursing Course, one of the elective courses in the fourth grade of the nursing program, was a 14-week course that was conducted through two contact hours per week. Data from both the groups were collected at the beginning and at the end of the course by the researchers using the "Introductory Information Form," the "Empathic Skill Scale", and the "Intercultural Sensitivity Scale". Data were analyzed through descriptive tests, t-test, the Mann-Whitney U test, and the Wilcoxon signed-rank test using statistical package software. In addition, the required approval was procured from the ethics committee of the relevant university and School of Health before the study was conducted.

RESULTS

No significant differences prevailed between the intervention and control groups in terms of total intragroup and intergroup Empathic Skill Scale and Intercultural Sensitivity Scale scores. However, a significant difference (Z = -4.000; p = 0.000) between the pretest and posttest scores was observed in the interaction confidence subdimension of the Intercultural Sensitivity Scale in the intervention group.

CONCLUSION

Although Intercultural Nursing Course did not lead to a significant change in students' empathic skills and cultural sensitivity levels, it enhanced their cultural sensitivity and self-confidence in intercultural communication and ensured maintenance of their empathic skills. Intercultural Nursing Course can thus valuably contribute to the understanding of cultural structure and values of society and to the development of techniques that can provide nursing care accordingly.

An Investigation of the Relationship Between Intercultural Sensitivity and Religious Orientation Among Nurses

This study aimed to investigate the relationship between intercultural sensitivity and religious orientation among nurses. This study utilized a cross-sectional model. It was conducted in a public hospital in a city located in the eastern part of Turkey between July and September 2018. The participants were 105 nurses who volunteered to participate in the study. Data were collected using the Socio-Demographic Characteristics Form, the Intercultural Sensitivity Scale, and the Religious Orientation Scale. The Intercultural Sensitivity Scale mean score of the participating nurses was found 82.55 ± 9.82, and the total mean score for the Religious Orientation Scale was 53.34 ± 7.56. A significant, positive relationship was found between the Intercultural Sensitivity Scale and the Religious Orientation Scale mean scores (p < .01). It is recommended that the study should be conducted with the participation of nurses from different cultures and religion, in larger groups and in a comparative manner.

Transcultural Nursing Care in Turkey

AIM

For quality and adequate nursing care, nurses should evaluate the cultural factors that patients have, respect these factors, and consider their impact on the patient's health. This review aimed to examine studies conducted in the field of transcultural nursing in Turkey.

METHOD

Studies published between 2000 and 2018 were searched from the electronic databases of ScienceDirect, Web of Science, Academic Search Complete, PubMed, Scopus, and Google Academic using the keywords care, culture, nursing, transcultural, transcultural nursing, and Turkey.

RESULTS

As a result of the search, 150 studies were obtained, and 31 studies that fit the inclusion criteria were evaluated. These studies attempted to determine the factors that cover different dimensions of transcultural nursing, nursing education and training process, clinical and hospital applications, and several scales and guides and have been adapted and used in the Turkish population.

CONCLUSION

Studies conducted in the field of transcultural nursing in Turkey have gained momentum recently and have a more basic descriptive level.

Knowledge, attitudes and prejudices of nursing students about the provision of transcultural nursing care to refugees: A comparative descriptive study

OBJECTIVES

The aim of this study was to determine the knowledge, attitudes, and prejudices of nursing students regarding the provision of transcultural nursing care to refugees.

METHODS

The sample of this comparative descriptive study was composed of 317 volunteering nursing students living in Ankara, Turkey. Descriptive statistics were presented as number, percentage, and mean ± standard deviation. The relationships among dependent and independent variables were analyzed with Pearson chi-square test. p ≤ 0.05 was accepted as statistically significant.

RESULTS

The mean age of the students was 21.19 ± 1.66 years; 88.6% were female. Only 30.0% (n = 95) of students (predominantly seniors) were educated on transcultural nursing. Statistically significant differences were found among grades of nursing students on the answers to the items, "Refugees are under coverage of general medical insurance system," "The concept of 'Health' differs from culture to culture," "Cultural features of the patient are important for caring nurse," "In order to provide care to only refugees and foreign patients, nurses from other cultures should be employed in hospitals," "Interpreters should be employed in hospitals 24 hours for services for refugees," and "According to my observations, refugees and their relatives admitted to the hospital are not respecting the healthcare workers and hospital rules." In addition, there was a statistically significant difference in students' comfort level with nursing care activities between those students who were literate in a foreign language and those who were not literate in a foreign language.

CONCLUSIONS

Our findings show that attending lectures on transcultural nursing in a curriculum of seniors and being literate in a foreign language had a positive impact on the attitudes of students in terms of the provision of medical care to refugees. It is recommended that nursing programs integrate lectures on transcultural nursing into the curricula of all four grades of nursing education and encourage students in language learning to better serve our disadvantageous guests.

Attitudes of Nurses in Turkey Toward Care of Dying Individual and the Associated Religious and Cultural Factors

The aim of this study was to determine the attitudes of nurses working in two university hospitals located in the west and east of Turkey toward care of dying individual as well as religious and cultural factors that influence their attitudes. The descriptive and comparative study was conducted with a total of 189 nurses who were working in adult inpatient clinics of two university hospitals in western (101 nurses) and eastern (88 nurses) Turkey between July and November 2016. The data were obtained by using the questionnaire and Frommelt Attitudes Toward Care of the Dying Scale. As a result of this study, it was determined that in terms of the status of receiving training the end-of-life care the majority of nurses received this training; however, this rate was higher (51.0%) in nurses working in the eastern hospital (p = 0.025). The nurses working in the east (51.6%) were determined to have more problems during caregiving due to their religious and cultural beliefs, the most frequent problem they experienced was "being uncomfortable due to privacy when giving care to patients from opposite gender" (57.1%). The emotions felt mostly by nurses during the care of dying patient were grief (nurses in the east = 48.5%, nurses in the west = 51.5%) and despair (nurses in the east = 40.4%, nurses in the west = 59.6%). Nurses working both in the east (98.27 ± 7.71) and in the west (97.19 ± 8.99) were determined to have positive attitude toward death, and there was no statistically significant difference between both groups in terms of the mean scores of the Attitudes Toward Care of the Dying Scale (p = 0.373). In accordance with these results, it is recommended to focus on death issues in end-of-life care during the nursing education and to support nurses with in-service trainings regularly after the graduation.

Nurses’ Experiences in a Turkish Internal Medicine Clinic With Syrian Refugees

Introduction: The increasing flow of Syrian refugees to Turkey, coupled with their extended stay, highlights the need for culturally competent health care, which includes nursing interventions. Purpose: The purpose of this study was to describe the experiences of nurses who provide care for Syrian refugees in internal medicine clinics in a hospital located in Turkey. Method: This descriptive study was based on qualitative content analysis using an inductive approach and involved discovery and description of the data. The study sample consisted of 10 nurses who work at the internal medicine clinic of a State Hospital in Turkey. Data were collected using semistructured interviews. Results: Three themes with related subthemes were derived from the data. Nurses who participated in the study experienced: (a) Nurses found communicating with Syrian refugees and their families difficult in the clinic. (b) Nurses observed and experienced differences and similarities in caring for Turkish and Syrian patients. (c) Nurses expressed and displayed compassion toward Syrian refugees during the caring process. Conclusion:In order for nurses to provide the best care for Syrian refugee patients, it is important to identify cultural caring behaviors observed by nurses in the promotion of culturally congruent nursing and health care.

Difficulties encountered by hospitalized Syrian refugees and their expectations from nurses

BACKGROUND

Treating patients with care and respecting their cultural values are key factors necessary to enhance the quality of nursing care.

AIM

The objective of this study was to explore and describe the difficulties experienced by hospitalized Syrian refugees and their expectations from nurses and hospital administration.

METHODS

We used a descriptive qualitative research approach to engage 30 Syrian refugees undergoing treatment in internal medicine who met the study criteria. Data were collected using a descriptive questionnaire and a semi-structured interview with open-ended interview questions. Interview transcripts were analysed using an inductive coding approach. Descriptive questions were analysed and presented via number and percentage. Other data were assessed using content analysis methods.

RESULTS

Three major themes were developed following the analysis of the interviews. We determined that the refugees who participated in the study experienced difficulties in communicating, meeting their personal needs and correctly following treatment instructions. They also had certain expectations from the hospital administration and nurses, and they felt gratitude for both nurses and the nation of Turkey.

CONCLUSIONS

The results of this study, shared with the executive administration of the hospital, may result in new policies which will help new Syrian refugee patients and patients with similar needs to have better experience related to patient care, communications and meeting personal needs.

IMPLICATION FOR NURSING AND HEALTH POLICY

It is important that nurses and other healthcare provider consider the difficulties and expectations of refugees regarding healthcare services and include same in the development of provider training programmes. Development of public health welfare and employment law and policies help to lay the groundwork for successful integration of refugees in new cultures and countries.