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Jafarian S. Culturally Responsive Care in Veterinary Medicine. Vet Clin North Am Small Anim Pract 2024; 54:889-910. [PMID: 39415397 DOI: 10.1016/j.cvsm.2024.08.001] [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: 10/18/2024]
Abstract
This article examines how culturally responsive care can enhance veterinary medicine by focusing on the interpersonal relationships between veterinarians, their teams, and pet owners. It begins by exploring the historical context of trust within veterinary practice and addresses stereotypes in pet ownership demographics, reinforcing the universal human-animal bond. The article outlines the components of culturally responsive care, noting the scarcity of research in veterinary settings and drawing extensively on the substantial research from human medicine, particularly nursing. It redefines veterinarians as trusted caregivers and details the benefits of culturally responsive care, advocating for more inclusive practices to inspire a more empathetic and culturally competent veterinary community.
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Furtado L, Coelho F, Pina S, Ganito C, Araújo B, Ferrito C. Delphi Technique on Nursing Competence Studies: A Scoping Review. Healthcare (Basel) 2024; 12:1757. [PMID: 39273781 PMCID: PMC11395531 DOI: 10.3390/healthcare12171757] [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: 07/01/2024] [Revised: 08/27/2024] [Accepted: 08/29/2024] [Indexed: 09/15/2024] Open
Abstract
This scoping review was conducted under the Joanna Briggs Institute (JBI) framework. It included primary studies published until 30 April 2023, obtained through a systematic search across PubMed, Web of Science, CINAHL, and MEDLINE databases. The review focused on primary studies that used the Delphi technique in nursing competence research, especially those related to defining core competency frameworks and developing instruments to assess professional competence. The goal was to analyze the different methodological approaches used by authors, synthesize them, and propose recommendations to enhance methodological rigor, reliability, and validity in the application of the Delphi technique. For this purpose, the following review question was established: "What is the available evidence on the use of the Delphi technique in the study of professional competence in nursing?". The extracted textual elements underwent a content analysis, resulting in dimensions established through an inductive approach. Twenty studies were included, yielding insights into diverse methodological options for conducting Delphi studies, organised around a set of dimensions: (1) preparatory procedures; (2) procedures for accessing and selecting experts; (3) acquisition of expert input; (4) data analysis and consensus; and (5) ethical and legal procedures and guarantees. The study's limitations include the inability to include certain studies due to a lack of response to requests for clarification from corresponding authors. Additionally, the primary studies' methodological quality was not assessed, which is another relevant aspect. The study's results offer valuable insights for researchers intending to utilise the Delphi technique within the context of the research referenced in the included studies. This information encompasses important methodological choices, highlighting their potential benefits and associated risks. The review was prospectively registered on the Open Science Framework (Registration No: osf.io/kp2vw).
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Affiliation(s)
- Luís Furtado
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Department of Nursing, Mental Health and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal
| | - Fábio Coelho
- Department of Nursing, Mental Health and Gerontology, School of Health, University of the Azores, 9700-042 Angra do Heroísmo, Portugal
| | - Sara Pina
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
| | - Cátia Ganito
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
| | - Beatriz Araújo
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Center for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Cândida Ferrito
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
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Maboko DR, Armstrong S, Casteleijn D. Patient perceptions of nurses' cultural competence in public sector hospitals in Gauteng. Health SA 2024; 29:2499. [PMID: 38962292 PMCID: PMC11220012 DOI: 10.4102/hsag.v29i0.2499] [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] [Received: 09/25/2023] [Accepted: 02/22/2024] [Indexed: 07/05/2024] Open
Abstract
Background Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses' cultural competence are largely unexplored in South Africa. Aim This study explored how the concept of cultural competence is perceived by patients. Setting Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals - district (level one), regional (level two), and academic (tertiary, level three). Methods This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch's eight steps of data analysis. Results Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses' level of cultural competence. Conclusion Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients. Contribution Patients' perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.
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Affiliation(s)
- Disebo R Maboko
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sue Armstrong
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Kim MK, Kim HY. Development of a lesbian, gay, bisexual, and transgender cultural competence scale for nurses in South Korea: a methodological study. WOMEN'S HEALTH NURSING (SEOUL, KOREA) 2024; 30:107-116. [PMID: 38987915 PMCID: PMC11237366 DOI: 10.4069/whn.2024.06.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE This study was conducted to develop a cultural competence scale for nurses regarding the lesbian, gay, bisexual, and transgender (LGBT) community and to test its validity and reliability. METHODS The study adhered to the 8-step process outlined by DeVellis, with an initial set of 25 items derived through a literature review and individual interviews. Following an expert validity assessment, 24 items were validated. Subsequently, a preliminary survey was conducted among 23 nurses with experience caring for LGBT patients. Data were then collected from a final sample of 322 nurses using the 24 items. Item analysis, item-total score correlation, examination of construct and convergent validity, and reliability testing were performed. RESULTS The item-level content validity index exceeded .80, and the explanatory power of the construct validity was 63.63%. The factor loadings varied between 0.57 and 0.80. The scale comprised five factors: cultural skills, with seven items; cultural awareness, with five items; cultural encounters, with three items; cultural pursuit, with three items; and cultural knowledge, with three items; totaling 21 items. Convergent validity demonstrated a high correlation, affirming the scale's validity. Internal consistency analysis yielded an overall reliability coefficient of 0.97, signifying very high reliability. Each item is scored from 1 to 6 (total score range, 21-126), with higher scores reflecting greater cultural competence in LGBT care. CONCLUSION This scale facilitates the measurement of LGBT cultural competence among nurses. Therefore, its use should provide foundational data to support LGBT-focused nursing education programs.
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Affiliation(s)
- Min Kyung Kim
- Department of Nursing, Catholic Sangji College, Andong, Korea
| | - Hye Young Kim
- College of Nursing, Keimyung University, Daegu, Korea
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Jakonen A, Mänty M, Nordquist H. Applying Crew Resource Management tools in Emergency Response Driving and patient transport-Finding consensus through a modified Delphi study. Int Emerg Nurs 2023; 70:101318. [PMID: 37517359 DOI: 10.1016/j.ienj.2023.101318] [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: 02/21/2022] [Revised: 05/15/2023] [Accepted: 05/31/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Emergency Response Driving (ERD) comprises a significant risk to safety in Emergency Medical Services (EMS). Crew Resource Management (CRM) tools play a major role in securing actions in high-risk procedures. The aim of this study was to find consensus on the important factors to consider when applying CRM tools in ERD and patient transport. METHODS ERD experts (n = 50) were recruited for a modified three-round Delphi study. Round 1 was based on previous research. The experts evaluated the items as important, neutral, or not important. The predetermined level of consensus was set at ≥ 80%. Answers given to the open-ended questions were analyzed using inductive content analysis. RESULTS Predetermined consensus was reached on 64 of 86 presented items (74.4 %). The mean values of items reaching consensus varied between 3.81 and 4.86 on a five-point Likert scale. The items where consensus was reached were rated as "important" on a trichotomized scale. CONCLUSION Multiple important factors to consider when applying CRM tools to ERD and patient transport were highlighted. This study provides valuable information to consider regarding EMS safety improvements. Further scientific research is needed to develop comprehensive recommendations.
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Affiliation(s)
- Antti Jakonen
- RDI Sustainable Wellbeing, South-Eastern Finland University of Applied Sciences, 48220 Kotka, Finland; Department of Public Health, Faculty of Medicine, University of Helsinki, 00140 Helsinki, Finland.
| | - Minna Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00140 Helsinki, Finland; Unit of Strategy and Research, City of Vantaa, 01300 Vantaa, Finland
| | - Hilla Nordquist
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00140 Helsinki, Finland; Department of Healthcare and Emergency Care, South-Eastern Finland University of Applied Sciences, 48220 Kotka, Finland; Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland
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Smith MR, Papadakis M, Munnik E. Diversity training for health professionals: Preparedness to competently address intellectual disability in the Western Cape Province, South Africa. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:24-39. [PMID: 34991398 DOI: 10.1177/17446295211050468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diversity training for health professionals in South Africa has traditionally been conceptualized as differences in gender, race or ethnicity, culture and sexual orientation. More recently physical disability and mental illness was included as a dimension. Intellectual disabilities received lip service as a diversity concern. This paper reports on health professionals' perceptions of the extent to which diversity training prepared them to competently deal with intellectual disabilities. This explorative study included a purposive sample of 18 health care professionals experienced in intellectual disability services. Two focus groups were facilitated over three sessions. Transcripts were analysed thematically. Health professionals felt inadequately prepared to consider intellectual disabilities as a diversity issue. They could not effectively advocate for reasonable accommodation. There was a differential familiarity with issues related to diversity and intellectual disability with profession constituting an additional intersecting dimension of diversity. Health professions did not perceive their diversity training to prepare them to deal competently with intellectual disabilities.
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Affiliation(s)
- Mario R Smith
- Department of Psychology, Faculty of Community and Health Sciences, 108325University of the Western Cape, Cape Town, South Africa
| | - Maryam Papadakis
- Department of Psychology, Faculty of Community and Health Sciences, 108325University of the Western Cape, Cape Town, South Africa
| | - Erica Munnik
- Department of Psychology, Faculty of Community and Health Sciences, 108325University of the Western Cape, Cape Town, South Africa
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Pettersson S, Holstein J, Jirwe M, Jaarsma T, Klompstra L. Cultural competence in healthcare professionals, specialised in diabetes, working in primary healthcare-A descriptive study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e717-e726. [PMID: 34145649 DOI: 10.1111/hsc.13442] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
Self-care is the most important cornerstone of diabetes treatment. As self-care is affected by cultural beliefs, it is important for healthcare professionals to be able to adapt their educational approach and to be culturally competent. The aim of this study was to describe the cultural competence in Swedish healthcare professionals, specialised in diabetes care and to examine related factors for cultural competence. The healthcare professionals' perceived level of cultural competence was measured across three domains-Openness and awareness, Workplace support and Interaction skills-in 279 Swedish healthcare professionals from all 21 regions of Sweden, using the Cultural Competence Assessment Instrument (Swedish version-CCAI-S). Descriptive statistics were used to describe cultural competence in healthcare professionals, and linear regression was conducted to examine factors related to cultural competence. Of the healthcare professionals studied, 58% perceived that they had a high level of Openness and awareness, 35% perceived that they had a high level of Interaction skills and 6% perceived that they had a high level of Workplace support. Two factors were found to be related to cultural competence, namely, high percentage of migrant clients at the healthcare clinic and whether the healthcare professionals previously had developed cultural competence through practical experience, education and/or by themselves. In conclusion, most healthcare professionals perceived that they had cultural openness and awareness but need more support from their workplace to improve their interaction skills. Cultural competence-related education could support the healthcare professionals to develop interaction skills.
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Affiliation(s)
- Sara Pettersson
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Jane Holstein
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Maria Jirwe
- Department of Health Sciences, Red Cross University College, Huddinge, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
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Diversity Competence in Healthcare: Experts’ Views on the Most Important Skills in Caring for Migrant and Minority Patients. SOCIETIES 2022. [DOI: 10.3390/soc12020043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Many researchers and practitioners agree that a specific skillset helps to provide good healthcare to migrant and minority patients. The sciences offer multiple terms for what we are calling ‘diversity competence’. We assume that teaching and developing this competence is a complex, time-consuming task, yet health professionals’ time for further training is limited. Consequently, teaching objectives must be prioritised when creating a short, basic course to foster professionals’ diversity competence. Therefore, we ask: ‘What knowledge, attitudes and skills are most important to enable health professionals to take equally good care of all patients in evermore diverse, modern societies that include migrant and (ethnic) minority patients?’ By means of a modified, two-round Delphi study, 31 clinical and academic migrant health experts from 13 European countries were asked this question. The expert panel reached consensus on many competences, especially regarding attitudes and practical skills. We can provide a competence ranking that will inform teaching initiatives. Furthermore, we have derived a working definition of ‘diversity competence of health professionals’, and discuss the advantages of the informed and conscious use of a ‘diversity’ instead of ‘intercultural’ terminology.
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Groot LJJ, Schers HJ, Burgers JS, Schellevis FG, Smalbrugge M, Uijen AA, van de Ven PM, van der Horst HE, Maarsingh OR. Optimising personal continuity for older patients in general practice: a study protocol for a cluster randomised stepped wedge pragmatic trial. BMC FAMILY PRACTICE 2021; 22:207. [PMID: 34666678 PMCID: PMC8526277 DOI: 10.1186/s12875-021-01511-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022]
Abstract
Background Continuity of care, in particular personal continuity, is a core principle of general practice and is associated with many benefits such as a better patient-provider relationship and lower mortality. However, personal continuity is under pressure due to changes in society and healthcare. This affects older patients more than younger patients. As the number of older patients will double the coming decades, an intervention to optimise personal continuity for this group is highly warranted. Methods Following the UK Medical Research Council framework for complex Interventions, we will develop and evaluate an intervention to optimise personal continuity for older patients in general practice. In phase 0, we will perform a literature study to provide the theoretical basis for the intervention. In phase I we will define the components of the intervention by performing surveys and focus groups among patients, general practitioners, practice assistants and practice nurses, concluded by a Delphi study among members of our group. In phase II, we will test and finalise the intervention with input from a pilot study in two general practices. In phase III, we will perform a stepped wedge cluster randomised pragmatic trial. The primary outcome measure is continuity of care from the patients’ perspective, measured by the Nijmegen Continuity Questionnaire. Secondary outcome measures are level of implementation, barriers and facilitators for implementation, acceptability and feasibility of the intervention. In phase IV, we will establish the conditions for large-scale implementation. Discussion This is the first study to investigate an intervention for improving personal continuity for older patients in general practice. If proven effective, our intervention will enable General practitioners to improve the quality of care for their increasing population of older patients. The pragmatic design of the study will enable evaluation in real-life conditions, facilitating future implementation. Trial registration number Netherlands Trial Register, trial NL8132. Registered 2 November 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01511-y.
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Affiliation(s)
- Lex J J Groot
- Department of General Practice, Amsterdam University Medical Centre, location VU University Medical Centre, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands.
| | - Henk J Schers
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Geert Grooteplein 21, 6525, EZ, Nijmegen, The Netherlands
| | - Jako S Burgers
- MUMC+/ Maastricht University, Department of General Practice, Care and Public Health Research Institute (CAPHRI), Universiteitssingel 40, 6229, ER, Maastricht, the Netherlands
| | - Francois G Schellevis
- Department of General Practice, Amsterdam University Medical Centre, location VU University Medical Centre, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam University Medical Centre, location VU University Medical Centre, De Boelelaan 1109, 1081, HV, Amsterdam, the Netherlands
| | - Annemarie A Uijen
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Geert Grooteplein 21, 6525, EZ, Nijmegen, The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081, HV, Amsterdam, the Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice, Amsterdam University Medical Centre, location VU University Medical Centre, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam University Medical Centre, location VU University Medical Centre, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
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Svensson A, Bremer A, Rantala A, Andersson H, Devenish S, Williams J, Holmberg M. Ambulance clinicians' attitudes to older patients' self-determination when the patient has impaired decision-making ability: A Delphi study. Int J Older People Nurs 2021; 17:e12423. [PMID: 34510764 DOI: 10.1111/opn.12423] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The proportion of older people is increasing and reflects in the demand on ambulance services (AS). Patients can be more vulnerable and increasingly dependent, especially when their decision-making ability is impaired. Self-determination in older people has a positive relation to quality of life and can raise ethical conflicts in AS. Hence, the aim of this study was to empirically explore attitudes among Swedish ambulance clinicians (ACs) regarding older patients' self-determination in cases where patients have impaired decision-making ability, and who are in urgent need of care. MATERIALS AND METHODS An explorative design was adopted. A Delphi technique was used, comprising four rounds, involving a group (N = 31) of prehospital emergency nurses (n = 14), registered nurses (n = 10) and emergency medical technicians (n = 7). Focus group conversations (Round 1) and questionnaires (Rounds 2-4) generated data. Round 1 was analysed using manifest content analysis, which ultimately resulted in the creation of discrete items. Each item was rated with a five-point Likert scale together with free-text answers. Consensus (≥70%) was calculated by trichotomising the Likert scale. RESULTS Round 1 identified 108 items which were divided into four categories: (1) attitudes regarding the patient (n = 35), (2) attitudes regarding the patient relationship (n = 8), (3) attitudes regarding oneself and one's colleagues (n = 45), and (4) attitudes regarding other involved factors (n = 20). In Rounds 2-4, one item was identified in the free text from Round 2, generating a total of 109 items. After four rounds, 72 items (62%) reached consensus. CONCLUSIONS The findings highlight the complexity of ACs' attitudes towards older patients' self-determination. The respect of older patients' self-determination is challenged by the patient, other healthcare personnel, significant others and/or colleagues. The study provided a unique opportunity to explore self-determination and shared decision-making. AS have to provide continued ethical training, for example to increase the use of simulation-based training or moral case deliberations in order to strengthen the ACs' moral abilities within their professional practice. IMPLICATIONS FOR PRACTICE Ambulance services must develop opportunities to provide continued training within this topic. One option would be to increase the use of simulation-based training, focusing on ethical aspects of the care. Another option might be to facilitate moral case deliberations to strengthen the ACs' abilities to manage these issues while being able to share experiences with peers. These types of interventions should illuminate the importance of the topic for the individual AC, which, in turn, may strengthen and develop the caring abilities within an integrated care team.
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Affiliation(s)
- Anders Svensson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.,Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.,Department of Ambulance Service, Växjö, Sweden
| | - Anders Bremer
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.,Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.,Department of Ambulance Service, Kalmar, Sweden
| | - Andreas Rantala
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.,Department of Health Sciences, Lund University, Lund, Sweden.,Emergency Department, Helsingborg General Hospital, Helsingborg, Sweden
| | - Henrik Andersson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.,Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Scott Devenish
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Julia Williams
- Paramedic Clinical Research Unit (ParaCRU), University of Hertfordshire, Hatfield, UK
| | - Mats Holmberg
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.,Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.,Department of Ambulance Service, Region Sörmland, Katrineholm, Sweden
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Leonardsen ACL, Helgesen AK, Ulvøy L, Grøndahl VA. Prehospital assessment and management of postpartum haemorrhage- healthcare personnel's experiences and perspectives. BMC Emerg Med 2021; 21:98. [PMID: 34454430 PMCID: PMC8403351 DOI: 10.1186/s12873-021-00490-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/10/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Postpartum hemorrhage (PPH) is a serious obstetric emergency, and one of the top five causes of maternal mortality globally. The most common causes of PPH include uterine atony, placental disorders, birth trauma and coagulation defects. Timely diagnosis and early management are critical to reduce morbidity, the need for blood transfusion or even mortality. External, manual aortic compression (AC) has been suggested as an intervention that reduce PPH and extend time for control of bleeding or resuscitation. This procedure is not commonly utilized by healthcare personnel. The incidence of home-births is increasing, and competence in PPH assessment and management is essential in prehospital personnel. The objective was to explore prehospital personnel's competence in PPH and AC, utilizing different tools. METHODS The study was conducted in a county in South-eastern Norway, including five ambulance stations. All prehospital personnel (n = 250) were invited to participate in a questionnaire study. The questionnaire included the PPH self-efficacy (PPHSE) and PPH collective efficacy (PPHCE) tools, as well as tool developed utilizing the Delphi technique. Descriptive statistics were used to analyze the quantitative data, while quantitative content analysis was used to analyse free-text responses. RESULTS A total of 87 prehospital personnel responded to the questionnaire, 57.5% male, mean age 37.9 years. In total, 80.4% were ambulance workers and/or paramedics, and 96.6 and 97.7% respectively reported to need more education or training in PPH. Moreover, 82.8% reported having managed patient(s) with PPH, but only 2.9% had performed AC. Prehospital personnels' responses varied extensively regarding knowledge about what PPH is, how to estimate and handle PPH, and how to perform AC. Mean self-efficacy varied from 3.3 to 5.6, while collective efficacy varied from 1.9 to 3.8. CONCLUSIONS This study indicates that prehospital personnel lack knowledge about PPH and AC, due to various responses to the developed questionnaire. Even though AC is an acknowledged intervention in PPH, few participants reported that this was utilized. Our findings emphasize the need for education and training in PPH and PPH handling generally, and in AC specifically.
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Affiliation(s)
- Ann-Chatrin Linqvist Leonardsen
- Department of Health and Welfare/Ostfold Hospital Trust, Ostfold University College, Postal box code (PB) 700, NO-1757 Halden, Norway
- Ostfold Hospital Trust, Department of Anesthesia, 300 NO-1714 Grålum, PB Norway
| | - Ann Karin Helgesen
- Department of Health and Welfare/Ostfold Hospital Trust, Ostfold University College, Postal box code (PB) 700, NO-1757 Halden, Norway
| | - Linn Ulvøy
- Department of Health and Welfare/Ostfold Hospital Trust, Ostfold University College, Postal box code (PB) 700, NO-1757 Halden, Norway
- Ostfold Hospital Trust, Prehospital Department, 300 NO-1714 Grålum, PB Norway
| | - Vigdis Abrahamsen Grøndahl
- Department of Health and Welfare/Ostfold Hospital Trust, Ostfold University College, Postal box code (PB) 700, NO-1757 Halden, Norway
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Maillet L, Champagne G, Déry J, Goudet A, Charest S, Abou-Malham S, Desjardins F, Touati N, Duhoux A, Jouego Fotso AC, Doré C, Roy B, Gagnon S, Lane J. Implementation of an intersectoral outreach and community nursing care intervention with refugees in Quebec: A protocol study. J Adv Nurs 2021; 77:4586-4597. [PMID: 34423471 DOI: 10.1111/jan.15022] [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: 07/19/2021] [Accepted: 07/24/2021] [Indexed: 11/28/2022]
Abstract
AIM To establish and assess an intersectoral local network focused on the roles of registered nurses and primary healthcare nurse practitioners to ensure the continuity of care and service pathways for refugees in Quebec. DESIGN Developmental evaluation with a mixed methodology. METHODS The qualitative component will include: (1) a document review; (2) observations of participants during meetings of different governance structures; (3) semi-structured interviews with key actors (n = 40; 20/neighbourhood interventions); and (4) focus groups with end users of the services (refugees) (n = 4; 6 to 8 participants per group). The quantitative component will be based on: (1) a data sheet on health and social interventions for refugees users filled in by registered nurses, primary healthcare nurse practitioners and physicians and (2) data analysis of the clinical-administrative database since 2012. This study received funding in June 2019 and Research Ethics Committee approval was granted in July 2020. DISCUSSION In Quebec, refugee vulnerability is exacerbated by the lack of integration of existing resources and the lack of access to care and continuity of services. To address these issues, an integrated local network for refugees must be developed. Additionally, we will explore the role of registered nurses and their collaboration with primary healthcare nurse practitioners. IMPACT This study will provide recommendations on how to optimize the scopes of practice of registered nurses and primary healthcare nurse practitioners, adapt care and services and develop a local intersectoral network to better meet the complex needs of refugees. It will evaluate the use and the appreciation of new services for targeted populations (neighbourhoods and refugees) and aim to improve the accessibility, continuity and user experience of all health services for those populations.
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Affiliation(s)
- Lara Maillet
- National School of Public Administration, Montreal, Canada.,Institut Universitaire de première ligne en santé et services sociaux, Sherbrooke, Canada
| | | | | | - Anna Goudet
- National School of Public Administration, Montreal, Canada.,Institut national de la recherche scientifique, Montreal, Canada
| | - Stéphanie Charest
- Institut Universitaire de première ligne en santé et services sociaux, Sherbrooke, Canada.,Centre intégré universitaire de santé et des services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
| | - Sabina Abou-Malham
- Institut Universitaire de première ligne en santé et services sociaux, Sherbrooke, Canada.,Université de Sherbrooke, Longueuil, Canada
| | - France Desjardins
- Institut Universitaire de première ligne en santé et services sociaux, Sherbrooke, Canada.,Centre intégré universitaire de santé et des services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
| | - Nassera Touati
- National School of Public Administration, Montreal, Canada
| | | | | | - Chantal Doré
- Institut Universitaire de première ligne en santé et services sociaux, Sherbrooke, Canada.,Université de Sherbrooke, Sherbrooke, Canada
| | | | - Suzanne Gagnon
- Université Laval, Quebec, Canada.,Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, Université Laval, Quebec, Canada
| | - Julie Lane
- Institut Universitaire de première ligne en santé et services sociaux, Sherbrooke, Canada.,Université de Sherbrooke, Sherbrooke, Canada
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Matsuoka S. Recovery-oriented nursing care based on cultural sensitivity in community psychiatric nursing. Int J Ment Health Nurs 2021; 30:563-573. [PMID: 33283443 PMCID: PMC7984065 DOI: 10.1111/inm.12822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/02/2022]
Abstract
Transforming to recovery-oriented care is an urgent issue in community psychiatric nursing in Japan. Because traditional psychiatry is still influential, nurses are required to possess cultural sensitivity to objectively view conflicts between values when providing recovery-oriented care. If recovery-oriented care based on cultural sensitivity is clarified, it would help nurses providing recovery-oriented care in non-recovery-oriented environments. Therefore, this study aimed to clarify recovery-oriented nursing care based on cultural sensitivity in community psychiatric nursing in Japan. A semi-structured interview with 21 community psychiatric nurses and participant observations for seven of them were performed. A qualitative description was undertaken to analyse the data. The relationships between categories were examined. The study conforms to the COREQ checklist. Through the analysis, six categories were revealed: 1. Continuously reflecting on one's own practice and the influence of the traditional mental health culture; 2. Constructing a partnership with clients to uphold their rights and responsibilities; 3. Having client-centred dialogue to help them enjoy life and grow; 4. Supporting clients' lives and strengthening their self-management; 5. Working as a team to achieve clients' wishes, which includes some risks, and 6. Maintaining a relationship between clients and the people who care for them. Category 1 was central and enclosed by categories 2, 3 and 4. Categories 5 and 6 were located outside of categories 1 to 4. The results showed cultural sensitivity enables recovery-oriented care even in non-recovery-oriented environments and include recognizing the traditional mental health culture, understanding clients' experiences and accepting other's values.
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Affiliation(s)
- Sumiko Matsuoka
- Department of Nursing, Konan Women's University, Kobe, Japan
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14
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Yadollahi S, Asadizaker M, Ebadi A, Molavynejad S. Cultural competence in clinical nursing: A qualitative study. INTERNATIONAL ARCHIVES OF HEALTH SCIENCES 2021. [DOI: 10.4103/iahs.iahs_139_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Nurse Cultural Competence-cultural adaptation and validation of the Polish version of the Nurse Cultural Competence Scale and preliminary research results. PLoS One 2020; 15:e0240884. [PMID: 33064767 PMCID: PMC7567385 DOI: 10.1371/journal.pone.0240884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/05/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Measuring nurses’ cultural competence is an important aspect in monitoring the acceptable quality in multicultural populations, and is a means for efficient modification of the educational process of nurses based on this assessment. Purpose The goal of this article is to offer a preliminary assessment of the cultural competence of nurses based on a Polish-language and -culture version of the Nurse Cultural Competence Scale (NCCS). Research method An adaptive and diagnostic cross-disciplinary concept was used in the research. Two hundred thirty-eight professionally active nurses in the southeast region of Poland took part in this study. The NCCS-Polish version (NCCS-P) questionnaire was used after linguistic adaptation and analysis of psychometric properties. Results Moderate levels of competence in the Cultural Knowledge Subscale (M = 3.42) were found in the group of nurses studied. The results indicate lowest competency levels in the Cultural Skill Subscale (M = 3.14). The highest values were obtained for the Cultural Awareness Subscale (M = 3.98) and the Cultural Sensitivity Subscale (M = 3.72). The Cronbach's alpha reliability coefficient for the NCCS-P scale was 0.94, with the subscale values ranging from 0.72 to 0.95. Factor validity analysis of the Polish adaptation of the NCCS-P scale pointed to its four-factor structure. The Kaiser-Mayer-Olkin sampling adequacy test was 0.905, and the Bartlett test of sphericity result was χ2 = 5755.107; df = 820; p<0.001. The four-factor structure is affirmed by the Kaiser criterion and the scree test result. Conclusions The NCCS-P psychometric properties were highly reliable and significant because of the opportunity for using them for research in Poland. Practical implications The scale can be used in intercultural research for comparing cultural competence of nurses, including Polish ones. This scale facilitates the precise monitoring of cultural competence among nurses and nurse managers, which may help in developing nursing policies geared toward a commitment to expanding cultural competence.
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Al Jasser B, Almoajel A. <p>Adopting the Triple Aim Framework in the Saudi Healthcare System: A Delphi Study</p>. Healthc Policy 2020; 13:2189-2197. [PMID: 33116997 PMCID: PMC7585547 DOI: 10.2147/rmhp.s251008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/12/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Helping healthcare systems to optimize performance using particular metrics through objective monitoring will positively impact an organization’s progress toward strategic goals and objectives. The Institute of Healthcare Improvement introduced the Triple Aim framework for guiding new or transforming health systems, concurrently improving population health and patients’ care experience, and reducing per capita cost. Consensus to determine applicable and appropriate measures to monitor this transformation within the scope of the three objectives is required. Thus, the study aimed to adopt the Triple Aim measures and reach a consensus among experts in healthcare systems on the applicability of the measures in the health system of Saudi Arabia. Methods A two-round Delphi study was conducted with 17 invited experts who were knowledgeable and experienced in healthcare systems and administration, quality improvement, and strategic planning. These rounds were based on the measures of the three objectives, where they were introduced as statements and grouped under each respective aim. The experts were instructed to score each measure using a 5-point Likert scale and were invited to formulate new measures related to the same aim. Statements reaching a consensus level of 80% were considered applicable measures for the Saudi health system. Results A total of 17 measures were circulated among experts; out of which, 16 measures reached a consensus. The 16 measures represent the three main domains of the Triple Aim model, ie, population health, experience of care, and cost per capita. The measure that failed to reach a consensus was the predictive model scores because it requires medical knowledge, where the majority of the experts were non-physicians. Conclusion A Delphi study was used to reach consensus among experts on the Triple Aim measures as a first step to building a solid foundation for the population management required to implement these initiatives in the future.
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Affiliation(s)
- Bandar Al Jasser
- Department of Health Administration, College of Business Administration, Master’s Degree Program in Health and Hospital Administration, King Saud University, Riyadh, Saudi Arabia
| | - Alia Almoajel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Alia Almoajel Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaTel/Fax +966 11 8050219 Email
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17
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Leonardsen ACL, Svendsen EJ, Heitmann GB, Dhayyat A, Morris A, Sjøborg KD, Olsen RM, Hardeland C. Development and validation of a questionnaire to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy. PLoS One 2020; 15:e0232984. [PMID: 32396569 PMCID: PMC7217426 DOI: 10.1371/journal.pone.0232984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/24/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cardiac arrest is rare in pregnancy, and up-to date competence can be difficult to assess and maintain. The objective of this study was to develop and validate a questionnaire to assess healthcare personnel experiences, self-assessed competence and perception of role and resposibility related to cardiac arrest and cardio-pulmonary resuscitation (CPR) in pregnancy. METHODS The study had a cross-sectional design, developing and validating a questionnaire: the Competence in cardiac arrest and CPR in pregnancy (ComCA-P). Development and validation of the ComCA-P was conducted in three stages: 1) Literature review and expert group panel inputs, 2) a pilot study and 3) a cross-sectional questionnaire study. In stage one, the ComCA-P was developed over several iterations between the researchers, including inputs from an expert group panel consisting of highly competent professionals (n = 11). In stage two, the questionnaire was piloted in a group of healthcare personnel with relevant competence (n = 16). The ComCA-P was then used in a baseline study including healthcare personnel potentially involved in CPR in pregnancy (n = 527) in six hospital wards. Based on these data, internal consistency, intra-class correlations, and confirmatory factor analysis were utilized to validate the questionnaire. RESULTS The expert group and pilot study participants evaluated the appropriateness, relevance and accuracy to be high. Formulation of the items was considered appropriate, with no difficulties identified related to content- or face validity. Cronbach's alpha was 0.8 on the thematic area self-assessment, and 0.73 on the theoretical knowledge area of the ComCA-P. On both the self-assessed competence items and the teoretical knowledge items, Kaiser-Meyer-Olkin was 0.8. Moreover, the Bertletts' test of sphericity was greater than the critical value for chi-square, and significant (p < .0001). CONCLUSIONS Findings indicate that the ComCA-P is a valid questionnaire that can be used to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy.
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Affiliation(s)
- Ann-Chatrin L. Leonardsen
- Department of Health and Welfare, Ostfold University College, Halden, Norway
- Department of Anesthesiology, Ostfold Hospital Trust, Grålum, Norway
| | - Edel J. Svendsen
- Department of Health and Society, University of Oslo, Oslo, Norway
| | | | - Adam Dhayyat
- Department of Medicine, Ostfold Hospital Trust, Grålum, Norway
| | - Ann Morris
- Department of Obstetrics and Gynecology, Ostfold Hospital Trust, Grålum, Norway
| | - Katrine D. Sjøborg
- Department of Obstetrics and Gynecology, Ostfold Hospital Trust, Grålum, Norway
| | - Richard M. Olsen
- Department of Competence Development, Ostfold Hospital Trust, Grålum, Norway
| | - Camilla Hardeland
- Department of Health and Welfare, Ostfold University College, Halden, Norway
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18
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Cultural competence in nursing: A concept analysis. Int J Nurs Stud 2019; 99:103386. [DOI: 10.1016/j.ijnurstu.2019.103386] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 11/18/2022]
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19
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Chae D, Kim H, Yoo JY, Lee J. Agreement on Core Components of an E-Learning Cultural Competence Program for Public Health Workers in South Korea: A Delphi Study. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 13:184-191. [DOI: 10.1016/j.anr.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/05/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022] Open
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21
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Hordijk R, Hendrickx K, Lanting K, MacFarlane A, Muntinga M, Suurmond J. Defining a framework for medical teachers' competencies to teach ethnic and cultural diversity: Results of a European Delphi study. MEDICAL TEACHER 2019; 41:68-74. [PMID: 29490534 DOI: 10.1080/0142159x.2018.1439160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Medical students need to be trained in delivering diversity-responsive health care but unknown is what competencies teachers need. The aim of this study was to devise a framework of competencies for diversity teaching. METHODS An open-ended questionnaire about essential diversity teaching competencies was sent to a panel. This resulted in a list of 74 teaching competencies, which was sent in a second round to the panel for rating. The final framework of competencies was approved by the panel. RESULTS Thirty-four experts participated. The final framework consisted of 10 competencies that were seen as essential for all medical teachers: (1) ability to critically reflect on own values and beliefs; (2) ability to communicate about individuals in a nondiscriminatory, nonstereotyping way; (3) empathy for patients regardless of ethnicity, race or nationality; (4) awareness of intersectionality; (5) awareness of own ethnic and cultural background; (6) knowledge of ethnic and social determinants of physical and mental health of migrants; (7) ability to reflect with students on the social or cultural context of the patient relevant to the medical encounter; (8) awareness that teachers are role models in the way they talk about patients from different ethnic, cultural and social backgrounds; (9) empathy for students of diverse ethnic, cultural and social background; (10) ability to engage, motivate and let all students participate. CONCLUSIONS This framework of teaching competencies can be used in faculty development programs to adequately train all medical teachers.
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Affiliation(s)
- Rowan Hordijk
- a Academic Medical Centre, University of Amsterdam, Amsterdam Public Health Research Institute , Amsterdam , The Netherlands
| | - Kristin Hendrickx
- b Department of Primary and Interdisciplinary Care , University of Antwerp , Antwerp , Belgium
| | - Katja Lanting
- a Academic Medical Centre, University of Amsterdam, Amsterdam Public Health Research Institute , Amsterdam , The Netherlands
| | | | | | - Jeanine Suurmond
- a Academic Medical Centre, University of Amsterdam, Amsterdam Public Health Research Institute , Amsterdam , The Netherlands
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22
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Murphy JP, Rådestad M, Kurland L, Jirwe M, Djalali A, Rüter A. Emergency department registered nurses' disaster medicine competencies. An exploratory study utilizing a modified Delphi technique. Int Emerg Nurs 2018; 43:84-91. [PMID: 30528661 PMCID: PMC7118464 DOI: 10.1016/j.ienj.2018.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 10/08/2018] [Accepted: 11/22/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Jason P Murphy
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Sophiahemmet University, Stockholm, Sweden.
| | - Monica Rådestad
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Lisa Kurland
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Örebro University, Institution for Medical Science, Örebro, Sweden
| | - Maria Jirwe
- Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Neurobiology and Society, Sweden
| | - Ahmadreza Djalali
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Anders Rüter
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Sophiahemmet University, Stockholm, Sweden
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Ko Y, Yu S. Core nursing competency assessment tool for graduates of outcome-based nursing education in South Korea: A validation study. Jpn J Nurs Sci 2018; 16:155-171. [PMID: 30156061 DOI: 10.1111/jjns.12223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 02/12/2018] [Accepted: 05/17/2018] [Indexed: 12/01/2022]
Abstract
AIM To develop a competency assessment instrument for nurses who have completed an outcome-based educational program based on national standards and to assess the content-, construct-, and criterion-related validity of that instrument. METHODS In the development stage, the competencies of nurses with 1-3 years' clinical experience after the completion of nursing education and training programs, based on national standards, were identified. A systematic literature review was conducted to derive the competencies in addition to the 12 national standard competencies. In the evaluation stage, the content-, construct-, and criterion-related validity of the developed tool were verified. For verification of the content validity at each stage, the participants were 10 nurse managers of general hospitals and 10 nurse professors. A factor analysis was conducted to assess the construct validity and the Cronbach's alpha coefficients and item-total correlation were used to assess the reliability of the developed scale. For the factor analysis, the participants were 141 nurses with 1-3 years' clinical experience who were recruited from four general hospitals. In order to evaluate the construct- and criterion-related validity, the correlations between a nursing performance measurement scale, a self-leadership tool, and the developed scale were examined. RESULTS A competency assessment instrument, consisting of 19 items on a 4-point scale, was developed and validated for assessing the competencies among nurses with 1-3 years' experience. CONCLUSIONS Nursing research, policy awareness, and leadership competencies were required by the Korean Accreditation Board of Nursing Education for nursing college graduates, but were removed due to poor content validity, indicating a need for nursing professionals to bridge the gap between educational standards in nursing colleges and clinical settings.
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Affiliation(s)
- YuKyung Ko
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, South Korea
| | - Soyoung Yu
- College of Nursing, CHA University, Pocheon-shi, South Korea
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Chang L, Chen SC, Hung SL. Embracing diversity and transcultural society through community health practicum among college nursing students. Nurse Educ Pract 2018; 31:156-160. [PMID: 29908449 DOI: 10.1016/j.nepr.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 10/16/2022]
Abstract
Based on 2015 annual report of foreign spouse populations were above 507,266 people in Taiwan. Most of them (68%) came from Mainland China, 29% from south-east Asia. 92% of foreign spouses were female (2015). Therefore, a challenge arises for nursing students to provide care to clients with multiple cultural variations in Taiwan. The study objectives were to explore the related factors of cultural care competence and estimate the effects of a short-term reinforced cultural course. The study used a quasi-experimental design. All participants were investigated to measure that changed in cultural competence before and after the community practice period. Of 95 participants, 46 experimental group students engaged with 3 times workshops. The study was conducted from May to August in 2015 at Southern Taiwan. The study results showed a significantly improvement of transcultural nursing competence from comparing control group with experimental group by ANCOVA analysis (p < .05). The study approved that the cultural workshop along with the community health nursing practice curriculum might develop students' transcultural nursing competence. In the future, in order to providing cultural sensitively care, a sustained transcultural curriculum should be advocated at Nursing schools in Taiwan.
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Affiliation(s)
- Luna Chang
- University of Texas at Houston, School of Public Health, USA; National Tainan Junior College of Nursing, Department of Nursing, #78, Sec.2, Min-Zu Rd., Tainan, 70043, Taiwan.
| | - Shu-Chuan Chen
- Kaohsiung Medical University, Department of Nursing, MSN, Taiwan; School of Nursing and Midwifery, Griffith University, Australia; National Tainan Junior College of Nursing, Department of Nursing, #78, Sec.2, Min-Zu Rd., Tainan, 70043, Taiwan.
| | - Shu-Ling Hung
- Saint Louis University, School of Nursing, USA; National Tainan Junior College of Nursing, Department of Nursing, #78, Sec.2, Min-Zu Rd., Tainan, 70043, Taiwan.
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Heaslip V. Editorial: Diversity and culture: threads in a golden tapestry which nurses have the privilege to enact and the responsibility to preserve. J Clin Nurs 2017; 27:3239-3240. [PMID: 29193475 DOI: 10.1111/jocn.14187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vanessa Heaslip
- Department of Nursing and Clinical Science, Faculty of Health and Social Science, Bournemouth University, Poole, UK
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Hörberg A, Jirwe M, Kalén S, Vicente V, Lindström V. We need support! A Delphi study about desirable support during the first year in the emergency medical service. Scand J Trauma Resusc Emerg Med 2017; 25:89. [PMID: 28877728 PMCID: PMC5588605 DOI: 10.1186/s13049-017-0434-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/30/2017] [Indexed: 11/30/2022] Open
Abstract
Background New and inexperienced emergency medical service (EMS) professionals lack important experience. To prevent medical errors and improve retention there is an urgent need to identify ways to support new professionals during their first year in the EMS. Methods A purposeful sample and snowball technique was used and generated a panel of 32 registered nurses with 12–48 months of EMS experience. A Delphi technique in four rounds was used. Telephone interviews were undertaken in round one to identify what desirable support professionals new to the EMS desire during their first year. Content analysis of the transcribed interviews yielded items which were developed into a questionnaire. The experts graded each item in terms of perceived importance on a 5-graded likert scale. Consensus level was set at 75%. Items which reached consensus were removed from questionnaires used in subsequent rounds. Results Desirable support was categorized into eight areas: Support from practical skills exercises, support from theoretical knowledge, support from experiences based knowledge, theoretical support, support from an introduction period, support from colleagues and work environment, support from management and organization and other support. The experts agree on the level of importance on 64 of a total of 70 items regarding desirable support. One item was considered not important, graded 1 or 2, 63 items were considered important, graded 4 or 5. Conclusion Even with extensive formal competence the EMS context poses challenges where a wide variety of desirable forms of support is needed. Support structures should address both personal and professional levels and be EMS context oriented.
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Affiliation(s)
- Anna Hörberg
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Academic EMS, Stockholm, Sweden.
| | - Maria Jirwe
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Stockholm, Sweden
| | - Susanne Kalén
- Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm City Council, Stockholm, Sweden
| | - Veronica Vicente
- The Ambulance Medical Service in Stockholm (AISAB) Sweden, Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Academic EMS, Stockholm, Sweden
| | - Veronica Lindström
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Academic EMS, Stockholm, Sweden
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Blake M, Bowes A, Gill V, Husain F, Mir G. A collaborative exploration of the reasons for lower satisfaction with services among Bangladeshi and Pakistani social care users. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1090-1099. [PMID: 27885738 DOI: 10.1111/hsc.12411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
This study explored underlying reasons for the expression of dissatisfaction with services among Bangladeshi and Pakistani social care users in England and investigated, using a collaborative approach, how these could be addressed. In-depth interviews were conducted in Birmingham, Leeds and London during 2012-2013 with 63 Bangladeshi, Pakistani and white British service users and 24 social care managers, social workers and care workers. A further 34 cognitive interviews were conducted within the same study. Following data analysis, three collaborative workshops involving service users and providers were held to validate the findings and to draw out policy and practice recommendations. Analysis of the cognitive interviews showed that higher dissatisfaction among Bangladeshi and Pakistani service users reported in social care surveys was not due to questionnaire design. Instead in-depth interviews showed that dissatisfaction across all three groups was expressed along the social care journey, including accessing care, communication with social workers and the nature of care received. While many issues were common to all three groups, cultural differences also emerged as affecting experiences of social care. These included misunderstandings about family roles in care; gender issues, especially relating to women; language and communication barriers, alongside the need for a more nuanced approach to ethnic 'matching'; and continuing limited cultural understanding among care workers. The collaborative workshops identified practical actions that could address some of the issues identified. These covered raising awareness of services within communities; improving support for informal carers; service user input to assessments; consistent and ongoing sharing of information; improving access; and more efforts to diversify and appropriately train the social care workforce. In conclusion, the paper presents the reality of dissatisfaction among these groups and argues for more action involving communities and service providers to address these persistent issues collaboratively.
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Affiliation(s)
| | - Alison Bowes
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | | | | | - Ghazala Mir
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Dahl K, Dahlen KJ, Larsen K, Lohne V. Conscientious and proud but challenged as a stranger: Immigrant nurses’ perceptions and descriptions of the Norwegian healthcare system. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2057158517690952] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The number of nurses in Norway educated outside of the European Union is increasing. The purpose of this study is to explore how immigrant nurses, all educated as nurses in their home countries, experience working as a nurse in Norway. The study has a qualitative design with a social constructivist perspective and is based on written narratives from open-ended questions representing 144 nurses from 18 different counties. Two main themes based on patterns from the participants’ text were constructed: ‘conscientious and proud as nurses’ and ‘impressed but challenged as strangers’. The findings are discussed in relation to research in cultural understanding. Immigrant nurses contribute with important knowledge and cultural competence to nursing and the Norwegian healthcare system, but there are also challenges. More knowledge is needed in education, research and in individual institutions about the contributions and challenges immigrant nurses bring with them.
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Affiliation(s)
- Kari Dahl
- Oslo and Akershus University College of Applied Sciences, Norway
| | | | - Kristian Larsen
- Oslo and Akershus University College of Applied Sciences, Norway
| | - Vibeke Lohne
- Oslo and Akershus University College of Applied Sciences, Norway
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Alizadeh S, Chavan M. Cultural competence dimensions and outcomes: a systematic review of the literature. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:e117-e130. [PMID: 26499469 DOI: 10.1111/hsc.12293] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2015] [Indexed: 06/05/2023]
Abstract
It has been widely suggested that cultural competence is an individual's core requirement for working effectively with culturally diverse people. However, there is no consensus regarding the definition or the components of this concept and there is a dearth of empirical proof indicating the benefits of cultural competence. Therefore, a systematic review was conducted to identify the most common cultural competence dimensions proposed in recent publications and to identify whether sufficient evidence exists regarding the efficacy of cultural competence in the healthcare context. A total of 1204 citations were identified through an electronic search of databases, of which 18 publications included cultural competence frameworks, and 13 studies contained empirical data on cultural competence outcomes. The overarching themes of the review were centred around the challenges faced by the healthcare sector in many countries due to growing cultural diversity, but lack of cultural competence, leading to predicaments that arise during intercultural interactions between patients and clinicians. This review will benefit researchers exploring cultural competence as one of the research variables impacting research outcomes.
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Affiliation(s)
- Somayeh Alizadeh
- Marketing and Management, Macquarie University, Sydney, New South Wales, Australia.
| | - Meena Chavan
- Marketing and Management, Macquarie University, Sydney, New South Wales, Australia
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Cai D, Kunaviktikul W, Klunklin A, Sripusanapan A, Avant PK. Identifying the essential components of cultural competence in a Chinese nursing context: A qualitative study. Nurs Health Sci 2016; 19:157-162. [DOI: 10.1111/nhs.12308] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/30/2016] [Accepted: 07/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Duanying Cai
- School of Nursing; Nantong University; Nantong City China
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | | | | | | | - Patricia Kay Avant
- School of Nursing; The University of Texas Health Science Center at San Antonio; San Antonio Texas USA
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Tavallali AG, Jirwe M, Kabir ZN. Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences. Scand J Caring Sci 2016; 31:54-62. [PMID: 26800093 DOI: 10.1111/scs.12314] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 11/09/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. AIM The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. METHOD A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. ETHICAL CONSIDERATIONS The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). RESULTS The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. CONCLUSIONS Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters.
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Affiliation(s)
- Azar Gashasb Tavallali
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Jirwe
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Zarina Nahar Kabir
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Bernhard G, Knibbe RA, von Wolff A, Dingoyan D, Schulz H, Mösko M. Development and Psychometric Evaluation of an Instrument to Assess Cross-Cultural Competence of Healthcare Professionals (CCCHP). PLoS One 2015; 10:e0144049. [PMID: 26641876 PMCID: PMC4671537 DOI: 10.1371/journal.pone.0144049] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 11/12/2015] [Indexed: 11/18/2022] Open
Abstract
Background Cultural competence of healthcare professionals (HCPs) is recognized as a strategy to reduce cultural disparities in healthcare. However, standardised, valid and reliable instruments to assess HCPs’ cultural competence are notably lacking. The present study aims to 1) identify the core components of cultural competence from a healthcare perspective, 2) to develop a self-report instrument to assess cultural competence of HCPs and 3) to evaluate the psychometric properties of the new instrument. Methods The conceptual model and initial item pool, which were applied to the cross-cultural competence instrument for the healthcare profession (CCCHP), were derived from an expert survey (n = 23), interviews with HCPs (n = 12), and a broad narrative review on assessment instruments and conceptual models of cultural competence. The item pool was reduced systematically, which resulted in a 59-item instrument. A sample of 336 psychologists, in advanced psychotherapeutic training, and 409 medical students participated, in order to evaluate the construct validity and reliability of the CCCHP. Results Construct validity was supported by principal component analysis, which led to a 32-item six-component solution with 50% of the total variance explained. The different dimensions of HCPs’ cultural competence are: Cross-Cultural Motivation/Curiosity, Cross-Cultural Attitudes, Cross-Cultural Skills, Cross-Cultural Knowledge/Awareness and Cross-Cultural Emotions/Empathy. For the total instrument, the internal consistency reliability was .87 and the dimension’s Cronbach’s α ranged from .54 to .84. The discriminating power of the CCCHP was indicated by statistically significant mean differences in CCCHP subscale scores between predefined groups. Conclusions The 32-item CCCHP exhibits acceptable psychometric properties, particularly content and construct validity to examine HCPs’ cultural competence. The CCCHP with its five dimensions offers a comprehensive assessment of HCPs’ cultural competence, and has the ability to distinguish between groups that are expected to differ in cultural competence. This instrument can foster professional development through systematic self-assessment and thus contributes to improve the quality of patient care.
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Affiliation(s)
- Gerda Bernhard
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail: ;
| | - Ronald A. Knibbe
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Alessa von Wolff
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Demet Dingoyan
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Boerner KE, Coulombe JA, Corkum P. Core competencies for health professionals' training in pediatric behavioral sleep care: a Delphi study. Behav Sleep Med 2015; 13:265-84. [PMID: 24628091 DOI: 10.1080/15402002.2013.874348] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The need to train non-sleep-specialist health professionals in evidence-based pediatric behavioral sleep care is well established. The objective of the present study was to develop a list of core competencies for training health professionals in assisting families of 1- to 10-year old children with behavioral insomnia of childhood. A modified Delphi methodology was employed, involving iterative rounds of surveys that were administered to 46 experts to obtain consensus on a core competency list. The final list captured areas relevant to the identification and treatment of pediatric behavioral sleep problems. This work has the potential to contribute to the development of training materials to prepare non-sleep-specialist health professionals to identify and treat pediatric behavioral sleep problems, ideally within stepped-care frameworks.
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Dauvrin M, Lorant V. Leadership and cultural competence of healthcare professionals: a social network analysis. Nurs Res 2015; 64:200-10. [PMID: 25871625 PMCID: PMC4418777 DOI: 10.1097/nnr.0000000000000092] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND International migration is a global phenomenon challenging healthcare professionals to provide culturally competent care. OBJECTIVES The purpose of this study was to investigate the influence of leaders on the cultural competence of healthcare professionals. METHODS A cross-sectional survey was conducted from 2010 to 2012 to obtain data for a social network analysis in 19 inpatient services and five primary care services in Belgium. The Competences in Ethnicity and Health questionnaire was used. A total of 507 healthcare professionals, including 302 nurses, identified their social relationships with other healthcare professionals working in their service. Highest in-degree centrality was used to identify the leaders within each health service. Multiple regressions with the Huber sandwich estimator were used to link cultural competence of leaders with the cultural competence of the rest of the healthcare staff. RESULTS Cultural competence of the healthcare staff was associated with the cultural competence of the leaders. This association remained significant for two specific domains of cultural competence-mediation and paradigm-after controlling for contextual and sociodemographic variables. Interaction analysis suggested that the leadership effect varied with the degree of cultural competence of the leaders. DISCUSSION Cultural competence among healthcare professionals is acquired partly through leadership. Social relationships and leadership effects within health services should be considered when developing and implementing culturally competent strategies. This requires a cautious approach as the most central individuals are not always the same persons as the formal leaders.
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Affiliation(s)
- Marie Dauvrin
- Marie Dauvrin, RN, MPH, PhD, is Postdoctoral Researcher, Fonds de la Recherche Scientifique-FNRS, Prospective Research for Brussels (INNOVIRIS) and Institute of Health and Society IRSS, Université catholique de Louvain, Belgium. Vincent Lorant, PhD, is Professor, Institute of Health Society IRSS, Université catholique de Louvain, Belgium
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Public health care nurses’ views of mothers’ mental health in paediatric healthcare services: a qualitative study. Prim Health Care Res Dev 2015; 16:470-80. [DOI: 10.1017/s1463423615000055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AimTo investigate public health nurses’ perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services.BackgroundAlthough maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses.MethodsFor this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard’s description of the four-step qualitative content analysis.FindingsThree categories – external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support – were interpreted to reflect the nurses’ perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum.ConclusionWe found that public health nurses can have an important role in supporting mothers’ mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers’ transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.
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Kangasniemi M, Pakkanen P, Korhonen A. Professional ethics in nursing: an integrative review. J Adv Nurs 2015; 71:1744-57. [DOI: 10.1111/jan.12619] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Mari Kangasniemi
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Piiku Pakkanen
- Department of Nursing Science; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Anne Korhonen
- Department of Pediatrics and Adolescence; Oulu University Hospital; Finland
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Chae DH, Lee CY. Development and Psychometric Evaluation of the Korean Version of the Cultural Competence Scale for Clinical Nurses. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 8:305-12. [DOI: 10.1016/j.anr.2014.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 05/22/2014] [Accepted: 06/27/2014] [Indexed: 10/24/2022] Open
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Understanding the ways in which health visitors manage anxiety in cross-cultural work: a qualitative study. Prim Health Care Res Dev 2014; 15:375-85. [DOI: 10.1017/s1463423613000340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Merrell J, Olumide G, Khanom A. ‘Work in progress’: nurse educators' views on preparing pre-registration nursing students in Wales for practice in multi-ethnic environments. J Res Nurs 2014. [DOI: 10.1177/1744987114546723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nurses need to be adequately prepared to practise competently in increasingly ethnically diverse communities. This study explored nurse educators' views regarding the extent and nature of pre-registration nursing education intended to prepare students for multi-ethnic practice in Wales. A qualitative approach was taken with a purposive sample of programme directors ( n = 6), branch leaders and lecturers ( n = 25) and practice mentors ( n = 35). Data were collected through focus groups, interviews, questionnaire and documentary review. Qualitative data were analysed using thematic analysis and three themes were identified: curriculum design and content, a theory–practice gap and personnel and material resources. Findings indicated that knowledge of the most effective way to prepare pre-registration nursing students for practice in multi-ethnic communities is ‘work in progress’ in Wales. Our findings raise questions about the extent to which the curriculum prepares students to engage with the Welsh social justice agenda. Improved clarity regarding what constitutes an adequate curriculum and improved preparation of nurse educators and mentors to competently and confidently prepare students for working within ethnically diverse communities is required.
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Affiliation(s)
- Joy Merrell
- Professor, College of Human and Health Sciences, Swansea University, UK
| | - Gillian Olumide
- Senior Lecturer, College of Human and Health Sciences, Swansea University, UK
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Dauvrin M, Lorant V. Adaptation of health care for migrants: whose responsibility? BMC Health Serv Res 2014; 14:294. [PMID: 25005021 PMCID: PMC4108228 DOI: 10.1186/1472-6963-14-294] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 06/25/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a context of increasing ethnic diversity, culturally competent strategies have been recommended to improve care quality and access to health care for ethnic minorities and migrants; their implementation by health professionals, however, has remained patchy. Most programs of cultural competence assume that health professionals accept that they have a responsibility to adapt to migrants, but this assumption has often remained at the level of theory. In this paper, we surveyed health professionals' views on their responsibility to adapt. METHODS Five hundred-and-sixty-nine health professionals from twenty-four inpatient and outpatient health services were selected according to their geographic location. All health care professionals were requested to complete a questionnaire about who should adapt to ethnic diversity: health professionals or patients. After a factorial analysis to identify the underlying responsibility dimensions, we performed a multilevel regression model in order to investigate individual and service covariates of responsibility attribution. RESULTS Three dimensions emerged from the factor analysis: responsibility for the adaptation of communication, responsibility for the adaptation to the negotiation of values, and responsibility for the adaptation to health beliefs. Our results showed that the sense of responsibility for the adaptation of health care depended on the nature of the adaptation required: when the adaptation directly concerned communication with the patient, health professionals declared that they should be the ones to adapt; in relation to cultural preferences, however, the responsibility felt on the patient's shoulders. Most respondents were unclear in relation to adaptation to health beliefs. Regression indicated that being Belgian, not being a physician, and working in a primary-care service were associated with placing the burden of responsibility on the patient. CONCLUSIONS Health care professionals do not consider it to be their responsibility to adapt to ethnic diversity. If health professionals do not feel a responsibility to adapt, they are less likely to be involved in culturally competent health care.
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Affiliation(s)
- Marie Dauvrin
- Institute of Health and Society IRSS, Université catholique de Louvain, Clos Chapelle aux Champs 30 boîte 1,30,15, Brussels 1200, Belgium.
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Bing-Jonsson PC, Bjørk IT, Hofoss D, Kirkevold M, Foss C. Competence in advanced older people nursing: development of ‘Nursing older people - Competence evaluation tool’. Int J Older People Nurs 2014; 10:59-72. [DOI: 10.1111/opn.12057] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 02/11/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Dag Hofoss
- Department of Nursing Science; University of Oslo; Oslo Norway
| | - Marit Kirkevold
- Department of Nursing Science; University of Oslo; Oslo Norway
| | - Christina Foss
- Department of Nursing Science; University of Oslo; Oslo Norway
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Shen Z. Cultural Competence Models and Cultural Competence Assessment Instruments in Nursing. J Transcult Nurs 2014; 26:308-21. [DOI: 10.1177/1043659614524790] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The author reviewed cultural competence models and cultural competence assessment instruments developed and published by nurse researchers since 1982. Both models and instruments were examined in terms of their components, theoretical backgrounds, empirical validation, and psychometric evaluation. Most models were not empirically tested; only a few models developed model-based instruments. About half of the instruments were tested with varying levels of psychometric properties. Other related issues were discussed, including the definition of cultural competence and its significance in model and instrument development, limitations of existing models and instruments, impact of cultural competence on health disparities, and further work in cultural competence research and practice.
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Affiliation(s)
- Zuwang Shen
- The City University of New York/Bronx Community College, Bronx, NY, USA
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Yang FY, Zhao RR, Liu YS, Wu Y, Jin NN, Li RY, Shi SP, Shao YY, Guo M, Arthur D, Elliott M. A core competency model for Chinese baccalaureate nursing graduates: a descriptive correlational study in Beijing. NURSE EDUCATION TODAY 2013; 33:1465-70. [PMID: 23810340 PMCID: PMC7130637 DOI: 10.1016/j.nedt.2013.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 05/14/2013] [Accepted: 05/31/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND A review of the literature showed that the core competencies needed by newly graduated Chinese nurses were not as of yet undocumented. OBJECTIVE To develop a psychometrically sound instrument for identifying and measuring the core competencies needed by Chinese nursing baccalaureate graduates. DESIGN Descriptive correlational and multicentre study. SETTING Seven major tertiary teaching hospitals and three major medical universities in Beijing. PARTICIPANTS 790 subjects, including patients, nursing faculty members, doctors and nurses. METHOD A reliable and valid self-report instrument, consisting of 58 items, was developed using multiple methods. It was then distributed to 790 subjects to measure nursing competency in a broader Chinese context. The psychometric characteristics of reliability and validity were supported by descriptive and inferential analyses. RESULTS The final instrument consists of six dimensions with 47 items. The content validity index was 0.90. The overall scale reliability was 0.97 with dimensions range from 0.87 to 0.94. Six domains of core competencies were identified: professionalism; direct care; support and communication; application of professional knowledge; personal traits; and critical thinking and innovation. CONCLUSION The findings of this study provide valuable evidence for a psychometrically sound measurement tool, as well as for competency-based nursing curriculum reform.
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Affiliation(s)
- Fang Yu Yang
- School of Nursing, Capital Medical University, Beijing 100069, PR China
| | - Rong Rong Zhao
- School of Nursing, Capital Medical University, Beijing 100069, PR China
- The Third Military Medical University, Chongqing, PR China
| | - Yi Si Liu
- School of Nursing, Capital Medical University, Beijing 100069, PR China
| | - Ying Wu
- School of Nursing, Capital Medical University, Beijing 100069, PR China
| | - Ning Ning Jin
- School of Nursing, Capital Medical University, Beijing 100069, PR China
| | - Rui Ying Li
- School of Nursing, Capital Medical University, Beijing 100069, PR China
| | - Shu Ping Shi
- Xuanwu Hospital affiliated to Capital Medical University, Beijing 100054, PR China
| | - Yue Ying Shao
- Xuanwu Hospital affiliated to Capital Medical University, Beijing 100054, PR China
| | - Ming Guo
- School of Nursing, Capital Medical University, Beijing 100069, PR China
| | - David Arthur
- Angeles University Foundation, Angeles City, Pampanga, Philippines
| | - Malcolm Elliott
- School of Nursing & Midwifery, Australian Catholic University, Melbourne, Australia
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Rådestad M, Jirwe M, Castrén M, Svensson L, Gryth D, Rüter A. Essential key indicators for disaster medical response suggested to be included in a national uniform protocol for documentation of major incidents: a Delphi study. Scand J Trauma Resusc Emerg Med 2013; 21:68. [PMID: 24025366 PMCID: PMC3848492 DOI: 10.1186/1757-7241-21-68] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 09/08/2013] [Indexed: 11/28/2022] Open
Abstract
Background Registration of data from a major incident or disaster serves several purposes such as to record data for evaluation of response as well as for research. Data needed can often be retrieved after an incident while other must be recorded during the incident. There is a need for a consensus on what is essential to record from a disaster response. The aim of this study was to identify key indicators essential for initial disaster medical response registration. By this is meant nationally accepted processes involved, from the time of the emergency call to the emergency medical communication centre until medical care is provided at the emergency department. Methods A three round Delphi study was conducted. Thirty experts with a broad knowledge in disaster and emergency response and medical management were invited. In this study we estimated 30 experts to be approximately one third of the number in Sweden eligible for recruitment. Process, structure and outcome indicators for the initial disaster medical response were identified. These were based on previous research and expressed as statements and were grouped into eight categories, and presented to the panel of experts. The experts were instructed to score each statement, using a five point Likert scale, and were also invited to include additional statements. Statements reaching a predefined consensus level of 80% were considered as essential to register. Results In total 97 statements were generated, 77 statements reached consensus. The 77 statements covered parts of all relevant aspects involved in the initial disaster medical response. The 20 indicators that did not reach consensus mostly concerned patient related times in hospital, types of support systems and security for health care staff. Conclusions The Delphi technique can be used for reaching consensus of data, comprising process, structure and outcome indicators, identified as essential for recording from major incidents and disasters.
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Affiliation(s)
- Monica Rådestad
- Department of Clinical Science and Education and Section of Emergency Medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
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Austin P, Henderson S, Power I, Jirwe M, Alander T. An international Delphi study to assess the need for multiaxial criteria in diagnosis and management of functional gastrointestinal disorders. J Psychosom Res 2013; 75:128-34. [PMID: 23915768 DOI: 10.1016/j.jpsychores.2013.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 05/13/2013] [Accepted: 05/14/2013] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess agreement, consensus, and disagreement between experts in different domains in the evaluation of functional gastrointestinal disorders (FGIDs). METHODS We conducted a modified Delphi study using 90 purposively sampled experts using an online survey tool to develop, distribute and analyse the Delphi rounds. Experts were sent 132 items generated from a literature review examining present and proposed future FGID evaluation. The survey items examined contributory factors and were divided into four sections examining risk and contributing factors, the therapeutic relationship, domains of measurement and the pros and cons of multiaxial assessment. The consensus level was set at 75%. KEY RESULTS 36 of 68 eligible participants (52%) replied to round one and 96 items gained consensus. Using expert feedback, we used thematic analysis to generate 33 additional items for round two. 31 of 36 participants (86%) replied to rounds two and three. In round two, 19 items gained consensus, and in round three, nine items gained consensus. Agreement was high concerning systematic approaches for both physiological and psychosocial components of FGIDs (91%) using laboratory and self-reporting findings (83%). Opinion was divided regarding physical risk factors such as previous surgery (53%) and genetic association (71%). Overall, 124 of the 167 items gained consensus. CONCLUSION AND INFERENCES We have identified expert consensus and disagreement on domains of information relevant to the evaluation of FGIDs. Experts agreed there is an immediate need for multi-axial assessment. Physiological and genetic risk factors are not fully accepted and require further study.
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Affiliation(s)
- Philip Austin
- Department of Anaesthesia and Pain Medicine, University of Edinburgh, Edinburgh, UK.
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Tavallali AG, Kabir ZN, Jirwe M. Ethnic Swedish Parents' experiences of minority ethnic nurses' cultural competence in Swedish paediatric care. Scand J Caring Sci 2013; 28:255-63. [DOI: 10.1111/scs.12051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Azar G. Tavallali
- Division of Nursing; Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Zarina Nahar Kabir
- Division of Nursing; Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Maria Jirwe
- Division of Nursing; Department of Neurobiology; Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
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Hörnsten Å, Lindahl K, Persson K, Edvardsson K. Strategies in health-promoting dialogues--primary healthcare nurses' perspectives--a qualitative study. Scand J Caring Sci 2013; 28:235-44. [PMID: 23594185 DOI: 10.1111/scs.12045] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 03/20/2013] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES The aim of this study was to describe dialogic strategies about health and lifestyle used by primary healthcare nurses (PHNs) in the Västerbotten Intervention Programme (VIP) in Sweden. BACKGROUND The VIP offers all citizens aged 40, 50 and 60 in Västerbotten County an individual health check-up followed by a health-promoting dialogue with a specialist PHN. Inconsistencies in previous reports of the effects of lifestyle counselling and health promotion suggest that it is important to study dialogues about health and lifestyle to understand health-promoting strategies and to highlight aspects important to improving their effects. METHOD In 2010, we conducted in-depth interviews with ten experienced PHNs working with the VIP at eight healthcare centres in Västerbotten County, Sweden. Qualitative content analysis was used to illuminate the nurses' strategies in health-promoting dialogues. The Regional Ethics Board (Dno 06-126M) approved the study. RESULTS The PHNs used various strategies in dialogues about health and lifestyle that fell under the five themes 'Guiding patients vs. pressuring them; Adjusting to patients vs. directing the conversation; Inspiring confidence vs. instilling fear; Motivating and supporting patients vs. demanding responsibility; and lastly, Introducing emotionally charged subjects or avoiding them'. CONCLUSIONS The results of this study may add knowledge about the difficulties and opportunities in health counselling. In the discussion, we suggest professional reflection as a means to increase knowledge and awareness about the self and context in the process of health counselling.
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Affiliation(s)
- Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
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Higginbottom GM, Richter MS, Mogale RS, Ortiz L, Young S, Mollel O. Identification of nursing assessment models/tools validated in clinical practice for use with diverse ethno-cultural groups: an integrative review of the literature. BMC Nurs 2011; 10:16. [PMID: 21812960 PMCID: PMC3175445 DOI: 10.1186/1472-6955-10-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 08/03/2011] [Indexed: 11/25/2022] Open
Abstract
Background High income nations are currently exhibiting increasing ethno-cultural diversity which may present challenges for nursing practice. We performed an integrative review of literature published in North America and Europe between 1990 and 2007, to map the state of knowledge and to identify nursing assessment tools/models which are have an associated research or empirical perspective in relation to ethno-cultural dimensions of nursing care. Methods Data was retrieved from a wide variety of sources, including key electronic bibliographic databases covering research in biomedical fields, nursing and allied health, and culture, e.g. CINAHL, MEDline, PUBmed, Cochrane library, PsycINFO, Web of Science, and HAPI. We used the Critical Appraisal Skills Programme tools for quality assessment. We applied Torraco's definition and method of an integrative review that aims to create new knowledge and perspectives on a given phenomena. To add methodological rigor with respect to the search strategy and other key review components we also used the principles established by the Centre for Reviews and Dissemination. Results Thirteen thousand and thirteen articles were retrieved, from which 53 full papers were assessed for inclusion. Eight papers met the inclusion criteria, describing research on a total of eight ethno-cultural assessment tools/models. The tools/models are described and synthesized. Conclusions While many ethno-cultural assessment tools exist to guide nursing practice, few are informed by research perspectives. An increased focus on the efficiency and effectiveness of health services, patient safety, and risk management, means that provision of culturally responsive and competent health services will inevitably become paramount.
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Kokko R. Future nurses' cultural competencies: what are their learning experiences during exchange and studies abroad? A systematic literature review. J Nurs Manag 2011; 19:673-82. [PMID: 21749541 DOI: 10.1111/j.1365-2834.2011.01221.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This article describes the development of cultural competence among nursing students. The focus is on illuminating the learning experiences of nursing students during their exchange. BACKGROUND As the world gets smaller, the demand for culturally competent nurses increases. Future nurses need to be open-minded towards international cooperation and willing to develop the quality of care from a cultural point of view. Nursing education in many countries provides an option for students to learn nursing in different cultures while taking part of their studies abroad. METHODS A systematic literature search was conducted. Inductive content analysis was applied to the data consisting of empirical studies (n=7) describing nursing students' studies abroad. RESULTS The process of developing cultural competence among nursing students on exchange was found to consist of three main themes, namely: (1) an increased cultural knowledge base, (2) personal growth and (3) the impact of exchange experiences on the nursing student's own practice. CONCLUSIONS Studies abroad are a beneficial strategy for the development of future nurses' cultural competence. IMPLICATIONS FOR NURSING MANAGEMENT Nursing is facing a crucial challenge to recruit culturally competent nurses, because an increasing number of patients are from different cultures. Nurses with experiences of studying abroad can offer employers a resource through their preparedness for culturally competent nursing.
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Affiliation(s)
- Raija Kokko
- Department of Health, Tampere University of Applied Sciences, Tampere, Finland.
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Hudelson P, Perron NJ, Perneger T. Using clinical vignettes to assess doctors' and medical students' ability to identify sociocultural factors affecting health and health care. MEDICAL TEACHER 2011; 33:e564-e571. [PMID: 21942493 DOI: 10.3109/0142159x.2011.602994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Methods are needed for assessing clinicians' cultural knowledge frameworks. METHOD We used a mail survey containing four short clinical vignettes to explore respondents' ability to identify sociocultural factors affecting health and health care. Participants included 299 physicians working at the University Hospitals of Geneva, 156 private physicians, and all 134 local medical students in their clinical years. Twenty-one sociocultural "domains" were identified through inductive coding of responses. For each vignette, we obtained the sum of codes as a measure of the respondent's awareness of sociocultural factors that might affect care in this particular situation. As internal consistency was reasonably high (0.68), we computed a single total score as the sum of responses given to all four vignettes. RESULTS Reponses correlated with factors that might be expected to impact clinicians' awareness of sociocultural factors affecting care. Medical students, females, respondents who had received cultural competence training, those with greater interest in caring for immigrant patients, and those with high self-assessed skills at exploring psychosocial and migration-related issues scored higher on the vignettes. CONCLUSIONS Brief clinical vignettes appear to be a relevant and feasible method for exploring physicians' knowledge of social and cultural factors affecting health and health care.
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