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Hall S, Rohatinsky N, Holtslander L, Peacock S. Mapping the Caregiver Experience in a Canadian Province: Research Methodology for the Saskatchewan Caregiver Experience Study. Can J Nurs Res 2024; 56:234-246. [PMID: 38280214 PMCID: PMC11308350 DOI: 10.1177/08445621241227720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Policies and services for older adults are increasingly focused on living in the community, rather than relying on institutions. A total of 70-80% of community care for older adults is provided by family and friend caregivers. With Canada's aging population, the number of caregivers to older adults is growing. PURPOSE The purpose of this paper is to describe the research methodology that was employed in the Saskatchewan Caregiver Experience Study. The methodology was used to map the experiences and gather perspectives of caregivers in Saskatchewan and to identify their priority support needs. METHODS Qualitative description was the approach in this study. An online qualitative survey was administered via SurveyMonkey and distributed via Facebook and community newsletters. The survey collected caregiver demographics and asked three open-ended questions regarding: (1) the challenges that caregivers experience; (2) the positive aspects of caregiving; and (3) the support needs and priorities of Saskatchewan caregivers. A fourth question where caregivers could freely express any other experiences or perspectives was included. Content analysis was the method used for data analysis. RESULTS 355 individuals met the inclusion criteria for this study. Participants were evenly distributed amongst urban-large, urban-small/medium, and rural settings in Saskatchewan. The average age of caregivers and care recipients were 61 and 83 respectively. CONCLUSION This study has implications for research, practice, and policy. By gathering the full spectrum of the caregiver experience in Saskatchewan, this study can help to inform how communities, governments, and our healthcare system can best support caregivers in their role.
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Affiliation(s)
- Steven Hall
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Noelle Rohatinsky
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Shelley Peacock
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
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Gray JA, Kim J. Cultural Competency Challenges Certified Nursing Assistants Experience in Providing Palliative Care. J Gerontol Nurs 2024; 50:35-41. [PMID: 38959508 DOI: 10.3928/00989134-20240618-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
PURPOSE Increasing racial and ethnic diversity in U.S. nursing facilities has necessitated the provision of more culturally competent care. This study explored the cultural challenges in providing palliative care from the perspective of certified nursing assistants (CNAs) and nurses in nursing facilities. METHOD A thematic analysis approach was used to examine data from semi-structured interviews with 12 CNAs and 11 nurses from six nursing facilities in a U.S. Midwestern state. RESULTS Four themes emerged from the data: Cultural Needs Expressed by Residents, Cultural Needs Expressed by Family Members, Accommodating Residents' Cultural Needs, and Organizational Responses to Cultural Competency Challenges. CONCLUSION Results highlighted the training variations on diversity and cultural competency issues and the varying cultural competency levels possessed by staff. To support residents' culture-related needs, staff need education and support. Organizations can provide foundational resources for this diversity of cultural expression, including providing more culturally diverse programming facilities. [Journal of Gerontological Nursing, 50(7), 35-41.].
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Vandecasteele R, Robijn L, Stevens PAJ, Willems S, De Maesschalck S. "Trying to write a story together": general practitioners' perspectives on culturally sensitive care. Int J Equity Health 2024; 23:118. [PMID: 38844971 PMCID: PMC11154983 DOI: 10.1186/s12939-024-02200-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/21/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Culturally sensitive care is integral to effective and equitable healthcare delivery, necessitating an understanding and acknowledgment of patients' cultural needs, preferences, and expectations. This study investigates the perceptions of cultural sensitivity among general practitioners (GPs), focusing on their intentions, willingness and perceived responsibilities in providing care tailored to cultural needs. METHODS In-depth interviews were conducted with 21 Flemish GPs to explore their perspectives on culturally sensitive care. Data analysis followed a conventional qualitative content analysis approach within a constructivist framework. A coding scheme was developed to identify recurring themes and patterns in the GPs' responses. RESULTS Findings reveal that culturally sensitive care provision is perceived as a multifaceted process, initiated by an exploration phase where GPs inquire about patients' cultural needs and preferences. Two pivotal factors shaping culturally sensitive care emerged: patients' specific cultural expectations and GPs' perceived responsibilities. These factors guided the process of culturally sensitive care towards three distinct outcomes, ranging from complete adaptation to patients' cultural requirements driven by a high sense of responsibility, through negotiation and compromise, to a paternalistic approach where GPs expect patients to conform to GPs' values and expectations. Three typologies of GPs in providing culturally sensitive care were identified: genuinely culturally sensitive, surface-level culturally sensitive, and those perceiving diversity as a threat. Stereotyping and othering persist in healthcare, underscoring the importance of critical consciousness and cultural reflexivity in providing patient-centered and equitable care. CONCLUSIONS This study emphasizes the significance of empathy and underscores the necessity for GPs to embrace the exploration and acknowledgement of patients' preferences and cultural needs as integral aspects of their professional role. It highlights the importance of shared decision-making, critical consciousness, cultural desire and empathy. Understanding these nuances is essential for enhancing culturally sensitive care and mitigating healthcare disparities.
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Affiliation(s)
- Robin Vandecasteele
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium.
| | - Lenzo Robijn
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium
| | - Peter A J Stevens
- Department of Sociology, Faculty of Political and Social Sciences, Ghent University, Sint-Pietersnieuwstraat 41, Ghent, 9000, Belgium
| | - Sara Willems
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Quality & Safety Ghent, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium
- Centre for the Social Study of Migration and Refugees, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
| | - Stéphanie De Maesschalck
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, Ghent University, University Hospital Campus, C. Heymanslaan 10, Ghent, 9000, Belgium
- Centre for the Social Study of Migration and Refugees, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
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Leyva-Moral JM, Tosun B, Gómez-Ibáñez R, Navarrete L, Yava A, Aguayo-González M, Dirgar E, Checa-Jiménez C, Bernabeu-Tamayo MD. From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students. BMC Nurs 2023; 22:356. [PMID: 37798717 PMCID: PMC10552190 DOI: 10.1186/s12912-023-01521-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. METHODS A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. RESULTS Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. CONCLUSIONS Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.
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Affiliation(s)
- Juan M Leyva-Moral
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - Betül Tosun
- Nursing Department, Faculty of Health Sciences, University of Hasan Kalyoncu, Gaziantep, Turkey
| | - Rebeca Gómez-Ibáñez
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain.
| | - Laura Navarrete
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
- Consorci Corporació Sanitaria Parc Taulí, Barcelona, Spain
| | - Ayla Yava
- Nursing Department, Faculty of Health Sciences, University of Hasan Kalyoncu, Gaziantep, Turkey
| | - Mariela Aguayo-González
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - Ezgi Dirgar
- Midwifery Department, Faculty of Health Sciences, University of Gaziantep, Gaziantep, Turkey
| | - Caterina Checa-Jiménez
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - M Dolors Bernabeu-Tamayo
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
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Latifovic E, Händler-Schuster D. Intercultural communication in long-term care: The perspective of relatives from Switzerland. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023:S1865-9217(23)00032-6. [PMID: 37127457 DOI: 10.1016/j.zefq.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 01/20/2023] [Accepted: 02/14/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Due to globalization and the resulting diversity intercultural communication is increasingly coming to the fore. In addition, long-term care is mainly staffed with caregivers who have a migration background, which makes successful intercultural communication all the more important. Therefore, the aim of the present study was to define recommendations by interviewing relatives which can be used to promote intercultural communication in long-term care with regard to relationship building. METHOD A qualitative explorative content analysis, which follows the content-structuring method with an inductive approach. The semi-structured guided individual interviews were conducted with relatives (n = 14) of residents from two retirement centers in Switzerland. RESULTS Four categories were defined: "Perceive communication as a need", "Consider the desire for recognition of relatives", "Promote readiness of caregivers", and "Know opportunities and challenges in intercultural communication". CONCLUSION Intercultural communication means being aware of the significance of culture and one's own origins in order to recognize the peculiarities of the counterpart and to interact sensitively with them. Relatives want to be actively involved when nurses reach their limits in communication and interaction. Relatives want safe care that is based on empathy. When nurses show concern towards others in a person-centered way and are aware of where they come from, this can promote trust and contribute significantly to supporting communication and interaction between cultures.
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Affiliation(s)
- Esmeralda Latifovic
- Zurich University of Applied Sciences, School of Health Sciences, Institute of Nursing, Winterthur, Switzerland
| | - Daniela Händler-Schuster
- Zurich University of Applied Sciences, School of Health Sciences, Institute of Nursing, Winterthur, Switzerland; Private University of Health Sciences, Medical Informatics, and Technology UMIT, Department of Nursing Science and Gerontology, Institute of Nursing, Hall in Tyrol, Austria; Te Kura Tapuhi Hauora-School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Te Herenga Waka-Victoria University of Wellington, New Zealand.
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Luhanga F, Maposa S, Puplampu V, Abudu E, Chigbogu I. "You have to strive very hard to prove yourself": experiences of Black nursing students in a Western Canadian province. Int J Nurs Educ Scholarsh 2023; 20:ijnes-2022-0094. [PMID: 37294866 DOI: 10.1515/ijnes-2022-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/20/2023] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This study explored the experiences of Black students in two western Canadian undergraduate nursing programs. METHODS Using a qualitative focused ethnography design grounded in critical race theory and intersectionality, participants were recruited using purposive and snowball sampling. Data were collected through individual interviews, and a follow-up focus group. Data were analyzed using collaborative-thematic analysis team approaches. RESULTS n=18 current and former students participated. Five themes emerged: systemic racism in nursing, precarious immigrant context, mental health/well-being concerns, coping mechanisms, and suggestions for improvement. CONCLUSIONS An improved understanding of Black student experiences can inform their recruitment and retention. Supporting Black students' success can potentially improve equity, diversity, and inclusivity in nursing education programs and/or their representation in the Canadian nursing workforce. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE The presence of a diverse nursing profession is imperative to meet the needs to provide more quality and culturally competent services to diverse population.
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Affiliation(s)
- Florence Luhanga
- School of Nursing, Saskatchewan Polytechnic, Regina campus, Regina, SK
| | - Sithokozile Maposa
- College of Nursing, University of Saskatchewan, Prince Albert Campus, Prince Albert, SK, Canada
| | - Vivian Puplampu
- School of Nursing, Saskatchewan Polytechnic, Regina campus, Regina, SK
| | - Eunice Abudu
- School of Nursing, Saskatchewan Polytechnic, Regina campus, Regina, SK
- University of Regina, Regina, SK
| | - Irene Chigbogu
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
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Červený M, Siaki L, Prosen M, Nagórska M. Challenges experienced by nurses caring for patients from different cultures: a scoping review of the literature, 2010-2020. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2022.13.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Tringale M, Stephen G, Boylan AM, Heneghan C. Integrating patient values and preferences in healthcare: a systematic review of qualitative evidence. BMJ Open 2022; 12:e067268. [PMID: 36400731 PMCID: PMC9677014 DOI: 10.1136/bmjopen-2022-067268] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To identify and thematically analyse how healthcare professionals (HCPs) integrate patient values and preferences ('values integration') in primary care for adults with non-communicable diseases (NCDs). DESIGN Systematic review and meta-aggregation methods were used for extraction, synthesis and analysis of qualitative evidence. DATA SOURCES Relevant records were sourced using keywords to search 12 databases (ASSIA, CINAHL, DARE, EMBASE, ERIC, Google Scholar, GreyLit, Ovid-MEDLINE, PsycINFO, PubMed-MEDLINE, Scopus and Web of Science). ELIGIBILITY CRITERIA Records needed to be published between 2000 and 2020 and report qualitative methods and findings in English involving HCP participants regarding primary care for adult patients. DATA EXTRACTION AND SYNTHESIS Relevant data including participant quotations, authors' observations, interpretations and conclusions were extracted, synthesised and analysed in a phased approach using a modified version of the Joanna Briggs Institute (JBI) Data Extraction Tool, as well as EPPI Reviewer and NVivo software. The JBI Critical Appraisal Checklist for Qualitative Research was used to assess methodological quality of included records. RESULTS Thirty-one records involving >1032 HCP participants and 1823 HCP-patient encounters were reviewed. Findings included 143 approaches to values integration in clinical care, thematically analysed and synthesised into four themes: (1) approaches of concern; (2) approaches of competence; (3) approaches of communication and (4) approaches of congruence. Confidence in the quality of included records was deemed high. CONCLUSIONS HCPs incorporate patient values and preferences in healthcare through a variety of approaches including showing concern for the patient as a person, demonstrating competence at managing diseases, communicating with patients as partners and tailoring, adjusting and balancing overall care. Themes in this review provide a novel framework for understanding and addressing values integration in clinical care and provide useful insights for policymakers, educators and practitioners. PROSPERO REGISTRATION NUMBER CRD42020166002.
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Affiliation(s)
| | | | - Anne-Marie Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carl Heneghan
- Primary Health Care, University of Oxford, Oxford, UK
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Harvey NR, Wynn ST. Simulating the Refugee Experience to Cultivate Cultural Competence and Sensitivity. J Christ Nurs 2022; 39:47-51. [PMID: 33661143 DOI: 10.1097/cnj.0000000000000822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Although the United States has offered refuge to millions of immigrants, healthcare providers still lack sufficient understanding of social and ethnic issues in this population. Sociocultural barriers inhibit service accessibility and compromise the quality and appropriateness of care for resettled refugees. To address this issue, faculty from a school of nursing pioneered a spiritually and culturally centered simulation experience to enhance prelicensure students' cultural competence and sensitivity in caring for refugees.
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What Constitutes Patient-Centered Care in Home Care? A Descriptive Study of Home Health Nurses' Attitudes, Knowledge, and Skills. Home Healthc Now 2022; 40. [PMCID: PMC9631776 DOI: 10.1097/nhh.0000000000001124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In their seminal paper outlining the proposed Future of Home Care, Landers et al. (2016) stated that “patient-centered care” (PCC) is one of the “pillars” of home care. They then asked the question, what is PCC in home care and how is it measured? A qualitative descriptive study explored the answer to this question. In-depth interviews were conducted with 20 home health nurses to identify how they incorporated patient-centered and culture-sensitive care (CSC) into their assessment and care planning practices. The data were categorized into attitudes, knowledge, and skills (including relationship-building, assessment, and care planning skills) associated with patient-centered/culture-sensitive care. The home health nurses had developed multiple strategies for delivering PCC, despite a lack of education in how to provide this care. They primarily learned their techniques through their caring for patients as unique, highly valued persons and their ability to form warm caring relationships with their patients. Together they painted a portrait of the attitudes, knowledge, and skills needed for PCC and CSC. PCC and CSC are mutually reinforcing concepts essential to the high-quality, equitable care needed to mitigate healthcare disparities prevalent in home healthcare. A teaching resource for incorporating PCC/CSC into home health clinician practice was derived from the data.
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Antón-Solanas I, Tambo-Lizalde E, Hamam-Alcober N, Vanceulebroeck V, Dehaes S, Kalkan I, Kömürcü N, Coelho M, Coelho T, Casa Nova A, Cordeiro R, Sagarra-Romero L, Subirón-Valera AB, Huércanos-Esparza I. Nursing students' experience of learning cultural competence. PLoS One 2021; 16:e0259802. [PMID: 34919540 PMCID: PMC8683022 DOI: 10.1371/journal.pone.0259802] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds. MATERIALS AND METHODS A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal. RESULTS 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice. CONCLUSION The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities.
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Affiliation(s)
- Isabel Antón-Solanas
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Elena Tambo-Lizalde
- Instituto de Investigación Sanitaria, Hospital Universitario Miguel Servet, Zaragoza, Spain
- Faculty of Health Sciences, Universidad San Jorge, Zaragoza, Spain
| | - Nadia Hamam-Alcober
- Servicio Aragonés de Salud, Miguel Servet Women’s and Children’s Hospital, Zaragoza, Spain
| | | | - Shana Dehaes
- Department of Nursing, AP University of Applied Sciences and Arts, Antwerpen, Belgium
| | - Indrani Kalkan
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Turkey
| | - Nuran Kömürcü
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Turkey
| | - Margarida Coelho
- School of Education and Social Science, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Teresa Coelho
- School of Education and Social Science, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Antonio Casa Nova
- School of Health Sciences, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Raul Cordeiro
- School of Health Sciences, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Lucía Sagarra-Romero
- Faculty of Health Sciences, Villanueva de Gállego, Universidad San Jorge, Zaragoza, Spain
| | - Ana B. Subirón-Valera
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
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Aydogdu ALF. Cultural Competence of Turkish Nurses and Nursing Students: An Integrative Literature Review. J Transcult Nurs 2021; 33:529-541. [PMID: 34906000 DOI: 10.1177/10436596211062938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Turkish population is characterized by its great cultural diversity, thus, Turkish nurses and nursing students often interact with patients of different cultural backgrounds from theirs. Cultural competence is needed to provide qualified contemporary nursing care. This study aimed to explore the literature on the cultural competence of Turkish nurses and nursing students. METHODOLOGY The Whittemore and Knafl review methodology was used to extract, summarize, and synthesize data of 15 primary research articles published between January 2011 and January 2021. The search was done in the Turkish Academic Network and Information Center-ULAKBIM (PubMed, TRDizin, DergiPark). RESULTS Three themes were identified: cultural competence, cultural-related problems, and importance of training on transcultural nursing. DISCUSSION Appropriate educational courses on transcultural nursing should be implemented in Turkish nursing schools as well as in continuing education programs for Turkish nurses.
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Shahzad S, Ali N, Younas A, Tayaben JL. Challenges and approaches to transcultural care: An integrative review of nurses' and nursing students' experiences. J Prof Nurs 2021; 37:1119-1131. [PMID: 34887030 DOI: 10.1016/j.profnurs.2021.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Provision of transcultural care is an essential nursing competency. It is important to comprehensively understand the challenges nurses and nursing students face while striving to provide transcultural care in clinical settings. PURPOSE The purpose of this review was to develop a comprehensive understanding of nurses' and nursing students' challenges and approaches to the provision of transcultural care to people with diverse ethnicities. METHODS An integrative review was conducted. Literature was searched within five databases, and 30 studies published from January 2010 to January 2021 were reviewed and appraised using mixed methods critical appraisal tool. Literature summary tables and inductive approaches were used for data extraction and synthesis. RESULTS The challenges to the provision of transcultural care were intrapersonal struggle, cultural conflicts, varied expressions of pain and suffering, and navigation of personal and organizational constraints. Addressing these challenges required nurses and students to practice self-criticism and tolerate differences, develop interpersonal and psychological skills, and collaborate with peers and patients' families. CONCLUSIONS Provision of transcultural care is a complex task for nurses and students because of different interpretation of personal and organizational factors. Health care institutions should proactively provide resources to nurses and students to strengthen their interpersonal and psychological skills to provide effective transcultural care.
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Affiliation(s)
| | - Nizar Ali
- Prime Institute of Health Sciences, Islamabad, Pakistan; PAEC General Hospital Islamabad, Pakistan
| | - Ahtisham Younas
- Swat College of Nursing, Mingora Swat, Pakistan; Faculty of Nursing, Memorial University of Newfoundland, Canada.
| | - Jude L Tayaben
- College of Nursing, Benguet State University @ La Trinidad, Philippines
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Geleta BA, Radie YT, Areri HA. Exploring cultural competence of nurses and associated barriers in Ethiopian tertiary hospitals: A qualitative study. Appl Nurs Res 2021; 62:151511. [PMID: 34815007 DOI: 10.1016/j.apnr.2021.151511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/25/2021] [Accepted: 10/03/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUNDS Cultural diversities in both patients and health professionals possess difficulties in cultural care. Such cultural diversities can lead to culturally inappropriate care and health disparities. Delivering culturally competent nursing care is a powerful tool to provide care equally for all patients and eliminate health disparities among culturally diverse people. The present study aimed to explore the cultural competence of nurses and associated barriers in Ethiopian tertiary hospitals. METHODS The study was conducted on eight purposively selected key informants from March 1 to April 30, 2018. Data was collected using semi-structured questions through face to face in-depth interview. The collected data analyzed using thematic analysis and presented in the form of text and table. RESULTS Eight (n = 3 females and n = 5 males) participants were involved in the study. After extensive analysis, four themes emerged: cultural competence, linguistic competence, cultural competence education and training, and barriers to cultural competence. Another six subthemes of barriers encountered by participants identified and consisted of the language barrier, trained interpreter and translator limitation, lack of knowledge of the patient's culture, lack of multicultural nursing workforce, and shortage of nursing staff, cultural and linguistic stereotypes. CONCLUSIONS Nurses less focused on cultural aspects of patients, and they focused more on biological factors and patients' disease. Interestingly, they expressed respect for the cultural and religious practice of patients and showed an interest to learn about cultural care nursing. Cultural competence of participants was hindered by several barriers that need nurses to overcome it.
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Affiliation(s)
- Bonsa Amsalu Geleta
- Department of Nursing, College of Public Health and Medical Science, Mettu University, Ethiopia.
| | - Yosief Tsige Radie
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Ethiopia.
| | - Habtamu Abera Areri
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Ethiopia
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Narayan MC, Mallinson RK. Transcultural Nurse Views on Culture-Sensitive/Patient-Centered Assessment and Care Planning: A Descriptive Study. J Transcult Nurs 2021; 33:150-160. [PMID: 34612735 DOI: 10.1177/10436596211046986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Culture-sensitive (CS) and patient-centered (PC) care are considered essential to achieve high-quality equitable care. The purpose of this study was to determine how expert nurses incorporate CS/PC care into their assessment and care planning practices, especially for culturally diverse and marginalized patients. METHODOLOGY Using a qualitative, descriptive design, we conducted a focus group at the October 2019 Transcultural Nursing Society Conference. Participants (n = 9) discussed how they instilled cultural sensitivity and patient-centeredness into their assessment and care planning skills. RESULTS Participants revealed attitudes, knowledge, and skills associated with CS/PC assessment and care planning. They also identified specific strategies for translating CS/PC theory into assessment and care planning practices. DISCUSSION Three principles and many pragmatic strategies for incorporating CS/PC care into daily practice emerged from the data. Nurses may find these principles and strategies helpful in integrating CS/PC care into their daily care of patients in busy clinical settings.
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Joo JY, Liu MF. Culturally tailored interventions for ethnic minorities: A scoping review. Nurs Open 2021; 8:2078-2090. [PMID: 34388862 PMCID: PMC8363345 DOI: 10.1002/nop2.733] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/20/2020] [Accepted: 11/10/2020] [Indexed: 01/22/2023] Open
Abstract
AIM This scoping review identifies strengths and weakness of culturally tailored interventions for ethnic minorities' care in the United States. It reviews recently published studies to improve understanding of these interventions for future research and practice. DESIGN Scoping review. METHODS By searching five electronic databases-CINAHL, PubMed, Ovid, Scopus and Web of Science, this review located 58 empirical studies published between 2015-2019. This review was guided by the PRISMA statements. RESULTS The review identified four weaknesses and five strengths of culturally tailored interventions. Weaknesses included unclear guidelines, low attention and retention rates, failure to measure processes and inadequate training for healthcare providers. The intervention strengths were culturally respectful and patient-centred care, healthy lifestyle promotion, increased family and community supports, technology use for efficient and timely care and increased knowledge of disease by participants.
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Affiliation(s)
| | - Megan F. Liu
- School of Gerontology Health ManagementCollege of NursingTaipei Medical UniversityTaipeiTaiwan
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Cacciatore J, Thieleman K, Fretts R, Jackson LB. What is good grief support? Exploring the actors and actions in social support after traumatic grief. PLoS One 2021; 16:e0252324. [PMID: 34043716 PMCID: PMC8158955 DOI: 10.1371/journal.pone.0252324] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/13/2021] [Indexed: 12/04/2022] Open
Abstract
Social support seems to enhance wellbeing and health in many populations. Conversely, poor social support and loneliness are a social determinant of poor health outcomes and can adversely affect physical, emotional, and mental well-being. Social support is especially important in traumatic grief. However, the ways in which grieving individuals interpret and define social support is not well understood, and little is known about what specific behaviours are perceived as helpful. Using qualitative description and content analysis, this study assessed bereaved individuals’ satisfaction of social support in traumatic grief, using four categories of social support as a framework. Findings suggest inadequate satisfaction from professional, familial, and community support. Pets emerged with the most satisfactory ratings. Further, findings suggest that emotional support is the most desired type of support following traumatic loss. Implications for supporting bereaved individuals within and beyond the context of the COVID-19 pandemic are discussed.
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Affiliation(s)
- Joanne Cacciatore
- School of Social Work, Associate Professor, Arizona State University, Phoenix, AZ, United States of America
- * E-mail:
| | - Kara Thieleman
- School of Social Work, Adjunct Faculty, Arizona State University, Phoenix, AZ, United States of America
| | - Ruth Fretts
- Atrius Health, Medical Doctor, Boston, MA, United States of America
| | - Lori Barnes Jackson
- School of Social Work, Graduate Student, Arizona State University, Phoenix, AZ, United States of America
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Groves PS, Bunch JL, Sabin JA. Nurse bias and nursing care disparities related to patient characteristics: A scoping review of the quantitative and qualitative evidence. J Clin Nurs 2021; 30:3385-3397. [PMID: 34021653 DOI: 10.1111/jocn.15861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/22/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Investigations of healthcare workers' implicit attitudes about patient characteristics and differences in delivery of healthcare due to bias are increasingly common. However, there is a gap in our understanding of nurse-specific bias and care disparities. AIMS To identify (a) the types of available evidence, (b) key factors and relationships identified in the evidence and (c) knowledge gaps related to nurse bias (nurse attitudes or beliefs towards a patient characteristic) and nursing care disparities (healthcare disparities related specifically to nursing care). METHODS Authors completed a scoping review using the Joanne Briggs Institute method and PRISMA-SCR checklist. Five databases were searched. After screening, 215 research reports were included and examined. Data were extracted from research reports and assessed for thematic patterns and trends across multiple characteristics. RESULTS Nurse bias and/or care disparity investigations have become increasingly common over the 38-year span of included reports. Multiple patient characteristics have been investigated, with the most common being race and/or ethnicity, gender and age. Twenty-nine of 215 studies identified a potential relationship between nurse bias regarding a characteristic and nursing care of individuals with that characteristic. Of these studies, 27 suggested the bias was associated with a negative disparate impact on nursing care. Only 12 reports included evaluating an intervention designed to reduce nurse bias or nursing care-related healthcare disparities. CONCLUSIONS Despite increasing research focus on individual bias and disparities in healthcare, the accumulated knowledge regarding nurses has not significantly advanced past a descriptive, exploratory level. Nor has there been a consistent focus on the role of nurses, who represent the largest component of the professional healthcare workforce. RELEVANCE TO CLINICAL PRACTICE National and international codes of ethics for nurses require provision of care according to individual, unique patient need, disregarding bias and incorporating patient characteristics into their plan of care.
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Affiliation(s)
| | | | - Janice A Sabin
- School of Medicine, University of Washington, Seattle, WA, USA
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Rodriguez‐Arrastia M, Ropero‐Padilla C, Fernández‐Sola C, Portillo MC. Nursing emigration in the United Kingdom: A qualitative exploration of the Spanish nursing community. Nurs Open 2021; 8:675-687. [PMID: 33570296 PMCID: PMC7877228 DOI: 10.1002/nop2.672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/27/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022] Open
Abstract
AIM To understand and describe the experiences and perceptions of migrant Spanish nurses working in the UK. DESIGN Online survey with open-ended questions. METHODS A total of 371 participants were recruited from online groups related to Spanish nurses working in the UK. RESULTS Four themes emerged from their content analysis: "Motivations for emigration: running away from job insecurity and unemployment," "Professional recognition," "Seeking better life stability" and "Future neediness: between a rock and a hard place." In these results, professional recognition was highlighted as a reason to stay in the host country, although the uncertainty represented by Brexit is reversing the migration trend that began years ago. Policymakers should be aware of these experiences to promote strategies and programmes, which encourage inclusion in the host country and will help these nurses in their transition process.
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Affiliation(s)
- Miguel Rodriguez‐Arrastia
- Faculty of Health SciencesPre‐Department of NursingJaume I UniversityCastellon de la PlanaSpain
- Research Group CYSFaculty of Health SciencesJaume I UniversityCastello de la PlanaSpain
- Centre for Migration Studies and Intercultural RelationsUniversity of AlmeriaAlmeriaSpain
| | - Carmen Ropero‐Padilla
- Faculty of Health SciencesPre‐Department of NursingJaume I UniversityCastellon de la PlanaSpain
- Research Group CYSFaculty of Health SciencesJaume I UniversityCastello de la PlanaSpain
| | - Cayetano Fernández‐Sola
- Faculty of Health SciencesDepartment of Nursing Science, Physiotherapy and MedicineUniversity of AlmeriaAlmeriaSpain
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Albaqawi HM, Butcon VE, Albagawi BS, Dayrit RD, Pangket P. Holistic nursing care among operating room nurses: Strengthening the standard of practice in Saudi Arabia. BELITUNG NURSING JOURNAL 2021; 7:8-14. [PMID: 37469797 PMCID: PMC10353580 DOI: 10.33546/bnj.1279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Holistic practices have been found beneficial for patients as well as nurses. They increase both the nurses and the patients' health-promoting behaviors, spirituality, and interpersonal relationships. OBJECTIVE This study aimed to determine holistic nursing care and compare its differences based on individual characteristics. METHODS This study employed a quantitative-cross sectional approach. It was conducted at the hospitals of Hail region, Kingdom of Saudi Arabia, from February 2020 to March 2020. Selected through convenience sampling, 154 operating room nurses participated in the study. Frequency and percentages were used to analyze the demographic information, and t-tests and analysis of variance were used to test for differences. RESULTS Holistic nursing dimensions such as physiological (4.72 ± 0.40), socio-cultural (4.53 ± 0.45), psychological (4.66 ± 0.32), and spiritual aspects (4.22 ± 0.73) were consistently carried out in the operating room. On the physiological dimension, no significant differences were found in years of experience [(t) -0.073; p > 0.942], gender [(t) -1.113; p > 0.27], or age [(F) 0.558; p > 0.57), but there was a significant difference with nationality [(t) -3.328; p < 0.001]. On the socio-cultural dimension, the length of experience [(t) 0.599; p > 0.550], gender, [(t) -1.420; p > 0.158], and age [(F) 0.148; p > 0.862] were not significant, but a significant difference was found with nationality [(t) -7.516; p < 0.001]. Regarding the psychological dimension, the length of experience [(t) -1.101; p > 0.276], gender [(t) -1.545; p > 0.129], and age [(F) 1.259; p > 0.287] were not significant, but there was a significant difference with nationality [(t) -5.492; p < 0.001]. Finally, with the spiritual dimension, no significant difference was found on length of experience [(t) -1.101; p > 0.276] or age [(F) 0.584; p > 0.559], but there were significant differences on gender [(t) -3.890; p < 0.001] and nationality [(t) -3.653; p < 0.001]. CONCLUSION Nationality is a causal factor to physiological, socio-cultural, psychological, and spiritual dimensions, while gender is significant to spiritual aspect. Regardless of nationality or gender, nurses must be knowledgeable regarding the significance of adopting holistic care to improve the quality of their care to their patients.
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Barriers to Accessing and Negotiating Mental Health Services in Asylum Seeking and Refugee Populations: The Application of the Candidacy Framework. J Immigr Minor Health 2020; 22:156-174. [PMID: 31444614 PMCID: PMC6952341 DOI: 10.1007/s10903-019-00929-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This review brought together research investigating barriers asylum seekers and refugees (AS&R) face in accessing and negotiating mental health (MH) services. The candidacy framework (CF) was used as synthesizing argument to conceptualize barriers to services (Dixon-Woods et al. in BMC Med Res Methodol 6:35, 2006). Five databases were systematically searched. Twenty-three studies were included and analyzed using the CF. The seven stages of the framework were differentiated into two broader processes-access and negotiation of services. Comparatively more data was available on barriers to access than negotiation of services. The Identification of Candidacy (access) and Appearances at Services (negotiation) were the most widely discussed stages in terms of barriers to MH care. The stage that was least discussed was Adjudications (negotiation). The CF is useful to understand inter-related barriers to MH care experienced by AS&R. A holistic approach is needed to overcome these barriers together with further research investigating understudied areas of candidacy.
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Pool NM, Stauber LS. Tangled pasts, healthier futures: Nursing strategies to improve American Indian/Alaska Native health equity. Nurs Inq 2020; 27:e12367. [PMID: 32548947 DOI: 10.1111/nin.12367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 11/30/2022]
Abstract
American Indian/Alaska Native (AI/AN) populations in the United States continue to experience overall health inequity, despite significant improvement in health status for nearly all other racial-ethnic groups over the past 30 years. Nurses comprise the bulk of healthcare providers in the U.S. and are in an optimal position to improve AI/AN health by transforming both nursing education and practice. This potential is dependent, however, on nurses' ability to recognize the distinct historical and political conditions through which AI/AN health inequities have been produced and sustained. Nurse providers, educators, and leaders must in turn recognize how the sustained conditions of marginalization and expropriation that underpin current AI/AN health inequities continue to shape contemporary AI/AN health outcomes. This manuscript builds upon the extant literature of AI/AN historical health policy and utilizes decolonial theorizations of nursing and a cultural safety framework to propose a series of immediately actionable steps for nursing intervention into AI/AN health inequity. Ultimately, we suggest that it is crucial for nurses to collaborate with AI/AN individuals and communities across educational and clinical settings to further refine these approaches in alignment with the disciplinary obligation of promoting social justice within healthcare.
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Affiliation(s)
- Natalie M Pool
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Leah S Stauber
- Department of Mexican American Studies, Institute for LGBT Studies, College of Nursing, University of Arizona, Tucson, AZ, USA
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Carthon JMB, Brom H, Poghosyan L, Daus M, Todd B, Aiken L. Supportive Clinical Practice Environments Associated With Patient-Centered Care. J Nurse Pract 2020; 16:294-298. [PMID: 32863798 PMCID: PMC7454202 DOI: 10.1016/j.nurpra.2020.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A lack of organizational supports in clinical settings may prevent nurse practitioners from providing patient centered care. Using a cross sectional survey design, data were collected from NPs in 1,571 practices across four states to investigate clinical practice environments and the extent to which they are associated with NP integration of patient preferences. Three-quarters of NPs reported frequent integration of patient preferences into clinical care. Overall, 371 practices (23.6%) were classified as good practice environments; the remaining 76.3% were mixed or poor environments. NPs in good environments were significantly more likely to integrate patient preferences (O.R. = 2.3, p <.001).
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Affiliation(s)
- J. Margo Brooks Carthon
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA 19104
| | - Heather Brom
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA 19104
| | - Lusine Poghosyan
- Columbia School of Nursing, 560 West 168th St., New York, NY 10032
| | - Marguerite Daus
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA 19104
| | - Barbara Todd
- Hospital of the University of Pennsylvania, 3400 Spruce St Suite 104 room 1107, Philadelphia, PA
| | - Linda Aiken
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA 19104
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Joo JY, Liu MF. Nurses’ Barriers to Care of Ethnic Minorities: A Qualitative Systematic Review. West J Nurs Res 2019; 42:760-771. [DOI: 10.1177/0193945919883395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several studies have reported nurses’ challenges when caring for ethnic minority patients from diverse cultures and who have language differences. This qualitative systematic review aims to identify and describe barriers to nursing practices and to understand the common perceptions that nurses in Western countries have when providing culturally competent care to ethnic minority patients. In this review, eight qualitative, peer-reviewed studies published from 2010 to 2018 are synthesized to identify barriers to nurses’ practice with ethnic minority patients. Qualitative systematic review protocols with thematic synthesis as a methodology were employed, and five common themes were identified: communication issues; unclear, missing, or culturally inappropriate care information and resources; insufficient cultural training and education; challenging therapeutic relationships with patients; and concern about quality of care. These results suggest that future studies should explore the cost-effectiveness of cultural competency training.
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Affiliation(s)
- Jee Young Joo
- Gachon University, College of Nursing, Incheon, Korea
| | - Megan F. Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei
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Villalobos AVK, Phillips S, Zhang Y, Crawbuck GSN, Pratt-Chapman ML. Oncology healthcare provider perspectives on caring for diverse patients fifteen years after Unequal Treatment. PATIENT EDUCATION AND COUNSELING 2019; 102:1859-1867. [PMID: 31056266 DOI: 10.1016/j.pec.2019.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/12/2019] [Accepted: 04/26/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The purpose of this study was to provide a snapshot of U.S. oncology provider perspectives on caring for diverse patients, including self-rated awareness, comfort, skills, practices, challenges, facilitators, and barriers. METHODS An online survey was administered to a convenience sample of multidisciplinary oncology providers. Descriptive statistics and bivariate analyses were computed for Likert-style items to investigate differences by level of past diversity training. Qualitative content analysis was conducted on open-response questions. RESULTS Roughly one-third (36.7%) of the 406 survey respondents reported receiving high levels of past diversity training, with statistically significant differences by training amount for self-rated skills and select awareness and practice items (p < 0.05). Key challenges qualitatively described included language barriers (n = 143) and alternative health beliefs (n = 52). Knowledge and training (n = 62), interpretation services (n = 53), and staff attitudes (n = 46) were the most frequently mentioned factors affecting culturally sensitive care. CONCLUSION Fifteen years after the publication of Unequal Treatment, the National Academies' landmark report on healthcare disparities, oncology healthcare providers have ongoing challenges caring for diverse patients and opportunities to implement recommendations from the report. PRACTICE IMPLICATIONS Content of diversity trainings should focus on identified gaps and practical challenges. Multi-level supports are needed, including resources and training for oncology providers.
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Affiliation(s)
- Aubrey V K Villalobos
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Serena Phillips
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Yuqing Zhang
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Graham S N Crawbuck
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA
| | - Mandi L Pratt-Chapman
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington DC, 20037, USA.
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McPherson T, Fontane P, Bilger R. Patient experiences with compounded medications. J Am Pharm Assoc (2003) 2019; 59:670-677.e2. [DOI: 10.1016/j.japh.2019.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/30/2019] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
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Markey K, Tilki M, Taylor G. Resigned indifference: An explanation of gaps in care for culturally and linguistically diverse patients'. J Nurs Manag 2019; 27:1462-1470. [DOI: 10.1111/jonm.12830] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 06/13/2019] [Accepted: 07/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery University of Limerick Limerick Ireland
| | - Mary Tilki
- School of Health and Social Sciences Middlesex University London UK
| | - Georgina Taylor
- School of Health and Social Sciences Middlesex University London UK
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28
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Markey K, O'Brien B, Graham MM, O'Donnell C. Juggling to survive: Master of Science postgraduate nursing students' experiences of studying far from home. J Res Nurs 2019; 24:250-262. [PMID: 34394532 DOI: 10.1177/1744987118812537] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Globally, government and higher education institutions are expected to increase international student numbers. Programme development, marketing international collaboration and management has been the focus of strategy roll out. Aims This study aimed to explore international student experiences while undertaking Master of Science postgraduate education far from home. Methods A qualitative descriptive design was used. Following ethical approval, 11 students studying on a Master of Science Nursing postgraduate programme in one health education institute in Ireland volunteered to participate. Students were of Asian origin and mixed gender and the average age was 27. Data were collected using face-to-face semi-structured interviews and data analysis followed Burnard's thematic framework. Results The data provide evidence of the complexities and challenges experienced when studying on a Master of Science postgraduate nursing programme. Students described a process of juggling to survive and succeed. Three overarching categories emerged: differing realities, working through, and learning new ways. Conclusions This study adds to international debate regarding structures and processes supporting international nurse education. In meeting ethnic and culturally-diverse student learning needs, consideration of learning and teaching approaches is warranted. For globalisation in nurse education to prosper, investment needs to move from focusing on recruitment towards structures and processes to nurture intercultural learning.
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Affiliation(s)
- Kathleen Markey
- Lecturers, Department of Nursing and Midwifery, University of Limerick, Ireland
| | - Brid O'Brien
- Lecturers, Department of Nursing and Midwifery, University of Limerick, Ireland
| | - Margaret M Graham
- Lecturers, Department of Nursing and Midwifery, University of Limerick, Ireland
| | - Claire O'Donnell
- Lecturers, Department of Nursing and Midwifery, University of Limerick, Ireland
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Brooks LA, Manias E, Bloomer MJ. Culturally sensitive communication in healthcare: A concept analysis. Collegian 2019. [DOI: 10.1016/j.colegn.2018.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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30
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Wang Y, Xiao LD, Yan P, Wang Y, Yasheng A. Nursing students' cultural competence in caring for older people in a multicultural and developing region. NURSE EDUCATION TODAY 2018; 70:47-53. [PMID: 30145534 DOI: 10.1016/j.nedt.2018.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 06/17/2018] [Accepted: 08/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Health disparities exist among different cultural groups in a multicultural society. Older people from minority groups usually face greater challenges in accessing and utilizing healthcare services due to language barriers, low levels of health literacy and cognitive impairment. OBJECTIVES The aims of this study were to measure nursing students' cultural competence in the context of caring for older people from diverse cultural backgrounds and explore associated factors affecting their cultural competence in order to inform curriculum design in Xinjiang, China. DESIGN A cross-sectional study design. SETTINGS The study was undertaken in the School of Nursing, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, China. PARTICIPANTS Students enrolled in a 4-year Bachelor of Nursing Program. METHODS Students' cultural competence was measured using a validated Chinese version of Cross-cultural Care Questionnaire. Data were collected using a self-administered survey. RESULTS The number of students in the survey was 677. Of those students, 59.5% of them were from an ethnic group other than Han Chinese. A higher proportion of students from ethnic groups, other than Han Chinese, were able to fluently speak a language other than Chinese and used this language in their study and daily lives. Nursing students demonstrated low scores in knowledge, skills and encounters subscales for cultural competence, but had a relatively high score in awareness across all academic years. Findings from students' responses to open-ended questions reveal the need to integrate cross-cultural care and gerontological care into the nursing curricula and support students to apply gerontological knowledge to practice in clinical placements. CONCLUSIONS Nursing students enrolled in a 4-year Bachelor degree program in a multicultural and less developed region demonstrated lower scores on cultural competence and recognized the need to develop crosscultural and gerontological competencies.
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Affiliation(s)
- Yanru Wang
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yun Wang
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ayiguli Yasheng
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
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Affiliation(s)
- Carolyn E Smith
- Carolyn E. Smith and Carissa L. Dent are RNs at WellSpan Health York Hospital in York, Pa. Ms. Smith is also adjunct nursing faculty at York College of Pennsylvania
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The contribution of open comments to understanding the results from the Hospital Survey on Patient Safety Culture (HSOPS): A qualitative study. PLoS One 2018; 13:e0196089. [PMID: 29672577 PMCID: PMC5908235 DOI: 10.1371/journal.pone.0196089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/07/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction To develop high-quality and safe healthcare, a good safety culture is an important feature of healthcare-providing structures. The objective of this study was to analyze the qualitative data of the comments section of a Hospital Survey on Patient Safety (HSOPS) questionnaire to clarify the answers given to the closed questions. Method Using the original data from a cross-sectional survey of 5,064 employees at a single university hospital in France, we conducted a qualitative study by analyzing the comments of a HSOPS survey and conducting in-depth interviews with 19 healthcare providers. We submitted the comments and the interviews to a thematic analysis. Results A total of 3,978 questionnaires were returned, with 247 comments collected. The qualitative analysis identified several structural failures. The main categories of the open comments were concordant with the lowest dimension scores found in the quantitative analysis. The most frequently reported failures were related to the staffing and hospital management support dimensions. The healthcare professionals perceived the lack of resources, including understaffing, as the major barrier to the development of a patient safety culture. Concrete organizational issues related to hospital handoffs and risk coordination were identified, such as transfers from the emergency departments and the lack of feedback following self-reporting of incidents. Conclusion The analysis of the open comments complemented the HSOPS scores, increasing the level of detail in the description of the hospital’s patient safety culture. Combined with a classical quantitative approach used in HSOPS-based surveys, the qualitative analysis of open comments is useful to identify organizational weaknesses within the hospital.
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Markey K, Tilki M, Taylor G. Understanding nurses’ concerns when caring for patients from diverse cultural and ethnic backgrounds. J Clin Nurs 2017; 27:e259-e268. [DOI: 10.1111/jocn.13926] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery; Health Science Building; University of Limerick; Limerick Ireland
| | - Mary Tilki
- School of Health and Social Sciences; Middlesex University; London UK
| | - Georgina Taylor
- School of Health and Social Sciences; Middlesex University; London UK
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34
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Eche IJ, Aronowitz T. Evaluating Cultural Competence of Pediatric Oncology Nurses at a Teaching Hospital: A Pilot Study. J Pediatr Oncol Nurs 2017; 34:422-426. [PMID: 28660797 DOI: 10.1177/1043454217713452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional descriptive study evaluated registered nurses’ self-ratings of cultural competence on the hematology/oncology unit at a large Northeastern urban children’s hospital. The Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals was used to measure 5 constructs of cultural competence. The study findings show that there were significant correlations between the knowledge and skill subscales (ρ = .57, P < .001) and the knowledge and desire subscales (ρ = .42, P < .05). The highest mean among the 5 subscales was cultural desire (mean = 15.5), indicating that nurses were motivated to engage in the process of becoming culturally competent. The lowest mean among the 5 subscales was cultural knowledge (mean = 11.2), followed by cultural skill (mean = 11.8), indicating that nurses did not perceive themselves to be well informed in these areas. The findings from this pilot study suggest that nurses on this pediatric oncology unit are most likely to possess cultural desire and cultural awareness, but there is certainly opportunity to engage and educate the staff. Targeted interventions to improve cultural competence on this inpatient unit are being explored and a larger scale study is being planned to assess the cultural competence of nurses across the hospital.
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35
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Xiao LD, Willis E, Harrington A, Gillham D, De Bellis A, Morey W, Jeffers L. Improving socially constructed cross-cultural communication in aged care homes: A critical perspective. Nurs Inq 2017; 25. [PMID: 28616899 DOI: 10.1111/nin.12208] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 11/27/2022]
Abstract
Cultural diversity between residents and staff is significant in aged care homes in many developed nations in the context of international migration. This diversity can be a challenge to achieving effective cross-cultural communication. The aim of this study was to critically examine how staff and residents initiated effective cross-cultural communication and social cohesion that enabled positive changes to occur. A critical hermeneutic analysis underpinned by Giddens' Structuration Theory was applied to the study. Data were collected by interviews with residents or their family and by focus groups with staff in four aged care homes in Australia. Findings reveal that residents and staff are capable of restructuring communication via a partnership approach. They can also work in collaboration to develop communication resources. When staff demonstrate cultural humility, they empower residents from culturally and linguistically diverse backgrounds to engage in effective communication. Findings also suggest that workforce interventions are required to improve residents' experiences in cross-cultural care. This study challenges aged care homes to establish policies, criteria and procedures in cross-cultural communication. There is also the challenge to provide ongoing education and training for staff to improve their cross-cultural communication capabilities.
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Affiliation(s)
- Lily Dongxia Xiao
- School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia
| | - Eileen Willis
- School of Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Ann Harrington
- School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia
| | - David Gillham
- School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia
| | - Anita De Bellis
- School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia
| | - Wendy Morey
- Workforce Development and Governance, Resthaven Inc., Wayville, SA, Australia
| | - Lesley Jeffers
- Aged Care Research and Development National Office, Aged Care Management Australia, Dulwich, SA, Australia
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36
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Cruz JP, Alquwez N, Cruz CP, Felicilda-Reynaldo RFD, Vitorino LM, Islam SMS. Cultural competence among nursing students in Saudi Arabia: a cross-sectional study. Int Nurs Rev 2017; 64:215-223. [PMID: 28295279 DOI: 10.1111/inr.12370] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This study assessed the cultural competence of nursing students in a Saudi University. BACKGROUND With the current situation of immigration in Saudi Arabia, the cultural diversity in healthcare facilities is anticipated to grow. This presents a great challenge to the members of the healthcare team. METHODS A cross-sectional study was conducted among 272 nursing students in a Saudi university using a self-administered questionnaire consisting of two parts, namely the respondents' demographics and cultural background information sheet and the Cultural Capacity Scale Arabic version. RESULTS The respondents showed the highest competence in their ability to demonstrate communication skills with culturally diverse patients and lowest in the familiarity with health- or illness-related cultural knowledge or theory. Gender, academic level, clinical exposure, prior diversity training, the experience of taking care of culturally diverse patients and patients belonging to special population groups were significant factors that could likely to influence cultural competence. DISCUSSION The findings suggest that the Saudi nursing students possess the ability to provide culturally appropriate nursing care to patients with a diverse cultural background. CONCLUSIONS Despite the good cultural competence reflected in this study, some aspects in ensuring a culturally competent care rendered by Saudi nursing students need to be improved. IMPLICATIONS FOR NURSING & HEALTH POLICY With the country's Saudization policy in health care (replacing foreign nurses with Saudi nurses), the findings can be used in designing training and interventions to meet the needs of Saudi nursing students regarding cultural competence development, which is integral in their preparation to assume their future roles as nurses. Policy guidelines, such as including cultural competency training and foreign languages training as mandatory continuing education for nurses, as well as integrating cultural competency and foreign languages in the prelicensure curriculum, should be developed and implemented in Saudi Arabia and other countries.
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Affiliation(s)
- J P Cruz
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Dawadmi, Saudi Arabia
| | - N Alquwez
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Dawadmi, Saudi Arabia
| | - C P Cruz
- Medical Laboratory Science Program, University of Wyoming, Casper, WY, USA
| | | | - L M Vitorino
- Paulista School of Nursing, Federal University of São Paulo - UNIFESP, São Paulo, Brazil
| | - S M S Islam
- Non-Communicable Diseases Initiative, International Center for Diarrhoeal Diseases Research, Bangladesh (icddr, b), Dhaka, Bangladesh.,NCD, Bangladesh University of Health Science Postdoc Research, Dhaka, Bangladesh.,Diabetes Research, University of Munich, Munich, Germany.,The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
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37
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Kim H, Sefcik JS, Bradway C. Characteristics of Qualitative Descriptive Studies: A Systematic Review. Res Nurs Health 2016; 40:23-42. [PMID: 27686751 DOI: 10.1002/nur.21768] [Citation(s) in RCA: 768] [Impact Index Per Article: 96.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 01/03/2023]
Abstract
Qualitative description (QD) is a term that is widely used to describe qualitative studies of health care and nursing-related phenomena. However, limited discussions regarding QD are found in the existing literature. In this systematic review, we identified characteristics of methods and findings reported in research articles published in 2014 whose authors identified the work as QD. After searching and screening, data were extracted from the sample of 55 QD articles and examined to characterize research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. In this review, three primary findings were identified. First, although there were some inconsistencies, most articles included characteristics consistent with the limited available QD definitions and descriptions. Next, flexibility or variability of methods was common and effective for obtaining rich data and achieving understanding of a phenomenon. Finally, justification for how a QD approach was chosen and why it would be an appropriate fit for a particular study was limited in the sample and, therefore, in need of increased attention. Based on these findings, recommendations include encouragement to researchers to provide as many details as possible regarding the methods of their QD studies so that readers can determine whether the methods used were reasonable and effective in producing useful findings. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hyejin Kim
- Doctoral Candidate, School of Nursing, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104
| | - Justine S Sefcik
- Doctoral Candidate, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Christine Bradway
- Associate Professor of Gerontological Nursing, School of Nursing, University of Pennsylvania, Philadelphia, PA
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Xiao LD, Willis E, Harrington A, Gillham D, De Bellis A, Morey W, Jeffers L. Resident and family member perceptions of cultural diversity in aged care homes. Nurs Health Sci 2016; 19:59-65. [PMID: 27485390 DOI: 10.1111/nhs.12302] [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: 03/30/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 11/28/2022]
Abstract
Similar to many developed nations, older people living in residential aged care homes in Australia and the staff who care for them have become increasingly multicultural. This cultural diversity adds challenges for residents in adapting to the care home. This study explores: (i) residents' and family members' perceptions about staff and cultural diversity, and (ii) culturally and linguistically diverse residents' and family members' experiences. An interpretive study design employing a thematic analysis was applied. Twenty-three residents and seven family members participated in interviews. Four themes were identified from interpreting residents and family members' perceptions of the impact of cultural diversity on their adaptation to aged care homes: (i) perceiving diversity as an attraction; (ii) adapting to cross-cultural communication; (iii) adjusting to diet in the residential care home; and (iv) anticipating individualized psychosocial interactions. The findings have implications for identifying strategies to support staff from all cultural backgrounds in order to create a caring environment that facilitates positive relationships with residents and supports residents to adjust to the care home.
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Affiliation(s)
- Lily Dongxia Xiao
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Eileen Willis
- Discipline of Health & Exercise Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Ann Harrington
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - David Gillham
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Anita De Bellis
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Wendy Morey
- Workforce Development and Governance, Resthaven Inc., Adelaide, South Australia, Australia
| | - Lesley Jeffers
- Residential Care, Anglicare SA Inc., Adelaide, South Australia, Australia
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39
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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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40
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Kalengayi FKN, Hurtig AK, Nordstrand A, Ahlm C, Ahlberg BM. 'It is a dilemma': perspectives of nurse practitioners on health screening of newly arrived migrants. Glob Health Action 2015. [PMID: 26205362 PMCID: PMC4513182 DOI: 10.3402/gha.v8.27903] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Screening newly arrived migrants from countries with high burden of communicable diseases of public health significance is part of the Swedish national strategy against the spread of these diseases. However, little is known about its implementation. OBJECTIVE This study aimed at exploring caregivers' experiences in screening newly arrived migrants to generate knowledge that could inform policy and clinical practice. DESIGN Using an interpretive description framework, we conducted semistructured interviews between November and December 2011 in four Swedish counties, with 15 purposively selected nurses with experience in screening migrants. Data were analyzed using thematic analysis. RESULTS Participants described a range of challenges including discordant views between migrants and the nurses about medical screening, inconsistencies in rules and practices, and conflicting policies. Participants indicated that sociocultural differences resulted in divergent expectations with migrants viewing the participants as agents of migration authorities. They also expressed concern over being given a new assignment without training and being expected to share responsibilities with staff from other agencies without adequate coordination. Finally, they indicated that existing policies can be confusing and raise ethical issues. All these were compounded by language barriers, making their work environment extremely complex and stressful. CONCLUSIONS These findings illuminate complex challenges that could limit access to, uptake, and delivery of health screening and undermine public health goals, and highlight the need for a multilevel approach. This entails avoiding the conflation of migration with health issues, harmonizing existing policies to make health care services more accessible and acceptable to migrants, and facilitating health professionals' work in promoting public health, improving interagency collaboration and the skills of all staff involved in understanding and effectively responding to migrants' needs, and improving migrants' health literacy through community outreach interventions.
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Affiliation(s)
- Faustine K Nkulu Kalengayi
- Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Umeå, Sweden;
| | - Anna-Karin Hurtig
- Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Clas Ahlm
- Department of Clinical Microbiology, Division of Infectious Diseases, Umeå University, Umeå, Sweden
| | - Beth M Ahlberg
- Department of Women's and Child Health, Uppsala University, Uppsala, Sweden.,Skaraborg Institute for Research and Development, Skövde, Sweden
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