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An Immersive Virtual Reality Simulation for Cross-Cultural Communication Skills: Development and Feasibility. Clin Simul Nurs 2023. [DOI: 10.1016/j.ecns.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Zhang H, Wu Y, Sun W, Li W, Huang X, Sun T, Wu M, Huang Z, Chen S. How does people-centered integrated care in medical alliance in China promote the continuity of healthcare for internal migrants: The moderating role of respect. Front Public Health 2023; 10:1030323. [PMID: 36684939 PMCID: PMC9845872 DOI: 10.3389/fpubh.2022.1030323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023] Open
Abstract
Background Continuity is crucial to the health care of the internal migrant population and urgently needs improvements in China. Chinese government is committed to promoting healthcare continuity by improving the people-centered integrated care (PCIC) model in medical alliances. However, little is known about the driving mechanisms for continuity. Methods We created the questionnaire for this study by processes of a literature research, telephone interviews, two rounds of Delphi consultation. Based on the combination of quota sampling and judgment sampling, we collected 765 valid questionnaires from developed region and developing region in Zhejiang Province. Structural equation models were used to examined whether the attributes of PCIC (namely coordination, comprehensiveness, and accessibility of health care) associated with continuity, and explored the moderated mediating role of respect. Results The result of SEM indicated that coordination had direct effect on continuity, and also had mediating effect on continuity via comprehensiveness and accessibility. The hierarchical linear regression analysis showed that the interactive items of coordination and respect had a positive effect on the comprehensiveness (β = 0.132), indicating that respect has positive moderating effect on the relationship between coordination and comprehensiveness. The simple slope test indicated that in the developed region, coordination had a significant effect on comprehensiveness for both high respect group(β = 0.678) and low respect group (β = 0.508). The moderated mediation index was statistically significant in developed areas(β = 0.091), indicating that respect had moderated mediating effect on the relationship between coordination and continuity via comprehensiveness of healthcare in the developed region; however, the moderated mediation effect was not significant in the developing region. Conclusion Such regional differences of the continuity promoting mechanism deserve the attention of policy-makers. Governments and health authorities should encourage continuity of healthcare for migrants through improving the elements of PCIC-coordination, comprehensiveness and accessibility of healthcare, shaping medical professionalism of indiscriminate respect, and empowering migrants to have more autonomy over selection of services and decisions about their health.
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Affiliation(s)
- Hao Zhang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yan Wu
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Wei Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Wuge Li
- Department of Clinical Medicine, School of Clinical Medicine, Hangzhou Medical College, Hangzhou, China
| | - Xianhong Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Tao Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Mengjie Wu
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhen Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shanquan Chen
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Wu J, Liu R, Shi L, Zheng L, He N, Hu R. Association between resident status and patients' experiences of primary care: a cross-sectional study in the Greater Bay Area, China. BMJ Open 2022; 12:e055166. [PMID: 35338060 PMCID: PMC8961107 DOI: 10.1136/bmjopen-2021-055166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Patients' experiences are important part of health services quality research, but it's still unclear whether patients' experiences are influenced by resident status. This study aimed to evaluate the association between resident status and patients' primary care experiences with the focus on migrants vs local residents. DESIGN A cross-sectional study using multistage cluster random sampling was conducted from September to November 2019. The data were analysed using general linear models. SETTING Six community health centres in Guangzhou, China. PARTICIPANTS 1568 patients aged 20 years or older. MAIN OUTCOME MEASURES Patients' primary care experiences were assessed using the Primary Care Assessment Tool. The 10 domains included in Primary Care Assessment Tool (PCAT) refers to first contact-utilisation, first contact-access, ongoing care, coordination (referral), coordination (information), comprehensiveness (services available), comprehensiveness (services provided), family-centredness, community orientation and cultural competence from patient's perspective. RESULTS 1568 questionnaires were analysed. After adjusting for age, sex, education, annual family income, self-perceived health status, chronic condition, annual medical expenditure and medical insurance, the PCAT total scores of the migrants were significantly lower than those of local residents (β=-0.128; 95% CI -0.218 to -0.037). Migrants had significantly lower scores than local residents in first contact utilisation (β=-0.245; 95% CI -0.341 to -0.148), ongoing care (β=-0.175; 95% CI -0.292 to -0.059), family-centredness (β=-0.112; 95% CI -0.225 to 0.001), community orientation (β=-0.176; 95% CI -0.286 to -0.066) and cultural competence (β=-0.270; 95% CI -0.383 to -0.156), respectively. CONCLUSION Primary care experiences of migrants were significantly worse off than those of local residents, especially in terms of primary care utilisation, continuity and cultural competence. Given the wide disparity in primary care experiences between migrants and local residents, Chinese healthcare system reform should focus on improving quality of primary care services for migrants, overcoming language barriers and creating patient-centred primary care services.
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Affiliation(s)
- JingLan Wu
- Department of Health Management, Sun Yat-Sen University School of Public Health, Guangzhou, Guangdong, China
| | - RuQing Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, Sun Yat-Sen University School of Public Health, Guangzhou, Guangdong, China
| | - Leiyu Shi
- Department of Health Policy & Management, School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lingling Zheng
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Ning He
- Department of Health Management, Sun Yat-Sen University School of Public Health, Guangzhou, Guangdong, China
| | - Ruwei Hu
- Department of Health Management, Sun Yat-Sen University School of Public Health, Guangzhou, Guangdong, China
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Adhikari M, Kaphle S, Dhakal Y, Duwadi S, Subedi R, Shakya S, Tamang S, Khadka M. Too long to wait: South Asian migrants' experiences of accessing health care in Australia. BMC Public Health 2021; 21:2107. [PMID: 34789215 PMCID: PMC8596381 DOI: 10.1186/s12889-021-12132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrants settling in a new country experience multiple complexities in navigating health care systems and adapting to a new way of life in the host country. In South Asia, migrating to another country for better life opportunities has been an ongoing trend and migration to Australia has significantly increased in recent years. Lower utilisation of health services and higher risks of chronic diseases among South Asian migrants poses a continuing challenge for the Australian health care system and little is known about why this demographic group does not access health services at the same rate. This study aimed to explore factors influencing access to health care by South Asian migrants in Australia. METHODS Using a mixed-method design, we conducted 62 online survey and 14 in-depth interviews with participants from four South Asian countries: Nepal, India, Bhutan, and Sri Lanka. Participants were recruited using a purposive snowball sampling approach following a standard ethical approval process. Survey data were analysed descriptively in SPSS and interview data were recorded, transcribed, and analysed thematically. RESULTS South Asian migrants experienced various complexities while accessing health services in Australia. The findings of this study highlighted a number of negative factors influencing their experiences of accessing health care: long waiting times for public health care, the expense of private health care, and communication problems due to socio-cultural differences. South Asian migrants also expressed their concern for a greater investment of resources into public health care to enable them to access quality and affordable care in these settings. CONCLUSIONS Given limited evidence available to help understand factors leading to the lower utilisation of health care and higher risks of chronic diseases among South Asian migrants, this study plays an important role in highlighting social, cultural, financial, and institutional factors that are critical to designing appropriate health-care strategies. This study recommends incorporating a collaborative and culturally competent model of care to increase access to health care and thereby help reduce existing disparities in health outcomes among South Asian migrant populations.
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Affiliation(s)
- Manju Adhikari
- LA GRANDEE International College, Pokhara Metropolitan City, Province 4 Nepal
| | | | - Yamuna Dhakal
- Central Queensland University, Melbourne, VIC Australia
| | - Sabina Duwadi
- Central Queensland University, Melbourne, VIC Australia
| | - Rajan Subedi
- Central Queensland University, Melbourne, VIC Australia
| | - Sonu Shakya
- Central Queensland University, Melbourne, VIC Australia
| | - Sunil Tamang
- Central Queensland University, Melbourne, VIC Australia
| | - Mukesh Khadka
- Central Queensland University, Melbourne, VIC Australia
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Effectiveness of Virtual Simulation to Enhance Cultural Competence in Pre-licensure and Licensed Health Professionals: A Systematic Review. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chae D, Kim Y, Ryu J, Asami K, Kim J, Kim K. E-learning cultural competence for public health workers: A feasibility and pilot study. Public Health Nurs 2021; 38:897-906. [PMID: 34019724 DOI: 10.1111/phn.12923] [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: 03/31/2021] [Accepted: 04/21/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To describe the development, feasibility, and preliminary efficacy of a seven-module e-learning for enhancing cultural competence of public health workers. DESIGN The study was based on the framework of the new Medical Research Council; a mixed methods design was used. SAMPLE A four-week pilot cluster-randomized controlled trial was conducted with 39 public health workers and 74 migrants in South Korea. Feasibility and preliminary efficacy were assessed according to initiation, retention, adherence, usability, acceptability, individual and organizational cultural competence, and migrant trust and satisfaction. Quantitative data were collected at baseline, 4 weeks, and 12 weeks. Focus group interviews were conducted with eight public health workers at 12 weeks. RESULTS Initiation, retention, and adherence rates were high. Participants agreed on acceptability, but exhibited mixed results on usability. Participants were satisfied with "well-structured content," "authentic case stories and videos," "increased interest in migrant care," and "opportunity for self-reflection." However, "flawless and trouble-free system," "screen design for easy navigation," "instructor's expertise," and "more situational cases and videos" were desired. Statistically significant differences were observed for individual cultural competence, migrant trust, and satisfaction. CONCLUSION Generally, the intervention seems feasible and has preliminary efficacy, yet usability improvement is necessary for full-scale randomized controlled trials.
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Affiliation(s)
- Duckhee Chae
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Yunekyong Kim
- Department of Nursing, Masan University, Changwon, South Korea
| | - Jeeheon Ryu
- Department of Education, Chonnam National University, Gwangju, South Korea
| | - Keiko Asami
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Jaseon Kim
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Kukhyeon Kim
- Department of Education, Chonnam National University, Gwangju, South Korea
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Chae D, Park Y, Kang K, Kim J. A multilevel investigation of cultural competence among South Korean clinical nurses. Scand J Caring Sci 2019; 34:613-621. [PMID: 31613997 DOI: 10.1111/scs.12760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/26/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is lack of empirical evidence on whether organisational variables affect the cultural competence of nurses. AIM This study aimed to investigate individual and organisational characteristics associated with South Korean clinical nurses' cultural competence. METHODS A descriptive cross-sectional research design was used. A convenient sample of 401 clinical nurses from 21 hospitals in South Korea was recruited between November 2015 and February 2016. Multilevel modelling was used to estimate the effects of individual- and organisation-level predictors. Data were analysed using the nlme package in R. RESULTS Multilevel modelling indicated that professionalism (β = 0.02, p < 0.001) and foreign language fluency (β = 0.25, p = 0.012) were significant individual-level predictors. Education on foreign patient care was marginally significant at p = 0.069. At the organisational level, nurse-to-patient ratio (β = 0.37, p = 0.038) and organisational cultural competence (β = 0.02, p < 0.001) were significant predictors. In addition, hospital ownership and work environment were marginally significant at p = 0.054 and p = 0.050, respectively. Furthermore, there was a significant cross-level interaction between professionalism and hospital ownership (β = 0.03, p = 0.003). CONCLUSION To provide culturally competent care, nurse leaders should recognise the importance of organisational-level factors, such as nurse staffing and organisational cultural competence, and create an environment that is inclusive of diverse patients, as well as promote professionalism among individual nurses.
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Affiliation(s)
- Duckhee Chae
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Yunhee Park
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, South Korea
| | - Kyeonghwa Kang
- Division of Nursing, Hallym University, Chuncheon, South Korea
| | - Jongdae Kim
- Business School, Seoul National University, Seoul, South Korea
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Kaihlanen AM, Hietapakka L, Heponiemi T. Increasing cultural awareness: qualitative study of nurses' perceptions about cultural competence training. BMC Nurs 2019; 18:38. [PMID: 31440116 PMCID: PMC6704569 DOI: 10.1186/s12912-019-0363-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/16/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nowadays, healthcare professionals worldwide deliver care for increasing numbers of culturally and linguistically diverse patients. The importance of cultural competence is evident in terms of the quality of healthcare, and more knowledge is needed about different educational models and approaches that aim to increase cultural competence. This study examines the perceptions of nurses about the content and utility of cultural competence training that focuses on increasing awareness of one's own cultural features. METHODS The training was conducted at one primary care hospital in southern Finland. Participants were registered nurses (n = 14) and practical nurses (n = 6) from different hospital units. Four 4-h training sessions-including lectures, discussions and short web-based learning tasks-were arranged during a four-week period. Semi-structured, small group interviews were conducted with 10 participants to examine their perceptions about the content and utility of the training. Qualitative content analysis with a conventional approach was used to analyse the data. RESULTS Perceptions about the training were divided into three main categories: general utility of the training, personal utility of the training, and utility of the training for patients. General utility pertains to the general approach that the training provided on cross-cultural care, the possibility to initiate an open discussion, and the opportunity to improve current practices. Personal utility pertains to the opportunity to become aware of one's own cultural features, to change one's way of thinking, to obtain a new perspective on one's own communication practices and to receive justification for carrying out particular workable practices. Utility for patients pertains to fostering better awareness and acknowledgement of patients' differing cultural features and an increased respect in healthcare delivery. Additionally, the quality of the training was highlighted, and suggestions for improvement were offered. CONCLUSION Training that increases healthcare professionals' awareness of their own cultural features was perceived as useful and thought-provoking. Increased awareness might facilitate the communication between healthcare professionals and patients, which is a crucial component of quality healthcare. It seems that in the future, training opportunities that allow larger groups to participate are needed, regardless of the time and place, and utilising the potential of e-learning should be considered.
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Affiliation(s)
- Anu-Marja Kaihlanen
- National Institute of Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Laura Hietapakka
- National Institute of Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Tarja Heponiemi
- National Institute of Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
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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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Rifai E, Janlöv AC, Garmy P. Public health nurses' experiences of using interpreters when meeting with Arabic-speaking first-time mothers. Public Health Nurs 2018; 35:574-580. [PMID: 30225947 DOI: 10.1111/phn.12539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/29/2018] [Accepted: 07/09/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to investigate public health nurses' experiences of using interpreters when meeting with Arabic-speaking first-time mothers. DESIGN AND SAMPLE An inductive qualitative design was used. Individual interviews were conducted with Swedish public health nurses (n = 11) with experience of working in child health care with interpreters when meeting with Arabic-speaking first-time mothers. MEASURES Data were analyzed using qualitative content analysis. RESULTS The analysis of the interviews resulted in one overarching theme: Having to accept and learn to incorporate interpreters when meeting with Arabic-speaking first-time mothers. Three subthemes were identified: (a) enabling an understanding of the situation of the mothers; (b) contributing to a trustful relationship; and (c) creating disturbing elements in the dialogue. CONCLUSIONS Using interpreters optimized the conversation between the public health nurse and the Arab-speaking first-time mother; however, the complexity of using interpreters was also apparent.
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Affiliation(s)
- Elissa Rifai
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| | | | - Pernilla Garmy
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden.,Department of Health Science, Clinical Health Promotion Center, Lund University, Lund, Sweden
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