An international cross-cultural study of nursing students' perceptions of caring

BACKGROUND

Single studies suggest that nursing students perceive caring as more an instrumental than expressive behaviour and indicate some differences between caring perceptions in junior and senior nursing students. However, there are limited studies investigating caring perceptions in nursing students across multiple cultures.

OBJECTIVE

To determine perceptions of caring in Slovene, Croatian, Chinese and Russian nursing students and explore whether there are statistically significant differences in perceptions of caring between countries and between first and third-year nursing students.

DESIGN

A cross-sectional descriptive study design was used.

SETTINGS AND PARTICIPANTS

The study included 604 nursing students enrolled in first and third year in seven different nursing faculties in four countries: Slovenia; China; Croatia; and the Russian Federation.

METHODS

The 25-item Caring Dimension Inventory (CDI-25) was used to measure caring perceptions. We also included demographic questions regarding age, gender, country, year of study and type of study. Demographic data were analysed using descriptive analysis while a two-way analysis of variance (ANOVA) adjusted for unequal sample sizes was performed together with a post hoc analysis of the results.

RESULTS

The results of two-way ANOVA showed that both main effects (country and year of study) were statistically significant, as well as their interaction at the 0.05 significance level. The main effect for country was F(3, 596) = 3.591, p < 0.0136 indicating a significant difference in CDI-25 between Slovenia (M = 108.9, SD = 9.2), Russian Federation (M = 107.1, SD = 8.2), China (M = 102.8, SD = 9.7) and Croatia (M = 110.0, SD = 8.6).

CONCLUSIONS

Perceptions of caring in nursing students differ across countries, probably due to different educational systems, curricula, cultural differences and societal values. Implementing caring theories in nursing curricula could help students to cultivate caring during their education.

Observations on Osteoporosis in Three Generations of Descendants of Holocaust Survivors

Throughout history, studies on episodes of famine have led to the discovery of metabolic abnormalities and hormonal aberrations as well as an increased incidence of cancer and mental health conditions. Starvation during early life is thought to nfluence the programming of childhood and adult bone metabolism, which may result in poor bone health in later life. This observational case series includes a small group (with no control group) of famine-exposed Holocaust survivors and their descendants. We proposed an investigational mechanism to determine any association between starvation and osteoporosis, both in the individual survivors and in their descendants.

Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study

BACKGROUND

Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the U.S.A., limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further.

METHOD

Data were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data.

RESULTS

The analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p<0.001). However, the findings varied significantly across countries, with the difference being significant only in the U.K., where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59–4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event.

CONCLUSIONS

These results do not support the notion that religious and spiritual life views enhance psychological well-being.

Hierarchization and segmentation of informal care markets in Slovenia

The article is the result of qualitative research of informal care markets in Slovenia in the field of childcare, elder care, and cleaning. The author assesses Slovenia's position in the “global care chain” and finds that “local care chains” prevail in the field of childcare and elder care, while a co-occurrence of female gender, “other” ethnicity, and poverty is typical in the field of household cleaning. The main emphasis of the article is on the analysis of hierarchization of the informal market of care work according to following two criteria: social reputation of individual type of care work and citizenship status of care workers.

Social policies related to parenthood and capabilities of Slovenian parents

We apply Sen's capability approach to evaluate the capabilities of Slovenian parents to reconcile paid work and family in the context of the transition to a market economy. We examine how different levels of capabilities together affect the work–life balance (WLB) of employed parents. We combine both quantitative and qualitative methodological approaches. The results of our quantitative and qualitative research show that increased precariousness of employment and intensification of work create gaps between the legal and normative possibilities for successful reconciliation strategies and actual use of such arrangements in Slovenia. The existing social policies and the acceptance of gender equality in the sphere of paid work enhance capabilities for reconciliation of paid work and parenthood, whereas the intensification of working lives, the dominance of paid work over other parts of life, and the acceptance of gender inequalities in parental and household responsibilities limit parents’ capabilities to achieve WLB.

Work, family, and managerial attitudes and practices in the European workplace: comparing Dutch, British, and Slovenian financial sector managers

Managers are key actors shaping employees’ capabilities to utilize work–life policies. However, most research on managers’ implementation of these policies has been conducted in liberal welfare states and ignores the impact of institutional context. In this study, we situate managers within specific workplace and national layers of context. We investigated how managers in financial organizations in the Netherlands, UK, and Slovenia talk about the utilization of work–life policies. Managers’ discourses stressed disruption and dependency considerations in these case studies, as in the US research. However, a further management discourse of the moral case or right thing to do also emerged. The lack of resources for replacing staff on leave creates disruption and reduces managers capability to support the use of work–life policies, even when they are statutory or if managers are inclined be supportive (dependency or moral argument). This is likely to impact on parents' capabilities.

INHA promoter polymorphisms are associated with premature ovarian failure

Inhibin is an important glycoprotein that is involved in folliculogenesis. INHA, the gene encoding the inhibin alpha subunit, was recently proposed as a candidate for premature ovarian failure (POF), a syndrome that leads to the cessation of ovarian function under the age of 40 years. 70 POF patients and 70 controls were screened for the previously identified INHA -16C>T transition mutation. The T allele was found in 31/70 (44.3%) of controls, but only 18/70 (25.7%) of POF patients. This result indicates that the T allele is significantly underrepresented in the POF patient population (Fisher's exact test, two-tail: P = 0.033). Sequence analysis of the INHA promoter in 50 POF patients and 50 controls identified a highly polymorphic imperfect TG repeat at approximately -300 bp, that consisted of four common haplotypes (A, B, C and D). The -16T allele is linked to the shortest repeat haplotype (haplotype C). Despite the association between haplotype C and POF, no significant difference was found between the promoter activity of a luciferase reporter construct containing haplotype C, and most of the other haplotypes tested. Interestingly, haplotype B failed to show any promoter activity. We conclude that the inheritance of specific INHA promoter haplotypes predispose to the development of premature ovarian failure.

Distribution of surnames and linguistic-cultural identities of the Slovenian and German minorities of northeastern Italy

In this study we have compared the structure of surnames of Slovenian and German (Carinthian) minorities of northeastern Italy with other municipalities of the neighbourhood. The analysis has been carried out by using estimates of the similarities between populations and the topological representation obtained by them, as well as the spatial autocorrelation. On the whole, this research shows some distinctions which depend on the territorial geography, especially in the mountainous area. Moreover, movements of individuals in the limited zones of the plain are evident, probably due to socioeconomic conditions, the moving of the people and their change of dwelling. Finally, it is probable that different Slovenian dialects generated characteristic structures of surnames which were well preserved in the most peripherical municipalities of the territory.

An evaluation of patient satisfaction amongst family practice patients with diverse ethnic backgrounds

OBJECTIVE

The aim of this study was to examine the impact of patients' ethnic diversity on the patient satisfaction rates.

DESIGN

We used the methodology developed in an international EUROPE study. The patients were asked to fill in self-administered questionnaires on their evaluations of the care received in the year prior to the survey. The instrument consists of 23 questions regarding specific family physicians' tasks evaluated on a 5 point Likert scale.

SETTING

Primary care practices of the National Railway Primary Health Care Services in Slovenia.

STUDY PARTICIPANTS

A questionnaire was handed out to 600 patients cared for by 10 physicians.

MAIN OUTCOME MEASURES

Percentages of highly satisfied patients in groups of patients with different ethnic backgrounds.

RESULTS

We achieved 65.7% response rate. The overall satisfaction was lower in non-Slovenian patients, however was not significant (83.6 vs. 85.8 points, p = NS). Non-Slovenian patients were less satisfied with regard to: "quick relief of their symptoms", "helping them to feel well so as to be able to perform their normal daily activities", physicians'"thoroughness" and their explanations concerning what the patients wanted to know about their symptoms and/or illness. In a multivariate analysis Slovenian nationality predicted higher patient satisfaction with the clinical "performance" of physicians.

CONCLUSIONS

As family practice remains an important source of primary health care for all patients, the providers should address the needs of all members of society regardless their social or cultural background. Undergraduate and postgraduate curricula have to address communication skills emphasising cultural differences.