RESUMO
Phenomenon: There is now broad acceptance that the development of cross-cultural competence (CCC) supports the delivery of appropriate care to diverse groups and is an essential component in medical education worldwide. CCC training in East Asian contexts has been constrained by the fact that "cultural diversity" training globally has focused primarily on the needs of racial and ethnic communities, to the relative neglect of other groups. The present study explores Taiwanese students' perceptions of CCC provision to identify gaps in local medical education and thus facilitate a more systematic delivery of CCC. Approach: Using an adapted and translated version of the Cross-Cultural Care Survey developed by Harvard Medical School, we collected 1567 student responses from four geographically-distributed Taiwanese medical schools between 2015 and 2017. In addition to student responses, we also collected 122 clinical teacher responses from two of the four medical schools that were surveyed to cross-examine the students' self-perceived competence. The data were analyzed with SPSS and ANOVA was employed with student data to compare the differences among different stages. The analysis focuses on CCC in 4 stages of training: general education, basic pre-clinical and integrated clinical sciences, clerkship, and internship. Findings: The findings show that students felt unprepared to deal with health disparities and the needs of diverse groups and there was no evidence of an increased sense of preparedness in the development of relevant skills in the analyses of the pre-clinical to clinical stages of the curriculum. Similarly, teachers also perceived students across the different stages of training to be unprepared in dealing with the health disparities and needs of diverse groups. However, although findings from teachers' responses parallel those from students, teachers tend to perceive students to be even more unprepared than they perceive themselves to be. The training for CCC appeared inadequate from both set of data and students perceive CCC training to be less explicitly evident in the medical program as it advances from the foundation stage to the pre-clinical stage. Insights: The study raises some crucial issues in terms of diversity and CCC training in medical education programs. The fact that increased awareness of health disparities and the needs of diverse groups fails to be aligned with a sense of preparedness and skillfulness confirms that CCC has not been explicitly and sufficiently addressed in the medical curriculum, particularly in the pre-clinical stage when the focus is on acquiring scientific and technical knowledge. This study shows how a questionnaire designed by and for an American medical institution situated in a highly diverse society can be adapted so that its findings serve as a baseline for medical education programs in Taiwan, and perhaps in other countries that are beginning to acknowledge hitherto "hidden" diversity. This study also has implications which indicate that CCC is crucial in the delivery of appropriate care by members of the medical profession to diverse patients.
Assuntos
Educação Médica , Estudantes de Medicina , Competência Cultural , Diversidade Cultural , Assistência à Saúde Culturalmente Competente , Currículo , HumanosRESUMO
High rates of mental health problems in adolescents have been well documented; less is known about elementary school children in disadvantaged communities. We examined emotional and behavioral health needs in 202 third and fourth graders enrolled in a charter school in a largely Hispanic community. The child-reported Revised Child Anxiety and Depression Scale-25 and Teacher's Report Form were used to evaluate mental health needs as perceived by these children and their teachers. The prevalence of teacher-reported depression and child self-reported anxiety was 7.0% and 6.67%, respectively. Living in a single parent household was found to be a specific risk factor in that those children had higher rates of emotional and behavioral problems than children living with both parents. Evidence of higher depression and anxiety identified in this sample compared to national representative data suggests the need for development of culturally sensitive early prevention and intervention in this underserved community.
Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Hispânico ou Latino/psicologia , Avaliação das Necessidades/estatística & dados numéricos , Populações Vulneráveis/psicologia , Transtornos de Ansiedade/psicologia , California/epidemiologia , Criança , Transtorno Depressivo/psicologia , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Área Carente de Assistência Médica , Inquéritos e Questionários , Populações Vulneráveis/estatística & dados numéricosRESUMO
The practice of lying to one's children to encourage behavioral compliance was investigated among parents in the US (N = 114) and China (N = 85). The vast majority of parents (84% in the US and 98% in China) reported having lied to their children for this purpose. Within each country, the practice most frequently took the form of falsely threatening to leave a child alone in public if he or she refused to follow the parent. Crosscultural differences were seen: A larger proportion of the parents in China reported that they employed instrumental lie-telling to promote behavioral compliance, and a larger proportion approved of this practice, as compared to the parents in the US. This difference was not seen on measures relating to the practice of lying to promote positive feelings, or on measures relating to statements about fantasy characters such as the tooth fairy. Findings are discussed with reference to sociocultural values and certain parenting-related challenges that extend across cultures.
Assuntos
Enganação , Relações Pais-Filho , Poder Familiar/etnologia , Poder Familiar/psicologia , Criança , China , Comparação Transcultural , Feminino , Humanos , Masculino , Estados UnidosRESUMO
The aim of the current study was to investigate whether optimism and self-efficacy mediated the association between shyness and subjective well-being in a sample of Chinese working adults. Two hundred and eight participants completed the Revised Cheek and Buss Shyness Scale, Life Orientation Rest-Revised, Satisfaction with Life Scale, and Positive and Negative Affect Scale. Structural equation modeling results showed that optimism mediated the relationship between shyness and measures of subjective well-being (life satisfaction, positive and negative affect). Self-efficacy mediated the association between shyness and positive subjective well-being (life satisfaction and positive affect). These results suggest that optimism and self-efficacy play unique mediating roles in the relationship between shyness and subjective well-being. They also have important implications for the development of intervention programs aimed at promoting subjective well-being of Chinese working adults through enhancing self-efficacy and optimism.