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1.
Psychiatr Psychol Law ; 31(2): 189-215, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38628247

RESUMO

Risk assessment instruments are used to estimate risk of recidivism and aid in decision-making and treatment planning. However, many of these instruments, including the Level of Service/Risk, Need, Responsivity (LS/RNR), are validated on predominantly Western populations, and research has questioned whether the factors included in the LS/RNR adequately capture the experiences and needs of non-Western communities, including Aboriginal and Torres Strait Islanders. The current study aimed to canvas the opinions of Aboriginal and Torres Strait Islander community justice workers as to the suitability of the LS/RNR for use with this population. A general qualitative methodology was adopted to gain in-depth information through the facilitation of a focus group, and data were analysed thematically. Whilst participants agreed that the LS/RNR risk factors are relevant to Aboriginal and Torres Strait Islander offenders, they reported that the instrument did not adequately capture relevant culturally specific considerations and made suggestions to improve the LS/RNR.

2.
Law Hum Behav ; 47(1): 1-11, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36931845

RESUMO

Police killings of Black civilians have brought unprecedented attention to racial and ethnic discrimination in the criminal justice and legal systems. However, these topics have been underexamined in the field of law-psychology, both in research and forensic-clinical practice. We discuss how a racial justice framework can provide guidance for advancing psycholegal research and forensic-clinical practice related to race, ethnicity, culture, and their intersections. A racial justice framework centers the goal of increasing fair and responsive treatment and just outcomes for the most vulnerable populations involved with the criminal justice, legal, and carceral systems and ending existing disparities. We argue that the framework should include the use of transparent nonobjectivity, in which racial justice is an explicit and acknowledged goal of research and practice that exists alongside a commitment to open and rigorous science and evidence-based practice. We then use the racial justice framework as a backdrop for discussing the articles and broader themes that appear in the special issue, which include racial biases in policing, public views of the police and use of force, expanding research on racial bias in lay judgments, understanding disparities in sentencing and corrections, and improving forensic practice. Finally, we look to the future, discussing practices and perspectives that can facilitate a racial justice approach in psycholegal research and forensic-clinical practice. Our recommendations include engaging in reflexivity and addressing positionality; expanding research questions and methods, especially qualitative and community-based participatory action research; centering and engaging with communities of color; greater emphasis on intersectionality; shifting toward structural and adaptive interventions; and greater integration of work from other fields. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Psicologia Forense , Aplicação da Lei , Humanos , Direito Penal , Polícia , Etnicidade , Justiça Social
3.
Psychol Assess ; 35(6): 484-496, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36862455

RESUMO

The use of statistical learning methods has recently increased within the risk assessment literature. They have primarily been used to increase accuracy and the area under the curve (AUC, i.e., discrimination). Processing approaches applied to statistical learning methods have also emerged to increase cross-cultural fairness. However, these approaches are rarely trialed in the forensic psychology discipline nor have they been trialed as an approach to increase fairness in Australia. The study included 380 Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander males assessed with the Level of Service/Risk Needs Responsivity (LS/RNR). Discrimination was assessed through the AUC, and fairness was assessed through the cross area under the curve (xAUC), error rate balance, calibration, predictive parity, and statistical parity. Logistic regression, penalized logistic regression, random forest, stochastic gradient boosting, and support vector machine algorithms using the LS/RNR risk factors were used to compare performance against the LS/RNR total risk score. The algorithms were then subjected to pre- and postprocessing approaches to see if fairness could be improved. Statistical learning methods were found to produce comparable or marginally improved AUC values. Processing approaches increased several fairness definitions (namely xAUC, error rate balance, and statistical parity) between Aboriginal and Torres Strait Islanders and non-Aboriginal and Torres Strait Islanders. The findings demonstrate that statistical learning methods may be a useful approach to increasing the discrimination and cross-cultural fairness of risk assessment instruments. However, both fairness and the use of statistical learning methods encompass significant trade-offs that need to be considered. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Comparação Transcultural , Medição de Risco , Estatística como Assunto , Humanos , Masculino , Austrália , Povos Indígenas , Medição de Risco/etnologia , Medição de Risco/estatística & dados numéricos
4.
Psychiatr Psychol Law ; 29(2): 223-240, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35755149

RESUMO

The workplace challenges of correctional officers have been well documented. Yet little is known about how such stressors impact the wellbeing of correctional officers from minority cultural-subgroups. This study explored Indigenous Australian correctional officers' social and emotional wellbeing (SEWB) when managing workplace adversity. Specifically, the study sought to identify culturally-specific stressors, protective factors and associated response tendencies to gain a more robust understanding of the factors that impact Indigenous officers' wellbeing in the workplace. In total, 15 Indigenous Australian correctional officers from the Northern Territory participated in the study through focus groups or semi-structured interviews. Thematic analysis of participant data revealed that Indigenous correctional officers' SEWB is influenced by four broad categories: cultural connection, morale, social functioning and somatic health. Results are discussed in terms of common themes, future research and implications for assisting the SEWB of Indigenous officers.

5.
Law Hum Behav ; 46(3): 214-226, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35604707

RESUMO

OBJECTIVE: Cross-cultural research into risk assessment instruments has often identified comparable levels of discrimination. However, cross-cultural fairness is rarely addressed. Therefore, this study explored the discrimination and fairness of the Level of Service/Risk, Need, Responsivity (LS/RNR) within a sample of Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander males. HYPOTHESES: We hypothesized that discrimination would not be significantly different for Aboriginal and Torres Strait Islander individuals and non-Aboriginal and Torres Strait Islander individuals. We further hypothesized that some fairness definitions would be unsatisfied. METHOD: The study included 380 males (Aboriginal and Torres Strait Islander, n = 180) from Australia. Discrimination was assessed with the area under the curve (AUC) and cross AUC (xAUC). To determine fairness, error rate balance, calibration, predictive parity, and statistical parity were used. RESULTS: The discrimination of the LS/RNR was not statistically different (p = .61) between groups. The xAUC identified disparities (p < .001), with the LS/RNR being unable to discriminate between Aboriginal and Torres Strait Islander nonreoffenders and non-Aboriginal and Torres Strait Islander reoffenders (xAUC = .46, 95% CI [.35, .57]). Disparities among certain fairness definitions were identified, with Aboriginal and Torres Strait Islander individuals scoring higher on the LS/RNR (d = 0.52) and nonreoffenders being classified as high risk more often. CONCLUSIONS: The findings suggest that the LS/RNR may not be a cross-culturally fair risk assessment instrument for Australian individuals, and standard discrimination indices with comparable levels do not imply that a risk assessment instrument is cross-culturally fair. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Serviços de Saúde do Indígena , Austrália , Comparação Transcultural , Feminino , Humanos , Masculino , Havaiano Nativo ou Outro Ilhéu do Pacífico , Gravidez , Grupos Raciais
6.
Australas Psychiatry ; 30(4): 486-489, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35089063

RESUMO

OBJECTIVE: With increasing levels of cultural diversity, it is important that mental health services are relevant and accessible to new migrant populations. Efforts have been made to bring attention to the unique experiences and needs of culturally and linguistically diverse (CALD) sub-groups in clinical settings, resulting in various frameworks and professional development workshops. While some of these strategies have raised awareness and persuaded service providers to accommodate different populations, few are effective and genuinely impact consumer outcomes. CONCLUSION: This paper proposes an integrated cross-cultural assessment framework comprising both clinical and organisational components to improve cross-cultural clinical encounters and consumer satisfaction. The framework underscores the importance of the therapeutic alliance through the building of rapport and trust. Moreover, the framework is designed to be organisationally feasible, and locally and practically oriented.


Assuntos
Comparação Transcultural , Diversidade Cultural , Humanos
7.
J Pers Assess ; 104(2): 252-264, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35061555

RESUMO

The HCR-20V3 is a violence risk assessment tool that is widely used in forensic clinical practice for risk management planning. The predictive value of the tool, when used in court for legal decision-making, is not yet intensively been studied and questions about legal admissibility may arise. This article aims to provide legal and mental health practitioners with an overview of the strengths and weaknesses of the HCR-20V3 when applied in legal settings. The HCR-20V3 is described and discussed with respect to its psychometric properties for different groups and settings. Issues involving legal admissibility and potential biases when conducting violence risk assessments with the HCR-20V3 are outlined. To explore legal admissibility challenges with respect to the HCR-20V3, we searched case law databases since 2013 from Australia, Canada, Ireland, the Netherlands, New Zealand, the UK, and the USA. In total, we found 546 cases referring to the HCR-20/HCR-20V3. In these cases, the tool was rarely challenged (4.03%), and when challenged, it never resulted in a court decision that the risk assessment was inadmissible. Finally, we provide recommendations for legal practitioners for the cross-examination of risk assessments and recommendations for mental health professionals who conduct risk assessments and report to the court. We conclude with suggestions for future research with the HCR-20V3 to strengthen the evidence base for use of the instrument in legal contexts.


Assuntos
Gestão de Riscos , Violência , Austrália , Previsões , Psiquiatria Legal , Humanos , Medição de Risco/métodos , Violência/psicologia
8.
J Interpers Violence ; 37(7-8): NP4341-NP4371, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-32946303

RESUMO

Child maltreatment research is increasingly recognizing the need to capture patterns of co-occurrence between different types of abuse/neglect and to consider their associations with psychosocial functioning. Few studies have examined these issues in justice-involved youth despite the fact that rates of maltreatment and trauma-related psychopathology are disproportionately high among this population. This study examined profiles of self-reported child physical abuse, sexual abuse, emotional abuse, and neglect among incarcerated juveniles in Victoria, Australia, using latent class analysis. We also investigated associations between maltreatment profiles and mental health and behavioral problems. Data pertaining to juveniles' experiences of maltreatment and mental health and behavioral functioning were collected from interviews, questionnaires, files, and administrative datasets. A three-class solution provided the best fit for the data and was conceptually meaningful: a "low/rare maltreatment" class (41%); "high physical and emotional abuse" class (23%); and a "poly-victimization" class (36%). Youth in the "poly-victimization" class experienced especially serious mental health and behavioral disturbances, including higher rates of mental illness, greater severity of internalizing and externalizing symptoms, impulsivity, substance abuse, self-harm and suicidal behavior, irritability, and early-onset violence. Results suggest there may be benefit in considering screening and assessment procedures in youth justice settings to identify poly-victimized youth in need of more intensive monitoring and treatment to address their complex clinical and behavioral profiles.


Assuntos
Maus-Tratos Infantis , Vítimas de Crime , Prisioneiros , Adolescente , Criança , Maus-Tratos Infantis/psicologia , Vítimas de Crime/psicologia , Humanos , Abuso Físico , Prisioneiros/psicologia , Vitória/epidemiologia
9.
J Interpers Violence ; 37(9-10): NP6301-NP6328, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-33063593

RESUMO

Australia's fast-growing migrant population encompasses many groups from culturally and linguistically diverse backgrounds. It is well documented that these groups experience varying pre- and post-migratory challenges. Despite this knowledge, little is known about the extent to which these groups experience and perceive violence and how or whether they seek assistance after such incidents. It is important to identify any potential discrepancies to ensure that services can provide the most targeted supports to victims. Data were collected from the 2016 Australian Bureau of Statistics Public Safety Survey. Using chi-square tests, prevalence, experiences, and perceptions of violence occurring after the age of 15, postincident support, reporting behaviors, and health variables related to violent incidents were compared across three cultural groups arranged by region of birth: born in Australia (BIA), born overseas in main English-speaking countries (BNMESC), and born overseas in non-English-speaking countries (BOC). BOC individuals reported much lower rates of violent victimization compared to BIA and BMSEC individuals. More than two-thirds of each cultural group did not report their most recent experience of violence to police. Violence was most commonly experienced at home, although a higher proportion of BIA individuals experienced violence at an entertainment venue, and a higher proportion of BOC individuals experienced violence outside (i.e., in the street). The contribution of Alcohol/Substances was much higher for BIA and BMESC compared to BOC individuals. BOC individuals experienced more anxiety post-incident, while more BIA individuals sustained physical injuries. A similar proportion of each group sought assistance post-incident, however, more BOC individuals had never told anyone about the incident. Perceptions of the violent incident were generally similar across groups, though fewer BOC individuals perceived the incident to be a crime. Some differences were apparent across cultural groups regarding the prevalence, experiences and reporting of violent incidents. Implications and future research directions are discussed within.


Assuntos
Vítimas de Crime , Violência , Agressão , Austrália/epidemiologia , Crime , Humanos
10.
Int J Offender Ther Comp Criminol ; 66(13-14): 1432-1453, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34075798

RESUMO

African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) "What works" in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.


Assuntos
Saúde Mental , Grupo Associado , Adolescente , Austrália , Humanos , Seguridade Social
11.
J Am Acad Psychiatry Law ; 49(3): 335-337, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34330750

RESUMO

A considerable number of papers have been published on the ethics of artificial intelligence for the purposes of violence risk assessment. In this issue of The Journal, Hogan and colleagues argue that artificial intelligence introduces novel concerns for violence risk assessment that require consideration. While the concerns that have been raised are entirely valid and require consideration, we argue that artificial intelligence does not herald a more serious or unique challenge in these areas relative to other forms of violence risk assessment.


Assuntos
Inteligência Artificial , Violência , Humanos , Medição de Risco
12.
BMC Psychol ; 9(1): 63, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33906682

RESUMO

BACKGROUND: Mental ill-health can impact an individual's capacity to interact with others, make decisions, and cope with social challenges. This is of particular importance for many Culturally and linguistically diverse (CALD) individuals who may be at various stages of the acculturation process. The increasing diversity of the Australian population necessitates informed and culturally relevant services that meet the needs of a changing demographic. However the extant research on the mental health needs of CALD Australians is limited. This study aimed to further our understanding of the mental health needs of young CALD Australians by exploring the mental health concerns and social factors exhibited by CALD individuals accessing community based youth mental health services in two major cities. METHODS: We performed a series of logistic regression models to ascertain if a concert of factors (i.e., clinical, socio-economic, criminal justice system involvement, child maltreatment, social support) were associated with CALD status RESULTS: Comparisons across factors revealed no significant differences between groups. A small number of correlates differentiated between CALD and non-CALD participants (mental illness diagnosis during childhood, family history of mental illness/suicide, sensation seeking, sensitivity to punishment, maternal overprotection) however these factors were no longer meaningful after adjustment for multiple comparisons. CONCLUSIONS: In help-seeking mainstream youth populations, cultural differences across clinical and environmental factors appear to be minimal.


Assuntos
Diversidade Cultural , Transtornos Mentais , Adolescente , Austrália , Criança , Humanos , Transtornos Mentais/terapia , Saúde Mental , Inquéritos e Questionários
13.
Int J Offender Ther Comp Criminol ; 65(1): 92-99, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32524914

RESUMO

There has been an increasing interest in cross-cultural risk assessment over the past 5 years. Much of this has been driven by concerns that particular risk instruments may be biased against, or ill-suited to, non-White offending populations. A growing body of work has asserted that unique cultural-specific risk factors and experiences may not be adequately considered within current risk assessment frameworks which have led to calls to culturally alter/remodel risk instruments. While recognising the importance of generalizable risk instruments, this article outlines a number of realities that cross-cultural risk assessment researchers must contend with before embarking on projects to alter instruments. With specific regard to structured professional judgement risk instruments, the article notes that efforts to culturally amend instruments, could paradoxically reduce accuracy and increase bias.


Assuntos
Comparação Transcultural , Grupos Populacionais , Cor , Humanos , Medição de Risco , Fatores de Risco
15.
BMC Public Health ; 20(1): 710, 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-32423391

RESUMO

BACKGROUND: Approximately 1 in 5 to 1 in 6 Indigenous Australian males are currently imprisoned or have previously been imprisoned. Recent work has also pointed to a widening socio-economic gap within the Indigenous population. Given the myriad social, wellbeing and environmental risk factors associated with justice-involvement, it is conceivable that incarceration may contribute to the increasing disparities found within the Indigenous population. This study aimed to explore the presence and extent of an 'incarceration gap' within the Indigenous population and to uncover which social factors characterise the disparity. METHODS: The study utilised data from the 2014-5 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). A number of socio-economic, environmental and clinical factors were compared by life-time incarceration status. Chi-square tests were used to examine the association between incarceration status and each of the comparison variables. RESULTS: Disparities were observed within the Indigenous Australian population across a number of important health and socio-economic markers by incarceration status - the most pronounced being for educational obtainment - year 10 completion (Never incarcerated 73%, Ever incarcerated 50%), labour force participation (Never incarcerated 56%, Ever incarcerated 26%) and drug/alcohol problems (Never incarcerated 7%, Ever incarcerated 29%). Never-incarcerated Indigenous males yielded aggregate proportions across numerous variables that approximated or matched general Australian population estimates. CONCLUSIONS: There appears to be evidence for a substantial 'incarceration gap' within the Indigenous Australian population.


Assuntos
Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Prisioneiros/psicologia , Determinantes Sociais da Saúde , Adulto , Austrália/epidemiologia , Indicadores Básicos de Saúde , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Classe Social , Fatores Socioeconômicos
16.
PLoS One ; 15(5): e0229389, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469882

RESUMO

Links between crystalline methamphetamine (CM) use and criminal offending are often drawn in the media; however, there has been little scientific research into this relationship. The aim of this study was to ascertain the prevalence and correlates of lifetime CM use among a sample of young people in detention in Australia and to examine whether an association exists between lifetime CM use and recidivism in this population.The sample included 202 young people (164 males) in youth detention in the state of Victoria, Australia. Participants were administered questionnaires related to lifetime substance use and socio-environmental experiences. Lifetime mental health data and offending data were obtained for each participant from public mental health and policing databases. More than one third (38%) of the sample reported lifetime CM use. In multivariate logistic regression analyses, older age, male gender, polysubstance use, and high levels of community disorganisation were associated with CM use. The presence of a psychiatric diagnosis over the lifetime was not significantly associated with CM use. CM use was also not significantly associated with violent recidivism. Efforts to address CM use and related harm in detained youth should include community-based strategies to reduce CM use among this vulnerable population following their release from detention. However, the findings suggest that CM use on its own is unlikely to be an important consideration for professionals concerned with determining which young people should be selected for treatment designed to reduce the risk of violent recidivism.


Assuntos
Comportamento Criminoso/efeitos dos fármacos , Delinquência Juvenil/psicologia , Metanfetamina/toxicidade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Analgésicos Opioides/efeitos adversos , Austrália/epidemiologia , Cannabis/efeitos adversos , Comportamento Criminoso/fisiologia , Feminino , Medicina Legal , Humanos , Delinquência Juvenil/legislação & jurisprudência , Masculino , Saúde Mental , Abuso Físico/psicologia , Polícia/estatística & dados numéricos , Saúde Pública , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
17.
Australas Psychiatry ; 28(4): 438-441, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32438872

RESUMO

OBJECTIVE: A key challenge facing justice health service providers is addressing and treating the high rates of mental illness among offenders. It is well documented that rates of mental illness are substantially higher within prison populations compared to the general population. As such, the need to provide ongoing treatment to prisoners experiencing mental health issues is of fundamental importance. Prisoners experiencing mental health disorders are more likely to have poorer social outcomes on release, including a greater likelihood of recidivism and poorer health outcomes. The growing numbers of justice-involved individuals from culturally and linguistically diverse (CALD) backgrounds signal the need for justice systems to adapt to the changing demographic. CONCLUSIONS: In this commentary, we argue that greater efforts to explore the nature and prevalence of mental illness among CALD groups in custody, where such concerns are often intertwined with additional complex personal, environmental and historical criminogenic risk factors, are desperately needed to improve system responses and reduce recidivism.


Assuntos
Diversidade Cultural , Transtornos Mentais/epidemiologia , Prisioneiros/psicologia , Humanos , Serviços de Saúde Materna , Transtornos Mentais/terapia
18.
J Trauma Stress ; 33(5): 794-803, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32339357

RESUMO

The rates of mental illness are significantly higher in prison populations compared to the general community; however, little research has examined the rates of mental illness for cross-cultural groups of prisoners in Australia. This omission is concerning given the increasingly diverse nature of the Australian prison population. To address this gap in knowledge, the present study aimed to identify rates of key mental health factors and associated psychological processes in a cohort of 191 men from culturally and linguistically diverse, Indigenous Australian and English-speaking backgrounds who were incarcerated at a maximum-security prison in Victoria, Australia. We also explored differences in both psychological distress levels and predictors of psychological distress. Although no significant mental health differences were identified cross-culturally, the results revealed that several mental health factors predicted psychological distress for all prisoners, F(11, 147) = 33.23, p < .001, R2 = .71. The experiences of anxiety and sleep disturbance-related symptoms, ß = .34; depressive symptoms, ß = .19; posttraumatic stress disorder symptoms, ß = .25; and the use of psychological processes, such as avoidance coping, ß = .16; and engagement in cognitive fusion, ß = .15, all predicted psychological distress. The use of positive thinking as a coping strategy was found to predict a reduced level of psychological distress for prisoners, ß = -.13. The findings indicated that the mental health profiles of cross-cultural groups of prisoners are similar in nature, suggesting that justice involvement may be a more useful predictor than cultural differences concerning psychological health.


Assuntos
Transtornos Mentais/etnologia , Prisioneiros/psicologia , Angústia Psicológica , Adaptação Psicológica , Adulto , Austrália/epidemiologia , Comparação Transcultural , Humanos , Masculino , Pessoa de Meia-Idade , Prisioneiros/estatística & dados numéricos , Vitória/epidemiologia , Adulto Jovem
19.
BMC Health Serv Res ; 19(1): 135, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30808355

RESUMO

BACKGROUND: Cross-cultural educational initiatives for professionals are now commonplace across a variety of sectors including health care. A growing number of studies have attempted to explore the utility of such initiatives on workplace behaviors and client outcomes. Yet few studies have explored how professionals perceive cross-cultural educational models (e.g., cultural awareness, cultural competence) and the extent to which they (and their organizations) execute the principles in practice. In response, this study aimed to explore the general perspectives of health care professionals on culturally competent care, their experiences working with multi-cultural patients, their own levels of cultural competence and the extent to which they believe their workplaces address cross-cultural challenges. METHODS: The perspectives and experiences of a sample of 56 health care professionals across several health care systems from a Mid-Western state in the United States were sourced via a 19-item questionnaire. The questionnaire comprised both open-ended questions and multiple choice items. Percentages across participant responses were calculated for multiple choice items. A thematic analysis of open-ended responses was undertaken to identify dominant themes. RESULTS: Participants largely expressed confidence in their ability to meet the needs of multi-cultural clientele despite almost half the sample not having undergone formal cross-cultural training. The majority of the sample appeared to view cross-cultural education from a 'cultural awareness' perspective - effective cross-cultural care was often defined in terms of possessing useful cultural knowledge (e.g., norms and customs) and facilitating communication (the use of interpreters); in other words, from an immediate practical standpoint. The principles of systemic cross-cultural approaches (e.g., cultural competence, cultural safety) such as a recognition of racism, power imbalances, entrenched majority culture biases and the need for self-reflexivity (awareness of one's own prejudices) were scarcely acknowledged by study participants. CONCLUSIONS: Findings indicate a need for interventions that acknowledge the value of cultural awareness-based approaches, while also exploring the utility of more comprehensive cultural competence and safety approaches.


Assuntos
Competência Cultural/educação , Assistência à Saúde Culturalmente Competente/normas , Pessoal de Saúde/educação , Adulto , Atitude do Pessoal de Saúde , Diversidade Cultural , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Estados Unidos
20.
BMC Med Educ ; 19(1): 14, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621665

RESUMO

Cultural awareness training for health professionals is now commonplace across a variety of sectors. Its popularity has spawned several alternatives (i.e., cultural competence, cultural safety, cultural humility, cultural intelligence) and overlapping derivatives (diversity training, anti-racism training, micro-aggression training). The ever-increasing reach of cultural awareness initiatives in health settings has generally been well intentioned - to improve cross-cultural clinical encounters and patient outcomes with the broader expectation of reducing health disparities. Yet the capacity of cultural awareness training to accomplish or even impact such outcomes is seldom comprehensively scrutinized. In response, this paper applies a much needed critical lens to cultural awareness training and its derivatives by examining their underpinning philosophies, assumptions and most importantly, verification of their effectiveness. The paper finds cultural awareness approaches to be over-generalizing, simplistic and impractical. They may even induce unintended negative consequences. Decades of research point to their failure to realize meaningful outcomes in health care settings and beyond. Broader expectations of their capacity to reduce health disparities are almost certainly unachievable. Alternative suggestions for improving cross-cultural health care interactions and research are discussed within.


Assuntos
Competência Cultural/educação , Assistência à Saúde Culturalmente Competente , Pessoal de Saúde/educação , Conscientização , Competência Cultural/psicologia , Diversidade Cultural , Assistência à Saúde Culturalmente Competente/normas , Pessoal de Saúde/psicologia , Humanos
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