Nursing students' experience of learning cultural competence.

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.

Two-Spirit Identity and Indigenous Conceptualization of Gender and Sexuality: Implications for Nursing Practice.

The word Two-Spirit is an umbrella term that is used to describe Indigenous peoples who are diverse in terms of their sexual orientation and gender identity, though community-specific definitions and roles for gender and sexual orientation are more extensive and varied. While the terminology of Two-Spirit is recent in its development, Indigenous conceptualizations of diverse gender identities, roles, and sexual orientations have existed since time immemorial and provide important insights into how cultural safety can be incorporated into caring practices. The purpose of this article is to introduce readers to the term Two-Spirit and to provide a broad overview of Indigenous conceptualizations of gender, sexuality, and spirit, to address implications for the nursing profession, and to outline potential applications of this knowledge in practice.

[Community health and interculturality]. / Santé communautaire et interculturalité.

An interventional research study in public health was carried out with populations originating from sub-Saharan Africa living in France. With the aim of acting on health inequalities through health education, the researchers focused notably on the links between intercultural relationships and the improvement of health promotion actions.

Recruitment of nurses from India and their experiences of an Overseas Nurses Program.

BACKGROUND: Overseas recruitment has been vital to the contribution of staff growth in the National Health Service (NHS). In 2011, high nursing vacancy rates within critical care required that overseas nurses were recruited. The recruited nurses were placed in an Overseas Nurses Program (ONP), a course designed to assist overseas nurses in adapting to the NHS. AIM: To describe the experiences of nurses recruited from India who participated in an ONP. DESIGN: A qualitative, research approach was chosen to gather descriptions of the lived experiences of nurses from India transitioning to London, to work in critical care settings. METHOD: A descriptive qualitative approach was taken using in-depth, semi-structured and audio-taped interviews. They were conducted over a 69-day period (30 November 2012 to 6 February 2013) with 16 nurses from India. The nurses were questioned about challenges, experiences and differences; they were also asked to make suggestions for other nurses undertaking an ONP in the future. Interviews were transcribed verbatim into a formal written style with NVivo10. RESULTS: Eleven females and five males aged 25-33 years who had completed up to four years of university training participated in this study. The themes extracted were autonomy and responsibility, language, culture (food and climate), loneliness and work challenges (ONP and essay writing). Participants identified that they would have benefited if pre-allocated mentors from non-English speaking countries who had previously been through the transition process were available to assist them with their personal and professional integration into a new country. CONCLUSION: Autonomy disparity, language barriers and cultural differences need to be recognised and acknowledged by multi-disciplinary teams, by allowing sufficient time and additional support for non-English nurses undergoing ONPs. RELEVANCE TO CLINICAL PRACTICE: Overseas nurses would benefit from being mentored by another nurse from a similar culture, with a non-English background. It may be feasible for overseas nurses to receive training in cultural competencies to improve disparities.

REVISITING "THE INVISIBLE CULTURE OF THE MULTIRACIAL, MULTIETHNIC INDIVIDUAL: A TRANSCULTURAL IMPERATIVE".

Past and present policies, politics, myths, stereotypes, and societal attitudes influence the lived experience of multiple heritage individuals, often resulting in marginalization, disparities, invisibility, cultural pain, and/or unmet needs. This article offers commentary about the past and present with thought-provoking questions for future direction regarding "The Invisible Culture of the Multiracial, Multiethnic Individual: A Transcultural Imperative." The commentary revisits and reminds readers about the 2001 article on the same topic, quickly brings them to the reality of the present, and challenges nurses and other professionals to dismantle disparities through cultural congruent care that focuses on making the invisible culture visible.

THE INVISIBLE CULTURE OF THE MULTIRACIAL, MULTIETHNIC INDIVIDUAL: A TRANSCULTURAL IMPERATIVE (REPRINT FROM 2001).

The main purpose of this introauctory article is to evoKe professional awareness, spark interest, stimulate thought, and disseminate information concerning multiracial, multiethnic (multiple heritage) individuals within the United States. General background information, terms, definitions, ethno-historical influences, practice implications, and current issues will be highlighted. Areasforfurther exploration will be proposed. Transcultural imperatives urge all nurses and other health care professionals to become active participants in the new cultural evolution of a different, broader worldview that uncovers the "invisible" culture of multiple heritage individuals. The new vision challenges nurse and other health care professionals to embark upon a new journey in the quest for cultural congruent care for all individuals.

Historic perspectives from anthropology. Reflections proposed to Transcultural Nursing.

History brings together meanings related to earlier periods, being aware of the past as a panorama to reread the present. Madeleine Leininger presented in 1970 an implicit and respectful message to the Nursing Profession when introducing Nursing and Anthropology. Two Worlds to Blend. Implicitly: Nursing you disregard culture. This article shows the absence of the history of anthropology and of nursing within Transcultural Nursing and it includes how education has influenced theoretic, methodological, and comparative approaches giving researchers the responsibility to decide their fundamentals. Berthoud (2001) has inspired the anthropological and historic perspectives of the author, thus universalism, relativism, and comparison are presented.

Walking in two worlds.

It has been nearly quarter of a century since nursing educator Irihapeti Ramsden wrote the guidelines on cultural safety (Kawa Whakaruruhau), ratified in 1992 and subsequently much revised (most recently in 2011) by the Nursing Council. The Te Puna Hauora Kaupapa Nursing Service at Tauranga Hospital has been in existence for more than 18 years. Despite this, the experiences of Maori nurses described here, and the lack of adoption of truly bicultural nursing services in other parts of the country, indicate far more investment is needed in Maori nursing. What all those working in the health-care system need is the capacity to deliver whanaungatanga models of care, through cultural awareness education, and through the development of cultural competencies.

Cultural competent patient-centered nursing care.

This article provides a theoretic framework for culturally diverse practice, provides a model for developing cultural competency, and provides best-practice guidelines for conducting a cultural assessment on patients to identify their diverse needs to integrate into a patient-centered plan of care. The role of ethics is discussed to empower mutual respect, equality, and trust building in patients to promote positive health care outcomes. Cultural diversity tool kits from the National League for Nursing and the American Association of Colleges of Nursing are reviewed to provide educational resources to the front line nurse.