A national survey of Swiss paediatric oncology care providers' cross-cultural competences.

BACKGROUND AND PURPOSE: Culturally diverse countries such as Switzerland face the challenge of providing cross-cultural competent care. Cross-cultural competent care needs an understanding of a patient's cultural context in order to provide safe and effective care. Therefore, we sought to examine cross-cultural competence of Swiss paediatric oncology care providers, and to explore their perceptions of barriers to and facilitators of cross-culturally competent care. DESIGN AND SAMPLE: We conducted a cross-sectional study. The data collection period was three weeks. Providers were recruited through collaborators at the participating paediatric oncology centres. All occupational groups who are in direct contact with patients and involved in their care were eligible (e.g., physicians, nurses, social workers, occupational therapists and physiotherapists). Surveying providers online, we captured five subscales of their cross-cultural competence and their perceptions as to how to facilitate cross-culturally competent paediatric oncology care. We employed the Cross-Cultural Competence of Healthcare Professionals (CCCHP) questionnaire. Besides descriptive and inferential statistics, we performed content analysis. FINDINGS: The response rate was 73.2% (n = 183/250). Analyses revealed differences in cross-cultural competence between occupational groups of paediatric oncology providers. Overall, social workers' cross-cultural competence was higher than nurses' or occupational therapists' and physiotherapists' cross-cultural competence. Physicians' cross-cultural competence was higher than nurses (with no statistically significant difference identified between physicians, occupational therapists and physiotherapists). Furthermore, our results suggest noteworthy differences among the four main occupational groups on the five CCCHP subscales. Physicians and social workers declared more positive attitudes than nurses; occupational therapists and physiotherapists reported lower skills than the other three groups; social workers scored higher on the emotions and empathy subscale than the other three groups; physicians were more knowledgeable and aware than nurses. Most frequently mentioned barriers were: language barriers (68.5%), different culture and values (19.2%), different illness understanding (9.2%). Most frequently mentioned facilitators were: professional translators (47.2%), continuous training (20.8%), professional cultural mediators (8.8%). CONCLUSIONS/IMPLICATIONS: Trainings and interventions are widely considered a principal strategy to advance providers' cross-cultural competence. Our findings of differences in cross-cultural competence among occupational groups further underpin the need to adapt training programmes and interventions to the respective occupational group and the respective dimension(s) of cross-cultural competence. In addition, professional translators and cultural mediators should be used. Lastly, reciprocal supervision and the promotion of multidisciplinary teams is crucial to enable oncology care providers to learn from each other and this exchange could also help to reduce some of the differences between the various occupational groups.

An Assessment of Lesbian, Gay, Bisexual, and Transgender Health Competencies Among Bachelors-Prepared Registered Nurses in Graduate-Level Study.

PURPOSE: To assess graduate nursing students' lesbian, gay, bisexual, and transgender (LGBT)-specific health competencies. METHOD: Using a cross-sectional design, a 13-item multiple response survey, derived from The Joint Commission guidelines and LGBT health competencies proposed by the Association of American Medical Colleges, was administered online to 116 registered nurses enrolled in graduate study. Survey items assessed nurses' knowledge of LGBT health, professionalism, provision of patient care, communication skills, care environment, gaps in learning, and systems-based practice. Descriptive analyses were used to summarize frequencies and proportions of study variables. RESULTS: Respondent nurses' knowledge about health, prevalent conditions, and social factors that influence LGBT health was somewhat limited. Respondents did not rate their knowledge about LGBT health high (µ = 3.11 [1.1], median = 3) and did not feel qualified to educate other colleagues about LGBT health issues (µ = 2.43 [1.26], median = 2). But 58% (n = 65) indicated that they felt comfortable performing prostate exams on transgender female patients (born with male genitalia); 62% (n = 70) felt comfortable doing pap smears for transgender male patients (born with female genitalia). Sixty nurses (52%) stated that they would advocate reforms within existing health care institutions to improve the care of LGBT patients. Cultural competency training was offered in some health care settings and environmental indications of inclusivity were inconsistent. CONCLUSIONS: LGBT health competence among graduate nursing students was limited. There is a need to reevaluate LGBT health-related content in nursing curricula as well as robust assessment of competence in LGBT health.

The influence of the oncology-focused transgender-simulated patient simulation on nursing students' cultural competence development.

BACKGROUND: Disparities experienced by transgender patients, especially in cancer care, leads to poorer outcomes and overall health. Simulation, using transgender simulated patients (SPs) with a focus on cancer care can be an effective way to foster cultural competence nursing education. METHODS: Guided by the National League for Nursing (NLN)/Jeffries Simulation Theory and Cultural Competence and Confidence Model, this grant funded pretest (n = 48) and posttest (n = 41) comparison group, quasi-experimental study aimed to understand changes in students' transcultural self-efficacy (TSE) following the transgender-simulated patient simulation (TSPS) focusing on an oncological emergency management. Developed by following recommended guidelines and standards, the TSPS had content validity review and pilot testing. It aimed to improve students' knowledge, skills, and attitudes with regard to providing culturally congruent nursing care. The statistical methods included paired sample t-tests, independent t-tests, and correlation analyses. RESULTS: Students who participated in the TSPS intervention had significantly higher posttest TSE scores (P < .05). DISCUSSION: SP methodology can be an effective way to foster cultural congruence in nursing care. The findings contribute to the importance of continuous efforts for the inclusion of lesbian, gay, bisexual, transgender, queer (LGBTQ) topic in nursing education to enhance culturally congruent care.

Addressing the quality of communication with older cancer patients with cognitive deficits: Development of a communication skills training module.

OBJECTIVE: Effective communication is an essential part of patient-centered care. The complexity of cancer care in older adults makes communication challenging, particularly when older patients have cognitive deficits and lose their autonomy. This paper describes the development, implementation, and evaluation of a communication skills training module for health care providers (HCPs) who work with older adults with cancer, with or at risk of developing cognitive deficits. METHOD: Using a pre-post single arm study design, 99 HCPs from a comprehensive cancer center in North-East USA, who worked primarily with geriatric patients, participated in the study. Participants included Advance Practice Providers (including Nurse Practitioners and Physician Assistants; n = 24, 24.2%); nurses (n = 23, 23.2%), social workers (n = 14, 14.1%), physicians (n = 13, 13.1%), and "other" HCPs (including occupational therapists, physical therapists, and psychologists; n = 20, 20.2%). The HCPs participated in a one-day geriatric communication skills training program in groups of 12-15 over a 2-year period. Participants complete pre-post surveys on module evaluation and perception of self-efficacy as well as pre-post video-recorded Standardized Patient Assessment (SPA) to evaluate communication skill uptake. RESULTS: Most participants evaluated the module positively; over 90% indicated that they agreed or strongly agreed with five of the six module evaluation items. HCPs' self-efficacy in communicating with cancer patients with cognitive deficits significantly increased from pre- to post-module training. There was a significant increase in the following communication skill use from pre- to post-training: checking patient preferences, declaring agenda, and inviting agenda. SIGNIFICANCE OF RESULTS: Results demonstrated a successful implementation of the program as evidenced through favorable program evaluation, significant gains in self-efficacy, as well as significant improvement in several communication skills.

Why do Thoracic Radiologists Need to Know About Cultural Competence (and What Is it Anyway)?

Thoracic radiologists meet patients when performing procedures such as transthoracic computed tomography-guided biopsy and during shared decision-making required for lung cancer screening. Both patients and thoracic radiologists are influenced by their cultures, which affect their health care interactions. While culture may relate to religion or ethnicity of individuals, it also includes multiple additional characteristics such as gender, socioeconomic status, sexual orientation, education, occupation, age, disability, and more. Patients from different cultures undergo similar medical procedures; however, care must be tailored according to the cultural and linguistic needs of each patient. Cultural competence allows all patients, from the same or different culture as the thoracic radiologist, to receive care that is tailored to the patient's cultural and linguistic needs. Cultural competence includes concepts such as cultural awareness, linguistic competence, and health literacy as well as avoiding bias and stereotyping. Culturally competent care requires appropriate services for interpretation, relating to spoken language, and translation, related to written reports and documents. The implications of not providing adequate interpretation and translation services include the inability to take an accurate health history and patient inability to understand the informed consent forms. Thoracic radiologic services should have culturally competent practices in place at every step of the care, starting from the first phone call when patients are making an appointment. This will allow patients to receive care that is culturally and linguistically appropriate and lead to better satisfaction and outcomes.

Web-based LGBT cultural competency training intervention for oncologists: Pilot study results.

BACKGROUND: Lesbian, gay, bisexual, and transgender (LGBT) cancer patients experience substantial health disparities, including poorer overall health and lower satisfaction with their cancer care than their heterosexual and cisgender counterparts, which may be due in part to a lack of culturally competent providers. To address these disparities, a web-based LGBT cultural competency training tailored to oncologists was developed by an interdisciplinary team of scientists, LGBT cancer survivors, cultural competency experts, oncologists, a web designer, and an instructional designer. METHODS: Oncologists (n = 44) were recruited from 3 academic cancer centers in Florida. Participants were administered the LGBT cultural competency training Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS) and completed pre- and posttraining measures regarding LGBT-related knowledge, attitudes (including general negative attitudes and health care-related attitudes), and clinical practices. After the training, participants completed training acceptability measures. RESULTS: Of the 44 participants, 33 (75%) completed the COLORS training. Participants were 55% non-Hispanic white, 63% male, and had a mean age of 47 years. Participants demonstrated significant improvements in LGBT-related knowledge (t = -4.9, P < .001), attitudes (Z = -3.0, P = .002; t = -2.5, P = .019), and clinical practices (Z = -3.5, P < .001) after completing the COLORS training (Wilcoxon signed rank tests were used for nonnormally distributed variables). Moreover, training acceptability was high, with 82% of participants rating the training as high quality, and 97% being willing to recommend the training to a colleague. CONCLUSION: The COLORS training is both feasible to administer and acceptable for use with oncologists, and may improve oncologists' LGBT-related knowledge, attitudes, and clinical practices. Larger trials are needed to examine the training's effectiveness in reducing LGBT cancer disparities, as well as its applicability to other types of care providers.

Translation, cultural adaptation, and validation of the Brazilian Portuguese version of the End-of-Life Professional Caregiver Survey.

OBJECTIVES: The aim of this study was to translate, culturally adapt, and psychometrically evaluate the Brazilian version of the "End-of-Life Professional Caregiver Survey" (BR-EPCS). METHOD: This is an observational cross-sectional study. The sample was composed of 285 Brazilian healthcare professionals who work or worked in the palliative care area. A minimum number of 280 participants were established, following the recommendation of 10 subjects for each instrument item. The European Organisation for Research and Treatment of Cancer - Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation. For the precise/reliable evaluation of factors measured by the BR-EPCS, Cronbach's alpha (α) and composite reliability coefficients were used. The factorial analyses were made by means of the exploratory structural equation modeling methods and confirmatory factor analysis. We have conducted a multiple linear regression analysis to evaluate the sociodemographic variables' capabilities in the result prediction measured by BR-EPCS factors. RESULTS: The factorial analysis showed the relevance of two factors: Factor 1 - "Given care effectiveness" (18 items; Cronbach's α = 0.94; Composite Reliability = 0.95) and Factor 2 - "Mourning and ethical and cultural values" (10 items; Cronbach's α = 0.89; Composite Reliability = 0.88). Multiple linear regression analyses revealed that the working time, sex, palliative care training, and its own advance directives are predictors of the constructs assessed by the BR-EPCS. SIGNIFICANCE OF RESULTS: The BR-EPCS is a reliable, valid, and culturally appropriate tool to identify the educational needs of healthcare professionals who work with palliative care. This instrument can be used for educational and research reasons.

Nurses' practice in quilombola communities: an interface between cultural and political competence / Práctica de enfermería en comunidades de quilombolas: interfaz entre competencia cultural y política / Prática do enfermeiro em comunidades quilombolas: interface entre competência cultural e política

ABSTRACT Objectives: to understand Family Health Strategy nurses' practices in the context of quilombola communities with an interface for cultural and political competences. Methods: a single integrated, qualitative case study carried out on seven Family Health Strategies located in the Metropolitan Region of Belo Horizonte, state of Minas Gerais. Seven nurses and 59 quilombolas participated. Data were collected through individual interviews with nurses, collective interviews with quilombolas and observation. For analysis, the thematic content analysis was adopted. Results: the results revealed structural and territorial problems, which are configured as barriers for professional-user encounter as well as for professional practice performance. Final Considerations: it is necessary that Family Health Strategy nurses, based on political and cultural competences, create strategies that minimize the difficulties found in the implementation of health actions directed to quilombolas. Such strategies anchored in inclusive public policies.

RESUMEN Objetivos: comprender la práctica de las enfermeras en la Estrategia de Salud Familiar en el contexto de las comunidades de quilombolas con una interfaz para las competencias culturales y políticas. Métodos: estudio de caso cualitativo integrado único realizado en siete Estrategias de Salud Familiar ubicadas en la Región Metropolitana de Belo Horizonte, Minas Gerais. Participaron 7 enfermeras y 59 quilombolas. Los datos fueron recolectados a través de entrevistas individuales con enfermeras, entrevistas colectivas con quilombolas y observación. Para el análisis, se adoptó el análisis de contenido temático. Resultados: los resultados revelaron problemas estructurales y territoriales, que se configuran como barreras para la realización del encuentro profesional-usuario, así como para la realización de la práctica profesional. Consideraciones Finales: es necesario que la enfermera de la Estrategia de Salud Familiar, basada en competencias políticas y culturales, cree estrategias que minimicen las dificultades encontradas en la implementación de acciones de salud dirigidas a las quilombolas. Dichas estrategias ancladas en políticas públicas inclusivas.

RESUMO Objetivos: compreender a prática do enfermeiro na Estratégia Saúde da Família no contexto de comunidades quilombolas com interface para as competências cultural e política. Métodos: estudo de caso único integrado, qualitativo, realizado em sete Estratégias Saúde da Família localizadas na Região Metropolitana de Belo Horizonte, MG. Participaram 7 enfermeiros e 59 quilombolas. Os dados foram coletados por meio de entrevistas individuais com enfermeiros, entrevistas coletivas com quilombolas e observação. Para a análise, adotou-se a análise temática de conteúdo. Resultados: os resultados revelaram problemas estruturais e territoriais, os quais se configuram como barreiras para a efetivação do encontro profissional-usuário, bem como para a efetivação da prática do profissional. Considerações Finais: é necessário que o enfermeiro da Estratégia Saúde da Família, alicerçado por competências políticas e culturais, crie estratégias que minimizem as dificuldades encontradas na concretização das ações de saúde direcionadas para os quilombolas. Tais estratégias ancoradas em políticas públicas inclusivas.

Validation of a Korean Version of the Spiritual Care Competence Scale: Focused on the Hospice and Palliative Care Setting.

This study aimed to examine the reliability and validity of a scale to assess the competence of Korean nurses who provide spiritual care for patients with terminal illnesses. The reliability and validity were examined using Cronbach α, item analysis, and exploratory factor analysis. The participants were 248 hospice nurses working at 40 hospices and palliative hospitals in South Korea. The results showed that the reliability was high, as indicated by a Cronbach α of .942. The exploratory factor analysis revealed 6 dimensions (assessment and implementation of spiritual care, professionalization and improvement of the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude toward the patient's spirituality, and communication) with 27 items. The 6 factors explained 68.20% of the variance in the Korean version of the Spiritual Care Competence Scale. From the results, the Korean version of the Spiritual Care Competence Scale may serve as an appropriate measure for provision of spiritual care for patients with terminal illness. In addition, it may be useful in assessing hospice and palliative nurses' ability for spiritual care.

The Function of Disclosing Medical Errors: New Cultural Challenges for Physicians.

A general consensus has been reached in health care organizations that the disclosure of medical errors can be a very powerful way to improve patients and physicians well-being and serves as a core component to high quality health care. This practice strongly encourages transparent communication with patients after medical errors or unanticipated outcomes. However, many countries, such as Brazil, do not have a culture of disclosing harmful errors to patients or standards emphasizing the importance of disclosing, taking responsibility, apologizing, and discussing the prevention of recurrences. Medical error is not discussed or approached during medical school. The stigma of error has a strong connection with value judgments, and emotional support for physicians does not exist. This paper suggests that open communication with the patient is essential. Guidance about error disclosure from health care organizations would be helpful for quality and patient safety and for health care professionals in countries like Brazil.

Nurses' perceptions of intensive care unit palliative care at end of life.

BACKGROUND: Significant barriers can block the provision of palliative care at the end of life in the intensive care unit (ICU). However, the relationship between perceptions of ICU quality palliative care and barriers to palliative care at the end of life is not well documented. AIMS AND OBJECTIVES: To describe ICU nurses' perceptions of quality palliative end-of-life care, barrier intensity and frequency to palliative care and their association with one another. DESIGN: This was a descriptive, correlational, cross-sectional design. METHODS: A convenience sample of 126 ICU nurses from two hospitals in Israel was recruited for the study. Participants completed three pencil-and-paper questionnaires (a personal characteristics questionnaire, the Quality of Palliative Care in the ICU and a revised Survey of Oncology Nurses' Perceptions of End-of-Life Care). Respondents were recruited during staff meetings or while on duty in the ICU. Ethical approval was obtained for the study from participating hospitals. RESULTS: The item mean score of the quality of palliative end-of-life care was 7·5/10 (SD = 1·23). The item mean barrier intensity and frequency scores were 3·05/5 (SD = 0·76) and 3·30/5 (SD = 0·61), respectively. A correlation of r = 0·46, p < 0·001 was found between barrier frequency and intensity and r = -0·19, p = 0·04 between barrier frequency and quality palliative end-of-life care. CONCLUSIONS: ICU nurses perceived the quality of palliative care at the end of life as moderate despite reports of moderate barrier levels. The frequency of barriers was weakly associated with quality palliative end-of-life care. However, barrier intensity did not correlate with quality palliative end-of-life care at a statistically significant level. Further research that investigates other factors associated with quality ICU palliative care is recommended. RELEVANCE TO CLINICAL PRACTICE: Barriers to palliative care are still common in the ICU. Increased training and education are recommended to decrease barriers and improve the quality of ICU palliative care.

In their own words: patient navigator roles in culturally sensitive cancer care.

PURPOSE: Patient navigation has emerged as a promising strategy in reducing disparities among diverse cancer patients. However, little is known about navigators' own perspectives on their roles in providing culturally competent care. The purpose of the present study is to describe these self-identified roles. METHODS: Data were collected from an online survey with a convenience sample of cancer patient navigators. Using NVivo 10, qualitative content analysis was conducted on free text responses to the question: "In your opinion, what is the role of a patient navigator or nurse navigator in the provision of culturally sensitive care to patients?" Frequencies of each navigator-identified role mentioned were tabulated. RESULTS: Of 294 respondents, 50.7% (n = 149) provided a response to the question of interest. Respondents described the following 11 interrelated navigator roles in the provision of culturally competent care: (1) assess and understand patient needs, (2) tailor care to patient, (3) build rapport/open communication, (4) facilitate communication between patient and health care team, (5) educate/provide resources to the patient, (6) advocate, (7) self-motivated learning, (8) address barriers to care, (9) involve/meet the needs of family or support people, (10) educate/support health care team, and (11) support patient empowerment in care. CONCLUSIONS: Patient navigators are uniquely well-positioned to improve cultural competence of cancer care given their role as liaison to patients and providers. Cancer care settings should use navigators with direct knowledge of patient culture whenever possible; however, communication and cultural competence training is highly recommended for all navigators given the diversity of patient needs.

Práticas de exclusão social: reflexões teórico-epistemológicas em torno de um campo de estudos / Social exclusion practices: theoretical and epistemological reflections on a camp of studies / Prácticas de exclusión social: reflexiones teórico- epistemológicas alrededor de un campo de estudios

As transformações econômicas, sociais, tecnológicas e culturais acontecidas durante a modernidade cons- tituíram um campo de tensão entre, de um lado, a valoração da individualidade no plano político e o surgi- mento de novas subjetividades e, de outro, a tendência à normalização, homogeneização e gestão de tais subjetividades. Dentro desse cenário, transformam-se e sofisticam-se práticas de exclusão social orien- tadas aos sujeitos que não se adequam aos padrões culturais positivamente valorados. Este texto objetiva apresentar uma reflexão teórico-epistemológica sobre a atualidade desse campo de estudos. Para tal, são contrastadas três perspectivas para o estudo das práticas de exclusão social: a teoria da dialética exclusão/inclusão, a abordagem de exclusão a partir de estudos sobre a interação social e a possibilidade de uma psicologia da exclusão fundamentada na teoria do reconhecimento intersubjetivo. Finalmente, reconhecemos o caráter transdisciplinar do campo de estudos sobre as práticas de exclusão social, a partir de uma perspectiva psicossocial.

The economic, social, technological and cultural transformations that took place during the modern era constituted a field of tension between, the valuation of individuality in the political plane and the emergence of new subjectivities and, the tendency towards normalization, homogenization and management of such subjectivities. Within this scenario, social exclusion practices, of those subjects that do not conform to the positively valued standards, are transformed and are more sophisticated. This paper aims to present a theoretical-epistemological reflection on the current relevance of social exclusion studies. Three perspectives are examined: the theory of the exclusion/inclusion dialectic, the approach of exclusion from studies on social interaction and the possibility of a psychology of exclusion based on the theory of intersubjective recognition. Finally, we recognize the transdisciplinary character of social exclusion, from a psychosocial perspective.

Las transformaciones económicas, sociales, tecnológicas y culturales que tuvieron lugar durante la modernidad constituyeron un campo de tensión entre, por un lado, la valoración de la individualidad en el plano político y la aparición de nuevas subjetividades y, por el otro, la tendencia a la normalización, homogeneización y gestión de tales subjetividades. Dentro de este escenario, se transforman y se sofistican prácticas de exclusión social orientadas a los sujetos que no se ajustan a patrones culturales valorados positivamente. Este texto tiene como objetivo presentar una reflexión teórico-epistemológica sobre el estado actual de este campo de estudio. Para ello, se contrastan tres perspectivas para el estudio de las prácticas de exclusión social: la teoría dialéctica de exclusión / inclusión, el enfoque de exclusión de los estudios sobre interacción social y la posibilidad de una psicología de exclusión basada en la teoría del reconocimiento intersubjetivo. Finalmente, reconocemos el carácter transdisciplinario del campo de estudio sobre las prácticas de exclusión social, desde una perspectiva psicosocial.

'Death is difficult in any language': A qualitative study of palliative care professionals' experiences when providing end-of-life care to patients from culturally and linguistically diverse backgrounds.

BACKGROUND: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care. AIM: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture. DESIGN: An emergent qualitative design, informed by theoretical and procedural direction from grounded theory research. SETTING/PARTICIPANTS: Four focus groups held with palliative care staff ( n = 28) in a single specialist palliative care service in Australia. RESULTS: The following themes emerged: (1) determining the rules of engagement around discussion of diagnosis and prognosis, (2) navigating the challenge of language to patient understanding, (3) understanding migration experiences to establish trust, (4) maintaining the balance between patient safety and comfort care, (5) providing a good death experience through accommodation of beliefs, and (6) navigating the important role of family members while privileging patient preferences. CONCLUSION: Underlying provider perceptions of caring for patients was that death is difficult in any language. Care was conceptualised as considering cultural and linguistic backgrounds within individualistic care. Understanding the migration experience and building trust were key elements of this individualised approach. Acknowledgement of the key role played by families in patient care and safety are strategies to minimise barriers and understand the concerns of this patient group.

Pesquisas transculturais em psicologia do desenvolvimento: considerações teórico-metodológicas / Cross-cultural research in developmental psychology: theoretical and methodological considerations / Investigaciones transculturales en psicología del desarrollo: consideraciones teórico-metodológicas

A cultura e os contextos sociais são aspectos importantes na investigação de fenômenos concernentes ao desenvolvimento humano. Tem-se como objetivo apresentar considerações teórico-metodológicas, baseadas na experiência de uma pesquisa realizada por pesquisadores brasileiros e canadenses, acerca dos procedimentos adotados na produção científica envolvendo a Psicologia Transcultural e a Psicologia do Desenvolvimento, apontando desafios e possibilidades para superá-los. Salienta-se a importância da adequação da pesquisa para diferentes culturas e recomenda-se atentar para os seguintes procedimentos: definição do tema de pesquisa, escolha e adaptação dos instrumentos de medida, definição do construto, treinamento dos pesquisadores e estudo piloto. A indicação de critérios dessa natureza tem como objetivo aprimorar a sistematização e descrição de estudos transculturais na área da Psicologia do Desenvolvimento para que se possam produzir resultados consistentes e válidos

The culture and social contexts are important in the investigation of aspects related to human development. The objective was to present theoretical and methodological considerations, based on our experience related to a research carried out by Brazilian and Canadian researchers, on the procedures adopted in the scientific literature involving the Transcultural Psychology and Developmental Psychology, pointing challenges and possibilities of overcoming them. The importance of adequacy of research for different cultures was stressed and it is recommended be attentive to the following: definition of the research topic, choice of the measuring instrument, definition of the construct, instrument adaptation, training researchers and pilot study. Indication criteria of this nature aims to improve the systematization and description of cross-cultural studies in Developmental Psychology, in order to make possible to produce consistent and valid results

La cultura y los contextos sociales son aspectos importantes en la investigación de fenómenos concernientes al desarrollo humano. Se tiene como objetivo presentar consideraciones teórico-metodológicas, basadas en la experiencia de una investigación realizada por investigadores brasileños y canadienses, acerca de los procedimientos adoptados en la producción científica envolviendo la Psicología Transcultural y la Psicología del Desarrollo, apuntando desafíos y posibilidades. Se destaca la importancia de la adecuación de la investigación para diferentes culturas y se recomienda atentar para los siguientes procedimientos: definición del tema de investigación, elección y adaptación de los instrumentos de medida, definición del constructo, entrenamiento de los investigadores y estudio piloto. La indicación de criterios de esa naturaleza tiene como objetivo mejorar la sistematización y descripción de estudios transculturales en el área de la Psicología del Desarrollo para que se puedan producir resultados consistentes y válidos

Developing and testing a brief clinic-based lung cancer screening decision aid for primary care settings.

BACKGROUND: Cancer screening-related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. PCPs play an essential role in facilitating comprehensive shared decision making (SDM). OBJECTIVE: To develop and test a decision aid (DA) and SDM strategy for PCPs and high-risk patients. DESIGN: The DA was tested with 20 dyads. Each dyad consisted of one PCP and one patient eligible for screening. A prospective, one-group, mixed-method study design measured fidelity, patient values, screening intention, acceptability and satisfaction. RESULTS: Four PCPs and 20 patients were recruited from an urban academic medical centre. Most patients were female (n = 14, 70%), most had completed high school (n = 15, 75%), and their average age was 65 years old. Half were African American. Patients and PCPs rated the DA as helpful, easy to read and use and acceptable in terms of time frame (observed t = 11.6 minutes, SD 2.7). Most patients (n = 16, 80%) indicated their intent to be screened. PCPs recommended screening for most patients (n = 17, 85%). CONCLUSIONS: Evidence supports the value of lung cancer screening with LDCT for select high-risk patients. Guidelines endorse engaging patients and their PCPs in SDM discussions. Our findings suggest that using a brief, interactive, plain-language, culturally sensitive, theory-based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting.

Cultural adaptation of Quality Of Care Through The Patient's Eyes -QUOTE-HIV / Adaptación cultural de Quality Of Care Through The Patient's Eyes - QUOTE-HIV / Adaptação cultural do Quality Of Care Through The Patient's Eyes -QUOTE-HIV

ABSTRACT Objective: to translate and adapt Quality of Care Through the Patient's Eyes - HIV (QUOTE-HIV) for the Brazilian population living with HIV/AIDS. Method: a methodological study, which followed the stages of translation, synthesis, back-translation, evaluation by the committee of experts and pre-test for cultural adaptation of the instrument. Results: the process of translation and cultural adaptation was considered adequate. Evaluation by the expert committee resulted in semantic, structural and grammatical adequacy of the evaluated items. 30 subjects considered the instrument to be easy to understand and suggested minor adjustments in some items. Conclusion: the Brazilian version of QUOTE-HIV has been adapted and validated in relation to its content. However, this is a study that precedes the process of evaluating the psychometric properties of the instrument, the results of which will be presented in a later publication.

RESUMEN Objetivo: traducir y adaptar el Quality of Care Through the Patient's Eyes - HIV (QUOTE-HIV) para población brasileña que vive con HIV/sida. Método: estudio del tipo metodológico, que siguió las etapas de traducción, síntesis, retro traducción, evaluación por comité de especialistas y pre test para adaptación cultural del instrumento. Resultados: el proceso de traducción y adaptación cultural fue considerado adecuado. La evaluación por comité de especialistas resultó en adecuaciones semánticas, estructurales y gramaticales de los ítems evaluados. Participaron del pre test 30 sujetos que consideraron el instrumento de fácil comprensión y sugirieron pequeñas adecuaciones en algunos de sus ítems. Conclusión: l a versión brasileña del QUOTE-HIV se encuentra adaptada y validada con relación a su contenido. Sin embargo, este es un estudio que antecede el proceso de evaluación de las propiedades psicométricas del instrumento, cuyos resultados serán presentados en publicaciones posterior.

RESUMO Objetivo: traduzir e adaptar o Quality of Care Through the Patient's Eyes - HIV (QUOTE-HIV) para população brasileira que vive com HIV/aids. Método: estudo do tipo metodológico, que seguiu as etapas de tradução, síntese, retrotradução, avaliação pelo comitê de especialistas e pré-teste para adaptação cultural do instrumento. Resultados: o processo de tradução e adaptação cultural foi considerado adequado. A avaliação pelo comitê de especialistas resultou em adequações semânticas, estruturais e gramaticais dos itens avaliados. Participaram do pré-teste 30 sujeitos que consideraram o instrumento de fácil compreensão e sugeriram pequenas adequações em alguns de seus itens. Conclusão: a versão brasileira do QUOTE-HIV encontra-se adaptada e validada em relação ao seu conteúdo. Contudo, este é um estudo que antecede o processo de avaliação das propriedades psicométricas do instrumento, cujos resultados serão apresentados em publicação posterior.

A concept analysis in relation to the cultural competency of the palliative care workforce in meeting the needs of young people from South Asian cultures.

ABSTRACTObjective:Our aims were to report an analysis of the concept of cultural competency and to explore how the cultural competency of the palliative care workforce impacts the holistic care of young people with palliative care needs from South Asian cultures. METHOD: Using keywords, we searched the online databases MEDLINE, CINAHL, ScienceDirect, and PubMed from January of 1990 through to December of 2016. Some 1543 articles were retrieved, and inclusion and exclusion criteria were applied. A total of 38 papers were included in the concept analysis. The data were analyzed using Coad's (2002) adapted framework based on Rodgers's (1989) evolutionary concept analysis, focusing on the attributes, antecedents, consequences, and related terms in relation to culturally competent care. A model case of culturally competent care was also constructed. RESULTS: The literature provides evidence that the concept of culturally competent care is a complex one, which is often expressed ambiguously. In addition, there is a paucity of research that involves service users as experts in defining their own needs and assessing their experiences related to cultural care. SIGNIFICANCE OF RESULTS: Cultural care should be integral to holistic patient care, irrespective of a person's race or ethnicity. There is an urgent need to involve young BAME patients with palliative care needs and their families in the development of a robust tool to assess cultural competency in clinical practice.

Adaptação cultural de intervenções preventivas em saúde mental baseadas em evidências / Cultural adaptation of evidence based prevention interventions in mental health / Adaptación cultural de intervenciones preventivas en salud mental basadas en evidencias

A adaptação cultural de intervenções preventivas em saúde mental baseada em evidências tem sido largamente praticada ao redor do mundo. No Brasil, estudos com esse foco são raros. Tal processo deve ser sistemático para alcançar, por um lado, a preservação dos componentes centrais da intervenção original e, por outro, a sensibilidade cultural para com a cultura adotante de modo a respeitar a sua identidade, valores e necessidades. Realizou-se uma revisão narrativa acerca de modelos de adaptação cultural de intervenções preventivas importadas ­ Planned Intervention Adaptation (PIA) Protocol; Strengthening Families Program Adaptation Model (SFP_Ad); e ADAPT-ITT ­ cujas etapas e características foram analisadas. Conclui-se que a adaptação cultural de programas preventivos em saúde mental deve basear-se em estudos empíricos, práticas colaborativas e sensibilidade ética. Estudos futuros devem investigar o custo-benefício do investimento na adaptação cultural de intervenções internacionais versus o desenvolvimento de intervenções locais, para os quais são necessárias capacidades diversas. (AU)

The cultural adaptation of evidence-based mental health preventive interventions has been widely practiced around the world. In Brazil, studies with this focus are rare. Such process must be systematic in order to achieve, on the one hand, the preservation of the core components of the original intervention and, on the other hand, the cultural sensitivity towards the adopting culture to respect its identity, values and needs. A narrative review on models of cultural adaptation of imported preventive interventions was carried out, including the Planned Intervention Adaptation (PIA) Protocol; Strengthening Families Program Adaptation Model (SFP_Ad); and the ADAPT-ITT, whose steps and characteristics were analyzed. It is concluded that the cultural adaptation of preventive programs in mental health should be based on empirical studies, collaborative practices and ethical sensitivity. Future studies should investigate the cost-effectiveness of investing in the cultural adaptation of international interventions versus the development of local interventions, for which different capacities are required. (AU)

La adaptación cultural de intervenciones preventivas en salud mental basada en evidencias, ha sido ampliamente practicada alrededor del mundo. En Brasil, son escasos los estudios con este enfoque. Este proceso debe ser sistemático para alcanzar, por un lado, la preservación de los componentes centrales de la intervención original y, por otro, la sensibilidad con la cultura adoptante para respetar su identidad, valores y necesidades. Se realizó una revisión narrativa acerca de modelos de adaptación cultural de intervenciones preventivas importadas - Planned Intervention Adaptation (PIA) Protocol; (SFP_Ad); y ADAPT-ITT - cuyas etapas y características se analizaron. Se concluye que la adaptación cultural de programas preventivos en salud mental debe basarse en estudios empíricos, prácticas colaborativas y sensibilidad ética. Estudios futuros deben investigar el costo-beneficio de la inversión, en la adaptación cultural de intervenciones internacionales, con relación al desarrollo de intervenciones locales, para las cuales son necesarias capacidades diversas. (AU)