Spiritual Interventions Used by Jewish Women to Facilitate the Family Continuum: A Qualitative Study.

Introduction: Spiritual interventions (SI) are used by patients and their families as a means to promote health. The family continuum (FC), which includes finding a partner/spouse, getting married, becoming pregnant, and having a safe pregnancy/birth, is an important concept for the Jewish culture as well as other cultures that have a traditional family-centered approach. There is a dearth of professional literature pertaining to SI to promote the FC. Although patients may use SI, this information is not routinely collected in a health history. The purpose of the study was to describe the experience of Jewish women's use of SI to promote the FC. Methods: This ethnographic study included interviews of Jewish women pertaining to FC, a text review, and field study. Coding of the text, site visits, and interviews were performed and reviewed to identify categories and themes and were refined until saturation was achieved. Results: Fifty-three observant and non-observant Jewish women participated in the study. Women expressed that SI were the means for them playing an active role in fulfilling the FC, and included intermediaries to God, self-improvement, and folk/spiritual remedies. The examples of SI included: visits to holy sites and spiritual leaders for blessings and advice, prayers, psalms, doing good deeds, eating special foods, wearing amulets, and performing certain SI with predesignated repetitions. Women attributed these SI to attaining an FC. Women who achieved each FC milestone without difficulty tended to use less SI, whereas women's SI usage increased the longer a milestone was not achieved. Conclusions: Jewish women are using many SI to promote the FC. Health care should be delivered in a culturally competent manner, which includes the incorporation of safe cultural practices. Obtaining a cultural assessment as part of the medical history could assist the health care professional in integrating safe SI into patient care.

ABM Clinical Protocol #12: Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home, Revised 2018.

A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols, free from commercial interest or influence, for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

The effect of a cultural competence educational intervention for first-year nursing students in Israel.

PURPOSE: To evaluate the effectiveness of an educational intervention to increase general cultural competence of first-year nursing students. DESIGN: This was a quasi-experimental study that used a convenience sample with an experimental group and a control group and pre- and posttesting. The sample comprised 146 first-year nursing students enrolled in the Introduction to Nursing course divided into an intervention group (n = 58) of students from one school and a control group (n = 88) including students from two schools. The intervention group received a 2-hour faculty lecture on cultural competence, and students prepared and delivered a student group presentation about a cultural group in Israel, basing the presentation on Campinha-Bacote's five constructs. A demographic data instrument and Campinha-Bacote's Inventory for Assessing the Process of Cultural Competence Among Healthcare Professional-Revised© were used for pre- and posttesting. FINDINGS: Students who received the educational intervention increased scores significantly (68 ± 6 to 73 ± 6, p = .000), students who did not receive the educational intervention had no significant increase (67 ± 6 to 66 ± 6). DISCUSSION/CONCLUSIONS: Introducing the topic of cultural competence for nursing students in the first-year Introduction to Nursing course as an integrative learning strategy revealed significant increases in cultural competence scores. IMPLICATIONS FOR PRACTICE: Recommendations are to include evidence-based cultural competence teaching strategies into the nursing curriculum.

Cultural competence of healthcare professionals caring for breastfeeding mothers in urban areas.

OBJECTIVE: Breastfeeding is strongly influenced by cultural considerations. Therefore, culturally competent healthcare professionals can provide more appropriate breastfeeding support and information. The purpose of this study was to measure the general cultural competence of healthcare professionals caring for breastfeeding mothers in an urban area. METHODS: Healthcare professionals involved in the care of breastfeeding mothers in New York, NY were surveyed utilizing Campinha-Bacote's Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R) and a demographic data instrument. RESULTS: Of 141 surveyed healthcare professionals, 128 completed the questionnaire. There were 18 physicians, 69 nurses, and 41 other allied health professionals in this sample. Of those surveyed, 76% reported a majority of their clients' cultural background differed from their own, 56% had studied cultural diversity in school, and 68% had attended a continuing education class on the subject. The mean score on the IAPCC-R was 68 +/- 9, which is culturally aware on Campinha-Bacote's continuum of culturally incompetent, culturally aware, culturally competent, and culturally proficient. There was no statistical difference in IAPCC-R scores whether or not the respondents had attended courses in school or worked with a more diverse population. Professionals who had attended continuing education courses on cultural diversity had significantly higher total scores (69 +/- 9 vs. 65 +/- 7, P = 0.021) and scores for cultural skill (14 +/- 2 vs. 13 +/- 2, P = 0.002) and desire (17 +/- 2 vs. 16 +/- 2, P = 0.011). Twenty-three percent of the participants achieved a score of cultural competence. They were more likely to have attended continuing education courses on cultural diversity (31% vs. 7%, P = 0.0003). CONCLUSIONS: The majority (77%) of healthcare professionals caring for breastfeeding mothers in urban areas did not achieve a score of cultural competence.