Spanish adaptation and validation of the Cultural Competence Assessment Tool (CCATool) for undergraduate nursing students.

AIM: To analyse and validate a contextually adapted version of the Papadopoulos' Cultural Competence Assessment Tool (CCATool) for Spanish undergraduate nursing students. BACKGROUND: Globalization has driven and intensified international migration. Thus, nurses must treat patients of many different cultural origins. Accordingly, both cultural competence and an appropriate tool with which to evaluate it are required. METHODS: The CCATool questionnaire was adapted for use in a Spanish context and was evaluated through a questionnaire completed by 262 undergraduate nursing students. Seven days later, the same students completed the questionnaire, without any intervention, and a subgroup of 144 students completed the questionnaire for a third time after taking a course in Transcultural Care. The reliability, sensitivity and stability of the questionnaire were assessed. RESULTS: The reliability of the questionnaire obtained an adequate Cronbach's alpha of 0.81. Stability was assessed at seven days, using the intraclass correlation coefficient, which showed good/excellent results. Moreover, the questionnaire was able to detect the changes related to the nursing educative programme, thus highlighting a good sensitivity of the tool. CONCLUSION: Cultural competence is an essential element of nurses' education, and instruction in this area should begin as soon as possible. In addition, an appropriate evaluation system is required. For this purpose, the present study describes and analyses a valid, reliable tool for use with undergraduate nursing students in Spain. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Health and education policies must be sensitive to the ethnic and cultural differences of the patients who are cared for, and address the situations that cause difficulties in care. Hospitals and health centres must offer good care to patients from diverse cultures, so one of the necessary situations is the training and evaluation of the cultural competence of health professionals.

Towards a national strategy for the provision of spiritual care during major health disasters: A qualitative study.

BACKGROUND: Spirituality is beneficial to health. Evidence around the benefits of Spiritual care (SC) is advancing, and training is becoming part of healthcare professional development. As the COVID-19 crisis showed, during major health disasters (MHDs), the demand for SC grows exponentially, while the burden of care and focus on preserving life often hamper its provision. Nonetheless, existing health emergency strategic frameworks lack preparedness for the provision of SC. AIM: The aim of this study was to identify the components for a National Strategy (NS) for the provision of SC during MHDs. METHODS: Descriptive, cross-sectional, qualitative phenomenological design based on individual, semi-structured e-interviews with nursing managers and National Health Service/volunteer chaplains based in England. Thematic analysis of 25 e-interview data was performed based on a dialogic collaborative process. RESULTS AND DISCUSSION: Eleven themes were identified as components of the proposed NS. From these components, specific recommendations for practical actions are provided. An integrated framework approach and smart investments in resources, staff training and technologies should be led by the paradigm of culturally competent and compassionate care. CONCLUSION: The need to have strategic frameworks, both national and local, that better equip a country healthcare sector to prevent, face, and recover from MHDs is paramount. Catering for the spiritual needs of the affected population should be a key aspect of any health emergency strategy to ensure the preservation of quality care.

Spiritual Support During COVID-19 in England: A Scoping Study of Online Sources.

Spiritual support is a key element of holistic care, and better healthcare professionals training and stronger strategic guidelines become urgent in light of health disasters and emergencies, such as the COVID-19 pandemic. To this end, the aim of this study was to explore spiritual support provision within mass and social media and the websites of spiritual leaders, institutions and NHS chaplaincy units during COVID-19 in England, between March and May 2020. A scoping review design informed by Levac and colleagues' five-staged framework was adopted, and adapted with a multi-strategy search to scope the different domains of online sources. Results revealed that spiritual support for dying patients, their families, health care staff, spiritual leaders and chaplains, had to be drastically reduced, both in quality and quantity, as well as being provided via different technological devices or domestic symbolic actions. No mention was found of a central strategy for the provision of spiritual support. This study points to the importance of developing centralized strategies to prepare healthcare systems and professionals in relation to spiritual support provision, both routinely and during health disasters and emergencies. Further research will have to explore innovative practices, in particular the role of digital technologies, in spiritual support provision.

The Influence of Culture on Attitudes Towards Humanoid and Animal-like Robots: An Integrative Review.

PURPOSE: The aim of the present review is to explore the influence of culture on attitudes towards humanoid and animal-like robots. DESIGN: An integrative review of current evidence. METHODS: Medline, CINAHL, PsycInfo, PubMed, and Google Scholar were searched from 2000 to 2017. A total of 22 articles met the inclusion criteria and were retrieved and analyzed. FINDINGS: Culture influences attitudes and preferences towards robots, but due to the limitations of the reviewed studies, concrete conclusions cannot be made. More consistent evidence was found with regard to the influence of culture on nonverbal behaviors and communication styles, with people being more accepting of a robot that behaved more closely to their own culture. CONCLUSIONS: The research field of human-robot interaction provides the current evidence on the influence that culture has on attitudes towards humanoid and animal-like robots, but more research that is guided by strong theoretical frameworks is needed. CLINICAL RELEVANCE: With the increased use of humanoid robots in the healthcare system, it is imperative that nurses and other healthcare professionals explore and understand the different factors that can affect the use of robots with patients.

Earbuds, smartphones, and music. Spiritual care and existential changes in COVID-19 times.

Rooted in a Durkheimian functionalist reading of religion, in this article, we present and discuss the results of a scoping study of on-line sources on the delivery of spiritual care during the COVID-19 pandemic in England. Spiritual care highlights the bond between healthcare and religion/spirituality, particularly within the growing paradigm of holistic and humane care. Spiritual care is also an area where the importance of the physical presence of receivers and providers is exceptionally important, as a classic anthropological understanding of the religious ritual would maintain. Three themes were found, which speak to changes brought about by the pandemic. These revolve around disembodiment, solitude, and technology in spiritual care, of religious and non-religious nature. A fourth theme encapsulates the ambivalence in the experience of spiritual care delivery, whereby distant and virtual care could only partially compensate for the impossibility of physical presence. On the one hand, we draw from anthropology of the ritual and phenomenology to make the case for the inalienability of intercorporeality in being there for the other. On the other hand, relying on digital religious studies and post-human theories, we argue for an opening up to new ways of conceptualising the body, being there, and being human.

Socially assistive robots in health and social care: Acceptance and cultural factors. Results from an exploratory international online survey.

AIM: This study explored the views of an international sample of registered nurses and midwives working in health and social care concerning socially assistive robots (SARs), and the relationship between dimensions of culture and rejection of the idea that SARs had benefits in these settings. METHODS: An online survey was used to obtain rankings of (among other topics) the extent to which SARs have benefits for health and social care. It also asked for free text responses regarding any concerns about SARs. RESULTS: Most respondents were overwhelmingly positive about SARs' benefits. A small minority strongly rejected this idea, and qualitative analysis of the objections raised by them revealed three major themes: things might go wrong, depersonalization, and patient-related concerns. However, many participants who were highly accepting of the benefits of SARs expressed similar objections. Cultural dimensions of long-term orientation and uncertainty avoidance feature prominently in technology acceptance research. Therefore, the relationship between the proportion of respondents from each country who felt that SARs had no benefits and each country's ratings on long-term orientation and uncertainty avoidance were also examined. A significant positive correlation was found for long-term orientation, but not for uncertainty avoidance. CONCLUSION: Most respondents were positive about the benefits of SARs, and similar concerns about their use were expressed both by those who strongly accepted the idea that they had benefits and those who did not. Some evidence was found to suggest that cultural factors were related to rejecting the idea that SARs had benefits.

Views about perceived training needs of health care professionals in relation to socially assistive robots: an international online survey.

BACKGROUND: As Artificial Intelligence and social robots are increasingly used in health and social care, it is imperative to explore the training needs of the workforce, factoring in their cultural background. OBJECTIVES: Explore views on perceived training needs among professionals around the world and how these related to country cultures. DESIGN: Cross-sectional, descriptive, mixed-methods international online survey. METHODS: Descriptive statistical analysis explored the ranking across countries and relationships with three Hofstede cultural dimensions. Thematic analysis was conducted on the open-ended text responses. RESULTS: A sample of N = 1284 participants from eighteen countries. Knowing the capabilities of the robots was ranked as the top training need across all participating countries and this was also reflected in the thematic analysis. Participants' culture, expressed through three Hofstede's dimensions, revealed statistically significant ranking differences. CONCLUSIONS: Future research should further explore other factors such as the level of digital maturity of the workplace. IMPACT STATEMENT: Training needs of health and social care staff to use robotics are fast growing and preparation should factor in patient safety and be based on the principles of person- and culture-centred care.

Establishing hospice care for prison populations: An integrative review assessing the UK and USA perspective.

BACKGROUND: models of care based on the hospice model have delivered effective support to dying people since their inception. Over the last 20 years this form of care has also been introduced into the prison system (mainly in the United States) to afford terminally ill inmates the right to die with dignity. AIM: the aim of this review is to examine the evidence from the United States and the United Kingdom on the promotion of palliative care in the prison sector, summarizing examples of good practice and identifying barriers for the provision of end-of-life care within the prison environment both in the USA and UK. DESIGN: an integrative review design was adopted using the Green et al. model incorporating theoretical and scientific lines of enquiry. DATA SOURCES: literature was sourced from six electronic databases between the years 2000 and 2011; the search rendered both qualitative and quantitative papers, discussion papers, 'grey literature' and other review articles. RESULTS: the results highlight a number of issues surrounding the implementation of palliative care services within the prison setting and emphasize the disparity between the USA model of care (which emphasizes the in-prison hospice) and the UK model of care (which emphasizes palliative care in-reach) for dying prisoners. CONCLUSION: the provision of palliative care for the increasing prison population remains under-researched globally, with a notable lack of evidence from the United Kingdom.

A qualitative exploration of care homes workers' views and training needs in relation to the use of socially assistive humanoid robots in their workplace.

AIM: The study aimed to explore the views and attitudes of care home workers about the socially assistive robot that was trialled in their workplace, in order to identify training needs in relation to the hypothetical future use of these robots in their workplace. BACKGROUND: Care home workers face challenging workload conditions which may require the exploration of new solutions such as the use of socially assistive robots (SARs). METHODS: This is a qualitative descriptive study which used semi-structured interviews. Care home workers (n = 23) in the UK participated in the study, and data collection took place between October 2019 and January 2020. NVivo software was used for data management, and a thematic inductive analysis was conducted. RESULTS: Findings indicated that many participants were open to the use of robots and valued the potential usefulness of SARs in the care setting. However, some participants showed resistance to the use of robots and did not feel comfortable with the idea of working alongside them. Participants wished to receive technical training that would enable them to be competent in using SARs. Participants took seriously their duty of care to the older people and thus wanted to ensure that the use of the SAR would not negatively impact on the care being provided. Robots were viewed as having potential to be supplementary to human carers, such as sharing the workload and improving upon the care already being provided. CONCLUSIONS: Care home workers express both positive and negative views in relation to the hypothetical future deployment of socially assistive humanoid robots in their workplace. IMPLICATIONS FOR PRACTICE: The findings highlighted the importance of values around person-centred care which should be taken into account when planning for the implementation of robots in social care settings and training care home workers in how to work with robots.

Empowering refugee families in transit: the development of a culturally competent and compassionate training and support package.

Background: Refugee parents who fled conflicts suffered violence and traumas and face huge challenges in supporting the health and welfare of their children while in transit. Aims: To describe the development of a culturally competent and compassionate training and support package (TSP) for nurses, social and health care workers and volunteers, with a focus on parenting needs among unsettled refugees fleeing conflict. Methods: The multi-method approach included: a scoping review covering parenting needs of refugees fleeing conflict zones; collection of stories from refugee parents, healthcare workers and volunteers via a mobile application; discussions between team members; a piloted and evaluated curriculum. Results: High levels of family distress and deterioration of parental identity were identified. Informed by these results, the curriculum is articulated along 20 bite-sized learning units, covering four age stages of childhood as well as targeting adults' well-being. Pilot training was evaluated positively, confirming feasibility and usefulness of the TSP. Conclusions: Unsettled refugee parents fleeing conflicts face psycho-social and practical difficulties negatively affecting their parenting skills. The care workforce should be trained in order to provide culturally competent and compassionate support to help these families. Open access digital platforms are promising as autodidactic and self-help tools among hard-to-reach populations.

Enactment of compassionate leadership by nursing and midwifery managers: results from an international online survey.

AIM: To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management. METHOD: A cross-sectional online survey. Using a snowballing sampling method, 1217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. First, content analysis of the responses was conducted, and second, a relative distribution of the identified themes for the overall sample and for each participating country was calculated. RESULTS: Six main themes were identified describing the attributes of a compassionate leader: (1) Virtuous support, (2) Communication, (3) Personal virtues of the manager, (4) Participatory communication, (5) Growth/flourishing/ nurturing and (6) Team cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour. CONCLUSION: The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members' difficulties (especially concerning child and other caring responsibilities), active support of and advocacy for the staff team and active problem solving and conflict resolution. While there were differences between the countries' views on compassionate healthcare management, some themes were widely represented among different countries' responses, which suggest key indicators of compassionate management that apply across cultures.

Transcultural communication in CAMHS: developing practitioners' awareness with an online cultural competency course.

BACKGROUND: CAMHS practitioners must be skilled in transcultural communication in order to meet the needs of their culturally diverse clients. METHOD: This article reports on the use of an online cultural competence course1 in promoting transcultural communication with CAMHS practitioners. RESULTS: A qualitative analysis of practitioners' course assignments indicated that new learning had occurred in relation to transcultural communication. Moreover, many practitioners reported actual changes to their clinical practice as a result. CONCLUSIONS: The course is considered to be an example of good practice for developing practitioners' awareness of transcultural communication, and prompting positive practices that may contribute to a more culturally competent CAMHS.

The Importance of Being a Compassionate Leader: The Views of Nursing and Midwifery Managers From Around the World.

INTRODUCTION: Despite the importance of compassionate leadership in health care, many of the existing publications do not account for the effect of culture. The aim of this study is to explore the views of nursing and midwifery managers from different countries in relation to the definition, advantages, and importance of compassion. METHODOLOGY: A cross-sectional, descriptive, exploratory online survey was conducted across 17 countries, containing both closed and open-ended questions. Data from N = 1,217 respondents were analyzed using a directed hybrid approach focusing only on qualitative questions related to compassion-giving. RESULTS: Four overarching themes capture the study's results: (1) definition of compassion, (2) advantages and importance of compassion for managers, (3) advantages and importance of compassion for staff and the workplace, and (4) culturally competent and compassionate leadership. DISCUSSION: Innovative research agendas should pursue further local qualitative empirical research to inform models of culturally competent and compassionate leadership helping mangers navigate multiple pressures and be able to transculturally resonate with their staff and patients.

Enablers and barriers to the implementation of socially assistive humanoid robots in health and social care: a systematic review.

OBJECTIVES: Socially assistive humanoid robots are considered a promising technology to tackle the challenges in health and social care posed by the growth of the ageing population. The purpose of our study was to explore the current evidence on barriers and enablers for the implementation of humanoid robots in health and social care. DESIGN: Systematic review of studies entailing hands-on interactions with a humanoid robot. SETTING: From April 2018 to June 2018, databases were searched using a combination of the same search terms for articles published during the last decade. Data collection was conducted by using the Rayyan software, a standardised predefined grid, and a risk of bias and a quality assessment tool. PARTICIPANTS: Post-experimental data were collected and analysed for a total of 420 participants. Participants comprised: older adults (n=307) aged ≥60 years, with no or some degree of age-related cognitive impairment, residing either in residential care facilities or at their home; care home staff (n=106); and informal caregivers (n=7). PRIMARY OUTCOMES: Identification of enablers and barriers to the implementation of socially assistive humanoid robots in health and social care, and consequent insights and impact. Future developments to inform further research. RESULTS: Twelve studies met the eligibility criteria and were included. None of the selected studies had an experimental design; hence overall quality was low, with high risks of biases. Several studies had no comparator, no baseline, small samples, and self-reported measures only. Within this limited evidence base, the enablers found were enjoyment, usability, personalisation and familiarisation. Barriers were related to technical problems, to the robots' limited capabilities and the negative preconceptions towards the use of robots in healthcare. Factors which produced mixed results were the robot's human-like attributes, previous experience with technology and views of formal and informal carers. CONCLUSIONS: The available evidence related to implementation factors of socially assistive humanoid robots for older adults is limited, mainly focusing on aspects at individual level, and exploring acceptance of this technology. Investigation of elements linked to the environment, organisation, societal and cultural milieu, policy and legal framework is necessary. PROSPERO REGISTRATION NUMBER: CRD42018092866.

Transcultural Nursing Society position statement on human rights.

In 2006, the Transcultural Nursing Society created a business plan with a firm commitment to social change and the support of human rights. One of the primary goals of the plan was to seek recognition from the United Nations as a Human Rights Organization. As a first step in articulating this goal, the board of trustees of TCNS tasked a small group of Transcultural Nursing Scholars to develop a position statement. This article is the culmination of the collaborative task force's efforts to define how TCNS seeks the fulfillment of human rights for people of all cultures worldwide.

Cultural competence in action for CAMHS: development of a cultural competence assessment tool and training programme.

This article details the development of a tool to measure the cultural competence of individuals working within the Children and Adolescent Mental Health Services (CAMHS). The CAMHS Cultural Competence in Action Tool - known as the CAMHS 'CCATool' - was one of the components of a national project which aimed at promoting cultural competence within CAMHS. The other component was a two day training programme. Both components were based on the Papadopoulos, Tilki and Taylor model of cultural competence development. The article also outlines the educational principles and learning strategies used in the training.

Views of nurses and other health and social care workers on the use of assistive humanoid and animal-like robots in health and social care: a scoping review.

BACKGROUND: Robots are introduced in many health and social care settings. OBJECTIVES: To provide an overview of the existing evidence related to the views of nurses and other health and social care workers about the use of assistive humanoid and animal-like robots. METHODS: Using the Joanna Briggs Institute guidelines we searched MEDLINE, PUBMED, CINHAL, EMBASE, PsycInfo, Web of Science, and IEEE Xplore digital library. Nineteen (19) articles met the criteria for inclusion. RESULTS: Health care workers reported mixed views regarding the use of robots. They considered an array of tasks that robots could perform; they addressed the issue of patient safety and raised concerns about privacy. CONCLUSIONS: A limited number of studies have explored the views of health care workers about the use of robots. Considering the fast pace with which technology is advancing in the care field, it is critical to conduct more research in this area. Impact Statement: Robots will increasingly have a role to play in nursing, health and social care. The potential impact will be challenging for the healthcare workforce. It is therefore important for nurses and other health and social care workers to engage in discussion regarding the contribution of robots and their impact not only on nursing care but also on future roles of health and social care workers.