The moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence in Korean public health nurses.

BACKGROUND: In an increasingly multicultural society, cultural competence and transcultural self-efficacy of public health nurses is important for providing culturally congruent care for client from diverse cultural background. To improv this, it is needed tailored and effective educational program based on the cultural competence educational needs. This study investigated the moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence. METHODS: This cross-sectional study recruited 217 public health nurses in Korea using convenience sampling from August 2018 to January 2019. A direct questionnaire was used to collect data. Study variables were analyzed using descriptive statistics, correlation, and the Hayes PROCESS macro (Model 1) moderation model. RESULTS: The mean scores for transcultural self-efficacy, cultural competence educational needs, and cultural competence were 62.33 ± 11.08, 58.19 ± 15.08, and 97.96 ± 17.09, respectively. Transcultural self-efficacy and cultural competence educational needs were positively associated with cultural competence. In the tested model, cultural competence educational needs had a conditional moderating effect on the relationship between transcultural self-efficacy and cultural competence. The positive association between transcultural self-efficacy and cultural competence was significant at low, medium, and high levels of cultural competence educational needs and stronger for those with high needs. CONCLUSIONS: Cultural competence educational needs may be an important determinant of cultural competence among public health nurses. To effectively increase cultural competence, transcultural self-efficacy should be increased by education programs tailored by cultural competence educational needs.

Not just a policy; this is for real. An affirmative action policy to encourage Aboriginal and Torres Strait Islander peoples to seek employment in the health workforce.

Delivery of culturally safe healthcare is critical to ensuring access to high-quality care for indigenous people. A key component of this is for Aboriginal and Torres Strait Islander people to be participants in the health workforce. The proportion of indigenous people in the health workforce should at least equate to the proportion in the population served. We describe the development and implementation of a successful affirmative action employment policy at Monash Health, one of Australia's largest Academic Health Centres, and provide perspective on its adoption.

An innovative educational strategy to addressing cultural competence in healthcare for quilombola women.

BACKGROUND: The Quilombola community is made up of descendants of enslaved Africans. These people represent an ethnic minority group within the Brazilian Black population with worse health indicators including higher rates of maternal mortality. CONTEXT: The Brazilian National Guidelines for education of health professionals state that cultural competence and education of ethnic-racial relations need to be reinforced. ACTIVITIES: An action research initiative was developed with the main goal of contributing to the development of cultural competence, interprofessional education, and collaborative work as well as improving the maternal and child indicators of the Quilombola community. An elective module for undergraduate health courses with the subject "Cultural Competence in Health Care for Quilombola Women" was implemented. Data on health-related needs identification, students' perceptions about interactions with the community, and competencies necessary to work with the Quilombola community were considered. OUTCOMES: Our educational strategy reinforces the importance of considering the processes that influence the health care of this population. The reflective capacity and communication skills emerged as the most important attitudinal and psychomotor components, respectively. FUTURE DIRECTIONS: Sustainability comes from partnerships established between the Quilombola community and the university to institutionalize educational and research strategies. This project contributes to reducing health inequities and deconstructing racism in the training of future health professionals. CONCLUSIONS: The creation of links, the building of trust between users and health staff, and the ability to reflect, with emphasis on communication, were shown as the main components of culturally competent behavior in maternal health care in the studied Quilombola population.

Internationally Educated Nurses' and Their Contributions to the Patient Experience

Internationally educated nurses (IEN) are a group who reflect Canada's diverse population as a result of rising immigration trends. There is increasing diversity of the general population in Canada and health service disparities exist. Reducing these disparities among the healthcare workforce and the patients they care for is important to meet language and other cultural needs of patients from different ethnic backgrounds. This article describes a study that examined internationally educated nurses' transition experiences in the field of nursing with the objective of describing their unique contributions to the patient care experience. A review of the literature provides background information, followed by the study methods, findings, and discussion. Descriptive phenomenology guided this qualitative study that included 11 participants. Findings from this study illustrate how IENs perceive themselves as an asset to nursing and patient care. Implications for the future of nursing education, practice, research, and administration are offered. Healthcare providers that reflect the diversity of Canada's population and can offer unique cultural perspective have potential to improve the patient experience during a hospital stay.

Developing a Web Site: A Strategy for Employment Integration of Internationally Educated Nurses.

In Canada and elsewhere, the case for hiring internationally educated nurses (IENs) has not been adequately made and guidance for employers is lacking. The Web site Internationally Educated Nurses: An Employer's Guide, launched in 2012, is intended to provide healthcare employers in Ontario with comprehensive information on the hiring and integration of IENs. An evaluation framework and mixed methods design were used to determine the usability of the site in relation to its goal. Convenience sampling was employed to select participants representing specified users (i.e., healthcare employers). Overall evaluation of usability was positive. Participants indicated that it raised their awareness of the advantages of hiring and integrating IENs to address shortages, increase workforce diversity, and provide culturally competent care. Future projects should focus on collaboration with employers to increase the uptake of IENs.

Au Canada et ailleurs, les avantages de l'embauche des infirmières et infirmiers diplômés à l'étranger (IIDE) n'ont pas été expliqués adéquatement et les employeurs manquent d'orientation à ce propos. Le site Web Internationally Educated Nurses: An Employer's Guide (Infirmières et infirmiers diplômés à l'étranger: Un guide destiné aux employeurs, en anglais seulement), lancé en juin 2012, vise à fournir aux employeurs dans le domaine des soins de santé de l'Ontario des renseignements complets sur l'embauche et l'intégration des IIDE. À partir d'un cadre d'évaluation et de diverses méthodes, le site Web a été soumis à une analyse afin de déterminer sa facilité d'utilisation en fonction de son objectif. Un groupe de participants représentant des utilisateurs précis (les employeurs dans le domaine de la santé) a été constitué au moyen d'un échantillonnage de commodité. Globalement, le résultat de l'évaluation de la facilité d'utilisation du site Web s'est révélé positif. Les participants ont indiqué que le site avait contribué à mieux les sensibiliser aux avantages et à l'importance de l'embauche des IIDE pour résoudre les problèmes de pénurie, pour accroître la diversité de l'effectif et pour offrir des soins adaptés sur le plan culturel. Les projets futurs devraient être axés sur une collaboration avec les employeurs afin d'accroître l'intégration des IIDE.

"When I feel safe, I dare to open up": immigrant and refugee patients' experiences with coproducing healthcare.

OBJECTIVE: Interest in the coproduction concept in healthcare is increasing. According to coproduction, services are, unlike goods, always coproduced by a user and a service provider. This study explored how immigrants and refugees perceive the coproduction of their healthcare service in clinical encounters. METHODS: We conducted semi-structured interviews with thirteen patients with varied backgrounds and health problems. Participants were purposefully recruited in an interdisciplinary clinic for immigrants and refugees at a Danish University Hospital. Interviews were transcribed, anonymized, and analyzed using meaning condensation. RESULTS: Patients emphasized the importance of a safe space where they could be themselves and feel supported. This encouraged them to be open and assume an active role in the coproduction of their health. A stable therapeutic alliance based on kindness and kinship helped them find strength and take responsibility for their own health. CONCLUSIONS: This study improves our understanding of how immigrants and refugees experience the coproduction of healthcare services. Further studies, evaluating long-term outcomes of coproduction efforts, are required. PRACTICE IMPLICATIONS: Providing a safe space in which health professionals have time to listen and empathically validate immigrant and refugee patients' lived realities, can enable patients to open up and become agents of their own health.

Critical Competencies of Military Embedded Health and Performance Professionals: The "Culture General" Approach.

Human performance teams (HPT) delivering a wide range of services within military unit communities serve as a model for advancing business practices in support of the 2018 National Defense Strategy. Relatively new, the demand for these embedded professionals continues to grow in response to its favorable proximity, community-based design, operationalized delivery system, and adaptive business practices. However, many civilian professionals come from diverse disciplines of specialties and experiences. As they integrate into unit communities, it becomes known that many do not possess formal training or experience working with the US military or its Servicemembers, delivering community-based services, operating in the capacity of a force multiplier, or culturally adapting their professional skills. Given the steep learning curve in transitioning from a conventional delivery model to the military embedded model, even newly minted military health and performance professionals may be underprepared when they arrive at their assigned military unit communities. In this article, we examine the military's embedded health and performance service delivery model. We add specific focus on those critical "embedded" professional competencies and skills foundational to establishing and sustaining thriving service delivery. We then offer strategies and tools collected from embedded health and performance professionals currently serving in military unit communities across the Department of Defense (DoD). Finally, we provide a rationale for the need for embedded competency training to improve the preparedness of professionals who are currently serving, will be serving, or have a general interest in serving as an embedded professional within DoD military unit communities.

Endocrine Nurses Society Position Statement on Transgender and Gender Diverse Care.

The Endocrine Nurses Society (ENS) is committed to clinical excellence in the art and science of endocrine nursing throughout the world. ENS recognizes that transgender and gender diverse (TGD) individuals face challenges and inequities that place them in the realm of health disparities. Further, TGD individuals often face substantial barriers to care and have difficulty finding healthcare providers who are knowledgeable about the unique health needs of this patient population. ENS recognizes that endocrine nurses care for young adult and adult TGD individuals. This position statement outlines recommendations for healthcare providers and organizations seeking to embrace a gender-affirming approach to care and increase access to high-quality, comprehensive care for TGD individuals. This Position Statement was accepted by ENS on September 8, 2020 and has been endorsed by the European Society of Endocrinology Nurse Committee, European Society of Paediatric Endocrinology Nurses, Pediatric Endocrine Nursing Society, Endocrine Nurses' Society of Australasia, and the Federation of International Nurses in Endocrinology.

LA COMUNICACIÓN, OBSERVACIÓN Y ÉTICA COMO ESENCIA DEL CUIDADO CULTURAL DE ENFERMERÍA / COMMUNICATION, OBSERVATION AND ETHICS AS THE ESSENCE OF CULTURAL NURSING CARE

En las dos décadas que llevamos del siglo XXI, pareciera que todo cambia de manera casi instantánea, uno de esos cambios, lo es la situación de migración de los seres humanos que se encuentra presente en los cinco continentes que conforman el mundo, esté hecho requiere de profesionales de enfermería preparados para entender el cuidado desde la cultura de la persona a la que se cuida. Durante el siglo XX, la mayoría de los profesionales de enfermería han sido formados bajo el paradigma occidental, las escuelas y facultades, están más preocupadas por la curación que por la prevención, el objetivo del presente artículo es reflexionar sobre la necesidad de profundizar en las habilidades de comunicación, observación y ética que debe tener el profesional de enfermería para otorgar cuidados culturales al ser humano cultural, ante el hecho de que en la mayoría de los países, el profesional de enfermería tiene contacto con diversos seres humanos culturales. El presente artículo de reflexión incluye en la introducción aspectos generales de la cultura y enfermería, en el cuerpo del artículo se habla sobre como la enseñanza de enfermería ha sido permeada por las necesidades de curación más que de los cuidados culturales, se finaliza con la conclusión de que las escuelas y facultades de enfermería deben ser abiertas a aceptar la diversidad cultural que tienen en su país para la enseñanza del cuidado del ser humano, considerando su cultura en combinación con los cuidados occidentales en que han sido formados los profesionales de enfermería, a partir de considerar que enfermería fue una de las primeras profesiones que durante el siglo XX incluyo en su lenguaje el concepto de cultura, por otro lado es conveniente mencionar que durante el tiempo que llevamos del siglo XXI pocos son los países en donde las escuelas de enfermería incluyen cuidados culturales del ser humano, que en este momento son primordiales dadas las características de movilidad nacional e internacional que tiene la población mundial.

In the two decades that we have been in the 21st century it seems that everything changes almost instantaneously. One of those changes involves the migration of human beings in the five continents that make up the world, a phenomenon that requires nursing professionals to provide care that considers the culture of each person being cared for. During the 20th century, most nursing professionals were trained under the western paradigm, when schools and faculties were more concerned with cure than prevention. The objective of this article is to reflect on the need to develop the skills of communication, observation, and ethics that the nursing professional must have to provide effective care for people from other countries and cultures. Following an introduction to general aspects of cultural and nursing, the body of this reflection article discusses how nursing education has been dominated by healing priorities rather than cultural considerations. The article ends with the conclusion that nursing schools and faculties should recognize the cultural diversity in their country when teaching the principles of care, and that they consider cultural factors in combination with the western concept of care in the training of nursing professionals. Considering that nursing was one of the first professions during the 20th century to include the concept of culture in its language, it is worth mentioning that in the 21st century there are few countries where nursing schools teach culturally sensitive care. This is now essential given the national and international mobility of the world population.

"It's Just Presence," the Contributions of Aboriginal and Torres Strait Islander Health Professionals in Cancer Care in Queensland.

Objectives: The aim of this research was to explore health professionals' perspectives on the provision of follow-up cancer care for Aboriginal and Torres Strait Islander patients in Queensland. Methods: Semi-structured interviews were conducted with Indigenous and non-Indigenous health professionals who had experience providing care for Indigenous cancer patients in the primary health care and hospital setting. Results: Participants were recruited from six Aboriginal Community Controlled Health Services (n = 17) and from a tertiary hospital (n = 9) across urban, regional, and remote geographical settings. Culturally safe care, psychological support, determining patient needs, practical assistance, and advocating for Indigenous health were identified as enablers to support the needs of Indigenous patients when accessing cancer care, and Indigenous health professionals were identified as the key enabler. Conclusion: Indigenous health professionals significantly contribute to the provision of culturally competent follow-up cancer care by increasing the accessibility of follow-up cancer care services and by supporting the needs of Indigenous cancer patients. All health professionals need to work together and be sufficiently skilled in the delivery of culturally competent care to improve the Indigenous cancer journey and outcomes for Indigenous people. Effective organizational policies and practices are crucial to enable all health professionals to provide culturally competent and responsive cancer care to Indigenous Australians.

Nurses' Experiences of Caring for Patients with Different Cultures in Mashhad, Iran.

BACKGROUND: Mashhad is a center of diverse cultures, where many local and foreign cultures live together in its context. One of the main needs of a society with cultural diversity is transcultural care of patients. Hence, the present study took the first step for care of culturally diversified and minority patients in Mashhad. This research has been conducted to explore the nurses' experience of caring from patients with different cultures. MATERIALS AND METHODS: This study is a qualitative research using phenomenological hermeneutics approach. The participations include nurses who have been working 5 or less than 5 years in the hospitals affiliated to Medical University of Mashhad. They were selected using purposeful sampling method. For data collection, semi-structured, in-depth interview was used. For data analysis, interpretation method was used. The interviews continued until saturation of data was obtained. RESULTS: Data analysis resulted in extraction of 4 themes including ethnocentrism, contradicting perceptions of care, it is not our fault, and lack of cultural knowledge. CONCLUSIONS: The experience of nurses in taking care of patients with other cultures showed that minorities and small cultures have been neglected in Mashhad and hospitalization of such people in hospitals and other clinics is not specific. We recommend that an educational curriculum about transcultural care should be added to nursing courses. Also, necessary equipment and facilities should be considered and prepared for culturally different patients in hospitals.

Leadership style and culturally competent care: Nurse leaders' views of their practice in the multicultural care settings of the United Arab Emirates.

Abstract It is well recognised that nurse leader managers play an important role in facilitating the quality and nature of hospital care, the improvement of work performance and work satisfaction. In the United Arab Emirates (UAE) they face the additional challenge of working within a context of significant linguistic and cultural diversity where leadership in the provision of culturally competent care is a major requirement. With this goal at the fore, a sample of 153 nurse-leader-managers, including matrons, nursing directors, supervisors, nurses-in-charge and in-service education staff from four private and six government hospitals completed the Multifactor Leadership Questionnaire (Bass & Avolio, 2004). The survey also explored participants' perceptions of the characteristics of good leaders and what they needed to do in their particular work place to enhance culturally competent care. The results showed nurseleader-managers used both transformational and transactional leadership attributes but in different combinations across the two hospital types.

A cross-sectional study of the differences in diabetes knowledge, attitudes, perceptions and self-care practices as related to assessment of chronic illness care among people with diabetes consulting in a family physician-led hospital-based first line health service and local government health unit-based health centers in the Philippines.

BACKGROUND: The purpose of this study was to investigate differences in diabetes knowledge, attitudes and perceptions (KAP), self-care practices as related to assessment of chronic illness care among people with diabetes consulting in a family physician-led tertiary hospital-based out-patient clinic versus local government health unit-based health centers in the Philippines. METHODS: People with diabetes consulting in the said primary care services were interviewed making use of questionnaires adapted from previously tested and validated KAP questionnaires and the patients' assessment of chronic illness care (PACIC) questionnaire. Adherence to medications, diabetes diet, and exercise and the number of diabetes consultations were asked. Analysis of variance was used to determine differences in KAP, self-care practices, and PACIC and regression analysis was used to determine any associations of the abovementioned variables to the PACIC ratings. RESULTS: A total of 549 respondents were included in the study. Differences in knowledge, attitudes, perceptions, PACIC, utilization of health services, and adherence to medications and exercise were all statistically significant. Ratings for diabetes knowledge, positive attitudes, and the perceptions of support attitudes and the abilities to perform self care, and the proportions of those properly utilizing health services and adhering to medications and exercise were higher while ratings for negative attitudes, perceived support needs, perceived support received and PACIC were lower among those consulting in the family physician-led health service. CONCLUSIONS: Combining family medicine-based approaches with culturally competent diabetes care may improve knowledge, attitudes, perceptions and self-care practices of and collaborative care with people with diabetes.

Cuidar multiculturalmente competente em saúde infantil e pediatria: Intervenção do enfermeiro especialista / Multiculturally competent care in child health and pediatrics: Specialist nurse intervention

Atualmente as fronteiras entre os países são cada vez mais permeáveis, existindo um maior contacto entre culturas do que outrora, devido à facilidade de mobilidade indivíduos e famílias. Deste modo, observam-se cada vez mais mutações profundas ao nível cultural, social e tecnológico, tornando as sociedades cada vez multiculturais, sendo que, a realidade portuguesa não é exceção. Nos últimos anos têm-se observado um aumento considerável de imigrantes em Portugal, oriundos de países como o Brasil, países africanos de língua portuguesa e países asiáticos como é o Paquistão, o Nepal e Bangladesh. Independentemente da sua proveniência a pessoa é e sempre será o centro dos cuidados de enfermagem, no entanto, as diferenças que a diversidade cultural transporta, mais do que as semelhanças, têm implicações significativas no que concerne à relação entre o enfermeiro e o cliente, podendo colocar em causa a qualidade dos cuidados prestados. Desta realidade, emerge a necessidade de desenvolver esforços no sentido da compreensão das diferenças culturais, de forma que promover cuidados culturalmente sensíveis, respeitando a identidade cultural da criança/jovem e família. A formação avançada constitui uma ferramenta essencial para a compreensão da complexidade associada à multiculturalidade e à interculturalidade, contribuindo assim para o cuidado de enfermagem culturalmente competente. Deste modo, no decorrer deste relatório procurou-se, com base no processo de enfermagem, prestar cuidados culturalmente competentes a clientes pediátricos em diferentes processos de saúde/doença, sustentados pela Teoria da Diversidade e Universalidade do Cuidado Cultural de Madeleine Leininger, pelo Modelo do Cuidado Culturalmente Competente de Campinha-Bacote e, também, pela Filosofia de Cuidados Centrados na Família. O presente relatório reflete o desenvolvimento de competências específicas e comuns de EEESIP, recorrendo a uma metodologia reflexiva, com os seguintes objetivos gerais: 1) Desenvolver competências comuns e específicas de EEESIP que possibilitem a prestação de cuidados à criança, jovem e família nos processos de saúde e de doença, nas suas diferentes fases de desenvolvimento como nos mais diversos contextos de cuidados pediátricos; 2) Desenvolver a competência cultural no cuidar da criança/jovem e família imigrante, nos diferentes contextos pediátricos. 7 A análise critica e reflexiva foi uma constante em todas atividades realizadas nos diferentes contextos de estágio, tendo-se evidenciando o desenvolvimento de competências, a contribuição de saberes e de estratégias no âmbito da enfermagem no que concerne a temática central do presente relatório e, por conseguinte, o desenvolvimento da enfermagem.

Nowadays, the borders between countries are more and more permeable and there is a great contact between different cultures due to the mobility of families. In this way, profound cultural, social, and technological mutations are increasingly being observed, leading to more and more varied societies at cultural level, and the Portuguese reality is no exception. In recent years there has been a considerable increase of immigrants in Portugal, coming from countries such as Brazil, Portuguese speaking African countries and Asian countries such as Pakistan and Nepal. However, the differences brought by cultural diversity, more than the similarities, have significant implications regarding the relationship between the nurse, the child and his/her family, and may jeopardise the quality of care. Thus, efforts should be made to understand the cultural differences to reduce the possible cultural shock, while maintaining and respecting the families' cultural identity. The constant and in-depth training constitutes an essential tool for understanding the complexity associated with multiculturalism and interculturalism, thus contributing to a culturally competent nursing care, integrated into the philosophy of care offered by the Campinha-Bacote's Model of Culturally Competent Care, Madeleine Leininger's Theory of the Diversity and Universality of Cultural Care and also the Philosophy of Family Centred Care. The present report presents the entire pathway for the development of specific and common competencies of the EEESIP, using a reflective methodology, with the following objectives 1) Development of common and specific competencies of the EEESIP which enable the provision of care to children and young people as well as their families in health and disease processes, in their different developmental stages as well as in the most diverse paediatric care settings; 2) Development of multiculturally competent care to migrant children and young people and their families, in the different paediatric settings. The critical and reflective analysis was a constant factor in all activities carried out in the different internship contexts, thus highlighting the development of skills and the contribution of the best strategies in nursing about the main topic of this report.

Atividade educativa para o desenvolvimento de competências culturais de enfermeiras(os) que atuam na saúde indígena na Amazônia paraense / Educational activity for the development of cultural competencies in nurses who work on indigenous health in the Amazon region of Pará

Introdução: A diversidade sociocultural na Amazônia brasileira requer dos profissionais da saúde competências culturais. No entanto, a assistência de enfermagem não difere entre os povos indígenas e não indígenas, a formação profissional e permanente é verticalizada e centrada na operacionalização dos serviços e as competências exigidas na saúde indígena são de natureza técnico-assistencial. Objetivo geral: Desenvolver, implementar e avaliar uma atividade educativa mediada pelos Círculos de Cultura para o desenvolvimento de competências culturais críticas com enfermeiras(os) que atuam na saúde indígena do DSEI Guatoc no estado do Pará. Método: Estudo de intervenção, de enfoque qualitativo com triangulação na obtenção, análise e avaliação dos dados. Utilizou-se os Círculos de Cultura como itinerário de pesquisa no desenvolvimento da atividade educativa. Realizaram-se cinco encontros na CASAI Icoaraci, CASAI e Polo de Marabá e sete encontros na CASAI e Polo Paragominas. Participaram dezenove enfermeiras(os) que atuavam mais de um ano nos serviços e não estavam afastadas do trabalho por qualquer motivo. A investigação iniciou após aprovação pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da USP. Os resultados do perfil das(os) participantes e do instrumento de autoavaliação foram lançados no programa Microsoft Excel, versão 2007, para análise descritiva. Os dados qualitativos foram organizados pela versão livre do software Atlas Ti e analisados segundo a hermenêutica-dialética. Resultados: A maioria das(os) participantes era constituída por mulheres, nortistas, negras e pardas, casadas; formada(o) em Instituições de Ensino Superior privadas; tinha especialização em Saúde Indígena e vínculo empregatício celetista. A autoavaliação não mostrou resultados tendenciosos a respostas socialmente aceitáveis, o que demonstra possível autoavaliação crítica e reflexiva. Emergiu na atividade educativa, mediada pelos círculos de cultura, na investigação temática, o tema gerador dificuldade de comunicação; na tematização, a interculturalidade funcional; e na problematização percebeu-se que ao analisar das situações-problemas as(os) participantes desenvolveram uma transitividade de consciência e produziu-se uma cartilha idiomática. Discussão: O conhecimento regulação é norteador da atuação das(os) participantes, mas durante os Círculos de cultura apresentaram uma transitividade de consciência, especialmente no domínio cognitivo dos atributos sensibilização/consciência e conhecimento cultural, pois manifestaram reflexão, crítica e mobilização no sentido de interconhecimento, reconhecimento e autoconhecimento, apontando para uma aproximação com a Ecologia de saberes e do conhecimento emancipação. Conclusão: Por meio da atividade educativa, mediada pelos círculos de cultura, apreendeu-se que o desenvolvimento de competências culturais na perspectiva crítica é um processo educativo dialogado, coletivo, colaborativo, insurgente e permanente que considera os domínios afetivo, cognitivo e comportamental, que interseccionam aos atributos do desejo, sensibilização/consciência, conhecimento, habilidades e encontros culturais, mas que também compreende a dimensão política da atuação da(o) enfermeira(o) que lê, codifica e interpreta o contexto histórico, social e cultural em que está inserida(o), ressignificando seus saberes, práticas e cuidado do outro e de si. Potencial de impacto da pesquisa: Ressignificar o cuidado e a atuação da(o) enfermeira(o) na saúde de povos tradicionais; contribuir para a teoria de enfermagem transcultural ao abordar as competências culturais a partir do paradigma crítico; impactar na educação permanente de enfermagem ao articular a dimensão profissional com a dimensão sociopolítica como proposta de processo educativo que considera as zonas de conflitos culturais do cotidiano de enfermeiras(os) que atuam em contexto de diversidade sociocultural; produzir um instrumento inédito de autoavaliação das competências culturais de enfermeiras(os) que atuam na saúde indígena. E por fim, produzir inovação por meio de uma tecnologia assistencial que possibilitou o exercício do trabalho coletivo e colaborativo e promoveu a interlocução idiomática do universo cultural indígena com os profissionais de saúde.

Introduction: The sociocultural diversity in the Brazilian Amazon demands cultural competences from the health professionals. Despite this fact, the nursing care provided to indigenous and non-indigenous people does not differ. The professional and permanent training is verticalized and centered around the operation of services. The competences required by the indigenous health have a technical-care nature. General goal: Develop, implement and evaluate an educational activity mediated by Culture Circles focused on the development of critical cultural competences alongside nurses who work on indigenous health at DSEI Guatoc in the state of Pará. Method: Qualitative intervention study approached through the triangulation of data acquisition, analysis and assessment. Culture Circles were used as research itinerary in the development of the educational activity. Five meetings were held at the CASAI Icoaraci, CASAI and Polo de Marabá, and seven meetings were held at CASAI and Polo Paragominas. Among the participants, there were 19 nurses who were working in these services for more than a year continuously without taking a work leave. The investigation started after the approval from the Research Ethics Committee of the University of São Paulo Nursing School. The results of the participants profile and the self-evaluation instrument were collected using Microsoft Excel, version 2007, for descriptive analysis. The qualitative results were organized using the free version of Atlas Ti and analyzed according to the dialectical hermeneutics method. Results: Most of the participants were women, northerner, black and colored, married; alumni from private universities; specialized in indigenous health and in a work contract under the general labor law, known as CLT. The self-evaluation did not show biased results towards socially accepted responses, which can demonstrate critical and reflective self-evaluation. During inquiry stage of the educational activity, mediated by culture circles, communication issues emerged as generative theme; in the thematization stage, the functional interculturality; and in the problematization, it became evident that the participants developed transitive consciousness owing to the analysis of the problem-posing situations, which resulted in the production of a idiomatic booklet. Discussion: The knowledge-regulation is the guiding principle for the work of the participants, yet they presented transitive consciousness during the culture circles. The cognitive domain brought out sensibleness/consciousness and cultural knowledge due to the manifestation of reflection, critical thinking and mobilization towards inter-knowledge, acknowledgement and self-knowledge. These pointed to a closeness to the ecology of knowledge and the knowledge emancipation. Conclusion: Through the educational activity, mediated by the culture circles, it was possible to understand that the cultural competences from a critical perspective is an educational process based on dialogue which can be described as collective, collaborative, insurgent and permanent. It takes into account the domains of affection, cognition and behavior, and intersects with the attributes of desire, sensibleness/consciousness, knowledge, abilities and cultural encounters. Furthermore, it comprehends the political dimension of a nurses work who reads, codes and interprets his or her social, cultural and historical context, changing the meaning of his or her knowledge, practice and care of others and him or herself. Research impact: Changing the meaning of the care and the work of a nurse regarding the health of traditional people; contributing to the transcultural nursing theory through the discussion of cultural competences from a critical paradigm; impacting the permanent nursing education as a result of articulating the professional dimension with the sociopolitical dimension, proposing it as an educational process that considers the cultural-conflicting zones in the daily life of a nurse who works in the context of sociocultural diversity; producing an unprecedented instrument of self-evaluation regarding cultural competences of nurses working on indigenous health; producing innovation by means of a care technology which allowed for collective and collaborative work, and promoted the idiomatic dialogue between the universe of the indigenous culture and the health professionals.