'DANMM that's good!': evaluating the feasibility and acceptability of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Programme across rural, regional and metropolitan NSW-a collaborative study protocol.

INTRODUCTION: This paper will describe the research protocol for the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Project, which will determine the feasibility and acceptability of a cultural mentoring programme designed for Aboriginal and Torres Strait Islander nurses and midwives across five diverse local health districts in New South Wales, Australia. Government and health agencies highlight the importance of culturally appropriate and safe environments for Aboriginal people. Specifically, New South Wales Health prioritises workforce strategies that support Aboriginal people to enter and stay in the health workforce. However, retaining Aboriginal nurses and midwives remains challenging. The DANMM Project aligns with these local and state-wide health plans and strategies, addressing critical issues of workforce cultural safety and retention. METHODS AND ANALYSIS: A mixed-methods study design will be employed to assess feasibility, acceptability and preliminary efficacy of the DANMM Programme across five publicly funded local health districts in New South Wales, Australia. Adhering to cultural safety, a project cultural governance group will be formed. Quantitative outcome measures include the use of questionnaires (Nursing Workplace Satisfaction Questionnaire, Ganngaleh nga Yagaleh Cultural Safety assessment tool). Resource implications will be measured using the Organisational Commitment and Health Professional Program Readiness Assessment Compass. These will be triangulated with individual and group yarning circles to provide a holistic evaluation of the programme. ETHICS AND DISSEMINATION: The study has ethics approval: Aboriginal Health and Medical Research Council (#2054/23); New South Wales Health Human Research Committees (Greater Western Human Research Committee #2022/ETH01971, Murrumbidgee-site-specific approval, Sydney Local Health District-site-specific approval, Western Sydney Local Health District-site-specific approval and Mid North Coast-site-specific approval); and Charles Sturt University Human Research Committee (#2054/23). Findings will be disseminated through peer-reviewed articles, conferences and through roundtable discussions with key stakeholders.

Integrated care competencies and their association with cross-cultural competence among registered nurses: A cross-sectional questionnaire survey.

AIM: To examine the association between the integrated care competencies and cross-cultural competence of registered nurses prior to the integration of social and healthcare services in Finland. DESIGN: A descriptive correlational cross-sectional questionnaire survey was conducted. METHODS: A simple random sample of 10,000 registered nurses was drawn from the Finnish Central Register of Valvira (National Supervisory Authority for Welfare and Health); 7000 of them were sent the online questionnaire, and a total of 1232 registered nurses participated in the study. We collected data using background questions, revised versions of the Competent Workforce for the Future tool in the four domains of client orientation, responsibility for personal or relative's welfare, fluency and clarity of services and access to the services and of the Cross-Cultural Competence of Healthcare Professional tool in the four domains of motivation/curiosity, attitude, skill and emotion/empathy. RESULTS: Participants demonstrated a high level of integrated care competencies (mean = 4.00, SD ± 0.49). An association was observed between integrated care competencies and their domains of skills, motivation/curiosity, emotions/empathy, and cross-cultural competence (p < 0.001). Female sex, older age, more working experience, employment in the private sector, and higher self-rated competence for working in a multicultural environment were positively associated with higher integrated care competencies. CONCLUSION: It is recommended that nurse managers and nurse educators emphasize the development of registered nurses' cross-cultural competence alongside integrated care competencies to meet the needs of different individuals and communities when providing integrated care. PATIENT OR PUBLIC CONTRIBUTION: Finnish registered nurses including all types of nurses, midwives and paramedics working the public and private healthcare, were involved in this study by responding to the online survey.

Jungian Analysis of the Chinese Mythological Image of Sun Wukong.

This paper examines the symbolism of the cultural image Sun Wukong (the Monkey King), a Chinese legendary hero, and how it influenced an eight-year-old boy's psychic development. Through an analysis of Sun Wukong's life from his birth to attaining Buddhahood, a three-phase healing process is identified in Sun Wukong's tale and the psychotherapeutic process: "naming and initiating," "nurturing and taming," and "transforming and transcending," proposed by Dr. Heyong Shen. Sandplay visually highlighted these key clinical changes in conscious awareness and developmental behaviour influencing the boy's individuation process. Images found either in cultural traditions or spontaneously emerging from the unconscious in individuals are of significance in human life, offering pathways to psychic healing and development. Further, myths and cultural resources used in clinical work demonstrate that having cultural competency is invaluable in Jungian analysis. Pathogenic and health-maintenance factors of culture can be explored in future clinical practice and research.

Cet article étudie le symbolisme de l'image culturelle d'un héros légendaire chinois; Sun Wukong (le roi singe). L'article explore comment cette image a influencé le développement psychique d'un garçon de huit ans. À travers une analyse de la vie de Sun Wukong depuis sa naissance jusqu'à ce qu'il atteigne la bouddhéité, un processus de guérison en trois phases est identifié dans le conte de Sun Wukong et dans le processus psychothérapeutique, et proposé par le Dr Heyong Shen : « nommer et initier ¼, « apprivoiser et nourrir ¼ et « transformer et transcender ¼. La thérapie par le jeu de sable a ensuite mis en évidence visuellement ces changements cliniques clés dans la prise de conscience et le comportement développemental, qui ont influencé le processus d'individuation du garçon. Les images trouvées dans les traditions culturelles ou qui émergent spontanément de l'inconscient chez les individus sont importantes dans la vie des êtres humains : elles fournissent des voies de guérison et de développement psychiques. De plus, les mythes et les ressources culturelles utilisés dans le travail clinique montrent que la compétence culturelle est inestimable dans l'analyse jungienne. Les facteurs pathogènes et les facteurs de maintien de la santé - présents dans la culture - peuvent être explorés dans la pratique clinique et la recherche futures.

Este artículo explora el simbolismo de la imagen cultural de Sun Wukong (el Rey Mono), un héroe legendario chino, y cómo influyó en el desarrollo psíquico de un niño de ocho años. A través de un análisis de la vida de Sun Wukong desde su nacimiento hasta alcanzar la Budeidad, se identifica un proceso de curación en tres fases en el cuento de Sun Wukong y en el proceso psicoterapéutico: "nombrar e iniciar", "domar y nutrir" y "transformar y trascender", propuestos por el Dr. Heyong Shen. A continuación, el juego de arena puso de relieve visualmente estos cambios clínicos en la conciencia y en el desarrollo del comportamiento, influyendo en el proceso de individuación del niño. Las imágenes que se encuentran tanto en las tradiciones culturales, como las que que emergen espontáneamente del inconsciente de los individuos son importantes en la vida humana, ya que ofrecen vías para la curación psíquica y el desarrollo. Además, los mitos y los recursos culturales utilizados en el trabajo clínico demuestran que tener competencia cultural es inestimable en el análisis junguiano. Los factores patógenos y de mantenimiento de la salud de la cultura pueden explorarse en la práctica clínica y la investigación futuras.

Self-Reported Level of Cultural Competence of Midwives in the North-West Province of South Africa.

INTRODUCTION: Limited research on cultural competence in nursing, midwifery, and education exists within low- and middle-income countries such as South Africa (SA). This study aimed to describe midwives' self-reported levels of cultural competence toward women receiving maternal care. METHODOLOGY: A descriptive, cross-sectional survey design and an all-inclusive sample of (N = 104; n = 82) midwives yielded a 79% response rate. Data were collected using the Transcultural Self-Efficacy Tool (TSET) questionnaire. Participants included midwives recruited from maternity units of five hospitals in South Africa: different hospitals that included one large district, two regional, and two tertiary hospitals in the North-West Province of SA. An all-inclusive sample of (N = 104; n = 82) midwives participated, representing a 79% response rate. RESULTS: Midwives reported an overall moderate level of competence regarding their knowledge and understanding of cultural factors; it was concerning that their confidence in interviewing patients from different cultural backgrounds on factors such as acculturation and worldview were the lowest. DISCUSSION: To the best of the authors' knowledge, this was the first study to assess the cultural competence of midwives in SA using TSET. The study highlighted the need for midwives' training to improve their cultural competence.

Navigating cultural competence in district nursing.

Cultural diversity is an evolving feature of modern-day society. It is recognised that many factors contribute to culturally competent care and evidence suggests there are still inequalities in care provision to some populations. District nurses (DN) deliver care to individuals', families and communities across varying demographics, and aim to provide high quality evidencebased, person-centred care. The scope of the DN and the community nursing team's practice is far reaching and extends across generations and an array of chronic complex health conditions. Therefore, it is imperative that DNs are aware of aspects surrounding cultural diversity, to ensure they can holistically assess and manage patients on their caseloads and support teams to practice culturally competent care. This article aims to provide an outline of key areas for exploration in cultural competence. It will highlight communication, pain, end of life, nutrition and health disparities to consider barriers and challenges for district nursing practice.

Cultural competence of nursing educators at medical universities of 2nd regional planning in Iran.

BACKGROUND: One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals' health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran. METHODS: The current research was a descriptive and survey study framed within Campinha-Bacote's cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software. RESULTS: The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates' interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants' responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants' responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73. CONCLUSIONS: The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran.

Aboriginal and Torres Strait Islander nurses and midwives culturally safe mentoring programmes in Australia: A scoping review.

Objective/Aim: To examine the experiences of culturally safe mentoring programmes described by Aboriginal and Torres Strait Islander nurses and midwives in Australia.Design: A systematic scoping review.Data Sources: The following databases were accessed: CINAHL Plus with Full Text (EBSCO), EMCARE (Ovid), MEDLINE (Ovid), INFORMIT (Health Collection/Indigenous Collection) and SCOPUS. Support relating to key words and appropriate databases was provided by a university librarian.Review Methods: Search terms across databases were sourced from 1997-2021, identifying a total of 161 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 18 papers reaching full-text review. Of the 18 full-text papers reviewed, six were eligible for inclusion in the final review.Results/Findings: Culturally safe mentorship was a positive experience for Aboriginal and Torres Strait Islander nurses and midwives. Thematic discussion identified three key themes: Mentorship as a way forward, Culture in mentorship, and Cultural safety's role in mentorship.Discussion: Culturally safe mentoring has been a key recommendation in the nursing literature for over 20 years. There is limited knowledge on what constitutes an effective programme as mentoring programmes have not been empirically evaluated or reviewed.Conclusion: This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability.Impact Statement: This review indicates that culturally safe mentoring has been a key recommendation in nursing literature for over 20 years. This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. However, there is limited knowledge of what constitutes an effective programme, as mentoring programmes have not been empirically evaluated or reviewed providing an opportunity for further research.Plain Language Summary: Little is known about Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. However, mentoring programme are seen as a key workforce retention strategy. This scoping review aims to explore and interpret Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. This review concludes that mentoring programmes require content in Cultural Safety and that programmes need to be empirically evaluated.

Nivel de Competencia Intercultural en estudiantes de Ciencias de la Salud desarrollada en práctica clínica / Intercultural competences achieved by health sciences students during the clinical practice

BACKGROUND: During their clinical practice, health Sciences students get acquainted with the cultural diversity of patients and learn to deal with this reality in a model of social learning. AIM: To determine the level of Intercultural Competence in Health Sciences students based on the Confrontation, Resistance, and Cultural Openness (CRAC) model, specific for health professionals. MATERIAL AND METHODS: Semi-structured interviews were conducted with 106 Health Sciences students from three universities in Chile. Content analysis was supported by the software ATLAS.ti version 9. RESULTS: The students progressed through the CRAC model and were able to configure a new level called Cultural Understanding, in which the participants innovated care models and offered new therapeutic schemes with cultural relevance. In addition, a fifth level called Cultural Inclusion was proposed. However, a training process with a marked theoretical/scientific emphasis can overshadow the learning process resulting from reflexive practical experience, reducing its real value such as traditional/ancestral medicine. CONCLUSIONS: The students were able to update the Confrontation, Resistance, Openness, Understanding and Intercultural Inclusion Model. The features of those participants who achieve the highest levels of intercultural competences should be explored and used for the training process.

Challenges for palliative care professionals in providing spiritual care to patients from religious or cultural minority groups: a scoping review of the literature.

In light of the increasing number of people living into advanced age and the intensification of migration flows, care provision to multi-cultural and religious patient populations has become an important concern for many palliative care professionals. The current scoping review aims to explore the main barriers to spiritual care provision for minority groups and identify some strategies to overcome such obstacles. The review draws some general recommendations for researchers, policymakers and clinicians. First, more empirical research on different patient groups is needed; studies should target not only nurses, but also other healthcare providers, to ensure that practice adequately reflects the multidisciplinary nature of palliative care. Secondly, training and education should be offered in various forms and at different levels, as well as go beyond factual knowledge about the beliefs and practices of various religions.

Bridging cultures in palliative care: A qualitative study of the care of Indigenous Australians with advanced illness.

BACKGROUND: Lack of access, late engagement and limited referral for palliative care remain critical issues in supporting Indigenous Australians with life limiting illness. AIM: To explore the experiences and perspectives of Indigenous and non-Indigenous health professionals regarding the provision of palliative care for Indigenous people with advanced disease. DESIGN: Qualitative study involving semi-structured focus groups/interviews with analysis following an inductive thematic approach. SETTING/PARTICIPANTS: A purposive sample (n = 54) of medical, nursing, allied health and Indigenous Hospital Liaison Officers engaged in caring for Indigenous patients at a metropolitan teaching hospital in Australia. RESULTS: Four overarching themes were identified regarding provision of palliative care for Indigenous patients. These were (1) the intersection of cultures - Indigenous peoples, health and palliative care, (2) bridging the cultural divide: the integral role of Indigenous Hospital Liaison Officers, (3) health professionals devolve their responsibility to provide culturally appropriate care and (4) building towards a more holistic, culturally aware provision of palliative care. CONCLUSIONS: For many Indigenous people, the health system may be experienced as inflexible, narrowly focused and even prejudiced and traumatising. For Indigenous patients at the end of life, these challenges are heightened. The Indigenous Hospital Liaison Officers, working at the intersections of these two cultures, are key to negotiating such challenges as they seek opportunities to facilitate communication and understanding between firmly held cultural needs.

Assessing cultural competency among Canadian chiropractors: a cross-sectional survey of Canadian Chiropractic Association members.

BACKGROUND: There is a paucity of research assessing cultural competency among Canadian chiropractors. Therefore, the aims of this study were to (1) measure cultural competency among Canadian chiropractors, (2) understand chiropractors' perspectives of challenges and attitudes regarding the delivery of chiropractic services to equity-seeking communities, and (3) assess contextual factors associated with cultural competency. METHODS: We conducted a cross-sectional survey of members of the Canadian Chiropractic Association (CCA) (May-July 2021). The survey instrument consisted of 57 questions related to demographics, cultural competency, perceptions about health disparities, and challenges in delivery of rehabilitation. Cultural competency was measured using the Cultural Awareness and Sensitivity and Cultural Competence Behaviours subscales of the Cultural Competence Assessment Instrument. We conducted a multivariate linear regression to assess factors that may be associated with cultural competency. RESULTS: A total of 3143 CCA members responded (response rate of 41%). Mean scores for the Cultural Awareness and Sensitivity subscale were 5.8/7 (95% CI 5.7; 5.8) and 4.2/7 (95% CI 4.1; 4.2) for the Cultural Competence Behaviour subscale. Most chiropractors (72-78%) reported observing important cultural health disparities across various care-related outcomes. Cost of services and language were identified as barriers to providing care to equity-seeking communities. Cultural Awareness and Sensitivity scores were weakly associated with gender (men), years of clinical practice, cultural health disparities, the statement "I think some people have an agenda to look for discrimination even where it does not exist (DEI attitudes)," race (Caucasian), and prior DEI training, (R2 = 0.15, p < 0.0001). Cultural Competence Behaviour scores were weakly associated with race (Caucasian), cultural health disparities, prior DEI training, increased years of clinical experience, and higher Cultural Awareness and Sensitivity scores (R2 = 0.19, p < 0.0001). CONCLUSION: This study provides the first description of cultural competency within the chiropractic profession in Canada. Findings suggest a gap between knowledge and behaviour and uncover several barriers and challenges that may inform the development of profession-specific training in cultural competence.

Interventions to prevent or manage obesity in Maori and Pacific adults: a systematic review and narrative synthesis.

OBJECTIVES: Obesity and its sequelae are an increasing problem, disproportionally affecting Maori and Pacific peoples, secondary to multifactorial systemic causes, including the effects of colonisation and the impact of globalisation. There is limited synthesised evidence on interventions to address obesity in these populations. The objective of this review is to identify evaluated interventions for prevention and management of obesity amongst Maori and Pacific adults, assess the effectiveness of these interventions, and identify enablers and barriers to their uptake. DESIGN: Systematic review of databases (Medline, PubMed, EMBASE, CINAHL, Scopus, CENTRAL), key non-indexed journals, and reference lists of included articles were searched from inception to June 2021. Eligibility criteria defined using a Population, Intervention, Control, Outcome format and study/publication characteristics. Quantitative and qualitative data were extracted and analysed using narrative syntheses. Study quality was assessed using modified GRADE approach. RESULTS: From the 8190 articles identified, 21 were included, with 18 eligible for quantitative and five for qualitative analysis. The studies were heterogenous, with most graded as low quality. Some studies reported small but statistically significant improvements in weight and body mass index. Key enablers identified were social connection, making achievable sustainable lifestyle changes, culturally-centred interventions and incentives including money and enjoyment. Barriers to intervention uptake included difficulty in maintaining adherence to a programme due to intrinsic programme factors such as lack of social support and malfunctioning or lost equipment. CONCLUSIONS: Normal weight trajectory is progressive increase over time. Modest weight loss or no weight gain after several years may have a positive outcome in lowering progression to diabetes, or improvement of glycaemic control in people with diabetes. We recommend urgent implementation of Maori and Pacific-led, culturally-tailored weight loss programmes that promote holistic, small and sustainable lifestyle changes delivered in socially appropriate contexts.

Finding more constructive ways forward in the debate over vaccines with increased disability cultural competence.

The aim of this article is to study the discursive construction of disability that takes place in the vaccine-autism controversy from the 1990s to 2000s, and an attempt to develop a more holistic framework to understand vaccine decisions and their motivations. It is argued that the debate over vaccines produces knowledge and meanings about disability, and that the vaccine-autism controversy is kept alive largely because of how it reproduces stigmatising accounts of disability and autism. The suggestion is that if the stigmatising elements of disability were removed in the debate over vaccines, there would be no controversy to keep alive in the broader vaccine debate. Hence, this article is an attempt to increase disability cultural competence in the media and among health authorities and health professionals and therethrough broaden the shared understanding of what it means to be or become disabled. By investigating the driving forces for past vaccine controversies, the goal is to find more constructive ways forward in present day and future debates over vaccines.

Checking the Pulse of Holistic and Culturally Competent Nursing Practice in Pennsylvania.

Traditionally, underrepresented racial and ethnic groups experience marginalization, leading to inequities and disparities in health and health care. A holistic approach to care delivery can help providers meet a culturally diverse patient population's unique healing needs. A systematic assessment of nurses' cultural competency practice was conducted in Pennsylvania to reveal opportunities and provide direction for holistic, culturally competent health care services. This exploratory cross-sectional descriptive study used the Cultural Competence Education and Awareness Survey (CCEAS) to examine cultural competence practices of registered nurses employed in the state of Pennsylvania. A total of 1246 registered nurses completed the survey. Respondents expressed a strong desire for cultural competency. Education and organizational infrastructure to facilitate cultural competency could be improved. Health care leaders and policy makers at all levels should explore opportunities to strengthen nurses' culturally competent practices through ongoing professional-development activities and enhanced organizational infrastructure.

A relação entre arte e vida em vigotski: uma análise conceitual / The relationship between art and life in vygotsky: a conceptual analysis / La relación entre arte y vida en vigotski: un análisis conceptual

Este trabalho teve como objetivo analisar a relação entre arte e vida segundo Vigotski. Para isso, foi realizada uma análise conceitual dos capítulos 1, 7, 9, 10 e 11 da Psicologia da Arte, do capítulo 13 da Psicologia Pedagógica e do texto O significado histórico da crise da Psicologia: Uma investigação metodológica. A pesquisa conceitual consiste na análise semântica dos principais conceitos de uma teoria com o intuito de elucidar seus sentidos ocultos ou confusos e desvendar possíveis contradições e ambiguidades no quadro teórico. Podemos observar que a arte é um fenômeno dialético tanto em sua criação como em seus efeitos. A influência da vida, isto é, da realidade sócio-histórica, na criação artística é indireta, pois ela é sempre mediada pelo psiquismo particular do artista. Já o efeito da arte sobre a vida possibilita que o ser humano se conscientize de sua realidade social e se engaje para mudá-la. A arte é, portanto, transformadora, pois reorganiza o psiquismo e possibilita uma mudança nas condições materiais dos seres humanos.(AU)

This study aims to analyze the relationship between art and life according to Vygotsky. Therefore, a conceptual analysis of chapters 1, 7, 9, 10, and 11 of Psychology of Art, chapter 13 of Educational Psychology and the text The Historical meaning of the Crisis of Psychology: A Methodological Investigation was carried out. Conceptual research consists of the semantic analysis of the main concepts of a theory to elucidate its hidden or confused meanings and to reveal possible contradictions and ambiguities in the theoretical framework. Results show that art is a dialectical phenomenon both in its creation and its effects. The influence of life, that is, of socio-historical reality, on artistic creation is indirect since it is always mediated by the artist's particular psyche. The effect of art on life, on the other hand, allows human beings to become aware of their social reality and engage to change it. Art is, therefore, transformative, as it reorganizes the psyche and enables a change in the material conditions of human beings.(AU)

Este proyecto tuve como objetivo analizar la relación entre el arte y la vida, según Vigotski. Para esto, fue realizado un análisis de los capítulos 1, 7, 9, 10 y 11 de Psicología del arte, del capítulo 13 de Psicología Pedagógica y del texto Él significado histórico de la crisis de la Psicología: una investigación metodológica. La pesquisa conceptual consiste en la analice semántica de los conceptos de una teoría, para aclarar sus significados ocultos o confusos y desvendar contradicciones y ambigüedades em el cuadro teórico. Pudimos observar que, el arte es un fenómeno dialéctico en su creación tanto como en sus efectos. La influencia de la vida, esto es, de la realidad socio-histórica, en la creación artística es indirecta, pues es mediada por el psiquismo particular de lo artista. Así, el efecto del arte sobre la vida habilita que lo ser humano adquiera conciencia de su realidad social y que se comprometa a cambiarla. El arte, consiguientemente, transformadora, pues reorganiza lo psiquismo y habilita un cambio en las condiciones materiales de los seres humanos.(AU)

[Intercultural competences achieved by health sciences students during the clinical practice]. / Nivel de Competencia Intercultural en estudiantes de Ciencias de la Salud desarrollada en práctica clínica.

BACKGROUND: During their clinical practice, health Sciences students get acquainted with the cultural diversity of patients and learn to deal with this reality in a model of social learning. AIM: To determine the level of Intercultural Competence in Health Sciences students based on the Confrontation, Resistance, and Cultural Openness (CRAC) model, specific for health professionals. MATERIAL AND METHODS: Semi-structured interviews were conducted with 106 Health Sciences students from three universities in Chile. Content analysis was supported by the software ATLAS.ti version 9. RESULTS: The students progressed through the CRAC model and were able to configure a new level called Cultural Understanding, in which the participants innovated care models and offered new therapeutic schemes with cultural relevance. In addition, a fifth level called Cultural Inclusion was proposed. However, a training process with a marked theoretical/scientific emphasis can overshadow the learning process resulting from reflexive practical experience, reducing its real value such as traditional/ancestral medicine. CONCLUSIONS: The students were able to update the Confrontation, Resistance, Openness, Understanding and Intercultural Inclusion Model. The features of those participants who achieve the highest levels of intercultural competences should be explored and used for the training process.

Inclusivity in Graduate Nursing Education: A Scoping Review.

BACKGROUND: Advancing inclusivity in graduate nursing education is paramount for preparing diverse nursing leaders to mobilize change within health care and educational systems. This scoping review examined inclusivity in graduate nursing education. METHOD: CINAHL, Medline, and ERIC databases were searched for studies published in English since 2011. Key journals and reference lists of included studies were hand searched. Included studies focused on inclusivity in the context of graduate nursing education. RESULTS: Data from 31 included studies are presented. Most of the studies (n = 22) aimed to cultivate inclusivity among students, primarily through cultural competence training. A few studies enacted inclusivity through program-level strategies (n = 4) or explored the lived experiences of diverse students (n = 5). CONCLUSION: Future research and education initiatives should advance a more holistic, intersectional approach to cultivating inclusivity, as well as emphasize enacting inclusivity through strategies to transform the learning environment. [J Nurs Educ. 2022;61(12):679-692.].

Providing culturally competent and universal health care in the Peruvian Amazon: The role of medical authority.

Peru's Ministry of Health promotes the provision of culturally competent and universal health care. To do so they have implemented policies aimed at addressing indigenous peoples' social, geographic, and financial barriers to health care as well as cultural gaps between them and (bio)medical providers. While scholars argued that these policies have fallen short, their explanations have ignored the role that medical providers' professional authority plays in implementing these policies. This study examined how medical providers aim to provide culturally competent care and facilitate patients' use of medical services while protecting their professional authority. This includes preserving control over their space of work and their capacity to legitimately diagnose, treat, and prognosticate medical problems. Ethnographic observations and 50 interviews conducted between May 2017 and February 2018 show that to facilitate the provision of culturally competent and universal health care, medical providers engaged in non-clinical tasks, trespassed bureaucratic rules, tolerated and integrated the use of traditional medicine, and expanded the time and place of their practice. To advance these strategies, medical providers sacrificed aspects of their social authority (e.g., their autonomy over their work) and their cultural authority (e.g., their ability to define treatment). However, providers also asserted aspects of their professional authority such as the ability to give patients instructions and advice and control over the use of traditional medicine. The latter had the potential of deterring some women from having institutional births, thus reproducing some of the constraints that indigenous people face in accessing health care.

Can mental healthcare for Muslim patients be person-centred without consideration of religious identity? A concurrent analysis.

BACKGROUND: Muslims constitute the largest, fastest growing religious minority in the UK. Globally, nurses are legally, morally and ethically obliged to provide non-discriminatory, person-centred, culturally sensitive care. This obligation includes supporting people with their religious needs where appropriate, but there is evidence this is not always happening, particularly for Muslims in mental health care. AIMS: This paper reviewed primary research to address the question: Can mental healthcare for Muslims be person-centred without consideration of religious identity? METHODS: Narrative synthesis and concurrent analysis. Searches were conducted post 2000 in MEDLINE, CINAHL, SAGE, PsychINFO and ASA with terms: 'Muslim', 'Islam* ', 'mental health', 'nurs* ', 'person-cent* ', 'religio* '. Narrative data were analysed for commonalities and themes. FINDINGS: Seven studies of sufficient quality were analysed. Unconscious religious bias was the overarching theme linking the findings that healthcare staff felt ill-prepared and lacked necessary knowledge and experience to work with diverse patient groups. Unconscious racial bias contributed to limited cultural/ religious competence in treatment and care. CONCLUSION: Religious identity is core for Muslim patients, so this group may not be receiving the person-centred care they deserve. Nurses need cultural and religious competence to deliver person-centred, holistic care to diverse patient populations, yet the importance of religious practice can be overlooked by staff, with harmful consequences for patient's mental and spiritual welfare. This paper introduces a welcome pack that could help staff support the religious observance of those Muslim patients/service-users wishing to practice their faith during their stay in health services.