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.

The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study.

BACKGROUND: Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia. METHODS: A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05. RESULTS: The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge. CONCLUSIONS: The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.

Examination of individualised care behaviours and ethnocentrism of nurses caring for refugees: A descriptive and exploratory study.

BACKGROUND: Qualified individualised nursing care should be provided to all communities and ethnic groups with free of ethnocentrism. AIMS: To evaluate nurses' individualised care behaviours and ethnocentric attitudes and predict the relationship between their individualised care behaviours and ethnocentric attitudes. DESIGN: A descriptive and exploratory study. METHODS: This study was conducted with 250 nurses working in a public and two private hospitals in a city, an area with many refugees. Data were collected using the Ethnocentrism Scale and Individualised Care Behaviours Scale. Structural equation model analysis to test hypothetical model and descriptive statistics were used. RESULTS: Nurses working in the private hospitals had a higher individualised care decision control mean score. Those nurses who enjoyed spending time with people from different cultures had lower mean ethnocentrism scale scores, higher individualised care clinical status, personal life and decision control status subscales mean scores compared to other nurses. Mean scores of the individualised care personal life and decision control status subscales of the nurses who followed the literature on transcultural nursing was higher. A significant relationship between the ethnocentrism levels and individualised care behaviours was identified. Accordingly, the ethnocentric attitudes of the nurses negatively affected their individualised care behaviours, and the model established between the two concepts is statistically appropriate. CONCLUSIONS: Nurses who work in private hospitals, receive intercultural nursing education and enjoy spending time with different cultures have higher individualised care behaviours and lower ethnocentrism levels. Ethnocentric attitudes of the nurses negatively affected their individualised care behaviours. Care strategies should be developed that consider the factors that will maximize individualised care practices that minimize ethnocentric behaviours among nurses. IMPLICATIONS FOR THE PROFESSION: Increasing awareness on individualised care behaviours, ethnocentric attitudes and effected factors will contribute to improve of nursing care quality of nurses while giving care to individuals from different cultures.

Nurses' experiences of providing transcultural nursing care to minority patients in Yunnan province: A descriptive qualitative study.

Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high-quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals.

[Implementation of an Advanced Nursing Practice to advance transcultural healthcare: A practical development project]. / Implementierung von Advanced Nursing Practice zur Förderung transkultureller Versorgung.

Implementation of an Advanced Nursing Practice to advance transcultural healthcare: A practical development project Abstract. Background: Patients and staff with different cultural backgrounds encounter each other in different roles at the children's hospital. Cultural differences are at the heart of misinterpretations and misunderstandings that can result in errors and prolong hospitalisation. Aim: To meet the challenges of reaching a common understanding in trans-cultural care, improve empowerment and ensure adequate treatment of children and family alike we introduced an ANP trans-cultural care team (ANP-TKV). Methods: The role of the ANP-TKV team was conceived as a project, encompassing a stakeholder and risk analysis, defining of the organisation, the setting of milestones, resources and controlling, as well as establishing an information concept. Results: The project concept successfully integrated and consolidated the APN-TKV team into our hospital activity. The team is now regularly consulted to manage complex trans-cultural situations, sensitises diverse professional groups and initiates professional inputs. It also provides helpful material and is able to anticipate potential current trans-cultural issues. Discussion: The evidence-based work of the ANP-TVK team has exerted positive effects on therapeutic teams as well as patients and their families and initiates a cultural change within the hospital. It is now an operative addition to the hospital's strategic commission. Further development of the meaning of trans-cultural and the question of allocation of financial and time resources to the APN-TKV team are presently under review.

Transcultural Adaptation of Tibetan Nursing Trainees: A Case Study of "9+3" Vocational Technical Students in Sichuan Province, China.

BACKGROUND Nursing education is an important part of the "9+3" vocational education program led by Sichuan Province. In the internship stage, nursing students of Tibetan ethnicity may have problems of intercultural adaptation in the process of getting along with patients, which may affect the effective nursing outcome. The purpose of this study was to clarify the current situation of transcultural adaptation of Tibetan trainee nurses and to provide more theoretical support and guidance. MATERIAL AND METHODS We collected 237 valid survey questionnaires, based on Ward's acculturation process model, from a total of 363 Tibetan trainee nurses in the "9+3" free vocational education program in Chengdu, Luzhou, and Nanchong of Sichuan Province. The SPSSAU project (2020), an online application software retrieved from https://www.spssau.com, was used for data coding and archiving. RESULTS The results of questionnaire and data analysis showed that the overall level of transcultural adaptation of Tibetan trainee nurses was that the number of people with poor adaptation was slightly higher than those with good adaptation, and most Tibetan trainee nurses were in the middle level. Meanwhile, sociocultural adaptation was better than psychological adaptation. There were no statistically significant differences among the 4 grouping variables: gender, student home region, the city where the internship hospital was located, and whether they were from a single-child family or not. CONCLUSIONS The results revealed that there was still transcultural maladjustment among Tibetan nurses in the internship stage, and the psychological maladjustment was more obvious than the sociocultural maladjustment. We provide countermeasures and suggestions to solve the problems of transcultural adaptation reflected in the research.

Determinants of transcultural self-efficacy among nurses in China: A cross-sectional study.

In this cross-sectional study, we explored the current status and the correlates of self-perceived transcultural self-efficacy among nurses working in a tertiary hospital in Hangzhou, China. A total of 336 nurses (age range, 24-50 years) completed the Chinese version of the Transcultural Self-Efficacy Tool. The majority of respondents were female (94.64%), and 67.26% were government employees. Between group differences were assessed using the rank sum test. Most nurses had a below-moderate level of self-perceived transcultural self-efficacy in all subscales (Cognitive [67.69%]; Practical [71.65%], Affective [66.75%]). Age, professional title, employment type, and income level had a significant influence on all three subscale scores of the survey instrument. Our findings highlight the need for inclusion of transcultural nursing in the continuing education curricula for nurses. Nursing managers should target continuing education based on the demographic characteristics of nurses. Hospital managers should consider minimizing the pay disparity between government-employed and temporary nurses. These initiatives can help improve the quality of nursing care in a cross-cultural milieu.

Cultural competence among nurses and its influencing factors: A cross-sectional study.

The purpose of this study was to investigate the level of cultural competence and its influencing factors among Chinese nurses by using a cross-sectional design. Participants were recruited from four tertiary hospitals in Jiangsu, China, and 325 nurses completed the Cultural Competence Inventory for Nurses in China. Data were analyzed using stepwise multiple regression to identify factors influencing cultural competence. The results showed that Chinese nurses self-rated cultural competence at a moderate level (mean value of 101.7 out of 145), which indicates that cultural training is necessary to improve their cultural competence. Nurses who were younger and had fewer years of working experience, had lower educational backgrounds, seldom learned about different cultures via mass media, and rarely resided in or visited places with different cultures tended to have lower cultural competence levels, and should be provided more opportunities for cultural training. By considering demographic characteristics that influence cultural competence among Chinese nurses, educators can specifically design cultural training content at an appropriate level, targeting trainees' needs and thereby enhance training effectiveness.

Nurses' Lived Experiences of Faith-Based Short-Term Medical Mission Trips.

ABSTRACT: To date, little has been shared of nurses' perception of their experiences after participating in faith-based, short-term medical mission trips. This qualitative research study, guided by Leininger's transcultural nursing theory and the Sunrise Model, explored this topic. The results illuminated seven themes and pointed to the importance of pretrip planning. The value for Christian nurses in engaging in international medical missions encompasses reflection and growth of one's worldview and experience in providing spiritual care cross-culturally.

Effects of Transcultural Nursing Education on the Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence of Students.

Purpose: To examine the effect of Transcultural Nursing education on nursing students' Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence.Design: A posttest quasi-experimental study with a control group.Methods: The participants were second year nursing students (n = 125). The experiment group was composed of students who had enrolled in the Transcultural Nursing course (n = 65). The control group consisted of students who did not enroll in this course (n = 60).Findings: The posttest scores of the experiment group in the scales were significantly higher than those in the control group (p < .01).Conclusion: Transcultural nursing course is an effective method to increase the professional values, empathic skills, cultural sensitivity and intelligence of students.

The transcultural adaptation and the validity and reliability of the Turkish Version of Perroca's Patient Classification Instrument.

AIM: This study examines the transcultural adaptation and the reliability and validity of the Turkish version of Perroca's Patient Classification Instrument. BACKGROUND: Nurse managers need valid and reliable patient classification tools for determining patients' acuity or dependency levels on nursing care for measuring nursing workloads. METHODS: This study was conducted in two stages in a private hospital in Istanbul, Turkey. First, the instrument was translated, and its content validation was analysed. In the second stage, data were gathered from 300 hospitalized patients and were analysed by factor analyses, Cronbach's alpha and Cohen's kappa. RESULTS: Validity testing with ten experts revealed a scale-content validity index of 0.93. Exploratory factor analysis revealed a two-dimensional instrument with distinct factor loadings and a variance of 66.97%. The confirmatory factor analysis revealed that the fit indices were satisfactory. This instrument had an overall Cronbach's alpha coefficient of .86 and Cohen's kappa coefficient of .826. CONCLUSION: The study provides evidence that the Turkish version of Perroca's Patient Classification Instrument is a valid and reliable tool to determine patients' acuity levels on nursing care. IMPLICATIONS FOR NURSING MANAGEMENT: This instrument may be used by nurse managers to determine acuity levels of patients and measure nursing workload.

Testing the psychometric properties of the Finnish version of the cross-cultural competence instrument of healthcare professionals (CCCHP).

BACKGROUND: To test the validity of the Finnish version of the Bernhard et al.'s Cross-Cultural Competence instrument of Healthcare Professionals (CCCHP). METHODS: The study sample comprised registered nurses (N = 810) from the Finnish "Competent workforce for the future" -project (COPE). Exploratory factor analyses and structural equation modelling were applied to test structural validity of the CCCHP. Internal consistency of the sub-scales was evaluated using the Cronbach's alphas. Criterion validity was explored in terms of received education for multicultural work, perceived difficulty of patients, and job satisfaction variables. RESULTS: The revised version of the instrument including four (motivation/curiosity, attitudes, skills and emotions/empathy) of the five original dimensions provided satisfactory psychometric properties (internal consistency, a good model fit of the data). Of the four remaining competence sub-scales, motivation/curiosity, attitudes and emotions/empathy were associated with the amount of received education for multicultural work, and all with perceived difficulty of patients, and all but attitudes with job satisfaction. CONCLUSION: This revised Finnish version of the CCCHP provides a useful tool for studies focusing on the healthcare personnel's cross-cultural competence in delivering effective and culturally sensitive healthcare services for patients from different cultures.

Exploring the experiences of cultural competence among clinical nurses in Taiwan.

AIMS: To generate a descriptive theory framework regarding the experiences of the cultural competencies among clinical nurses in Taiwan. BACKGROUND: With the advances in, and the easy accessibility to health care services, frontline nurses require a higher cultural competence to perceive and satisfy the needs of the culturally diverse patients. METHODS: A qualitative approach using a grounded theory was applied. There were 30 nurses recruited by purposive sampling. RESULTS: 'Unprepared when encountering different cultures' was the core theme for describing and guiding the process of examining the nurses' experiences with a cultural competence. 'Awareness of value differences' was identified as the antecedent condition. The nurses revealed that they have had difficulty implementing their nursing work and seeking resources that represented situations in which interactive behavioral characteristics appeared to improve their cultural competencies. The nurses managing different cultural situations ultimately learned to tolerate the different cultures and to give patients culturally appropriate care, which thereby enhanced the care quality. CONCLUSIONS: This study highlights the multiple layers of cultural competence experienced by the nurses and the understanding of cultural diversity among patients and caregivers. These results will assist the healthcare providers by offering references for clinical healthcare based on the patients' subjectively different cultural perspectives. Medical organizations should design an in-service educational program/instructions concerning culture to help strengthen the nursing specialists' relevant cultural competencies, to meet the individual patients' cultural care needs, and thereby boost the clinical care quality.

Exploring Cultural Health Practices at a Midwestern University.

This study investigated complementary health practices (CHPs) at a Midwestern state university to examine regional usage rates. Study results demonstrated a high use of CHPs as compared with national studies, supporting significance of incorporating CHPs in the nursing curriculum to ensure culturally competent and safe care for all populations.

Evaluating Relevance of Nursing Theories in Cross-Cultural and International Contexts.

Nursing has evolved over the past five decades in propagating the development of theoretical and empirical evidence through the application of nursing theories. The objective of this commentary is to stimulate scholarly debate focused on the development, application, and adaptation of nursing theory by nurse scientists, its relevance in the cross-cultural contexts, and to discuss future directions with a call to action using Leininger's seminal work on Culture Care Theory. The implicit nature of nursing theories preclude the optimal use and application in cross- cultural contexts because of the limitations in achieving conceptual, semantic, and operational equivalence. Work conducted by nurse scientists to date demonstrates that cultural values and beliefs are integral in cross-cultural contexts to enhance meaningful theory application for health interventions. More work is needed to advance nursing science through cross-cultural application of theories in research, practice, and education to optimize nursing theory adaptation in cross-cultural and international contexts.

The Nurse Philanthropist: Where Care and Cause Meet.

A transcultural clinical nurse specialist narrates how nursing has provided ways to exercise her passion for the clinical intellect as it intersects with the compassion of the heart. She encourages nurses to become social justice entrepreneurs, or what she terms Nurse Philanthropists, devoting time, talent, and energy to social justice issues as activists, advocates, and ambassadors. Florence Nightingale was the first Nurse Philanthropist, using wealth she inherited to establish St. Thomas Hospital in London. However, nurses do not have to be wealthy in order to enter the world of philanthropy. Inspired by the work of Madeleine Leininger, the author has established several non-profits that have grown into Zaman International, an organization with more than 4000 volunteers, 220 partner organizations, a baby cemetery, a fresh food program that delivers hot meals to homes, well and water projects in several countries, a vocational training and literacy program, and a one-stop center providing food, clothing, and essential needs for female-headed households living on less than $12,000 a year, helping negotiate a better future for them and re-pattern the cycle of intergenerational poverty.

Social Determinants of Health: Cultural Competence Is Not Enough.

In our nation of rapidly growing diversity and increasing cross-cultural interactions, cultural competence has been recognized as critical for reducing health disparities and improving access to high-quality health care. However, more than a decade of experience in establishing, developing, and implementing cultural immersion programs for nursing students in the United States and in developing countries has convinced this scholar that although cultural competence is of critical importance, many other factors need to be examined and kept in mind as we continue to take on the monumental challenge of eliminating health disparities. This article presents the background and context of current efforts to eliminate health disparities and points out some other key considerations that will be vital in achieving the desired outcome.

Teaching the Meaning of Culture in a Baccalaureate Nursing Curriculum.

Because culture affects virtually every aspect of life, including health beliefs, customs, and practices, it is imperative that nursing students recognize and value its critical importance to the people whom they will care for as clients/patients. Hence, the notion of culture must be introduced early on in nursing programs and threaded throughout the entire curriculum.

Diversity, Inclusion, and Storying: Connecting Across Cultures to Give Meaning to Patients' Whole Health.

Transcultural nursing inspires us for humanness. The breadth of a culture is handed down through stories. Storytelling creates understanding and mutuality within a culture and between cultures. Deeper understanding can lead to better patient outcomes across variances in health, wellness, and social standing. The intentional use of storying by six nurses in a project called Story Care led to more appreciative understanding of the other's culture and raised awareness of self in interaction with another. The nurses, patients, and their families had deliberate opportunities to learn more about another who was culturally different, to understand how historical perspectives influence the dynamics of interactions, and to explore a sense of commonality and mutuality in nurse-patient engagements. As we strive for cultural intelligence, diversity, and inclusion in our organizations, transcultural nursing helps nurses connect to and be mindful of cultural ways in which we understand a patient's or population's vulnerability, determination, spirit, and strengths that give meaning to their whole health.

Cervical cancer prevention among quilombola women in the light of Leininger's theory. / Prevenção do câncer do colo uterino de quilombolas à luz da teoria de Leininger.

OBJECTIVE Our purpose was to discuss practices of cervical cancer prevention among Quilombola Women. METHOD This study used, in 2014, a qualitative research approach aiming twenty women from a quilombola community (people who live in quilombos, descendants of Afro-Brazilian slaves), which is located in Bahia. A semi-structured interview was developed by researchers in order to collect data. The Ethno-nursing Research method was used to analyze the data. RESULTS The use of cultural care through medicinal plants, and the nursing professional care (Pap Smear exam procedure) were stated by Quilombola women as serving as prevention practices against cervical cancer. However, most women stated that they did not use any prevention practices. CONCLUSION Social, cultural and health access issues are practices that are linked to the cervical cancer prevention among Quilombola Women. Therefore, it is indispensable to create an appropriate care plan for Quilombola women's reality.