Faculty and student cross-cultural learning through teaching health promotion in the community.

Cross-cultural learning for nursing students and faculty increased through a collaborative venture of teaching health promotion classes in a Hmong community. Through the learning process, nursing students and faculty learned about Hmong culture, and Hmong participants learned about health. The purpose of this article is to describe the process and evaluation of health promotion classes in a Hmong community.

Hmong/medicine interactions: improving cross-cultural health care.

BACKGROUND AND OBJECTIVES: There are now more than 100,000 Hmong (Southeast Asian) refugees in the United States. This study examined interactions between Hmong patients and their health care providers and identified specific factors that either enable or obstruct health care delivery. METHODS: We used semistructured interview techniques to investigate patients' and providers' experiences, looking for attitudes, ideas, or behaviors that could be modified to improve health care delivery. Interviews with 23 Hmong patients, 18 health care providers, and six translators were audiotaped, transcribed, and analyzed by a multidisciplinary team. Methods included text analysis, theme identification, rank ordering, participant observation, immersion-crystallization, and open-ended discussion. RESULTS: Hmong patients and their US-trained health care providers have different health belief systems. Both linguistic and cultural translation were seen as problematic. Additionally, an overwhelming number of patients identified kindness, caring, and a positive attitude as important provider characteristics. Providers noted difficulties in understanding Hmong conceptions of acute versus chronic diseases, illness prevention, and pain, both physical and psychological. Many respondents gave suggestions for improvement: 1) learn more about each other's cultures, 2) be patient, kind, and positive, 3) avoid negative statements or predictions, 4) improve translation quality, 5) explain medical terms using visual aids, 6) respect Hmong family-centered decision making, 7) increase the time allotted for translated clinical encounters, and 8) train Hmong health care providers. CONCLUSIONS: Many basic issues in relations between clinicians and Hmong patients must be addressed to improve health care communication.

Linking research and practice through discussion.

PURPOSE: To describe the process and outcomes of a researcher-initiated discussion group with nurses in clinical practice. DESIGN: Descriptive case study. The study, which began in 1991, included one group of four acute care nurses. Between 1992-1996, three other groups of nurses participated. METHODS: Nurses in practice read and discussed articles from a program of research on breast cancer during a series of group sessions. The semi-structured sessions were tape-recorded. RESULTS: Participants suggested how to make article content more understandable to clinicians; they affirmed findings relevant to practice; and identified ways to integrate research in practice. CONCLUSIONS: Discussion served as a means for the researcher and nurses to connect the research-practice gap through learning the practice perspective and the process and value of research. Discussion groups are recommended to enhance science-based clinical practice.

Health professional training for multi-disciplinary care of elderly patients with type II diabetes.

With funding support from the Northern Wisconsin Area Health Education Center, we conducted a survey to assess continuing education needs of health care professionals providing diabetes self-care management and nutrition therapy to patients with Type II diabetes in rural northern Wisconsin and conducted a conference to address the identified needs. Of the topics surveyed, respondents ranked themselves lowest in knowledge and experience in the following areas: 1) application of revised guidelines for medical nutrition therapy, 2) considering patients, differing cultural needs, and 3) team management of diabetes. They were most comfortable with the technical aspects of care, e.g., insulin administration and blood glucose monitoring. One hundred seven health care professionals attended a one-day continuing education conference sponsored by the Eau Claire Family Practice Residency and the University of Wisconsin-Eau Claire School of Nursing, to address the topics identified by the needs assessment survey.

Quality of life in long-stay institutions in England: nurse and resident perceptions.

Quality of life (QOL) of older persons living in institutions is a critical consideration in international economic policies and health care decisions. Yet, there is little relevant research to support decisions about culturally acceptable and effective nursing care for this population. This qualitative study explored and compared perceptions of older residents and nurses in three long-stay institutions in south-west England. It addressed issues viewed as important to a good QOL for residents and ways in which nurses promote QOL. A convenience sample of 10 residents aged 65 and older (80% female) and nine nurses (n = five registered general nurses and four enrolled nurses) were interviewed using a semi-structured schedule. Interview data were analysed using an analytic induction method of content analysis. While theme frequency and examples differed, themes common to both residents and nurses were individuality, professionalism, connectedness, and physical functioning. Resident responses tended to be personal, succinct, and sometimes negative. Nurses' responses were more positive, detailed, and reflective of general professional responsibilities. Implications for nursing education, research, and practice are discussed. Improvement in QOL will be addressed differently based on social and cultural settings. However, there may be commonalities that are applicable across cultures.

Development of a transcultural health education program for the Hmong.

CNSs face unique opportunities and challenges in meeting the health care needs of culturally diverse populations. As an education consultant involved in the development and implementation of a transcultural health education program, a CNS is required to have expert knowledge of the target population's health beliefs, values, and practices as well as knowledge of their language, level of literacy, and traditional teaching-learning styles. A critical consideration includes the use of a pluralistic model of education that addresses both the implicit and explicit conditions of learning and education. This paper describes the model and its application in the development and implementation of a health education program for the Hmong. The transcultural education process is examined and analyzed for appropriateness and effectiveness.

Application of Moos and Schaefer's (1986) model to nursing care of elderly persons relocating to a nursing home.

Elderly persons relocating to a nursing home experience a life transition that they usually perceive as a crisis. Effective coping with this transition/crisis requires effective management of the event. Nurses caring for these persons are challenged to assess and intervene to assist them to achieve positive outcomes from this transition. Moos & Schaefer's (1986) Conceptual Model for Understanding Life Crises and Transitions depicts a process by which nurses may help elderly persons cope effectively with relocation to a nursing home. This paper describes the model and its application to the nursing care of elderly persons relocating to a nursing home, including a case study. The extent to which the model has been empirically tested with populations in long-term care settings is critically analysed.