Delivery of culturally competent care to children with cancer and their families--the Latino experience.

This article discusses selected cultural factors such as language and interpretation services, beliefs, health care practices, and communication styles of Latino families that can increase and enhance the ability of nurses to work with a child with cancer and his or her family. Suggestions for research and clinical intervention are presented.     

Expanding conceptualizations of culturally competent care

AIM: The aim of the study was to gain an understanding of cultural competence from the perspectives of non-mainstream nurse educators, specifically those of Latin heritage. BACKGROUND/RATIONALE: Although the theoretical concepts of 'cultural diversity' and 'culturally competent care' have been supported and promoted by the largest professional nursing organizations, the practical application of these concepts has often created difficulties for nurse researchers, educators, and clinicians. The lack of progress in teaching and evaluating cultural competence suggested the need to 'center the margins' and explore cultural competence from the margins of one particular non-mainstream nursing group, Latina nurse educators. DESIGN/METHODS: A grounded theory research design was employed. A group of 10 doctoral, prepared, self-identified, Latina nurse educators participated in face- to-face audiotaped interviews. Data collection, analysis, and theoretical sampling decisions occurred concurrently, strengthening theory generation. Institutional review board approval was received for all steps of the study. The major limitation of the study was the omission of student voices. RESULTS/FINDINGS: The analysis suggests that the Latina participants shared the common purpose of teaching students how to think about difference. The teaching practices of this group of Latina educators was based on a belief that 'difference' is not solely about specific cultural groups. For example, content about 'Hmongs' or 'Latinos'. Rather, Latina faculty focused on teaching students how to directly connect with anyone perceived as different from oneself. CONCLUSION: Latina faculty did not distinguish between competent care and culturally competent care; for them, competence necessarily includes cultural competence. They conceptualize the provision of competent care to all persons who are perceived as different, rather than focusing only on those who are perceived as 'culturally' different. These conceptualizations have the potential to shed new light on how nurses and nurse educators think about, develop, and integrate cultural competence into nursing education, practice, and research.     

Promoting culturally competent care for gay youth.

Gay youth and those questioning their sexual identity have been referred to as "hidden," "invisible," "stigmatized," and "marginalized." As a result, the unique safety and health needs of this subculture have been overlooked, or worse, ignored, placing these youth at risk. Because school nurses have been identifying at-risk populations of students and developing programs to promote youth and family health for years, they should be prepared to provide health care for the subculture of gay youth. However, nurses are saying they do not have the knowledge or skills needed to identify and address the needs of this group. Providing school nursing care for gay youth requires the school nurse to be culturally competent. School nurses need to be aware of, sensitive to, and knowledgeable about the subculture. They must also possess communication skills required to relate appropriately to this group. This article presents information and nursing strategies that will promote the safety and health of gay youth while enhancing the school nurse's cultural competence.     

Mexican Americans' perceptions of culturally competent care

Although the literature abounds with authors' discussions of the need for nurses and other health care providers to deliver safe and optimal care to patients of diverse ethnic groups, little work has focused on defining and measuring the dimensions of culturally competent care. The purpose of this research was to identify culturally competent concepts from the perspective of Mexican Americans. Focus group interviews with Mexican American registered nurses and Mexican American lay recipients of health care were used to explore the participants' subjective perceptions regarding the indicators of culturally competent care. For this group of Mexican American registered nurses, the influence of culture remained strong despite nursing professional experience and knowledge of Western biomedical system. The predominance of themes emphasizing respect, caring, understanding, and patience in health care encounters support the critical importance of personal processes of health care with Hispanics.     

Conceptual framework for the provision of culturally competent services in public health settings

To develop a conceptual framework for the provision of culturally competent services in public health based on literature and expert panel reviews. Public health professionals conducted expert panel reviews for face and content validity of the conceptual framework. Results from the panel and theories from public health literature were used to strengthen the framework. Based on an ecological perspective, the framework consists of systems, sub-systems, concepts, and characteristics, including the context, individual provider, organization, service, and client. This framework is viable for the provision of culturally competent services in a variety of public health settings.     

Culturally competent care for Latino elders in long-term care settings

The decision to place a family member in a long-term care (LTC) facility results in a variety of experiences for families. The experience of Latino families can be particularly problematic for the different relatives involved in the process. Placing a loved one in an LTC facility goes against cultural norms for Hispanic families that can lead to problems for both the family and the facility staff. Information about the cultural norms that are violated along with ways that the care providers and administrative staff can make adjustments in the environment to assist these residents will improve outcomes and meet the needs of diverse health care consumers.     

What has the literature taught us about culturally competent care of women and children

This article describes what is currently in the literature about culturally competent care for women and children. With the population of the United States growing increasingly diverse, there is a developing need for cultural competency among nurses and throughout healthcare organizations. Cultural competence includes both culture-specific and culture-generic knowledge, attitudes, and skills. While databased literature on cultural competency still requires further development, we do have evidence of positive outcomes of culturally competent care. The end result of the provision of culturally competent care by culturally competent nurses and healthcare organizations can be significant improvements in the health and well-being of women and children.     

Effective communication and delivery of culturally competent health care

Effective communication between patients and health care providers is a critical element to quality health care. Becoming aware of patients' attitudes, beliefs, biases, and behaviors that may influence patient care can help clinicians improve access to and quality of care. Health care providers should develop a strategic plan for improvement, then implement and evaluate the plan to include structured, continuously improving progress toward achieving cultural competency goals. In this challenging health care environment, health care providers need the skills to explore the meaning of illness, to determine patient's social and family context, and provide patient-centered and culturally competent care.     

Transcultural nursing courses online: implications for culturally competent care

Cultural diversity must be taken seriously by both faculty and students, and requires action by both parties for successful integration into online learning. Limited diversity in the nursing workforce or student population creates a need for learning cultural competence. Online transcultural nursing courses meet this learning need and provide opportunities for a variety of students and faculty participation from around the world. Successful online learning experiences can contribute to the provision of culturally competent nursing care.     

Supporting cross-cultural communication and culturally competent care in the linguistically and culturally diverse hospital settings of UAE

The United Arab Emirates (UAE) has become a linguistically and culturally diverse society where the majority of health care staff is drawn from a range of non-Arabic speaking backgrounds. In hospitals, the resultant mix of language and cultural differences highlights the importance of the role of nurses in facilitating the quality of care as the primary healthcare workers communicating and interacting with both patients and colleagues. Given the dearth of research in this area in the unique context of UAE, this research sought to identify the kind of strategies in use to effectively communicate to provide culturally competent care (CCC). Data were collected from a total of 153 hospital staff from four private and six government hospitals across UAE. While nurses in both hospital types used a variety of strategies to support cross-cultural communication they saw a need for additional communication support and professional development.     

Developing a culturally competent health care workforce in Japan: implications for education

In recent years, the population of foreign nationals and individuals from diverse cultural, racial, ethnic, and linguistic populations has consistently increased in Japan. An apparent failure by the health care workforce to deliver culturally congruent health care services has resulted in dissatisfaction with the health care system on the part of foreign nationals and increased potential for negative health care outcomes. Primary hindrances to the development of a culturally competent health care workforce include limited exposure to foreigners, cultural factors, and language difficulties. Recommendations are proposed for strategic educational actions to address these obstacles and develop in Japan a culturally competent health care workforce.     

The interface of anthropology and nursing guiding culturally competent care in psychiatric nursing

Nurses and all health care providers are called on to involve patients and families in health care decision-making and to accommodate culturally diverse populations. This article describes the Interface of Anthropology and Nursing Model (IAN), which is derived from the works of Kleinman and Peplau, classical theorists from anthropology and nursing, respectively. This model provides a framework for nurses to uncover cultural information through the elicitation, analysis, transfer, restructure, and feedback of explanatory models within the interpersonal nurse-patient relationship. Such integration of theory enhances a holistic nursing practice incorporating good communication, mutual decision making, and fostering patient agency.