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.     

Cultural perspectives on nursing in the 21st century.

By the year 2000, more than one fourth of the US population will consist of individuals from culturally diverse groups. Increasing numbers of international visitors and exchange students will use the US health care delivery system, and US nurses will engage in international interchanges with increasing frequency. To keep pace with these population and health care trends, US nurses will need to base their nursing care on a theoretically sound foundation that draws on knowledge from the physical, natural, and behavioral sciences, as well as on research-based theories from transcultural, cross-cultural, and international nursing. The purposes of this article are to (1) trace past, present, and future population trends among minority groups in the United States; (2) examine the ways in which transcultural nursing has provided a framework for meeting the health care needs of culturally diverse people; (3) identify current issues and trends in transcultural nursing; and (4) suggest ways in which nurses can prepare for the increasing numbers of culturally diverse individuals who are projected to need nursing care in the future.     

Cultural competence: assessment and education resources for home care and hospice clinicians

Home healthcare and hospice clinicians face many challenges in the complex healthcare system caring for patients and their families in the home environment. One of those challenges is providing culturally competent care for an increasingly diverse population. This article will highlight free, easily accessible, online resources to assist clinicians and organizations to assess organizational and individual cultural competence and provide many resources for cultural competency education programs.     

Cultural awareness: bridging the gap between caregivers and Hispanic patients

The healthcare environment is undergoing rapid change. Healthcare settings have shifted from acute care to encompass a variety of other locations. The healthcare work force is changing from a common ethnic origin to include a multitude of ethnic and racial groups. The patient population also embraces a plethora of different cultural backgrounds. By the year 2080, an estimated 51.1% of the population will be composed mostly of Hispanics, followed by African Americans and Asians. This dynamic transformation has created a critical need for nurses to become more knowledgeable and culturally aware to care for and work with people of other cultures. This article attempts to sensitize nurses to the important roles culture and ethnicity play in the delivery of optimal nursing care. The domain of intercultural communication and its importance in providing culturally competent, patient-relevant care is discussed.     

Diversity issues in the delivery of healthcare

What does it mean to be culturally competent and proficient? What criteria are used to describe a culturally competent healthcare delivery system and how can an individual or an organization grow in competency? What is the delivery of competent care related to me personally?This article addresses these questions with the assumption that knowing one's viewpoints on how culture change offers a sample of the glasses through which we view others. Culture and culture change are defined, and four models that explain the process of culture change are discussed in detail. These models represent different world views held to explain the phenomena of acculturation. The article concludes with a summary of the recommended National Standards for cultural and linguistic appropriate healthcare services developed by the Office of Minority Health. The concepts described can serve as universal tools for individuals and/or organizations interested in cultural competency.     

Awareness: the heart of cultural competence

Cultural competency in critical care is providing care to patients and their families that is compatible with their values and the traditions of their faiths. This requires awareness of one's own values and those of the healthcare system. The nurse must also become aware of the cultural and spiritual values of patients and families. Although knowledge of many cultures is impossible, willingness to learn about, respect, and work with persons from different backgrounds is critical to providing culturally competent care. This article discusses elements essential for increasing cultural competency.     

Culture diversity/a mobile workforce command creative leadership, new partnerships, and innovative approaches to integration

Today's healthcare environment requires that nursing leaders meet the needs of a growing multicultural workforce and patient population. Cultural factors may be overlooked as healthcare delivery becomes increasingly dominated by technological, economic, and social changes. Through creative leadership, the chief nurse executive (CNE) can encourage staff to pay closer attention to cultural factors that will impact on patient, staff, and hospital outcomes. The CNE can begin by enhancing his/her own multicultural competency, building these competencies in his/her staff, and then empowering staff to respect and accommodate cultural differences. An understanding to transcultural nursing theory can enhance the development and maintenance of a multicultural perspective. The use of Madeline Leininger's Culture Care modalities can assist staff in making culturally competent decisions and in implementing actions. This article will provide an overview of one community hospital's experiences in integrating a multicultural perspective to better meet the needs of specific patient populations.     

An Examination of the Folk Healing Practice of Curanderismo in the Hispanic Community

Curanderismo is a system of traditional folk practices and beliefs that address health and healing in the Hispanic community. Curanderismo serves a function in the daily lives of Hispanics worldwide, providing them access to culturally appropriate healthcare, and agency over their own, and their family’s health. Cultural competency in the area of curanderismo is invaluable, as curanderismo is a folk resource that if acknowledged and embraced by nurses and healthcare practitioners can aid in healthcare delivery and increased healthcare utilization among Hispanic populations.     

Culturally Congruent Care in Radiology Nursing

The United States' diversity is growing, making it difficult for nurses to meet the needs of patients from a wide range of cultures, belief systems, and groups. Nursing is not new to providing culturally competent care; however, the profession's demographic shift has made it a priority. Improving nurses' cultural competency can lead to increased access to health care and, as a result, better health outcomes. Nurses in all specialties work with people from all walks of life, which necessitates that they have the knowledge and skills necessary to care in a culturally appropriate manner. Radiology nurses, in particular, influence care in a variety of settings and provide care to people of all ages and acuities, making the commitment to fostering culturally congruent practice even more critical. Nurses can begin this process by critically reflecting on their own biases as well as the concepts of cultural humility, competence, and competemility.     

Barriers and facilitators of care for diverse patients: Nurse leader perspectives and nurse manager implications

Objective

To examine chief nurse executives’ perspectives on: (1) the provision of culturally and linguistically appropriate services in hospitals and (2) to identify barriers and facilitators associated with the implementation of culturally and linguistically appropriate services.

Background

Hospitals continue to face challenges providing care to diverse patients. The uptake of standards related to culturally and linguistically appropriate services into clinical practice is sluggish, despite potential benefits, including reducing health disparities, patient errors, readmissions and improving patient experiences.

Method

A qualitative study with chief nurse executives from one eastern United States (US). Data were analysed using content analysis.

Results

Seven themes emerged: (1) lack of awareness of resources for health care organisations; (2) constrained cultural competency training; (3) suboptimal resources (cost and time); (4) mutual understanding; (5) limited workplace diversity; (6) community outreach programmes; and (7) the management of unvoiced patient expectations.

Conclusions

As the American population diversifies, providing culturally and linguistically appropriate services remains a priority for nurse leaders. Being aware and utilizing the resources, policies and best practices available for the implementation of culturally and linguistically appropriate services can assist nursing managers in reaching their goals of providing high quality care to diverse populations.

Implications for Nursing Management

Nurse managers are key in aligning the unit's resources with organisational goals related to the provision of culturally and linguistically appropriate services by providing the operational leadership to eliminate barriers and to enhance the uptake of best practices related to culturally and linguistically appropriate services.     

Educational needs of psychiatric nurses for continuing competency

BACKGROUND: Practice setting diversification has created an increased need for psychiatric nurses to assume more independent roles, while at the same time being able to demonstrate the corresponding degree of competency to practice. Psychiatric nurses were invited to share their perceptions concerning changes occurring in mental health care, proactive strategies for participating in these changes, and educational opportunities to ensure continuing competency to practice. METHOD: Focus groups were conducted with psychiatric nurses located in various Regional Health Authorities in southern and central regions of Manitoba, Canada. RESULTS: Research findings suggest that psychiatric nurses are primarily concerned with balancing the requirement to demonstrate continuing competence to practice with the challenges associated with the evolving mental healthcare system. CONCLUSION: If the requirement for continuing competence is to be reasonable and achievable, it will be essential that the program generate insight into the necessity for such a program to be implemented and acquire support among the registered psychiatric nurse membership.     

Design and evaluation of interprofessional cross-cultural communication sessions

Abstract

The 2013 National Standards for Culturally and Linguistically Appropriate Services (CLAS) call for healthcare professionals to provide quality care and services that are responsive to diverse cultural health beliefs and practices. Accreditation organizations for health professional programs require their curriculum to adequately prepare future practitioners for serving culturally and linguistically diverse populations. Another common curricular need of health professional programs is interprofessional education (IPE). This study presents data that evaluates two IPE culturally competent communication sessions designed for pharmacy and nursing students. Teams of nursing and pharmacy students (n?=?160) engaged in case studies focused on developing cross-cultural communication skills, using the LEARN model. Quantitative survey data collected pre-test and post-test measured cultural competency (including subscales of perceived skills, perceived knowledge, confidence in encounter, and attitude) and knowledge related to culturally competent communication. Univariate ANOVA results indicate that actual knowledge as measured by the test and all four Clinical Cultural Competency Questionnaire (CCCQ) subscales significantly increased after the IPE sessions. Pharmacy students scored higher than nursing students on the knowledge pre-test, and nursing students had a more positive attitude at pre-test. The IPE sessions effectively addressed all learning outcomes and will continue in future course offerings. Using cross-cultural communication as a thematic area for IPE program development resulted in educational benefits for the students. To further strengthen nursing and pharmacy students’ interprofessional practice, additional IPE opportunities are to be explored.     

Cultural Competency in Baccalaureate US Nursing Education: Hybrid Course

The ability to appropriately care for diverse populations is an expected competency of the graduated Bachelor of Science in Nursing (BSN). To provide effective materials to ensure this competency is met, the American Association of Colleges of Nursing developed the Toolkit of Resources for Cultural Competent Education for Baccalaureate Nurses. The toolkit provides information on cultural competency models and teaching strategies nurse educators can use to facilitate student learning in cultural sensitivity and competency. This article demonstrates how one model in particular, Campinha-Bacote's Model of Cultural Competence, was utilized for 15 weeks in an undergraduate BSN nursing course for a student population in an urban school of nursing to effectively provide students with the skill set needed to give culturally competent care. This article will provide the methods and strategies used to teach cultural competency as based on Campinha-Bactote's Model in an undergraduate nursing course.     

Cultural Competencies in Emergency Medicine: Caring for Muslim-American Patients from the Middle East

Background

Cultural competency is crucial to the delivery of optimal medical care. In Emergency Medicine, overcoming cultural barriers is even more important because patients might use the Emergency Department (ED) as their first choice for health care. At least 2.2 million Muslims from Middle Eastern background live in the United States.

Objective

We wanted to create a succinct guideline for Emergency care providers to overcome cultural barriers in delivering care for this unique population.

Method

A compensative search on medical and health databases was performed and all the articles related to providing healthcare for Muslim-Americans were reviewed.

Result

The important cultural factors that impact Emergency care delivery to this population include norms of modesty; gender role; the concept of God's will and its role in health, family structure, prohibition of premarital and extramarital sex; Islamic rituals of praying and fasting; Islamic dietary codes; and rules related to religious cleanliness.

Conclusions

The Muslim-American community is a fast-growing, under-studied population. Cultural awareness is essential for optimal delivery of health care to this minority. We have created a succinct guideline that can be used by Emergency Care providers to overcome cultural barriers. However, it is important to consider the heterogeneity and diversity of this population and to use this guideline on an individual basis.     

Culturally competent primary care response for women of immigrant and refugee backgrounds experiencing family violence: A systematic review protocol

AimThis review will identify, critically appraise, and synthesise evidence on culturally competent approaches to the provision of primary care to women of immigrant and refugee backgrounds who experience family and domestic violence.BackgroundWomen from some immigrant and refugee backgrounds are known to be at a higher risk for harms from family and domestic violence. However, little is known about cultural competency in the provision of primary care for these women and how this enables, or hinders, clinicians in caring for them.Design/methodsA systematic review using Critical Interpretive Synthesis of quantitative, qualitative, and mixed-methods studies and grey literature that report cultural competency in the provision of primary care for women over 16 years of age experiencing family and domestic violence. Our search strategy will include electronic database searches, citation tracking, and grey literature searches. Two reviewers will independently carry out title, abstract, and full text screening using the Covidence software, then quality assessment, and data extraction. We will appraise quality using the Crowe Critical Appraisal Tool for quantitative and mixed methods studies; Quality Framework for qualitative studies; and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for grey literature. A qualitative critical synthesis of the included studies and grey literature will be completed.DiscussionCritical interpretive synthesis is an iterative method that allows reviewers to explore various foci of the concept in question and answer the research question posed at the outset comprehensively. The expected outcome of the review is an evidence-based model of culturally competent primary care related to family and domestic violence.     

Health care and nursing in Saudi Arabia

Aim:  This paper reviews healthcare provision in Saudi Arabia and the development of nursing together with its current challenges.
Background:  Health care in Saudi Arabia is developing fast with multiple governmental and independent service providers. Economic growth has impacted upon health needs through population and health behaviour change. The development of the indigenous nursing workforce has been slow resulting in much nursing care being delivered by migrant nurses.
Conclusion:  There is a need to increase the proportion of indigenous nurses so that culturally appropriate holistic care can be delivered. Without shared culture and language, it will be difficult to deliver effective health education within nursing care to Saudis.     

Enhancing cultural competency and empathy toward foreign patients for Korean nursing students through a simulation: A quasi-experimental study

AimThis study aimed to develop a transcultural nursing simulation-based learning program with patients from the United Arab Emirates and evaluate its effects on cultural competence and empathy among undergraduate nursing students in South Korea.BackgroundThe importance of cultural competency and empathy has increased with the increased number of foreign patients in Korea. The United Arab Emirates (UAE) is one of the top Middle Eastern countries from which patients visit Korea for medical services. Because South Korea is a largely homogenous country, foreign patients often experience difficulties in their hospitalizations when Korean nurses lack cultural competency in caring for them. To improve cultural competency, a practical form of education, such as a simulation, is necessary. In addition, the simulation module based on cultural competency model allowing nursing students to provide effective and culturally responsive services to ethnically diverse patients.DesignThis quasi-experimental study used a non-randomized control group design with a convenience sample.MethodsThe program was administered to 53 Korean undergraduate nursing students (26 control and 27 experimental). Fourteen teams of two students practiced infection prevention training with the mother of a 7-year-old child with immunodeficiency. Participants’ cultural competency and empathy were assessed before and after the TN-SBL using an online survey. The effects of cultural competency and empathy were analyzed using a generalized estimation equation.ResultsNursing students in the TN-SBL group showed more positive improvement in cultural competence and had increased cognitive empathy levels than students in the control group.ConclusionThe simulation module developed in this study improved students’ cultural competency and empathy levels. It is valuable because the scenario was developed based actual clinical cases of Emirati patients and their families. The simulation module was designed based on the cultural competency model to raise awareness of cultural diversity and allow students to directly practice culturally competent care. It can be used to educate Korean nurses and improve the quality of care provided to Arabic-speaking Muslim patients.     

Cultural competency of graduating BSN nursing students

Providing culturally appropriate care is an essential nursing competency for new graduates. Multiple curricular approaches are being used to achieve this end. When measured by Campinha-Bacote's Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals-R, graduating students (n = 515) from six different BSN programs scored, on average, in the culturally aware range. These results suggest that no one curricular approach is proving to be more effective than another in achieving essential cultural competency.     

Patient-centered care in a medical home

There is general consensus that our current healthcare delivery system will not be able to supply an adequate workforce, contain costs, and meet the ever-increasing chronic-care needs of the growing and aging population in the United States (US). Some of the major challenges to the U.S. healthcare system are faced by those on the front lines, namely the healthcare workers in primary care. Part of the emerging solution for primary care is the adoption of the Patient-Centered Medical Home Model. The intent of this model is to provide coordinated and comprehensive care rooted in a strong collaborative relationship. Carilion Clinic in Southwestern Virginia is implementing this patient-centered model in which a proactive, multidisciplinary care team collectively takes responsibility for each patient. In this article we will elaborate on the concepts of patient-centered care and patient-centered medical homes, after which we will offer an exemplar describing the process that Carilion Clinic is using to establish patient-centered medical homes throughout their primary care departments. Limitations of the Patient-Centered Medical Home Model will also be discussed.