The Effects of the Situated Simulation Program on the Cultural Competence of Hemodialysis Nurses: A Quasi-Experimental Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Sample
2.2. Measurements
2.2.1. Participants’ Characteristics
2.2.2. Nursing Cultural Competence Scale
2.3. Intervention Course
2.3.1. Basic Concepts of Cultural Competence
2.3.2. Integrating the GAS Method of Debriefing into the Cultural Competency Situated Simulation Program
2.4. Data Collection
2.5. Statistical Analysis
2.6. Ethical Considerations
3. Results
3.1. Demographic Variables of Participants
3.2. Distribution of the Scores Obtained from the Three Tests on the NCCS Total and Subscale Scores
3.3. The Effects of the Educational Intervention on the Cultural Competence of the Participants
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- United States Renal Data System. Annual Data Report Chapters. Available online: https://usrds.org/2017/view/Default.aspx (accessed on 16 December 2022).
- Annals of Kidney Disease in Taiwan. 2021. Available online: https://library.nhri.org.tw/ebook/ (accessed on 10 August 2023).
- Ahmad, B.; Zaman, F.; Syed, M.A.; Rahim, S.; Mohammad, A.H.; Sajid, A.S. Effect of age and gender on acute complication of hemodiasis in patients with chronic kidney disease secondary to diabetes mellitus. Pak. Armed Forces Med. J. 2020, 3, 781. Available online: https://search.proquest.com/docview/2430631929?accountid=8000 (accessed on 20 February 2022).
- Anjomshoa, F.; Esmaeli Abdar, M.; Rafiei, H.; Arjmand Kermani, M.; Hassanarabi, F.; Hasani, A.; Esmaeili, Z. Depression among hemodialysis patients: A cross-sectional study in southeast of Iran. Int. J. Epidemiol. Res. 2014, 1, 24–28. [Google Scholar]
- Rafiei, H.; Hoseinabadi-Farahani, M.J.; Aghaei, S.; Hosseinzadeh, K.; Naseh, L.; Heidari, M. The prevalence of psychological problems among ostomy patients: A cross-sectional study from Iran. Gastrointest. Nurs. 2017, 15, 39–44. [Google Scholar] [CrossRef]
- Leung, K.C.D. Psychosocial aspects in renal patients. Perit. Dial. Int. 2003, 23 (Suppl. 2), S90–S94. [Google Scholar] [CrossRef] [PubMed]
- Damery, S.; Sein, K.; Nicholas, J.; Baharani, J.; Combes, G. The challenge of managing mild to moderate distress in patients with end stage renal disease: Results from a multi-centre, mixed methods research study and the implications for renal service organisation. BMC Health Serv. Res. 2019, 19, 989. [Google Scholar] [CrossRef] [PubMed]
- Sein, K.; Damery, S.; Baharani, J.; Nicholas, J.; Combes, G. Emotional distress and adjustment in patients with end-stage kidney disease: A qualitative exploration of patient experience in four hospital trusts in the West Midlands, UK. PLoS ONE 2020, 15, e0241629. [Google Scholar] [CrossRef]
- Gregory, D.M.; Way, C.Y.; Hutchinson, T.A.; Barrett, B.J.; Parfrey, P.S. Patients’ perceptions of their experiences with ESRD and hemodialysis treatment. Qual. Health Res. 1998, 8, 764–783. [Google Scholar] [CrossRef] [PubMed]
- Sekkarie, M.A.; Abdel-Rahman, E.M. Cultural challenges in the care of refugees with end-stage renal disease: What western nephrologists should know? Nephron 2017, 137, 85–90. [Google Scholar] [CrossRef]
- Ministry of Foreign Affairs, Republic of China (Taiwan). 2021–2022 Taiwan at a Glance. Available online: https://multilingual.mofa.gov.tw/web/web_UTF-8/MOFA/glance2021-2022/2021-2022%20Taiwan%20at%20a%20Glance%20(English).pdf (accessed on 4 November 2022).
- Kim, E.Y.; Lee, Y.N.; Chang, S.O. Measuring the resilience of patients on hemodialysis: Development of a patient on hemodialysis resilience scale. Nephrol. Nurs. J. 2020, 47, 229–237. [Google Scholar]
- Mahabeer, S.A. A descriptive study of the cultural competence of hemodialysis nurses. CANNT J. 2009, 19, 30–33. [Google Scholar]
- Truong, M.; Paradies, Y.; Priest, N. Interventions to improve cultural competency in healthcare: A systematic review of reviews. BMC Health Serv. Res. 2014, 14, 99–115. [Google Scholar] [CrossRef] [PubMed]
- Douglas, M.K.; Rosenkoetter, M.; Pacquiao, D.F.; Callister, L.C.C.; Hattar-Pollara, M.; Lauderdale, J.; Milstead, J.; Nardi, D.; Purnell, L. Guidelines for implementing culturally competent nursing care. J. Transcult. Nurs. 2014, 25, 109–121. [Google Scholar] [CrossRef] [PubMed]
- Shen, Z. Cultural competence models and cultural competence assessment instruments in nursing: A literature review. J. Transcult. Nurs. 2015, 26, 308–321. [Google Scholar] [CrossRef] [PubMed]
- Kim, J.; Park, J.H.; Shin, S. Effectiveness of simulation-based nursing education depending on fidelity: A meta-analysis. BMC Med. Educ. 2016, 16, 152. [Google Scholar] [CrossRef] [PubMed]
- Park, H.R.; Park, J.W.; Kim, C.J.; Song, J.E. Development and validation of simulation teaching strategies in an integrated nursing practicum. Collegian 2017, 24, 479–486. [Google Scholar] [CrossRef]
- Besar, S.N. Situated learning theory: The key to effective classroom teaching? Int. J. Cult. Stud. 2018, 1, 49–60. [Google Scholar]
- Fanning, R.M.; Gaba, D.M. The role of debriefing in simulation-based learning. Simul. Healthc. 2007, 2, 115–125. [Google Scholar] [CrossRef]
- Cheng, A.; Eppich, W.; Grant, V.; Sherbino, J.; Zendejas, B.; Cook, D.A. Debriefing for technology enhanced simulation: A systematic review and meta-analysis. Med. Educ. 2014, 48, 657–666. [Google Scholar] [CrossRef]
- Sawyer, T.; Eppich, W.; Brett-Fleegler, M.; Grant, V.; Cheng, A. More than one way to debrief: A critical review of healthcare simulation debriefing methods. Simul. Healthc. 2016, 11, 209–217. [Google Scholar] [CrossRef]
- Freytag, J.; Stroben, F.; Hautz, W.E.; Eisenmann, D.; Kämmer, J.E. Improving patient safety through better teamwork: How effective are different methods of simulation debriefing? Protocol for a pragmatic, prospective and randomised study. BMJ Open 2017, 7, e015977. [Google Scholar] [CrossRef]
- Huang, M.H.; Hsieh, H.Y.; Liu, S.H.; O’Donnell, J.M.; Hsieh, T.H. Simulation-based learning using the gather-analyze-summarize tool. Formosan. J. Med. 2016, 20, 534–539. [Google Scholar]
- Krueger, L. Experiences of Hmong patients on hemodialysis and the nurses working with them. Nephrol. Nurs. J. 2009, 36, 379–387. [Google Scholar] [PubMed]
- Letvak, S.; Ruhm, C.J.; McCoy, T. Depression in hospital employed Nurses. Clin. Nurse Spec. 2012, 26, 177–182. [Google Scholar] [CrossRef]
- Hsu, H.C.; Lin, S.C.; Lee, Y.H.; Wu, H.Y.; Wang, P.Y.; Li, J.Y.; Lin, M.H. Development and testing of the shared decision-making attitudes scale among nurses in Taiwan: A cross-sectional scale development study. BMJ Open 2021, 11, e044733. [Google Scholar] [CrossRef] [PubMed]
- Liang, Y.W.; Chen, W.Y.; Lin, Y.H.; Su, S.Y.; Lee, M.H.; Chao, P.Y. An exploratory analysis of nurses’ multicultural caring competence. Taiwan J. Public Health 2014, 33, 549–562. [Google Scholar]
- Lin, M.H.; Chang, T.H.; Lee, Y.H.; Wang, P.Y.; Lin, L.H.; Hsu, H.C. Developing and validating the nursing cultural competence scale in Taiwan. PLoS ONE 2019, 14, e0220944. [Google Scholar] [CrossRef]
- Shore, S. A curricular model of cross-cultural sensitivity. J. Phys. Ther. Educ. 2007, 21, 53–59. [Google Scholar] [CrossRef]
- Liang, K.Y.; Zeger, S.L. Longitudinal analysis using generalized linear models. Biometrika 1986, 73, 13–22. [Google Scholar] [CrossRef]
- Ho, T.T.; Oh, J. Development and evaluation of cultural competence course on undergraduate nursing students in Vietnam. Int. J. Environ. Res. Public Health 2022, 19, 888. [Google Scholar] [CrossRef]
- Chen, H.C.; McAdams-Jones, D.; Tay, D.L.; Packer, J.M. The impact of service-learning on students’ cultural competence. Teach. Learn. Nurs. 2012, 7, 67–73. [Google Scholar] [CrossRef]
- Cerezoa, P.G.; Galceran, M.S.; Soriano, M.G.; Camps, M.L.; Moral, J.M.L. Design and evaluation of an educational course in cultural competence for nursing. Procedia Soc. Behav. Sci. 2014, 132, 262–268. [Google Scholar] [CrossRef]
- Chang, L.; Chen, S.C.; Hung, S.L. Embracing diversity and transcultural society through community health practicum among college nursing students. Nurse Educ. Pract. 2018, 31, 156–160. [Google Scholar] [CrossRef]
- Stiles, A.S.; Schuessler, Z.; James, L. Comparison of two Methods of teaching culture to bachelor of science in nursing students. J. Nurs. Educ. 2018, 57, 609–613. [Google Scholar] [CrossRef]
- Cicolini, G.; Della Pelle, C.; Comparcini, D.; Tomietto, M.; Cerratti, F.; Schim, S.M.; Di Giovanni, P.; Simonetti, V. Cultural competence among Italian nurses: A multicentric survey. J. Nurs. Scholarsh. 2015, 47, 536–543. [Google Scholar] [CrossRef] [PubMed]
- Horvat, L.; Horey, D.; Romios, P.; Kis-Rigo, J. Cultural competence education for health professionals. Cochrane Database Syst. Rev. 2014, 5, CD009405. [Google Scholar] [CrossRef]
- Haugan, G.; Sørensen, A.H.; Hanssen, I. The importance of dialogue in student nurses’ clinical education. Nurse Educ. Today 2012, 32, 438–442. [Google Scholar] [CrossRef] [PubMed]
- Schellings, G.; Van Hout-Wolters, B. Measuring strategy use with self-report instruments: Theoretical and empirical considerations. Metacogn. Learn. 2011, 6, 83–90. [Google Scholar] [CrossRef]
- Oxford Languages. Available online: https://languages.oup.com/google-dictionary-en (accessed on 4 November 2022).
- Abdel-Fattah, H.M.M. Emotional intelligence and emotional stability in crises. J. Psychiatry Psychiar. Disord. 2020, 4, 56–62. [Google Scholar]
- Burgoon, J.K.; Wang, X.; Chen, X.; Pentland, S.J.; Dunbar, N.E. Nonverbal behaviors “speak” relational messages of dominance, trust, and composure. Front. Psychol. 2021, 12, 624177. [Google Scholar] [CrossRef]
- Austin, Z. Qualitative research: Getting stated. Can. J. Hosp. Pharm. 2014, 67, 436–440. [Google Scholar]
Variables | n | % | |
---|---|---|---|
Gender | Male | 2 | 5.0 |
Female | 38 | 95.0 | |
Marital status | Married | 19 | 47.5 |
Unmarried | 21 | 52.5 | |
Educational attainment | Diploma | 13 | 32.5 |
Bachelor’s degree | 27 | 67.5 | |
professional nursing level | N1 | 14 | 35.0 |
N2 | 14 | 35.0 | |
N3 | 12 | 30.0 | |
Experience in caring for foreigners | yes | 25 | 62.5 |
no | 15 | 37.5 | |
Experience of attending cultural courses | yes | 14 | 35.0 |
no | 26 | 65.0 | |
mean | SD | ||
Age (year) | 43.27 | 6.60 | |
Nursing seniority (year) | 20.62 | 7.79 | |
Nursing seniority in HD (year) | 12.68 | 9.08 |
Variables | T0 | T1 | T2 | |||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | |
Total score a | 2.68 | 0.73 | 2.94 | 0.79 | 2.67 | 0.88 |
Cultural awareness ability | 2.36 | 0.92 | 2.59 | 1.04 | 2.32 | 0.99 |
Cultural action ability | 2.65 | 0.91 | 2.86 | 1.01 | 2.48 | 1.01 |
Cultural resource application ability | 2.99 | 1.01 | 3.37 | 1.07 | 3.09 | 1.09 |
Self-learning cultural ability | 2.71 | 0.88 | 2.92 | 0.94 | 2.78 | 1.34 |
Parameter | B (95% CI) | Std. Error | Wald χ2 | p |
---|---|---|---|---|
Total score a | ||||
Intercept | 2.12 (1.92, 2.3251.52) | 0.10 | 449.29 | <0.001 |
Group b | ||||
Low score vs. high score | 1.20 (0.94, 1.46) | 0.13 | 81.11 | <0.001 |
Time | ||||
T1-T0 | 0.36 (0.08, 00.64) | 0.14 | 6.44 | 0.011 |
T2-T0 | 0.29 (0.06, 0.52) | 0.11 | 6.25 | 0.012 |
Group × Time c | ||||
high score × T2 | −0.39 (−0.80, 0.01) | 0.21 | 3.50 | 0.06 |
high score × T1 | −0.38 (−0.75, −0.02) | 0.18 | 4.33 | 0.03 |
Cultural awareness ability | ||||
Intercept | 1.54 (1.40, 1.68) | 0.07 | 471.35 | <0.001 |
Group b | ||||
Low score vs. high score | 1.77 (1.38, 2.17) | 0.20 | 78.30 | <0.001 |
Time | ||||
T1-T0 | 0.55 (0.12, 0.98) | 0.21 | 6.49 | 0.01 |
T2-T0 | 0.33 (0.09, 0.58) | 0.12 | 7.27 | 0.007 |
Group × Time c | ||||
high score × T2 | −0.95 (−1.49, −0.41) | 0.27 | 12.08 | 0.001 |
high score × T1 | −0.99 (−1.54, −0.43) | 0.28 | 12.16 | <0.001 |
Cultural action ability | ||||
Intercept | 2.16 (1.89, 2.42) | 0.133 | 261.81 | <0.001 |
Group b | ||||
Low score vs. high score | 1.38 (1.07, 1.69) | 0.16 | 74.90 | <0.001 |
Time | ||||
T1-T0 | 0.32 (−0.11, 0.75) | 0.21 | 2.12 | 0.14 |
T2-T0 | 0.06 (−0.23, 0.36) | 0.15 | 0.19 | 0.66 |
Group × Time c | ||||
high score × T2 | −0.48 (−1.01, 0.04) | 0.26 | 3.28 | 0.07 |
high score × T1 | −0.43 (−0.95, 0.09) | 0.26 | 2.58 | 0.10 |
Cultural resources application ability | ||||
Intercept | 2.23 (1.99, 2.48) | 0.12 | 319.19 | <0.001 |
Group b | ||||
Low score vs. high score | 1.65 (1.31, 2.00) | 0.17 | 88.20 | <0.001 |
Time | ||||
T1-T0 | 0.63 (0.12, 1.14) | 0.25 | 5.97 | <0.001 |
T2-T0 | 0.44 (0.05, 0.83) | 0.19 | 4.94 | 0.01 |
Group × Time c | ||||
high score × T2 | −0.55 (−1.08, −0.01) | 0.27 | 4.05 | 0.04 |
high score × T1 | −0.65 (−1.23, −0.07) | 0.29 | 4.86 | 0.02 |
Self-learning cultural ability | ||||
Intercept | 2.28 (2.06, 2.50) | 0.11 | 403.20 | <0.001 |
Group b | ||||
Low score vs. high score | 1.46 (1.13, 1.79) | 0.16 | 75.01 | <0.001 |
Time | ||||
T1-T0 | 0.35 (0.02, 0.69) | 0.17 | 4.37 | 0.03 |
T2-T0 | 0.69 (0.32, 1.05) | 0.18 | 14.02 | <0.001 |
Group × Time c | ||||
high score × T2 | −0.69 (−1.42, 0.04) | 0.37 | 3.43 | 0.06 |
high score × T1 | −0.66 (−1.05, −0.26) | 0.20 | 10.79 | 0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hsu, J.-C.; Wang, M.-S.; Wang, P.-Y.; Lian, S.-Y.; Lin, M.-H. The Effects of the Situated Simulation Program on the Cultural Competence of Hemodialysis Nurses: A Quasi-Experimental Study. Healthcare 2023, 11, 2609. https://doi.org/10.3390/healthcare11192609
Hsu J-C, Wang M-S, Wang P-Y, Lian S-Y, Lin M-H. The Effects of the Situated Simulation Program on the Cultural Competence of Hemodialysis Nurses: A Quasi-Experimental Study. Healthcare. 2023; 11(19):2609. https://doi.org/10.3390/healthcare11192609
Chicago/Turabian StyleHsu, Jui-Chin, Min-Shu Wang, Pao-Yu Wang, Shu-Yu Lian, and Mei-Hsiang Lin. 2023. "The Effects of the Situated Simulation Program on the Cultural Competence of Hemodialysis Nurses: A Quasi-Experimental Study" Healthcare 11, no. 19: 2609. https://doi.org/10.3390/healthcare11192609