Search Results (12)

Background: The quality of healthcare experiences for Indigenous communities is worse when compared to non-Indigenous patients. Bias and discrimination within healthcare systems relate to worsened care and worsened health outcomes for Indigenous patients. The purpose of this study was to learn about the experiences of Indigenous people within healthcare settings, as well as their viewpoints for improving healthcare delivery to this population. Methods: Indigenous research methods were employed in this study as clinic administrators and staff, elders, and Indigenous researchers collaborated on the study purpose, design, and analysis. Twenty Indigenous patients participated in one of four focus groups regarding their experiences with healthcare systems. Results: Seven main themes emerged, highlighting participants’ experiences during health encounters, in relation to healthcare systems, and Indigenous health beliefs. Participants discussed challenges and barriers in each area and offered recommendations for care delivery to this population. Conclusions: Participants in this study highlighted that biased care results in poor quality of healthcare delivery and that there are actionable steps that providers and systems of healthcare can take to reduce bias within healthcare systems. The provision of culturally congruent care is imperative in improving the health and well-being of Indigenous communities. Full article

Background: Cultural competence is central to ensuring effective culturally congruent care to patients and fostering positive work environments, particularly in multicultural settings. Objective: This study aimed to analyse the relationship between cultural competence, the nursing work environment, and the delivery of culturally congruent care in multicultural units of a healthcare organisation in Portugal. Method: This was a quantitative, descriptive, and cross-sectional study, targeting nurses from multicultural units. Data were collected using both online and paper-based questionnaires, which included the Cultural Competence Questionnaire for Help Professionals, the Nursing Work Index—Revised Scale (NWI-R-PT), and a single question assessing nurses’ perceptions of the adequacy of the culturally congruent care they provide. Results: A moderate, positive correlation was identified between cultural competence and the Fundamentals for Nursing, while the nursing work environment was influenced by organisational support, professional category, and unit type. Discussion: The findings suggest that enhancing cultural knowledge and technical skills and reinforcing management support may positively impact culturally congruent care delivery in multicultural settings. Conclusion: This study contributes to nursing knowledge by highlighting the complex interactions between cultural competence and the work environment in Portuguese multicultural healthcare units. Future research should explore the impact of transcultural nursing leadership on multicultural work environments and in the delivery of culturally congruent care. Full article

Background: In the existing literature, there are many guidelines regarding cultural competencies for healthcare professionals and many instruments aiming to measure cultural competence. However, there is no consensus on which core cultural competencies are necessary for healthcare professionals. Aim and Methods: This study employed the PRISMA 2020 statement to systematically review Delphi studies and identify the core cultural competencies on which experts, who have been working with diverse populations in the fields of healthcare and allied healthcare, have reached a consensus. For this purpose, we searched, retrieved, and reviewed all Delphi studies conducted between 2000 and 2022 in the databases Scopus, PubMed, CINAHL, Medline, and PsycInfo and coded and synthesised the results qualitatively. Results: The systematic search resulted in 15 Delphi studies that met eligibility criteria and in which 443 experts from 37 different countries around the globe had participated. The review of these Delphi studies showed that the core competencies necessary for healthcare professionals to ensure that they provide culturally congruent care were: Reflect, Educate, Show Interest and Praise, Empathise, and Collaborate for Therapy. Discussion and Conclusion: These competencies make the abbreviation and word RESPECT, which symbolically places emphasis on respect as the overarching behaviour for working effectively with diversity. The study also provides a new, comprehensive definition of the cultural competence of healthcare professionals and opens new directions in formulating standardised guidelines and research in cultural competence in healthcare and allied healthcare. Full article

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. Aim: This study aimed to identify nurse managers’ interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders’ experience in international settings. Methods: A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. Results: Nurse managers’ interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients’ worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories—transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. Conclusions: These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire. Full article

Despite the universality of death for humanity, end-of-life care needs and expectations are highly unique and influenced by the individual’s cultural conditioning, values, and beliefs. In the pursuit of quality end-of-life care provision within the increasingly complex and diverse contemporary medical context, it is vital for cultural idiosyncrasies to be taken into consideration in order to attend to the individual patient’s needs and end-of-life goals. Palliative chaplains, as the spiritual care specialists within the multidisciplinary healthcare team, play a crucial role in the support and facilitation of the holistic vision of end-of-life care delivery. However, the capacity of the chaplains to become culturally competent practitioners are often insufficiently addressed in their professional educational pathways, creating additional challenges for them in their practice. Using Hong Kong as a case study, this article examines the impact of cultural diversity on the effectiveness of the chaplains’ delivery of end-of-life spiritual care. Specifically, special attention will be focused on two identified challenges resulting from the lack of integration of local cultural understandings within the religion-cultural practice framework of chaplaincy formation: the cultural taboo of death, and the cultural idiosyncrasies in end-of-life communication. This article hopes to raise awareness of cultural incongruencies within the current chaplaincy professional formation and development, and to initiate further attention and efforts to support chaplains in becoming culturally competent practitioners in the pluralistic healthcare landscape. Full article

Background: European nurses are expected to provide appropriate care for patients from diverse cultural backgrounds. However, there is limited knowledge and understanding of this process. The aim of this study was to analyse the perceptions of culture and experiences of caring for patients from diverse cultural backgrounds of a purposive sample of qualified nurses from four European countries, namely Belgium, Portugal, Spain and Turkey. Methods: A qualitative phenomenological approach was selected in order to understand complex phenomena through the participants’ lived experiences, meanings and perspectives. Individual interviews and focus groups took place with 28 staff nurses and 11 nurse managers from four European countries. The sociodemographic and cultural characteristics of the sample were described and analysed using descriptive statistics. Qualitative data were transcribed verbatim, translated into English and analysed following Braun and Clark’s phases for thematic analysis. Results: Five themes and twelve subthemes emerged from thematic analysis of the transcripts. The themes included: (1) relevance of culture for nursing; (2) culture in the healthcare service; (3) qualities of the healthcare professionals; (4) challenges to culturally competent care; (5) becoming a culturally competent nurse. Conclusions: There are challenges to the delivery of culturally congruent care, namely language and communication difficulties, prejudices and stereotyping in the health service, a tendency for ethnocentrism, a lack of education and training in cultural competence and a lack of support from the health service to facilitate new ways of acting. Full article

Perceptions of race influence the way health care is delivered to minority populations, particularly multiracial people. Currently only 11% of American physicians are Black or Latinx, making the chances slim that Black and Latinx patients will be treated by a co-ethnic. White supremacy is well documented in the medical literature—along with efforts to combat it—yet medical education and health care are still largely based on studies by and about white people. This privileging of whiteness is increasingly evident as the COVID-19 pandemic has shone a renewed spotlight on disparities in health and care in the U.S. The current study considers how doctors perceive race and use it to make healthcare decisions. Among the (N = 509) doctors in this sample, few said they considered the patient’s race. Of those who did, many determined race by some method other than asking the patient directly. The most common methods were observing skin tone and observing cultural cues. Doctors perceived nearly half the multiracial targets as monoracial. Targets who followed the norm of hypodescent were significantly more likely to be identified congruently by doctors. Targets who identified at the extremes of the color spectrum (black and white) were easier to identify, while the beige tones in the middle of the spectrum were more challenging. Patient ancestry was the most relevant criterion in explaining the congruence of racial identification between patients and doctors, while characteristics of the doctors were nearly irrelevant. Full article

Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S. This qualitative descriptive study describes the experiences of 13 African American men who acted as caregivers to adult chronically ill or debilitated loved ones, the majority of whom provided care during the COVID-19 pandemic. The revised Sociocultural Stress and Coping Model (R-SSCM) guided this study. Individual interviews were conducted via the Zoom application. Content analysis revealed four themes: (1) “My time to take the reins”, (2) “It’s a male thang”, (3) “Caring amid a pandemic”, and (4) “Effects of the caregiver’s journey”. This study’s findings in relation to the literature provide overdue attention to the African American male caregiving experience, especially in relation to the COVID-19 pandemic. The implications of our findings include the need for more culturally congruent support services for African American male caregivers, as well as increased efforts to encourage trust in the healthcare system—especially in relation to vaccination for the SARS-CoV-2 virus. Full article

Traditional methods of detecting Chlamydia pecorum in tissue samples such as polymerase chain reaction or cell culture are laborious and costly. We evaluated the use of a previously developed C. pecorum LAMP assay using minimally processed ovine samples. Cotyledon (n = 16), foetal liver (n = 22), foetal lung (n = 2), and vaginal (n = 6) swabs, in addition to cotyledon (n = 6) and foetal liver (n = 8) tissue samples, were rapidly processed and used for LAMP testing without DNA extraction. Overall, LAMP test results were highly congruent with the in-house reference qPCR, with 80.43% (37/46; 72.73% positive agreement (PA); 84.75% negative agreement (NA)) overall agreeance for swab samples, and 85.71% (12/14; 80% PA; 88.89% NA) overall agreeance for tissue samples. Out of the 11 total discrepant results, discrepancy was mainly observed in samples (n = 10) with less than 100 copies/µL C. pecorum DNA. While sensitivity could be improved, the simplicity, low cost, and accuracy of detection makes this test amenable for use at point-of-care for detecting C. pecorum in sheep. Full article

As a response to the call for reimagining early childhood education for social sustainability in the future, this conceptual paper aims to suggest revisiting and strengthening the case to include intentional intergenerational engagements and programmes in kindergartens as approaches towards sustainable futures for children. In this paper, we argue that we must talk about intergenerational solidarity on all levels, including in early childhood education and care settings, and that it must be deliberate and by design. Learning from cultural–historical concepts and the UN Convention on the Rights of the Child, intergenerational programmes in early years settings are to be presented as intentional initiatives and opportunities for interrelated and collaborating actors and institutions to bring younger children and older adults together. We present a conceptual framework that features conflicts and opportunities within overlapping and congruent spaces to understand conditions for various intergenerational practices and activities in different places, and to promote intergenerational dialogues, collaborations and shared knowledge, contributing to a relational and socially sustainable future for which we aim. Full article

Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to the individual, has been criticized for not applying a dedicated and more diverse strategy for most disadvantaged migrants in dealing with the pandemic. In order to mitigate the unequal burden on the marginalized members of society, increasing efforts have been addressed to digital health technologies. Despite the strong potential of providing collective public health benefits, especially in a highly digitalized context as Sweden, need for a stronger cooperation between the public health authorities and migrant community leaders, representatives of migrant associations, religious leaders and other influencers of disadvantaged groups has emerged. Suggestions are presented on more culturally congruent, patient-centered health care services aimed to empower people to participate in a more effective public health response to the COVID-19 crisis. Full article

Contemporary social and health care services exhibit a significant movement toward increasing client involvement in their own care and in the development of services. This major cultural change represents a marked shift in the client’s role from a passive patient to an active empowered agent. We draw on interaction-oriented focus group research and conversation analysis to study workshop conversations in which social and health care clients and professionals discussed “client involvement”. Our analysis focuses on the participants’ mutually congruent or discrepant views on the topic. The professionals and clients both saw client involvement as an ideal that should be promoted. Although both participant groups considered the clients’ experience of being heard a prerequisite of client involvement, the clients deviated from the professionals in that they also highlighted the need for actual decision-making power. However, when the professionals invoked the clients’ responsibility for their own treatment, the clients were not eager to agree with their view. In addition, in analyzing problems of client involvement during the clients’ and professionals’ meta-talk about client involvement, the paper also shows how the “client involvement” rhetoric itself may, paradoxically, sometimes serve to hinder here-and-now client involvement. Full article