Competent Care Research Articles

Pengaruh Kompetensi, Independensi dan Due Professional Care terhadap Kualitas Internal Audit

Based on the results of observations, the background to this research is the fluctuation in the number of employees and internal auditors, as well as fluctuations in the number of case findings discovered by internal audit which are thought to be caused by various factors. This research aims to determine the influence of Competency, Independence and Due Professional Care both partially and simultaneously on the Quality of Internal Audit at Bank BJB Syariah Braga Bandung Head Office. The research objects in this report are employees at Bank BJB Syariah Braga Bandung Head Office. This type of research is quantitative research with an associative approach and the type of data used is primary data processed using the IBM SPSS Statistics 26 application, with data collection techniques in the form of observation, interviews, literature studies and questionnaires. The sampling technique is probability sampling with simple random sampling. The population in this research is all employees at Bank BJB Syariah Braga Bandung Head Office, totaling 384 people with a sample of 80 people. The research results show that Competence, Independence and Due Professional Care partially influence the Quality of Internal Audit at Bank BJB Syariah Braga Bandung Head Office by 70.1%, 53% and 65.9%, and simultaneously influence is 71.1%.

The Mediating Role of Compassion in the Relationship Between Nurses' Ethnocultural Empathy and Cultural Sensitivity: Structural Equation Model Analysis.

Nurses must possess the capacity for compassionate care and exhibit empathy to promote culturally competent care. This research investigated the mediating role of compassion in the relationship between ethnocultural empathy and intercultural sensitivity among nurses. The study was conducted at a hospital that provides health care services to refugees. In total, 125 nurses were recruited through the simple random sampling technique. Data were collected using a personal form and three scales. Statistical analysis was performed using SPSS23 and AMOS24. Nurses' cultural sensitivity positively influenced their compassion competence and ethnocultural empathy. Compassion competence did not function as a full mediator in the relationship between intercultural sensitivity and ethnocultural empathy. This study revealed that exposure to different cultures contributed to compassion competence, ethnocultural empathy, and cultural sensitivity skills in nurses. Cultural competence is a critical component of nursing care; therefore, it should be developed through curriculum revisions and a sensitive and supportive discussion of experiences.

Underrepresentation of Hispanic women in science, technology, engineering, mathematics, and medicine.

Despite ongoing efforts to increase the number of women in science, technology, engineering, and mathematics (STEM) and in medicine, Hispanic women remain severely underrepresented in these fields. This disparity not only hinders scientific innovation and the delivery of culturally competent medical care but also perpetuates a systemic exclusion. Research specifically addressing the challenges faced by Hispanic women, the extent of underrepresentation in these disciplines, and strategies to mitigate these issues is sparce. The authors conducted a systematic analysis of peer-reviewed articles to address this gap. The findings reveal a stark underrepresentation of Hispanic women across all examined fields, particularly compared with White women. In addition, the underrepresentation persists whencompared with Hispanic men, although the disparity is less pronounced. The authors identify ongoing disparities in promotion, compensation, and retention ratesfor Hispanic women; present data for barriers to entry and retention; and highlight existing programs and strategies aimed at addressing this underrepresentation. Finally, a framework is presented for future studies and actionable initiatives, and the broader implications of these findings for the field of oncology are highlighted.

Survey of Urogynecology Fellows on the Care of Patients with Differences in Sex Development/Intersex Traits.

Patients with differences in sex development or intersex traits (DSD/I) struggle to find clinically competent care in adulthood. We sought to describe the surgical exposure of Urogynecology and Reconstructive Pelvic Surgery (URPS) fellows who had previously trained in ObGyn (URPS-Gyn) to patients with DSD/I and their interest in performing 18 relevant procedures. We hypothesized that most graduating fellows would not have had exposure to many of the surgeries. We administered a cross-sectional online questionnaire of graduating URPS-Gyn fellows from April to June 2021. Questions assessed procedural knowledge, training, and clinical interest. Of 56 eligible URPS-Gyn fellows graduating in 2021, a total of 14 completed the survey. Twelve (86%) had heard about most procedures (14 out of 18 surgeries listed); however, there was heterogeneity in exposure to specific surgeries and self-reported preparedness to perform them. Respondents were more interested in performing procedures that they were prepared to perform. Only 6 out of 11 who responded to questions about beliefs in training felt that it was important for residents to receive training regarding surgeries for patients with intersex traits, and only 8 felt it important for fellows to receive this surgical training. Three anticipated seeing patients with intersex traits. Graduating URPS-Gyn fellows expressed interest in performing surgeries to meet the needs of patients with DSD/I. However, respondents had heterogeneous exposure and self-assessments of their proficiency. URPS-Gyn providers may be key collaborators in providing care for the growing number of adults with DSD/I seeking care.

Analysis of Urban Indian Organizations' Promotion of Cancer Services.

The burden of cancer remains elevated for American Indian/Alaska Natives (AI/AN) in the United States, particularly urban communities. Urban Indian Organizations (UIOs) are part of the Indian health care system for urban AI/AN populations to receive culturally competent care; therefore, it is important that UIOs convey the importance of cancer preventive and treatment options through their websites. The purpose of this study was to utilize the Indian Health Service (IHS) Office of Urban Indian Health Programs' official website to identify, analyze, and describe IHS funded UIOs offering cancer-related services. We utilized qualitative content analysis on UIOs with primary care service capabilities. After determination of UIOs, each eligible website was reviewed to determine if promotion of specific cancer related services was being done based on the following categories: primary prevention, cancer screening, cancer support, and information/technology services that focus on the social determinants of health. There is limited, vague, or outdated information on UIO websites regarding the type of cancer-related services and programs provided. We found that while twenty-one of thirty-four UIOs list any mention of cancer screenings, few mentioned specific testing capabilities for various cancers. In addition, the listing of support and preventative services was also limited with less than half of UIOs reporting on patient navigation services, among others. There is untapped potential in the utilization of websites for extending the impact of UIOs and their work with urban AI/AN populations in prevention, screening, and support of cancer patients in a culturally appropriate manner that can improve outcomes.

Association of Social Vulnerability Index With Declining Recommended Surgical Treatment in Head and Neck Cancer Patients.

To investigate the impact of county-level social vulnerability on patients' decision to refuse recommended surgical treatment. Retrospective cohort analysis conducted on HNSCC cases documented in the latest available SEER databases from 2000 to 2020; various demographic, including county of residence, and disease-related variables were collected. CDC's Social Vulnerability Index (SVI) was assigned based on patients' county of residence, and patients were subsequently categorized into four SVI quartiles. Pearson chi-square tests and binomial logistic regression was conducted to determine the impact of variables on patients' refusal of surgical treatment. Among 83,184 patients, 2.6% (2,165) refused surgical intervention recommended by their physician as part of treatment. Social vulnerability (higher SVI), male sex, older age, more advanced disease stage, belonging to non-Hispanic Black or Native Hawaiian/Asian Pacific Islander Race and Origin, and single marital status were associated with higher likelihood of refusing surgery. SVI is a significant factor in the refusal of recommended surgical treatment in HNSCC patients. Advanced disease stages and social vulnerability appear to interplay, influencing treatment decisions. Culturally competent care and support for socially vulnerable patients may mitigate disparities in treatment acceptance, potentially improving survival outcomes. 3 Laryngoscope, 2025.

Assessment of spiritual care competencies of critical care health professionals: An integrative review.

The primary aim of the present study was to assess the competencies related to the spiritual care by nurses and health professionals who work in intensive care units, and how these competencies influence clinical practice. As a secondary objective, we have discussed the strengths, weaknesses and threats of incorporating and teaching these competencies among the included studies. An integrative review of studies published in English, Spanish and Portuguese was performed in the following databases: Embase, Web of Science, Medline/PubMed, PsycInfo, LILACS and Cochrane. Eleven out of a total of 2,239 articles were included. Most were cross-sectional studies with nurses and the main competencies included were "spiritual care attitude" and "knowledge-related spirituality". The studies were separated into three themes: "Strengths", "Weakness" and "Opportunities". The results showed there are several challenges for professionals working in ICUs, including lack of time, high workload and the influence of the cultural context. Furthermore, few professionals are actually trained to provide spiritual care in the ICU and this care is often provided only at the end of life. Despite this evidence, only one quasi-experimental study on training on the subject in the ICU was identified and no trials, reinforcing the need for more educational studies. There is still a large gap regarding spiritual care in the intensive care environment, often related to the lack of training and knowledge of the team. Exploring the competencies involved in spiritual care provided by health professionals is a way to deepen the debate within the healthcare-related scientific scenario. Our findings allow a better understanding of outcomes related to healthcare, based on the assessment of these competencies and aspects related to critical patients, expanding the possibility of building scientific knowledge in the health area and allowing thoughts about multiple forms of research, including randomized clinical studies.

Cultural Competency of Family Medicine Practitioners Working in Saudi Arabia: A Review Article Dr Shehla Nasr

Background: Cultural Saudi Arabia's varied population, customary medical beliefs, religious customs, and a transforming healthcare environment create a multifaceted challenge for achieving cultural competency in healthcare. Cultural competency training can greatly influence healthcare since it relates to the knowledge, attitudes, and skills of healthcare workers, thereby impacting patient health outcomes. Aim: This review paper aims to examine the literature evaluating cultural competency among Family Medicine professionals in Saudi Arabia based the healthcare workers reported barriers and training received. Method: A total of 7 relevant scientific articles were selected from various databases (such as Google Scholar, PubMed, and Science Direct) for this review, based on keywords such as “Culture Competency”, “Family Medicine Practitioners”, “Saudi Arabia” and “Healthcare Competency”. Results: The results highlighted the challenges in achieving cultural competency, with confounding factors including healthcare provider’s gender, age, and experience. Healthcare professionals also reported issues related to lack of sufficient training on cultural competency, and showed their preference and willingness to receive cultural competency education in their practice. Data examining the impact of health professionals' cultural biases and assumptions on patient care was not available, suggesting an area for further research. Conclusion: Delivering tailored culturally competent care to patients poses a significant challenge in Saudi Arabia. A thorough assessment of individual training programs to enhance cultural competence in relation and therefore patient care must be prioritised. Incorporating a wider range of cultural viewpoints into future research is also essential, as well as measuring the level of cultural competency specifically among Family Medicine professionals.

Pathways for Social Equity: An Audit of Bureaucratic Representation, Diversity, and Cultural Competency in Florida Nursing Homes

Social equity is a central concern in public service provision. As a concept, social equity is comprised of several disparate concepts including representative bureaucracy, diversity management, and cultural competency, each focusing on a specific function necessary for achieving equitable processes, outputs, and outcomes. While many organizations implement reforms across all three of these dimensions simultaneously, existing applications in the literature tend to only focus on one at a time—potentially obfuscating the true impact of social equity reforms within public organizations. By constructing a dataset of over 600 nursing homes in Florida, our descriptive analysis reveals that nursing homes are unrepresentative, lack diversity, and tend to provide culturally competent care in underperforming homes. We further examine the sectoral differences between for-profit homes and not-for-profit. Our article contributes to the literature by providing an in-depth audit of how nursing homes practice representation, diversity, and cultural competency.

A psychometric assessment for evaluating spiritual care competency for geriatric nurses

This study evaluates the validity and reliability of the Chinese Version of Spiritual Care Competency (C-SCC) for geriatric nurses. Using convenience and snowball sampling, 1,094 geriatric nurses were randomly divided into two groups of 547 each for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA confirmed a four-dimensional structure, explaining 74.399 % of the total variance. Structural validity was assessed through EFA and CFA, while correlation analysis evaluated concurrent and convergent validity. Internal consistency, measured by Cronbach's α coefficient, was 0.987, with individual factors scoring 0.983, 0.964, 0.933, and 0.976. Test-retest reliability was 0.983, and concurrent validity was 0.860 (P < 0.01). Modified CFA results (RMSEA = 0.04, GFI = 0.93, AGFI = 0.93, NFI = 0.93, RFI = 0.93, PGFI = 0.62) indicated a well-fitting model with excellent psychometric properties. The C-SCC is a reliable tool for assessing spiritual care competencies among geriatric nurses.

Nurses’ Compassion and Patient-Centered Care Competency at the Egyptian Health Care Authority Hospitals in Port Said Governorate

Nurses’ Compassion and Patient-Centered Care Competency at the Egyptian Health Care Authority Hospitals in Port Said Governorate

‘I know I am caring’: fostering ethical care awareness and practice among pre-service early childhood teachers

ABSTRACT Ethical care in early childhood education [ECE] involves practices and principles that guide educators in nurturing young children with respect, empathy, and moral responsibility. As a dynamic field, learning how to care for young children using context-specific approaches in real-life situations can be challenging for pre-service early childhood teachers owing to insufficient training and opportunities for reflective practice that require ongoing adaptation and learning. We propose a practice-based learning approach that combines reflective practice, context-specific training, and collaborative learning designed to foster the practical wisdom needed for pre-service early childhood teachers to respond to ethical care. For navigating complex situations and context-specific decision making, the participants identified the roles and functions of sensing behaviour, empathising with needs, responsive interaction, being present, engaging in equal dialogue, using gentle tone and appropriate body language in different ethical care dilemmas, and effectively combining theoretical knowledge with practical application. This practice-based approach incorporates reflective exercises, mentorship, and peer feedback to promote changes in the learning preferences and professional identity development of pre-service early childhood teachers. It highlights the profound influence of a practice-based learning approach on both professional development and the development of ethical care competencies among pre-service early childhood educators.

ASSESSMENT OF THE CRITICAL CARE NURSING COMPETENCY FOR PATIENT SAFETY IN ICU SETTING

Critical care nursing competencies are vital for ensuring patient safety in ICU settings. This study aimed to assess the knowledge, attitudes, and practices of nurses regarding critical care competencies in a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted among 133 ICU nurses. Data were collected using a validated questionnaire assessing competencies in preparation, patient assessment, communication, role recognition, and organization. Descriptive and inferential statistics were used to analyze the data. Results: The majority of nurses demonstrated high competency in preparation (87.2%), patient assessment (82.0%), and equitable care (88.0%). However, gaps were observed in the documentation of communication with patients’ families and consistent adherence to documentation protocols. Nurses with higher qualifications (Post RN and BSN) and more clinical experience performed significantly better than their counterparts. Conclusion: The study identifies key strengths and gaps in critical care nursing competencies. Targeted interventions, including structured training programs and the implementation of standardized protocols, are recommended to enhance competency levels and ensure patient safety in ICU settings.

Effect of two teaching methods on nursing students' acquisition of patient-centered communication competence in older people care: a cluster randomized trial.

Patient-centered communication is an essential skill in nursing, particularly in the care of older adult patients. However, generation Z nursing students, who primarily communicate through digital platforms, face unique challenges in adapting to traditional face-to-face communication with older adults. As a result, there is a need for teaching methods that align with this generation's learning style to enhance their communication skills. This study aimed to compare the effectiveness of two teaching methods-standardized patient simulation and role-play-on nursing students' acquisition of patient-centered communication competence in older people care. A controlled cluster-randomized trial was conducted with 124 nursing students, divided into eight teaching groups. Students participated in either a standardized patient simulation or a role-play workshop, each consisting of a 1.5-h online module and a 1.5-h face-to-face session. The three components of patient-centered communication competence-knowledge, skills, and self-efficacy-were assessed using simulated scenarios at pre-test, post-test, and 6-week follow-up. Between-group and within-group differences were measured based on the number of students who achieved competence. Both interventions significantly improved students' knowledge, skills, and self-efficacy in patient-centered communication between pre- and post-tests, with improvements maintained at follow-up. No significant differences were found between the two methods. Both standardized patient simulation and role-play are effective in enhancing patient-centered communication competence in older people care. However, neither method was found to be superior in teaching knowledge, skills, or self-efficacy.

Exploring Black Birthing Experiences: A Systematic Review and Social-Ecological Analysis of Disparities in the United States.

Black birthing people in the United States face disproportionately high risks and adverse experiences during childbirth compared to their White counterparts. These challenges are shaped by a complex interplay of factors across individual, interpersonal, organizational, community, and policy levels. This systematic review explores the lived experiences of Black birthing people in the United States, using the Social Ecological Model to identify and analyze factors contributing to disparities in Black birthing health experiences. Eighteen qualitative studies, published between 2017 and 2024 and encompassing a sample of 570 participants, were systematically reviewed. A comprehensive search was conducted across PubMed, CINAHL, PsycINFO, and Scopus databases between March and May 2024. Studies were selected based on stringent inclusion criteria, and thematic analysis was applied to identify recurring factors that shape Black birthing experiences in the United States. Key themes include personal health beliefs, psychological stress, medical distrust, interactions with healthcare professionals, family and peer influences, and the pervasive effects of systemic racism and healthcare policies. Together, these factors contribute to ongoing disparities in Black birthing healthcare experiences for Black birthing people in the United States. The findings underscore the importance of culturally competent care, equitable healthcare policies, and strong community support systems in addressing the unique challenges faced by Black birthing people. Targeted interventions, policy reforms, and continued research are essential for improving Black birthing experiences and outcomes. This review provides crucial insights into the multifaceted challenges in Black birthing experience emphasizing the need for culturally sensitive practices, policy changes for equity, and strengthened community resources. These steps are vital for ensuring respectful, equitable, and supportive experiences for Black birthing people in the United States.

Bridging the critical gap between infectious disease blood donation screening and connection to healthcare services: the American Chagas disease example.

Chagas disease (Trypanosoma cruzi infection) affects ~ 290,000 USA residents and is included in routine blood donation screening panels. Donors are notified of positive T. cruzi-screening results, deferred from donation, and given limited information for next steps. Individuals living with undiagnosed, uncommon infections often face substantial barriers in accessing physicians with infectious disease competency, confirmatory testing, and continuum of care after the point of blood donor deferral. We assessed 46T. cruzi-deferred donors' experience following deferral, highlight donor challenges, and provide public health institution opportunities to support cases of rare transfusion-transmitted infections in the USA.

Increasing Graduate Student Awareness of Cultural Competence Through Bias Exploration Related to Diverse Cultural Families.

Emphasis by the American Nurses Association and the American Association of Colleges of Nursing regarding the importance of cultural competence in nursing education led to the development of a strategy to address personal bias in graduate nursing students. With the updated Essentials and a change to competency-based education, a need to address culturally congruent practices while increasing awareness of professional organization recommendations exists. Since Domain 2 of the Essentials highlights that culturally competent care is essential to person-centered care, a strategy that enhances knowledge by expanding the definition of culture beyond ethnicity and race was developed.

Exploring lack of trust and its impact on access and utilization of primary healthcare services among African immigrant women in the United States: a qualitative study of Ethiopian immigrant women

BackgroundLack of trust is a critical issue in healthcare that contributes to the growing disparities in access and utilization of health among minoritized and disadvantaged populations in the U.S. This study explored how lack of trust affects Ethiopian immigrant women’s (EIW) primary healthcare (PHC) experience and the personal and structural factors exacerbating the problem.MethodA qualitative cross-sectional design was used to collect data through in-depth interviews with EIW (N = 21) living in six states (MO, MD, VA, KS, MI and IN) and Washington DC using a pilot-tested semi-structured interview guide. A mix of purposive and snowball sampling was used to recruit participants who: (1) identify as an Ethiopian immigrant; (2) identify as a female; (3) be 18 years and older; (4) arrived in the U.S. within the last five years; and (5) speak Amharic or English languages. The interviews were recorded, transcribed verbatim, translated and cleaned for errors. An inductive thematic analysis was followed to analyze data using Nvivo12 software.ResultsThe findings showed that lack of trust is a significant concern among EIW negatively affecting their PHC experience and decisions in seeking care. The thematic analysis revealed five major factors contributing to the erosion of trust in PHC among EIW: (1) reliance on medication in U.S. healthcare system (2) preference for traditional homemade remedies over PHC recommendations and modern medicine (3) faith and its influence on trust and PHC decisions (4) lack of transparency in PHC, and (5) multilevel discrimination in PHC.ConclusionThe analysis suggested that PHC professionals provide understandable and contextualized health information, practice transparency, familiarize themselves with the healthcare system in immigrants’ countries of origin by asking their patients, and prioritize culturally competent care to gain trust. At structural and policy levels, reform is needed to dismantle systemic problems that enable and perpetuate discrimination, diversify the healthcare workforce, revise healthcare training curriculums and procedures to reflect immigrant needs, establish multi-sectoral collaboration between health, education, and immigration sectors to create conducive care environment for immigrants. Further research and conversation around alternative medicine is vital to expand evidence-based and inclusive PHC services for immigrants.

Online education in palliative care - A national exploratory multimethod study.

With an increased number of people living with multiple progressive diseases, online education courses have been created to address the growing need for competence in palliative care. However, there is limited knowledge about the form and content of these courses, or of participants' experiences. This study aims to map the status, content, and evaluation of online palliative care courses in Sweden. This exploratory study used both quantitative and qualitative methods. The study process involved searching for online palliative care courses on the web and through contact with Swedish palliative care organisations, and then participating in these courses, surveying education providers, and analysing and validating responses. Quantitative data were analysed using descriptive statistics, while thematic analysis was applied to the free-text responses. Nine online courses provided by five different organisations were mapped. These courses educated over 30 000 healthcare professionals, predominantly assistant nurses and registered nurses. There was a large discrepancy between the number of people who enrolled in and the number who completed the online courses. Shortcomings identified related to lack of systematic evaluation from the participants' perspectives, if and how knowledge was integrated into clinical practice, and difficulties in making the courses sustainable. Overarching and national systems for online education are needed. These would require sustainability considerations and guidelines for implementation, evaluation and follow-up of non-university-based online educational initiatives in palliative care. In addition, it is crucial for employers to support professionals undergoing such education, ensuring that they are given opportunities to share their feelings and discuss any challenging thoughts that arise during and after the course.

Development of a perceived nutrition care competencies scale for Japanese dietetic students: A cross-sectional survey.

There are currently few appropriate instruments for assessing nutrition care competencies in clinical practice. This study aimed to develop a perceived nutrition care competencies (PNCC) scale for dietetic students and test its validity. Factors that influence PNCC scores were examined through a cross-sectional study. This cross-sectional survey involved 501 dietetic students (mean age of 21.4 years, 428 females) and employed a web-based questionnaire between September 2022 and February 2023. A scale derived from previous research was used to assess nutrition management practices and basic dietetic competencies. Questionnaire data were analysed using exploratory factor analysis. Exploratory factor analysis identified five factors: nutritional status assessment and preparation for intervention, communication skills for nutritional support, nutritional diagnosis and recording, supplementation suggestions and coordination and dietitian orientation and attitude. Multivariate logistic regression analysis showed that field practice increased the 'nutrition diagnosis and recording' scores, and the subconcepts 'nutrition diagnosis and recording' and 'suggestion and coordination of nutritional supplementation' showed odds ratios (ORs) <1 for the 'online role-play among students' experience. In addition, experience with face-to-face simulated patients increased the total scores (OR 2.46, 95% confidence interval 1.43-4.22, p = 0.001). The PNCC scale demonstrated reliability and validity, offering a valuable measure of dietetics students' perceptions of their nutrition care practice competence. The findings highlight the need to increase the willingness of the students to work as dietitians and to incorporate realistic, safe learning experiences beyond on-site practice to enhance nutrition management practice competency.