Dimensions Of Care Research Articles

Quality indicators of long-term care for older people in OECD countries; a rapid scoping review

Abstract Background The COVID-19 pandemic has exposed the vulnerability of older people living in long-term care facilities (LTCF), highlighting the urgent need for research on the quality of care for this group of the population. There is no universal definition for quality of care in LTCF, and yet, multiple tools and indicators have been developed to measure it. In this rapid scoping review, we aim to provide a comprehensive overview of the current knowledge on quality of care concepts and indicators for older people in LTCF in OECD countries. Methods This review follows the World Health Organization (WHO) guide for rapid reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) extension for scoping reviews, including protocol registration (https://doi.org/10.17605/OSF.IO/34B2S). The electronic bibliographic databases MEDLINE (PubMed), EMBASE, and CINAHL were searched in September 2023 for studies published between 2013 and 2023 for quality indicators in LTCF. Experts in quality of care in LTCF were contacted and consulted to retrieve sources of grey literature. Information on the definition or framework of quality of care, quality of care dimensions, measurement instruments, context and purpose of the measurement will be extracted. Results Of the 8,516 identified records, 6,449 were screened by title and abstract after removing duplicates. A total of 469 publications will be screened in full-text. Experts recommended 40 websites to be screened for quality indicators. The PRISMA flowchart diagram will be provided to describe the selection process. Conclusions This review aims to improve the quality of care for older people living in LTCF. Our results will identify which concepts and dimensions of care are currently being measured in OECD countries, whether they are backed by any definition and scientific framework of quality of care for older residents of LTCF, and whether there is consideration of closing gaps in quality measurement. Key messages • Quality of care is an understudied field in the context of long-term care facilities for older people. • In order to further improve quality in long-term care for older people, it is necessary to systematically review the current state of knowledge on quality concepts and indicators.

New constellations of care: between local and transnational care practices of young Europeans living in the UK during the (im)mobility regimes of a pandemic

ABSTRACT The restrictions to international travel during the COVID-19 pandemic have posed significant barriers to transnational family life. This paper focusses on the negotiation of familial obligations of over 300 young EU nationals aged 14–25 living in Britain. We examine how care practices were reconfigured within families, as forced immobility, absence and loss became part of transnational family life. Young people’s agency was activated to engage in desirable circulations of care, while they also engaged in acts of citizenship locally that had a care dimension. Many young people contributed to local initiatives of caring for others, such as mutual aid initiatives and local groups extending care practices to non-familial relations. We examine thus the range of care receiving and care giving practices and resources involved, including material resources, time, affection and sharing information. These practices involved family members locally or at a distance, but also non-familial relations, to shape new constellations of care.

An assessment of adequate quality antenatal care and its determinants in India

BackgroundAntenatal care (ANC) is an important component in the continuum of care. Providing adequate quality ANC is necessary to prevent maternal and newborn mortality. The coverage of ANC has increased significantly in the last decade in India, but a mere increase in coverage is insufficient if the issue of quality is not simultaneously addressed. This study examines the change in each component of quality ANC between 2015-16 and 2019-21, highlights the factors associated with adequate quality ANC, and observes the state- and district-level distribution of adequate quality ANC during 2019-21.MethodsThis study is based on data from the two most recent rounds of the National Family Health Survey (NFHS), the Indian equivalent of the Demographic and Health Surveys (DHS). These rounds were conducted in 2015-16 and 2019-21 in selected households of India with a total of 190,797 and 176,843 sampled births, respectively. The dependent variable was quality antenatal care, a composite variable consisting of skilled healthcare providers, timeliness, sufficiency, and appropriateness of content. The independent variables were mother’s age, education, wealth quintile, birth order, mass media exposure, health insurance coverage, relationship with the head of household, facility exposure, intended pregnancy, history of adverse pregnancy outcomes, and other socio-demographic variables. Change in each component and dimension of quality antenatal care was assessed using data from both rounds of the survey. A multivariate multinomial logistic regression analysis was employed to identify the determinants of adequate quality ANC using the NFHS-5 data.ResultsThe findings revealed that 32 per cent of mothers received adequate quality antenatal care in 2019–2021, an increase of only 9% points compared to the 2015-16 period. Two significant barriers to achieving adequate quality antenatal care, in terms of appropriateness of content, were the provision of Iron and Folic Acid (IFA) tablets and counselling. The highest utilisation of adequate quality antenatal care was observed in the southern states. The utilisation of quality ANC increased with an increase in women’s education and wealth status; and was more prevalent among those with health insurance coverage and exposure to mass media.ConclusionDespite some improvements in the coverage of antenatal care, the quality of antenatal care continues to be very low and needs urgent attention. Achieving quality antenatal care in both content and experience requires addressing service gaps and developing better measures to capture and improve women’s care experiences.

Analysis of Longitudinal Trajectory and Influencing Factors of Supportive Care Needs in Colorectal Cancer Patients With Enterostomy.

The aim of this study was to understand the dynamic changes in the needs of patients with enterostomy during the 3 months after discharge and its possible influencing factors. A prospective observational design. This study investigated the supportive care needs of patients who underwent colorectal cancer surgery with colostomy in three Chinese hospitals from May 2023 to October 2023 during the 3 months following discharge from the hospital. The growth mix model was used to describe the needs trajectory and analyse the heterogeneity of the trajectory. Univariate analysis was used to find the factors that might affect the heterogeneity of needs trajectory of patients with enterostomy, and then logistic regression analysis was used to determine the influencing factors of the heterogeneity of needs trajectory of patients with enterostomy. The reporting of this study adhered to the STROBE checklist. A total of 232 patients with enterostomy completed follow-up. There was heterogeneity in the developmental trajectories of supportive care needs of enterostomy patients and the trajectories of the five dimensions of supportive care needs. The heterogeneity factors affecting the trajectory of supportive care needs included the enterostomy patient's psychosocial adjustment score, type of enterostomy, and educational background and the heterogeneity factors affecting the five dimensions trajectory of supportive care needs include psychosocial adjustment score, tumour staging, type of enterostomy, smoking, chemotherapy and enterostomy self-care knowledge score. The needs of patients with enterostomy within 3 months after discharge were dynamic. Identifying and meeting the unmet needs of patients with enterostomy was crucial to improving the health-related quality of life of patients with enterostomy. None. The needs of patients with enterostomy were dynamic, with the needs of most patients with enterostomy decreasing within 3 months of discharge, but some patients with enterostomy continued to have high needs at 3 months after discharge, and clinical nurses were expected to pay special attention to these patients.

The relationship between moral distress and clinical care quality among nurses: an analytical cross-sectional study

BackgroundNurses constitute the largest group of service providers in the healthcare system and significantly influence the quality of healthcare services. Factors such as ethical considerations may be related to the quality of care. This study aimed to determine the relationship between moral distress and the quality of clinical care among nurses working in Gonabad, Iran.MethodsAn analytical cross-sectional study was conducted on 252 nurses working in emergency, internal medicine, surgery, psychiatry, critical care and maternity wards at Allameh Bohlool Hospital from May to July 2023. This research used demographic information questionnaire, the revised Moral Distress Scale (MDS-R), and the Quality Patient Care Scale (QUALPAC). The significance level for the study was set at p < 0.05.ResultsThere was a significant relationship between the frequency of moral distress and the quality of clinical care (p = 0.032), as well as between the intensity of moral distress and the quality of clinical care (p = 0.043). Nurses who experienced moral distress more frequently and intensely provided better quality care. However, there was no significant relationship between the effect of moral distress and the quality of clinical care (r = 0.032, p = 0.619). Additionally, a significant statistical relationship was found between the intensity of moral distress and the physical dimension of clinical care quality (r = 0.171, p = 0.007), indicating that increased moral distress intensity was associated with higher quality of physical care.ConclusionsNurses who experience higher levels of moral distress, both in terms of frequency and intensity, perform better in the care they provide and deliver it in the best possible manner, particularly in the physical dimension of care.

The role of primary care practitioners in cancer control in South Africa: a systems-based case study

Aim Cancer care has largely been the domain of oncology specialists. With increased awareness of the importance of primary care in the context of universal health coverage, there has been a shift to explore the role of primary care in comprehensive cancer management. This includes health promotion, screening, diagnosing, referral to oncology services, and longitudinal care that includes co-ordination of care, survivorship, and palliative care. This paper focuses on the role of primary care practitioners in health promotion, early detection and care co-ordination. Nurses and doctors who work in primary care are included as primary care practitioners. Methods Using a patient vignette narrative tool, the triad of patient empowerment in the form of enhanced health literacy, clinical competence, and system effectiveness, are discussed as the basis for early cancer detection. A complex intervention to improve primary-level cancer care and the implications thereof for the important role of care co-ordination undertaken by primary care practitioners, is also presented. Findings For effective patient assessment, primary care practitioners must be trained in screening and diagnostic techniques as part of their clinical competencies as generalists. These competencies include risk identification, counselling skills, expert clinical examination, interpretation of basic x-rays, minor surgical skills, interpreting blood tests, and point-of-care ultrasound. Against a backdrop of ongoing budget constraints, consumables and equipment needed for diagnosis should be readily available and referral pathways for patients and specimens should be clearly defined and resourced. Conclusions Primary care practitioners in community-based facilities are well-placed to engage with the psychosociocultural dimensions of care. The SA health system places primary care at the point of closest contact with communities. Efficient care pathways are needed by primary care practitioners to adopt the role of care co-ordinator when patients with suspected or confirmed cancer enter these pathways. When considered alongside the overburdened primary care patient-load and the ever-increasing mix of co-morbidities, the complexity of primary care is appreciated. Understanding the complexities of primary care in the context of cancer control is an important component of a holistic cancer control programme.

Investigating the relationship between moral courage and caregiving behaviours among nurses working in COVID-19 wards in Iran.

To examine the correlation between moral courage and caregiving behaviour among nurses who are employed in the COVID-19 ward in Iran. This study is a descriptive-correlational and cross-sectional research conducted in 2021 in the city of Tehran, Iran. A total of 270 nurses employed in COVID-19 wards, who had been working in these wards for at least 1 month, were recruited from XXX hospitals and XXX Hospital. Data collection was conducted from September to November 2021. The data collection tools included a demographic information form, the Caring Dimension Inventory (CDI-25), and the Professional Moral Courage Scale (PMC). The designed questionnaire links were provided to the participants virtually through the Persian platform 'Pars Line' and via WhatsApp. Descriptive statistics and inferential statistics were used to examine the relationship between moral courage and care behaviour. There was a significant difference in the mean of caring behaviour between the age groups (<30 and >40 years old), and the work experience groups (<5 years and >15 years) (p < 0.05). Ethical values also varied significantly between certain age and experience groups (p < 0.05), but no significant differences were found in ethical behaviour across most ages (30-40 years) and work experience categories (>10 years) (p > 0.05). The level of moral courage among the nurses was higher than the median score of the instrument (87.31 ± 10.37). Among the dimensions of moral courage, the highest score was related to the dimension of ethical factors (17.64 ± 2.64), and the lowest score was related to the dimension of multiple values (17.26 ± 2.78). The level of caring behaviours among the nurses was lower than the median score of the instrument (46.11 ± 10.84). Among the dimensions of caring behaviours, the highest score was related to physical-technical behaviours (19.22 ± 5.27), and the lowest score was related to professional behaviours (1.35 ± 0.67). Based on the analysis, moral courage had a weak and inverse correlation with caring behaviours among nurses. The higher moral courage does not necessarily result in improved caregiving behaviours, emphasizing the need for further research to explore and address this relationship. No Patient or Public Contribution.

Assessing the dimensions and structure of thwarted interpersonal needs

IntroductionThe Interpersonal Needs Questionnaire-15 (INQ-15) assesses interpersonal needs comprising suicidal desire based on the Interpersonal Theory of Suicide (IPTS): Thwarted belongingness (TB) and perceived burdensomeness (PB). The IPTS is applied to many psychological-affective states and disorders, collectively showing state-specific pathways to suicidal features. Given the prevalent application of the IPTS, determining how the constructs are comprised and operate is critical. Consistent with the network perspective of psychological constructs, we used network and algorithmic methods to evaluate thwarted interpersonal needs. MethodsA sample (N = 863) aggregated from two independent studies (Sokol & Serper, 2019; Sokol et al., 2023) was used for analysis. ResultsNetwork analysis identified three dimensions that were invariant by suicide-risk status: PB, and two dimensions from the TB items. Accounting for wording effects, one-dimensional structures presented in 9 %–23 % of replicates. The loadings comparison test algorithm suggested that the constructs were consistent with a network composition (over latent), and centrality indices identified meaningful strong and bridge features. LimitationsThe samples were demographically homogeneous, and more diverse samples in terms of sexuality, racial/ethnic identification, culture, and socioeconomic status might yield different findings. ConclusionFindings indicate that thwarted interpersonal needs are comprised of perceived burdensomeness, loneliness, and absence of reciprocal care dimensions and that loneliness-related experiences may be mechanisms by which PB and TB-related experiences co-occur. Additionally, results showed that the INQ-15 may have previously unquantified method effects, but the overall identified dimensions are stable. These results yield a nuanced conceptualization of interpersonal needs and their function.

Focus on the blind spots of clinician-patient interactions: A critical narrative review of collusion in medical setting.

Collusions, interpersonal phenomena with an impact on patients, significant others, clinicians, and care, are mainly described in the psychotherapeutic literature but also occur in the medical setting. Comprehended as an unconscious bond between two or more persons from a psychotherapeutic perspective, definitions and collusive situations described in the medical setting vary. The question arises whether medical collusions, compared to collusions occurring in the psychiatric setting emerge in different clinical situations or are not identified as transference-countertransference experiences, since there is less sensitivity for the unconscious dimensions of care. We systematically reviewed the medical literature on collusions. Even though a read threat, avoidance of unpleasant feelings (mainly anxiety), runs through the described collusions, the unconscious dimensions and associated defensive maneuvers are rarely evoked. Given the expressed desire to act on collusions in medicine, involving third-party psychiatric liaison clinicians, who supervise clinicians, and hereby help to disentangle collusions, could be beneficial.

Analysis of the integration of competencies in a Humanization Curricular Line: Case study on the curriculum of a technical career in health

Introduction: the curricular insertion of humanization in sociosanitary education faces the challenge of counteracting the predominant biomedical approach, which fragments healthcare. This technical model has led to the dehumanization of care, ignoring emotional, social, and cultural dimensions, and generating dissatisfaction among patients and professionals.Methods: descriptive case study, which analyzes the pre- and post-intervention learning outcomes of a humanization curricular line, evaluating the relevance of competencies and subcompetencies for humanization in healthcare through a descriptor matrix.Results: between 2017 and 2024, the humanization curricular line showed a significant change in the addressed competencies. The relational competence became predominant, increasing from 41% to 48% of the learning outcomes. Competencies such as ethics, emotional, spiritual, cultural, and management notably increased, while the scientific-technical competence decreased from 71% to 44%, becoming equivalent to the others.Conclusions: the incorporation of competencies for humanization in the health education curriculum reflects a more integral and human-centered approach, integrating relational, ethical, cultural, emotional, and spiritual competencies. This is essential for training professionals capable of providing inclusive and holistic care that addresses the complex multidimensional needs of users

Achieving Health Equity: Combatting the Disparities in American Access to Musculoskeletal Care : Disparities Exist in Every Aspect of Orthopaedic Care in the United States - Access to Outpatient Visits, Discretionary and Unplanned Surgical Care, and Postoperative Outcomes. What Can We Do?

Healthcare disparities influence multiple dimensions of orthopaedic care including access, burden and incidence of disease, and outcome in varying populations. These disparities impact healthcare at both the micro and macro scale of the healthcare experience from individual patient-physician relationships to reimbursement rates across the United States. This article provides a review of how healthcare disparities contribute to the landscape of orthopaedic care and specifically highlights how disparities affect outpatient visits, discretionary and unplanned surgical care, and postoperative outcomes. Current research demonstrates the widespread presence of healthcare disparities in the field of orthopaedics and gives both objective and subjective evidence confirming disparities' measurable influence. The disparities most highlighted by our review include differences in orthopaedic care based on insurance type and race. Currently disparities in orthopaedic care are deeply connected to patient insurance status and race. In the outpatient setting insurance significantly impacts access to care, travel burden, and utilization of services. The emergent setting is similarly influenced with measurable differences in lack of access to acute care, rates of inappropriate triage, and timeliness of care based on insurance status and race. Additionally, the postoperative period is not immune to disparities with likelihood of follow up, experience of catastrophic medical expenses, and postoperative outcomes also being affected. Addressing these disparities is a pressing need and may include solutions like wider expansion and acceptance of publicly funded insurance and the development of readily available and easily measurable metrics for healthcare equity and quality in vulnerable populations.

Toward mainstreaming care activities in transportation: a time use and mobility segmentation approach

ABSTRACT This paper assesses the importance of incorporating care dimensions into activity-travel segmentation to understand daily life mobility strategies. The data came from six neighbourhoods in Concepción, Chile, and included detailed information on activity-travel time use and interaction and classification schemes to identify care purposes. The study uses self-organizing maps to build incremental behavioural segments from weekly mobility and time use variables, adding care activities to assess their role in this segmentation. The results identify groups with a higher burden on care than others, emphasizing the role of transport mode and time use patterns. The result remarks caregiving activities hidden within other categories, identifying groups of caregivers, including domestic workers and women who work and have intense accompanying activities with children. The results highlight the differences between mobility patterns between different segments to make more invisible care and other related activities disproportionately performed by groups of women.

Midwifery assessment and interventions protocol for adolescent pregnancy: a Delphi method approach

Background: Adolescence pregnancy poses risks for both mothers and infants, often due to insufficient prenatal care resulting from societal stigmatization and lack of awareness. Around 16 million adolescents aged 15-19 years in the world give birth each year; in Indonesia, the first pregnant women aged &lt;20 years are 45.10%, while in West Sumatra, it is 33.7%. To address this issue, integrated programs and midwifery care have been implemented. However, providing such care to adolescent mothers comes with its own set of challenges.Purpose: This study aims to conduct a midwifery assessment and intervention protocol for adolescent pregnancy.Method: Qualitative approach The Delphi method involved two rounds of evaluation, with twenty-one participants who were independent practice midwives, six midwives involved in the mother and child health program, and nine midwifery lecturers from accredited educational institutions A (excellent). Participants had at least five years of clinical experience and were selected using purposive non-probability sampling. Participants evaluated statements related to midwifery care during the Delphi process. The validity of these statements was determined by participants providing a minimum score of 3, and the Content Validity Ratio (CVR) was calculated. Statements with a CVR greater than 0.8 were considered valid.Results: Based on expert consensus, important assessments for adolescent pregnant women include addressing issues of gender equality and domestic violence, reproductive and sexual health, risks associated with smoking and substance abuse, maintaining a healthy pregnancy, and adequately preparing for labor and parenthood.Conclusion: Midwifery management and midwifery information were deemed valid dimensions of midwifery care; relational care had one invalid item.

Assessing Patient Safety Culture: Insights from a Neurological Institute.

A cross-sectional descriptive study was conducted among healthcare workers exercising at a neurological institution using a validated Hospital Survey of Patient Safety Culture questionnaire containing ten safety care dimensions. A total of 123 responses to the questionnaire were analyzed, accounting for 34.5% of the total (Cronbach's alpha=0.677). Among the participants, 61.8% considered the level of awareness regarding patient safety to be acceptable. The dimensions considered as strengths were "Organizational learning and continuous improvement" with the highest positive response (60.3%) "Relationship patient-staff member" (58.9%) and "Teamwork within units" (58.9%). However, the dimensions considered as weaknesses were "Management support for patient safety" with 28.5% of positive responses and "Communication openness and non-punitive response to error" (40%). Patient safety culture among healthcare professionals is at an average with "Organizational learning and continuous improvement" being a positive aspect. However, improvements should be made in all dimensions to enhance and promote patient safety within the institution.

Development and implementation of a roadmap for improving quality of care in prearthritic hip disease: A journey over 20 years.

The understanding and treatment of prearthritic hip disease has evolved remarkably over the past 20 years. The principal investigator and the multicenter Academic Network of Conservational Hip Outcomes Research (ANCHOR)group have had a key role in improving the quality of care for these patients suffering from thethree most common prearthritic conditions: femoroacetabular impingement,developmental dysplasia of the hip, and residual Legg-Calve-Perthes Disease.We aim to demonstrate that based on the six quality of care dimensions as defined by Donabedian, our 20-year academic journey has markedly improved the quality of care for young patients with prearthritic hip disease.

"It doesn't Always Have to Be an Expert": Professionals' Perceptions of Practical Aspects of the Existential Dimension of Care for People Approaching Death.

'Existential' can be seen as a broad term for issues surrounding people's experiences and way of thinking about life. This study examined availability of existential care and found that many different staff categories performed existential care. Existential care is associated with conversations and experienced as both easy and difficult; several factors were cited, e.g. insufficient time, stress and the difficulty of addressing existential questions for oneself. Respondents reported need for education, guidance and reflection around existential issues and care. Existential care is described as a natural part of patient care that all professional categories have a responsibility to offer.

Identifying the drivers of overall rating of cancer care: Insights from the second wave of the Swiss Cancer Patient Experiences study.

Patient experience surveys gather information on various aspects of care via numerous survey items. Identifying the most critical areas of patient experience to prioritize for quality care improvement can be challenging. The objective of this study was to determine which care experience items are the drivers influencing patients' overall rating of cancer care. Data from 2750 adult patients with cancer from the second wave of the Swiss Cancer Patient Experiences study were analyzed. This cross-sectional survey was conducted in eight Swiss hospitals from September 2021 to February 2022. Stepwise logistic regression examined the relationship between overall care rating and 29 patient experience items covering different patient-centered care dimensions while adjusting for sociodemographic and health variables. Overall, patients rated their cancer care experience at 8.9 out of 10. Stepwise regression identified seven drivers contributing to overall care rating. The strongest drivers were "professionals worked well together" (odds ratio [OR],4.81) and "tests were not repeated" (OR,2.09) from the coordination and integration dimension, "offered support for symptoms during treatment" (OR,2.11) from the physical comfort dimension, followed by "hospital staff ensured available home support" (OR,1.99), "offered to see health professional for concerns" (OR,1.91), "treatment options were explained" (OR,1.75), and "involved in treatment decisions as desired" (OR,1.68). This study evaluated the care experiences of patients with cancer with a comprehensive tool that identified seven key factors independently associated with overall care rating. By concentrating on these areas, hospitals can not only improve the patient care experience but also efficiently allocate resources to quality improvement initiatives.

Nursing Students’ Spiritual Care: Implications to Related Learning Experience (RLE)

The integration of spiritual care into the education of nursing students is paramount for fostering holistic and patient-centered healthcare. As the nursing profession evolves, there is a growing recognition of the interconnectedness of physical, emotional, and spiritual well-being. However, traditional nursing curricula often inadequately address the spiritual dimension of care, potentially leaving nursing students ill-prepared to address the diverse and complex needs of their future patients. Therefore, this study aimed to examine the level of spiritual care practices and knowledge among nursing students in a private tertiary higher education institution during the new normal in one of the private colleges in Pampanga. This study establishes facts that are used to analyze nursing students’ level of spiritual care practices and knowledge. A descriptive design is applied specifically, the descriptive-evaluative and descriptive-comparative research designs in this study. Purposive sampling was utilized and included a total sample of 154 nursing students who have face-to-face classes and clinical duty, particularly levels II and III from one of the Colleges of Nursing in Pampanga, Philippines. This study will utilize a two-parted questionnaire. Part 1 involved the profile of the respondents as their age, gender, civil status, year level/religion. Part 2 will use an adopted standardized instrument, the Spiritual Tool Questionnaire contains (Robles, 2014) that a 64-item questionnaire that focuses around seven elements. The result of the study shows that there is no significant difference between institutional support. Thus, the null hypothesis is accepted. Additionally, the researchers propose that student nurses incorporate a transcultural approach in their patient interactions. This is essential for minimizing bias, building positive relationships, and fostering an environment where patients feel at ease expressing their emotions to student nurses. Furthermore, armed with verified facts and data, nursing institutions can formulate targeted strategies and interventions aimed at enhancing education in spiritual care. Consequently, this contributes to the progression of clinical competence among nursing students.

Cultural competence and associated factors among nurses working in public hospitals of South Wollo zone, Northeast Ethiopia: a multi-center cross-sectional study

BackgroundEnhancing cultural competence stands as a cornerstone in the realm of clinical nursing. Consequently, nurses engaging with culturally diverse communities encounter significant challenges. In Ethiopia, nurses providing care often prioritize physical well-being, the therapeutic journey, and medical interventions, while overlooking the critical cultural dimensions of patient care. Therefore, this study aims to assess the level of cultural competence and its determining factors among nurses employed in public hospitals located in the South Wollo Zone of northeastern Ethiopia.MethodsA multicenter, institution-based cross-sectional study was conducted, involving 629 nurses employed in public hospitals across northeastern Ethiopia. Participants were selected using a simple random sampling method. Data were gathered using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire (NCCSQ), and subsequently entered into Epi-data 4.6 for analysis. Statistical analysis was performed using SPSS version 26, employing multiple linear regression analysis to identify determining factors.ResultThe participants’ overall mean score for cultural competence was 3.198 [95% CI: 3.161, 3.234]. Specifically, factors such as being a female nurse (β = 0.089, CI: 0.019–0.159), having a diploma level of education (β = -0.084, CI: -0.101 to -0.007), having 11–20 years of work experience (β = 0.412, CI: 0.090–0.815), a 1:15 nurse-to-patient ratio (β = 0.081, CI: 0.010–0.162), experience with caring for culturally and ethnically diverse patients (β = 0.362, CI: 0.248–0.476), comprehensive hospital level (β = 0.699, CI: 0.496–0.903), and attending cultural training (β = 0.002, CI: 0.234–0.931) were predictors of the mean score for cultural competence.ConclusionIn this study, the level of cultural competence was found to be at a moderate level and need more effort. Factors such as gender, years of work experience, nurse-to-patient ratio, experience in caring for culturally and ethnically diverse patients, hospital level, educational attainment, attendance of cultural training, and the presence of a feedback system for cultural competence were identified as predictors of cultural competence level. Sharing experiences from higher-level hospitals to lower-level ones and strengthening cultural competence training sessions for nurses can significantly enhance cultural competence within clinical settings.

Chaplains Forming a Meaningful Relationship with Older People With Dementia – Insights to Pastoral Care in Nursing Home Settings

Abstract This article investigates the formation of meaningful pastoral care relationships by chaplains with older people with dementia in nursing homes. The study responds to the recently highlighted need for theological exploration of wellbeing by providing a theological analysis of how a meaningful pastoral care relationship is formed from chaplains’ perspectives. The study employs thematic analysis of ten interviews to uncover core themes. These include the embodied aspects of pastoral care, which highlight the non-verbal dimensions of pastoral care; emotional support, emphasizing the chaplains’ role in providing comfort and empathy; interpersonal relations, detailing the dynamics between chaplains, older people with severe dementia, and the care environment; and supporting the personal relationship with God, underscoring the individual’s religious and spiritual connections. This research contributes to understanding how theological considerations inform pastoral care practices, offering insights into the nuanced religious and spiritual needs of older adults with dementia within a nursing home setting.