Intercultural Care Research Articles

Investigation of Nursing Students' Intercultural Care Experiences in Clinical Practice

Aim: Today, many health institutions provide treatment and care services to foreign nationals. Nursing students participate in the care of foreign patients during clinical practice and experience providing intercultural care. This study was conducted to examine nursing students' experiences of intercultural care in clinical practice. Method: The study was conducted with 292 students studying in the nursing department of a foundation university in Istanbul. Data were collected with a questionnaire form consisting of questions examining the students' sociodemographic characteristics and their experiences of providing care to patients from different cultures, and were evaluated with frequency, percentage, mean and standard deviation in SPSS 22.0 program. Findings: The average age of the nursing students included in the study was 20.8, 88.4% were female, and 98.3% were single. 31.5% of the students did not know a foreign language, 61% of those who knew English, and they most frequently encountered Syrian, Libyan and Lebanese patients in hospitals. 16.8% of the students have received intercultural care training, 33.9% have provided care to foreign patients many times, 62% have experienced difficulties while providing care, and 35.3% can often reach an interpreter. The most negative situations experienced by foreign patients in intercultural care are communication, security, and violence, respectively. Students encounter difficulties during data collection, patient education, treatment, and physical examination regarding intercultural care. Conclusion and recommendations: It can be recommended that intercultural care be included in the nursing curriculum, foreign language education of students be developed, advance planning be done in practice areas, and there should be interpreters and language-speaking employees in hospitals.

An educational approach to develop intercultural nursing care for refugees from Ukraine: A qualitative study.

To describe how nurses and nursing students in Poland and the United States perceive the practice of intercultural care of refugees from Ukraine. Millions of Ukrainian citizens sought safety in other countries when Russia invaded Ukraine in February 2022. Nurses in Poland and the United States are positioned to provide nursing care for refugees from Ukraine yet lack intercultural knowledge, skills, and attitudes to meet refugee needs. This education-focused qualitative description study was conducted in Spring 2023. Eighteen MSN and BSN students from one university in Poland and one university in the United States completed an international virtual exchange course that concentrated on the health and well-being of refugees from Ukraine. Students' reflection papers generated the data for this study. Content analysis was used to systematically structure the data, and themes were inductively derived for an initial understanding of intercultural care for refugees. The COREQ guidelines were followed for reporting study findings. Major themes were troubled communication, overlooked trauma-informed care, and compromised vaccine status. Language differences, a gap in nursing knowledge, and cultural variations impeded intercultural care. To address intercultural care for refugees from Ukraine, macro- and microlevel factors should be considered. Healthcare facilities need certified interpreters or adequate language-access technology for nurses. Nursing programs might evaluate content on trauma-informed care and cultural competency to meet the needs of war-affected refugees. Leaders from Ukrainian refugee communities could partner with nurses to deliver culturally relevant information to increase vaccine uptake. Nurses should advocate for inclusion of the WHO competency standards of care for refugees in healthcare policies with emphasis on communication and evidence-informed practice. Placing Ukrainian community leaders on health councils could bridge the gap between refugees and mainstream society.

Evaluating the cross-cultural competence instrument for healthcare professionals (CCCHP) among nurses in Okinawa, Japan

BackgroundTo provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study’s purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses.MethodsDuring June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach’s alpha coefficient was used to test reliability.ResultsA total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach’s alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics.ConclusionThis study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals.

A Workshop for Education for Shared Life: Bedouins and Jews Female Teaching Students at Kay College for Education in the Southern Region of Israel

The importance of multiculturalism in education in general and in academic institutions for teacher training in particular, it receives a lot of attention in the academic-educational research field. Most of the studies held in Israel about teacher training accompanied by a multicultural approach as part of an educational concept discussed the distinction between the attitudes of students from different cultural groups or their achievements; Others proposed models for multicultural education or contented themselves with raising awareness of the need to design models. This study seeks to propose an interventional concept oriented to situation assessment and well planned within the framework of diverse lessons as part of a pragmatic tool – applicable that seeks to educate for intercultural care and cultural competence. To examine these training processes, the qualitative paradigm was chosen by the activation of an action research that continued within the framework of a course called: “Education for ambassadors for a shared life” that was prepared in advance after a careful assessment of the situation and divided into structured steps. 10 female teaching students participated in the study: 6 Jewish and 4 Bedouin Muslim women, residents of the southern region of the State of Israel. The students wrote reflections and were asked to formulate a joint educational project. The results of the study emphasize the importance of learning the mutual culture as a tool that produces closeness and reducing stereotypes; Understanding the need to take mutual cultural responsibility as future teachers and citizens; Collaborative learning spaces of this type create a safe educational space for self-expression and presentation of personal and cultural identity. Cultural sublimation and a sense of belonging were also expressed. All the participants recognize the importance of the topic and the need to learn.

First Contact With Transcultural Care: A Phenomenological Study of Practical Turkish Nursing Students' Experiences in a Migrant Health Center.

This study examines the subjective experiences of Turkish students who work in immigrant health facilities providing nursing care to people of different cultures. Nurses are often encountered by immigrants in these centers. Although qualitative research on nurses' experiences assisting immigrants has been often cited in the literature, the literature on nursing students' experiences is limited. The study has a descriptive qualitative design. Data were collected using a face-to-face, in-depth, and semistructured interview form. The data were evaluated using a content analysis method. The study yielded four themes: (a) inability to control emotions, (b) barriers to care involvement, (c) benefits of intercultural care, and (d) recommendations. Learning intercultural care is critical in these years of increased immigration. Understanding nursing students' experiences is essential for improving the quality of intercultural care.

Comparison of the Iranian and Scandinavian bachelor of nursing curriculum (Sweden): A scoping review.

The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care. The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases. The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation. It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.

Perceptions of health professionals of obstetrics/gynecology departments regarding the concept of intercultural care in the region of central Macedonia

Perceptions of health professionals of obstetrics/gynecology departments regarding the concept of intercultural care in the region of central Macedonia

Incorporation of Professionals with Training in Interculturality into Sexual and Reproductive Health Services: Feasibility Analysis

This study evaluates the political, legal, organizational, and availability of resources for the onboarding of health professionals trained in interculturality for sexual and reproductive health care of the indigenous population in public health services. A case study was carried out using a qualitative methodology that implemented intercultural care strategies in reproductive health in two Mexican states with the presence of indigenous population. In regards of the political feasibility, the interest of the actors, positioning, and power were explored. In regards of legal feasibility, the presence of legal impediments was analyzed. In the case of organizational feasibility, we explored the organizational structure and functions of the personnel. Finally, for evaluating the availability of resources, we analyzed the budget available for hiring personnel with intercultural training. Political feasibility shows that the actors recognize the importance of including personnel with intercultural training for reproductive health care in indigenous population; despite this, in both states, there is no clear position in favor of it. In legal feasibility, no impediment for hiring these personnel was found. In organizational feasibility, the organizational structure of health services does not include a unit to oversee intercultural health services and practices and does not specify intercultural functions in the professional required profiles. In both states, there is no budget allocation for hiring personnel with an intercultural profile. Therefore, intercultural actions implemented are part of the local initiative of decision-makers to respond to reproductive health problems within indigenous population. The overall feasibility assessment does not show clear results in favor of incorporating health professionals trained in interculturality for sexual and reproductive health care for indigenous population. Therefore, it is still necessary to advocate on this issue so that intercultural hiring policies can be explicitly concretized in the acquisition of public health services.

Health care providers' perspectives on challenges and opportunities of intercultural health care in diabetes and obesity management: a qualitative study.

Migrants often face worse health outcomes in countries of transit and destination because of challenges such as financial constraints, employment problems, lack of a network of social support, language and cultural differences, and difficulties accessing health services. As understanding how the migrant context affects patient-provider engagement is critical to the provision of contextually appropriate care, this study aimed at understanding primary health care provider perspectives on challenges and opportunities of the intercultural care process for migrant patients with diabetes and obesity. This qualitative study within a multimethod, participatory research project involved primary care providers in clinics and primary care networks in Edmonton, Alberta, between September 2019 and February 2020. We explored health care providers' approaches to diabetes and obesity management, and experiences of and challenges with intercultural care. We conducted a thematic analysis using an interpretive qualitative approach. We conducted 9 interviews and 4 focus groups and identified 3 themes: a shift from traditional weight loss-centred approaches; relationships and navigating cultural distance; and importance of and limitations in identifying and addressing root causes and barriers. Health care providers encounter considerable nonmedical challenges when supporting immigrant patients, such as navigating cultural distance and working with patients' financial constraints. The nonmedical challenges we identified can hinder the process of chronic disease management. Thus, in addition to educational programs and trainings to enhance the cultural competency of health care providers, incorporating avenues for cultural brokering in health care can provide invaluable support in patient-provider engagements to mitigate these challenges.

Teaching resilience in fragile times

Teaching resilience in fragile times

Challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers: A qualitative study

BackgroundBurn injuries in childhood create serious trauma for both children and their caregivers. Burn injuries require extensive nursing care to reduce complications and to restore optimal functional health conditions. When children receive burn treatment and their caregivers are migrants with different languages, religions, and habits, nurses must adopt a cultural approach while caring for such patients. AimThis descriptive qualitative study aimed to reveal the challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers. MethodPurposive sampling was used to recruit the nurses (n = 12). Semi-structured face-to-face interviews were conducted with nurses using an interview guide, and the interviews were recorded. Thematic analysis was used to create themes in the study. ResultsThe data were gathered around three main themes: “challenges” with the subcategories “communication,” “trust relationship,” and “care burden”; “expectations for better care” with the subcategories “translator support” and “hospital environment”; and “intercultural care” with the subcategories “cultural-religious differences” and “intercultural sensitivity.” ConclusionsThe results of this study provide a novel insight into nurses’ experiences with migrant child patients and their caregivers, and can be used to develop action plans to provide effective cultural care for patients receiving burn treatment and their caregivers.

Contextualizing Diabetes and Obesity Care for Immigrant and Refugee Populations.

Context: Personalized healthcare strategies are recommended for diabetes and obesity. This approach helps to identify and address root causes and barriers to patients' health, and provides them with a sense of agency in healthcare. To develop such strategies for migrant patients, there should be a deeper understanding of their situation. Objective: To understand healthcare gaps and opportunities for enhancing diabetes and obesity care for immigrant and refugee populations in primary care. Study Design, Setting and Population Studied: A community-based research, involving 3 qualitative studies conducted in Edmonton, Alberta. Study participants were: 1) members of ethnocultural communities with diabetes and/or obesity; 2) Multicultural Health Brokers (MCHB) - community health workers (CHW) in these communities; and 3) Healthcare providers (HCP). Data set and Analysis: We generated data through interviews and focus groups. Community member (CM) study had 3 focus groups (two groups of 8 males & females (mixed); one of 13 females); and 22 interviews (5 males, 8 females). MCHB study had 10 interviews (females) and 2 observation sessions. HCP study had 4 focus groups (two groups of 6; 2 groups of 8 mixed) and 9 interviews (2 males, 7 females). Data were thematically analyzed. Outcome Measures: CM study explored lived experiences of diabetes and obesity. HCP study examined experiences with caring for patients with diabetes and obesity from ethnocultural communities. MCHB study examined broker roles in relation to primary care. Results: CM study showed that pre- and post-immigration stressors interact synergistically with the lived experience of diabetes and obesity thereby compounding the adverse disease effects. HCP study showed significant challenges navigating cultural distance and trying to address the non-medical issues of migrant patients. MCHB study illustrated their embeddedness in ethnocultural communities playing an invaluable but largely unrecognized role as partners in primary healthcare. Conclusions: Our findings highlight the challenges of intercultural care in primary care settings. CHWs like the MCHB can provide context for healthcare providers, thereby supporting a personalized and context-informed care that understands the intersecting realities of migrant populations. Collaborations with CHWs in primary care have widespread implications for improving healthcare and reducing health disparities for migrants with diabetes and/or obesity.

Construction of an intercultural care program for international migrants in northwestern Mexico.

To describe the construction process of an intercultural care program for international migrants in northwestern Mexico. Report of professional experiences, according to what was suggested by Daltro and Faria. The development and evolution of care for international migrants has favored the elaboration of a community-like Social Service Program for students of a public university in northwestern Mexico, so that intercultural health and health care for this population become part of the curricular training of the new generations of nursing graduates, in a context in which international migration is a topic of great social and cultural relevance. The construction and application of the Salud-Migrante program will enhance compliance with international recommendations on universal health for migrants, promoting respect for identity and cultural diversity in their actions.

Construction of an intercultural care program for international migrants in northwestern Mexico

RESUMEN Objetivo: Describir el proceso de construcción de un programa de cuidado intercultural a personas migrantes internacionales en el noroeste de México. Método: Relato de experiencias profesionales, acorde a lo sugerido por Daltro y Faria. Resultados: El desarrollo y evolución del cuidado a personas migrantes internacionales ha favorecido la estructuración de un Programa de Servicio Social de tipo comunitario para estudiantes de una universidad pública en el noroeste de México, por lo que la salud intercultural y el cuidado a la salud a esta población se vuelve parte en la formación curricular de las nuevas generaciones de licenciados en enfermería, en un contexto en que la migración internacional es tema de gran relevancia social y cultural. Conclusión: La construcción y aplicación del programa Salud-Migrante fortalecerán el cumplimiento de las recomendaciones internacionales en materia de salud universal para personas migrantes, promoviendo en sus acciones el respeto a la identidad y diversidad cultural.

Portfólio acadêmico: reflexões sobre o ensino de enfermagem em interculturalidade

Abstract This study seeks to reflect on intercultural care regarding the how to act in the nursing process in the face of different cultures. This is a theoretical study with reflexive approach based on the experience of the academic in building their portfolio carried out in 2020 by means of reflections based on academic portfolios of the fifth semester of a nursing program in the South region of Brazil. After analysis of the produced material and of the noted reflections in the portfolio diary, the following categories emerged: intercultural care in nursing courses and interculturality in the pandemic. Thus, after reflection and discussion on nursing care, we will focus on interculturality in the face of the courses taken, the experiences of the academic trajectory in this period, and, finally, the impacts of the COVID-19 pandemic in the process of care for people from the point of view of interculturality. This thematic becomes important for bringing up a reflection on the nurse-patient relation.

Intercultural care for people of migrant origin with dementia - A literature analysis.

Close to 12 million people of migrant origin who are 65 years or older live in different European countries. In the European Union (EU) and the European Free Trade Association (EFTA) countries, approximately half a million are estimated to have dementia. This rate is expected to increase in the coming decades. People of migrant origin who develop dementia and their families face challenges people without migration backgrounds do, but due to cultural differences, additional challenges may arise. There is an increasing need for interculturally sensitive care. There is research on certain aspects of intercultural care and this study will be a comprehensive summary of current topics in intercultural care. What factors of intercultural care for people of migrant origin with dementia can be identified? What requirements and aspects are necessary to ensure intercultural care? A systematic literature analysis in the databases PubMed, PsycInfo and Psychology and Behavioural Sciences Collection was conducted. Thirty-nine articles were eligible for analysis. Enhancement in the areas diagnostics, education and information, healthcare services and healthcare professionals to ensure intercultural care is needed. Current evidence supports the need for (a) thorough education of people of migrant origin with dementia, their families and healthcare professionals, (b) collaborations among everyone involved, (c) embracing different cultures in healthcare services, (d) the implementation of a care navigator functioning as a contact person and connecting all relevant parties with one another and (e) dementia testing suitable to the target group to ensure culturally sensitive and appropriate care for people of migrant origin with dementia and their families.

Cultural Competence and Cultural Intelligence of Healthcare Professionals Providing Emergency Medical Services.

Background: There are more and more foreigners in Poland who become clients of the Polish healthcare system. They use, among others, emergency medical services provided by healthcare professionals: doctors, nurses, and paramedics. Skillful care for culturally different patients requires cultural competencies and cultural intelligence to ensure good quality of care and cultural safety. The study aimed to measure and assess the cultural competencies and cultural intelligence of medical professionals working in hospital emergency departments (HEDs) and hospital emergency rooms (HERs) in Małopolska, a region in southern Poland. Methods: The following questionnaires were used in the study: the Cross-Cultural Competence Inventory (CCCI), the Cultural Intelligence Scale (CQS), and Questionnaire on Attitudes Towards Culturally Divergent People. In total, 709 medical professionals participated in the study, including 363 nurses, 223 paramedics, and 123 doctors. Results: Cultural intelligence—the overall score and the scores on the metacognitive, cognitive, motivational, and behavioral subscales were significantly higher among HED and HER doctors. Cultural competencies—the overall score and the score on the cultural adaptation subscale were also significantly higher among HED and HER doctors. The CCCI and CQS scores were influenced by selected variables: taking care of and close interactions with representatives of other cultural circles; staying outside Poland for more than a month. Doctors were the group of medical professionals that were most tolerant and most positive towards people from other cultures. Conclusions: The research results confirm the positive impact of contact of medical professionals with people from other cultures on their cultural competencies and cultural intelligence. They indicate the need for training in acquiring cultural competencies and developing cultural intelligence, especially among nurses. They demonstrate the need to raise awareness among HED and HER medical professionals about issues in intercultural care and to increase diversity efforts, especially among nurses.

Intercultural sensitivity, intercultural competence and their relationship with perceived stress among nurses: evidence from Iran

ABSTRACT The aim of the present study is to investigate sensitivity and crosscultural competence, and their relationship with nurses' stress. The study was performed on 310 nurses selected by random sampling. Data were collected by demography, competence, intercultural sensitivity, and stress questionnaires. Data were analyzed using SPSS 20. Results indicated intercultural competence was moderate and intercultural sensitivity was low. Nurses' stress was high and had a significant inverse relationship with their competency and cross-cultural sensitivity. Respect for intercultural interaction had the highest mean and enjoyment from intercultural interaction had the lowest mean. Multivariate analysis of variables showed that only respect for cultural diversity could be a predictor of low mean scores of nurses' perceived stress. With increasing intercultural competence and sensitivity, patients' stress in intercultural care decreases. Therefore, the role of culture and intercultural care in nursing education should be emphasized.

Zinervaring in gesprek

In interfaith spiritual care, the emphasis is too much on the ideological contents (their generic correspondences or their special individuality), whether or not linked to an official mandate of the spiritual counselor. Worldview contents can indeed have a function in guiding clients, by offering a perspective on the current experience and to symbolize it. In this way they are instrumental to what it is really about: stimulating the experience of meaning in and from the conversation. The focus on this experience can be grounded and stimulated by the existential approach. Imagination and sensitivity to physical perception thus form an important contribution to the meaning-giving process, in addition to the authentic testimony of one’s own spiritual inspiration. Interreligious spiritual care should be part of intercultural spiritual care, of which an analysis of the language is an important component.

The theory of caritative caring: Katie Eriksson's theory of caritative caring presented from a human science point of view.

The Finnish nursing theorist Katie Eriksson's (1943-2019) theory of caritative caring represents a non-medical paradigm concerning the phenomena of nursing. The aim of this article was to present an oversight of the development of Eriksson's theory of caritative caring from a human science point of view. The historical development of the theory is outlined, combined with a brief overview of its philosophical connections, its impact on contemporary caring science research and its implications for nursing care. Caring science is considered a human science in the Nordic tradition, as it is deeply rooted in basic issues of human life and existence. The key ideas of Eriksson's theory of caritative caring are linked to the metaparadigm concepts of human being, health and suffering, caring and environment. All of these are permeated with the ethos of caritative caring, that is, the caritas thought of human love and mercy, and the honouring of the absolute dignity of human beings. Epistemologically, Gadamer is the most influential philosopher when it comes to the theory of caritative caring. Eriksson's theory is used in, for example, intercultural caring, caring for patients suffering from addiction, the importance of aesthetic surroundings, providing ethically good care for older people and mothers as patients in psychiatric care. In these fields of research, Eriksson's ideas of ethics, caring and suffering are highlighted in various clinical contexts. Beyond the areas of nursing care in which Eriksson's work has been cited and developed, there are at least two areas that have been actively enhanced by her works: the field of leadership and education for nursing teachers. According to Eriksson, it is momentous to ponder scientific results as not limited to empirically strengthened, randomized outcomes. Part of making the results of scientific work evident is up to the individual nurses and their being in the world.