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Cultural Competence (cultural + competence)
Selected AbstractsWORKING TOWARD CULTURAL COMPETENCENURSING FOR WOMENS HEALTH, Issue 4 2000MAKING THE FIRST STEPS THROUGH CULTURAL ASSESSMENT No abstract is available for this article. [source] The Story Catches You and You Fall Down: Tragedy, Ethnography, and "Cultural Competence"MEDICAL ANTHROPOLOGY QUARTERLY, Issue 2 2003Janelle S. Taylor Anne Fadiman 's The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Noonday Press, 1997) is widely used in "cultural competence" efforts within U.S. medical school curricula. This article addresses the relationship between theory, narrative form, and teaching through a close critical reading of that book that is informed by theories of tragedy and ethnographies of medicine. I argue that The Spirit Catches You is so influential as ethnography because it is so moving as a story; it is so moving as a story because it works so well as tragedy; and it works so well as tragedy precisely because of the static, reified, essentialist understanding of "culture" from which it proceeds. If professional anthropologists wish our own best work to speak to "apparitions of culture" within medicine and other "cultures of no culture," I suggest that we must find compelling new narrative forms in which to convey more complex understandings of "culture." [medical education, cultural competence, tragedy, ethnography, theories of culture] [source] Putting Cultural Competence into PracticeNURSING FOR WOMENS HEALTH, Issue 2 2000Barbara Peterson Sinclair MN No abstract is available for this article. [source] Emergency Medical Practice: Advancing Cultural Competence and Reducing Health Care DisparitiesACADEMIC EMERGENCY MEDICINE, Issue 1 2009Aasim I. Padela MD Abstract In an increasingly diverse patient population, language differences, socioeconomic circumstances, religious values, and cultural practices may present barriers to the delivery of quality care. These obstacles contribute to the health care disparities observed in all areas of medical care. Increasing cultural competence has been cited as part of the solution to reduce disparities. The emergency department (ED) is an environment where cultural sensitivity is particularly needed, as it is often a primary source of health care for the underserved and ethnic and racial minorities and a place where high patient volume and acuity place the provider under demanding time pressures, yet the emergency medicine (EM) literature on health care disparities and cultural competence is limited. The authors present three clinical scenarios highlighting challenges in providing equitable emergency care to minority populations. Using these cases as illustrations, three processes are proposed that may improve the quality of care delivered to minority populations: 1) increase cultural awareness and reduce provider biases, enabling providers to interact more effectively with different patient populations; 2) accommodate patient preferences and needs in medical settings through practice adjustments and cultural modifications; and 3) increase provider diversity to raise levels of tolerance, awareness, and understanding for other cultures and create more racially and/or ethnically concordant patient,physician relationships. [source] Beyond Cultural Competence: Human Diversity and the Appositeness of Asseverative GoalsCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2005Arthur M. Nezu I argue that, as a profession, psychology needs to aspire beyond the goal of achieving cultural competence when addressing issues of human diversity. Although laudable, cultural competency as a goal may not set the bar high enough to achieve equity regarding those minority groups traditionally neglected or marginalized. As such, I further argue that asseverative objectives,ones that ask us to aver, affirm, and embrace human diversity,would be more consistent with a truly egalitarian perspective and our own code of ethics. I then describe barriers to achieving such goals that exist as endemic aspects of clinical psychology's worldview of human behavior and psychopathology, as well as inherent characteristics of simply being human. Last, I suggest that in order to reach such asseverative goals, we need to be more active (as compared to simply reading relevant journal articles) in our daily activities when it comes to issues of human diversity. [source] Cultural competence: a conceptual framework for teaching and learningMEDICAL EDUCATION, Issue 3 2009Conny Seeleman Objectives, The need to address cultural and ethnic diversity issues in medical education as a means to improve the quality of care for all has been widely emphasised. Cultural competence has been suggested as an instrument with which to deal with diversity issues. However, the implementation of culturally competent curricula appears to be difficult. We believe the development of curricula would profit from a framework that provides a practical translation of abstract educational objectives and that is related to competencies underlying the medical curriculum in general. This paper proposes such a framework. Methods, The framework illustrates the following cultural competencies: knowledge of epidemiology and the differential effects of treatment in various ethnic groups; awareness of how culture shapes individual behaviour and thinking; awareness of the social context in which specific ethnic groups live; awareness of one's own prejudices and tendency to stereotype; ability to transfer information in a way the patient can understand and to use external help (e.g. interpreters) when needed, and ability to adapt to new situations flexibly and creatively. Discussion, The framework indicates important aspects in taking care of an ethnically diverse patient population. It shows that there are more dimensions to delivering high-quality care than merely the cultural. Most cultural competencies emphasise a specific aspect of a generic competency that is of extra importance when dealing with patients from different ethnic groups. We hope our framework contributes to the further development of cultural competency in medical curricula. [source] Lesbian, gay, bisexual and transgender young people's experiences of distress: resilience, ambivalence and self-destructive behaviourHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2008Jonathan Scourfield BA MA DipSW PhD Abstract The research presented in this paper set out to explore the cultural context of youth suicide and more specifically any connections between sexual identity and self-destructive behaviour, in the light of international evidence about the disproportionate risk of suicidal thoughts and suicide attempts in lesbian, gay, bisexual and transgender (LGBT) young people. The empirical basis for the paper is qualitative research that was carried out in the North West of England and South Wales. Focus groups and interviews were conducted with a total of 69 young people, with a purposive sample to reflect diversity of sexual identity, social class and regional and rural-urban location. The paper presents a thematic analysis of the data specifically relating to the experiences of LGBT young people. A range of strategies that LGBT young people employ in the face of distress are described. These are categorised as resilience, ambivalence and self-destructive behaviour (including self-harm and suicide). The potential implications for health and social care of these strategies include the need for ecological approaches and for sexual cultural competence in practitioners, as well as prioritisation of LGBT risk within suicide prevention policies. [source] Patients' perceptions of cultural factors affecting the quality of their medical encountersHEALTH EXPECTATIONS, Issue 1 2005Anna M. Nápoles-Springer PhD Abstract Objective, The aim of this study was to identify key domains of cultural competence from the perspective of ethnically and linguistically diverse patients. Design, The study involved one-time focus groups in community settings with 61 African,Americans, 45 Latinos and 55 non-Latino Whites. Participants' mean age was 48 years, 45% were women, and 47% had less than a high school education. Participants in 19 groups were asked the meaning of ,culture' and what cultural factors influenced the quality of their medical encounters. Each text unit (TU or identifiable continuous verbal utterance) of focus group transcripts was content analysed to identify key dimensions using inductive and deductive methods. The proportion of TUs was calculated for each dimension by ethnic group. Results, Definitions of culture common to all three ethnic groups included value systems (25% of TUs), customs (17%), self-identified ethnicity (15%), nationality (11%) and stereotypes (4%). Factors influencing the quality of medical encounters common to all ethnic groups included sensitivity to complementary/alternative medicine (17%), health insurance-based discrimination (12%), social class-based discrimination (9%), ethnic concordance of physician and patient (8%), and age-based discrimination (4%). Physicians' acceptance of the role of spirtuality (2%) and of family (2%), and ethnicity-based discrimination (11%) were cultural factors specific to non-Whites. Language issues (21%) and immigration status (5%) were Latino-specific factors. Conclusions, Providing quality health care to ethnically diverse patients requires cultural flexibility to elicit and respond to cultural factors in medical encounters. Interventions to reduce disparities in health and health care in the USA need to address cultural factors that affect the quality of medical encounters. [source] Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcareINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2007Alan Pearson RN, FRCN, FRCNA Abstract Objectives, The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria, This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy, The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological quality, Methodological quality was independently established by two reviewers, using standardised techniques from the Joanna Briggs Institute (JBI) System for the Unified Management, Assessment and Review of Information (SUMARI) package. Discussion with a third reviewer was initiated where a low level of agreement was identified for a particular paper. Following inclusion, data extraction was conducted using standardised data extraction tools from the JBI SUMARI suite for quantitative and qualitative research. Data synthesis was performed using the JBI Qualitative Assessment and Review Instrument and JBI Narrative, Opinion and Text Assessment and Review Instrument software to aggregate findings by identifying commonalities across texts. Quantitative data were presented in narrative summary, as statistical pooling was not appropriate with the included studies. Results, Of the 659 identified papers, 45 were selected for full paper retrieval, and 19 were considered to meet the inclusion criteria for this review. The results identified a number of processes that would contribute to the development of a culturally competent workforce. Appropriate and competent linguistic services, and intercultural staff training and education, were identified as key findings in this review. Conclusions, The review recommends that health provider agencies establish links with organisations that can address needs of culturally diverse groups of patients, include cultural competence in decision support systems and staff education as well as embed them in patient brochures and educational materials. The review also concluded that staff in-service programs consider the skills needed to foster a culturally competent workforce, and recruitment strategies that also explicitly address this need. [source] Nursing students' perceptions of the importance of caring behaviorsJOURNAL OF ADVANCED NURSING, Issue 4 2008Zahra Khademian Abstract Title.,Nursing students' perceptions of the importance of caring behaviours Aim., This paper is a report of a study to determine the nursing students' perceptions of the importance of caring behaviours. Background., Caring has been considered as the essence of nursing. It is believed that caring enhances patients' health and well-being and facilitates health promotion. Nursing education has an important role in educating the nurses with adequate caring abilities. Method., Ninety nursing students (response rate 75%) responded to a questionnaire consisting of 55 caring behaviours adapted from items on Caring Assessment Questionnaire (Care-Q). Behaviours were ranked on a 5-point Likert-type scale. The caring behaviours were categorized in seven subscales: ,accessibles', ,monitors and follows through', ,explains and facilitates', ,comforts', ,anticipates', ,trusting relationship' and ,spiritual care'. Data were collected in Iran in 2003. Findings., The students perceived ,monitors and follows through' (mean = 4·33, SD = 0·60) as the most and ,trusting relationship' (mean = 3·70, SD = 0·62) as the least important subscales. ,To give patient's treatments and medications on time' and ,to do voluntarily little things,' were the most and least important caring behaviours, respectively. ,Explains and facilitates' statistically and significantly correlated with age (r = 0·31, P = 0·003) and programme year (r = 0·28, P = 0·025). Gender had no statistically significant influence on students' perceptions of caring behaviours. Conclusion., Further research is needed, using longitudinal designs, to explore nursing students' perceptions of caring behaviours in different cultures, as well as evaluation studies of innovations in curriculum and teaching methods to improve learning in relation to cultural competence and caring concepts. [source] Identifying the core components of cultural competence: findings from a Delphi studyJOURNAL OF CLINICAL NURSING, Issue 18 2009Maria Jirwe Aim., To identify the core components of cultural competence from a Swedish perspective. Background., The cultural diversity of Swedish society raises challenges for nursing practice. Nurses need to be culturally competent, i.e. demonstrate the effective application of knowledge, skills and attitudes to practice safely and effectively in a multicultural society. Existing frameworks of cultural competence reflect the socio-cultural, historical and political context they were developed in. To date, there has been no research examining cultural competence within a Swedish context. Design., A Delphi survey. Methods., A purposeful sample of 24 experts (eight nurses, eight researchers and eight lecturers) knowledgeable in multicultural issues was recruited. Interviews were undertaken to identify the knowledge, skills and attitudes that formed the components of cultural competence. Content analysis yielded statements which were developed into a questionnaire. Respondents scored questionnaire items in terms of perceived importance. Statements which reached consensus were removed from questionnaires used in subsequent rounds. Three rounds of questionnaires were distributed during 2006. Results., A total of 118 out of 137 components reached a consensus level of 75%. The components were categorised into five areas, cultural sensitivity, cultural understanding, cultural encounters, understanding of health, ill-health and healthcare and social and cultural contexts with 17 associated subcategories. Conclusions., There are some similarities between the issues raised in the current study and existing frameworks of cultural competence from the USA and the UK. However, Swedish experts placed less emphasis on ethnohistory and on developing skills to challenge discrimination and racism. Relevance to clinical practice., This study identified the core components of cultural competence important to nurses practising within a multicultural society such as Sweden. Acquisition of the knowledge, skills and attitudes identified should enable nurses to meet the needs of patients from different cultural backgrounds. The components of cultural competence can form the basis of nursing curricula. [source] Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groupsJOURNAL OF CLINICAL NURSING, Issue 6 2007Elizabeth J Halcomb BN, IC Cert Aims., This integrated literature review seeks to identify the key considerations in conducting focus groups and discusses the specific considerations for focus group research with culturally and linguistically diverse groups. Background., The focus group method is a technique of group interview that generates data through the opinions expressed by participants. Focus groups have become an increasingly popular method of data collection in health care research. Although focus groups have been used extensively with Western populations, they are a particularly useful tool for engaging culturally and linguistically diverse populations. The success of focus groups in this context is dependent upon the cultural competence of the research team and the research questions. Methods., The electronic databases Medline, CINAHL, Embase, Psychlit and the Internet using the Google Scholar search engine were explored using the search terms ,focus group', ,cultural sensitivity', ,transcultural nursing', ,transcultural care', ,cultural diversity' and ,ethnic groups'. Hand searching of reference lists and relevant journals was also undertaken. English language articles were selected for the review if they discussed the following issues: (i) methodological implications of the focus group method; (ii) strengths and limitations of the focus group method; (iii) recommendations for researchers and (iv) use of the focus group in culturally and linguistically diverse groups. Conclusions were drawn from each of the articles and consensus regarding a summary of recommendations was derived from a minimum of two authors. Results., Findings from this review revealed several key issues involving focus group implementation including recruitment, sample size, data collection, data analysis and use within multicultural populations. Strengths and limitations of the focus group method were also identified. Conclusions., Focus groups are a useful tool to expand existing knowledge about service provision and identify consumer needs that will assist in the development of future intervention programmes, particularly within multicultural populations. Careful planning related to methodological and pragmatic issues are critical in deriving effective data and protecting participants. Relevance to clinical practice., Focus groups can facilitate increased understanding of perspectives of culturally and linguistically diverse groups and thereby shape clinical practice to better meet the needs of these groups. [source] Developing cultural competence in working with Korean immigrant familiesJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2006Irene J. Kim The authors provide an in-depth examination of the historical background, cultural values, family roles, and community contexts of Korean Americans as an aid to both researchers and clinicians in developing cultural competence with this particular group. First, the concept of cultural competence is defined. A brief history of Korean immigration patterns to the United States and demographic information about Korean Americans are reviewed. Second, Korean cultural values, family structure, and family roles are examined as they impact relationships in research and clinical contexts. Three indigenous concepts (cf. L. Kim, 1992) that may be useful in developing cultural competence include haan (suppressed anger), jeong (strong feeling of kinship), and noon-chi (ability to evaluate social situations through implicit cues). Clinical case examples and accounts from a community-based research perspective illustrate these cultural values. Third, important community resources in the Korean American context are highlighted. Links between cultural competence and "ecological pragmatism" (Kelly, Azelton, Burzette, & Mock, 1994) are discussed. © 2006 Wiley Periodicals, Inc. [source] HEALING LOSS, AMBIGUITY, AND TRAUMA: A COMMUNITY-BASED INTERVENTION WITH FAMILIES OF UNION WORKERS MISSING AFTER THE 9/11 ATTACK IN NEW YORK CITYJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 4 2003Pauline Boss A team of therapists from Minnesota and New York workied with labor union families of workers gone missing on September 11, 2001, after the attack on the World Trade Center, where they were employed. The clinical team shares what they did, what was learned, the questions raised, and preliminary evaulations about the multiple family meeting that were the major intervention. Because of the vast diversity, training of therapists and interventions for families aimed for cultural competence. The community-based approach, preferred by union families, plus family therapy using the lens of ambiguous loss are proposed as necessary additions to disaster work. [source] DEVELOPING CULTURALLY COMPETENT MARRIAGE AND FAMILY THERAPISTS: TREATMENT GUIDELINES FOR NON-AFRICAN-AMERICAN THERAPISTS WORKING WITH AFRICAN-AMERICAN FAMILIESJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2002Roy A. Bean To serve African-American families effectively, marriage and family therapists need to develop a level of cultural competence. This content analysis of the relevant treatment literature was conducted to examine the most common expert recommendations for family therapy with African Americans. Fifteen specific guidelines were generated, including orient the family to therapy, do not assume familiarity, address issue of racism, intervene multi-systemically, do home visits, use problem-solving focus, involve religious leader, incorporate the father, and acknowledge strengths. conceptual and empirical support for each guideline is discussed, and conclusions are made regarding culturally conpetent therapy with African-American families. [source] The Story Catches You and You Fall Down: Tragedy, Ethnography, and "Cultural Competence"MEDICAL ANTHROPOLOGY QUARTERLY, Issue 2 2003Janelle S. Taylor Anne Fadiman 's The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Noonday Press, 1997) is widely used in "cultural competence" efforts within U.S. medical school curricula. This article addresses the relationship between theory, narrative form, and teaching through a close critical reading of that book that is informed by theories of tragedy and ethnographies of medicine. I argue that The Spirit Catches You is so influential as ethnography because it is so moving as a story; it is so moving as a story because it works so well as tragedy; and it works so well as tragedy precisely because of the static, reified, essentialist understanding of "culture" from which it proceeds. If professional anthropologists wish our own best work to speak to "apparitions of culture" within medicine and other "cultures of no culture," I suggest that we must find compelling new narrative forms in which to convey more complex understandings of "culture." [medical education, cultural competence, tragedy, ethnography, theories of culture] [source] Designing for diversity: Incorporating cultural competence in prevention programs for urban youthNEW DIRECTIONS FOR YOUTH DEVELOPMENT, Issue 111 2006Marion J. Goldstein If prevention programs are going to be effective in appealing to the sensibilities of urban youth and ultimately alter their behavior, they need to place diversity with respect to culture, class, and environment at the center of prevention efforts. [source] Boundary Maintenance as a Barrier to Mental Health Help-seeking for Depression Among the Old Order AmishTHE JOURNAL OF RURAL HEALTH, Issue 3 2002Denise M. Reiling Ph.D. This paper describes "boundary maintenance" as a barrier to help-seeking for depression within an Old Order Amish enclave. Observations and qualitative interview data were collected from 50 members of the Old Order Amish enclave and from the 8 mental health providers in their rural community. The Amish reported fairly high levels of depression, concomitantly high levels of reluctance to seek treatment for depression from mental health providers, and very low levels of service utilization. The functionality of boundary maintenance to group cohesion was discovered to be a significant barrier to help-seeking for depression from outside providers. Boundary maintenance was achieved through two social control mechanisms: religious-based stigmatization of depression and the construction of mental health providers as illegitimate help agents. Suggestions have been made to assist providers in achieving cultural competence among the Amish, in order to reduce the threat that the Amish perceive to their cultural boundaries. [source] Emergency Medical Practice: Advancing Cultural Competence and Reducing Health Care DisparitiesACADEMIC EMERGENCY MEDICINE, Issue 1 2009Aasim I. Padela MD Abstract In an increasingly diverse patient population, language differences, socioeconomic circumstances, religious values, and cultural practices may present barriers to the delivery of quality care. These obstacles contribute to the health care disparities observed in all areas of medical care. Increasing cultural competence has been cited as part of the solution to reduce disparities. The emergency department (ED) is an environment where cultural sensitivity is particularly needed, as it is often a primary source of health care for the underserved and ethnic and racial minorities and a place where high patient volume and acuity place the provider under demanding time pressures, yet the emergency medicine (EM) literature on health care disparities and cultural competence is limited. The authors present three clinical scenarios highlighting challenges in providing equitable emergency care to minority populations. Using these cases as illustrations, three processes are proposed that may improve the quality of care delivered to minority populations: 1) increase cultural awareness and reduce provider biases, enabling providers to interact more effectively with different patient populations; 2) accommodate patient preferences and needs in medical settings through practice adjustments and cultural modifications; and 3) increase provider diversity to raise levels of tolerance, awareness, and understanding for other cultures and create more racially and/or ethnically concordant patient,physician relationships. [source] Beyond Cultural Competence: Human Diversity and the Appositeness of Asseverative GoalsCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2005Arthur M. Nezu I argue that, as a profession, psychology needs to aspire beyond the goal of achieving cultural competence when addressing issues of human diversity. Although laudable, cultural competency as a goal may not set the bar high enough to achieve equity regarding those minority groups traditionally neglected or marginalized. As such, I further argue that asseverative objectives,ones that ask us to aver, affirm, and embrace human diversity,would be more consistent with a truly egalitarian perspective and our own code of ethics. I then describe barriers to achieving such goals that exist as endemic aspects of clinical psychology's worldview of human behavior and psychopathology, as well as inherent characteristics of simply being human. Last, I suggest that in order to reach such asseverative goals, we need to be more active (as compared to simply reading relevant journal articles) in our daily activities when it comes to issues of human diversity. [source] Conceptions of Literature in University Language CoursesMODERN LANGUAGE JOURNAL, Issue 2 2009CECILIA ALVSTAD In this article we set out to explore and discuss reasons for reading literary texts in university curricula of foreign languages. Our analysis is based on 2 sources of information: 16 syllabi of Spanish as a foreign language and a questionnaire in which 11 university instructors teaching these syllabi express their intentions. We point to a number of risks when emphasis is predominantly placed on instrumental goals such as acquisition of vocabulary and grammar or cultural knowledge. We suggest, instead, that the literary modules within language curricula should formulate their own specific goals. Rather than privileging linguistic and cultural competences to be trained, the literary modules could, for example, raise students' awareness of the facts that there are many ways of reading a text but that interpretation nevertheless remains a historically situated and constrained activity. [source] | ||||||||||||||||||||||||||||