This study investigates health care providers’ perceptions and practice in culturally sensitive care. 8 in-depth interviews were conducted with health care providers that lasted an average of 25 minutes. The findings revealed that health care providers tend to understand culturally sensitive care within the patient-centered care perspective. Their practice of culturally sensitive care is partially limited by language barriers, cultural barriers, and limited trainings in cultural sensitivity, while interpreting services, verbal and nonverbal communication strategies, collaborations with colleagues and self-education promote their practice of it. These findings underscore the importance of acknowledging health care providers’ influences in promoting culturally sensitive care, and the necessity of offering adequate amount of teachings and trainings in cultural sensitivity at health care programs and hospitals.

Objective: To examine the discourses used by trainee and qualified clinical psychologists from the South West of England to manage discussions of spirituality and religion as they relate to clinical practice. Methods: Four focus groups were carried out with a total of 25 qualified and trainee clinical psychologists. Transcripts were analysed using discourse analysis. Results: Three key discourses were identified, giving insight into how cohorts of qualified and trainee clinical psychologists manage discussions of these difficult topics. These were: balancing medical and therapeutic discourses, particularly when discussing psychosis and religious or spiritual beliefs; positioning and the Other, including religion and spirituality as a proxy for talking about race; and negotiating what can or cannot be said, principally when sharing personal views. Conclusion: Ensuring that clinical psychologists have an awareness of the different discourses in use within the profession and how these may impact practice is important. Explicit discussion of the medical and therapeutic discourses likely to arise across different settings should be encouraged, including how these can constrain discussions around difficult topics such as spirituality and religion, race, and sexuality. Training should equip psychologists to have an awareness of othering, particularly in relation to religion or spirituality and race, and the potential effects this could have on power and engagement in therapy and broader work.

Colorectal cancer is the 3rd leading cause of cancer-related deaths. Early screening provides the best prospects for preventing the morbidity and mortality associated with the disease. Nurses have the duty to promote health and prevent diseases. However, low rates of colorectal cancer screening continue to be reported, especially among African Americans who continue to suffer disproportionately from the disease. There is a need for a culturally-sensitive clinical practice guideline that nurses can use to educate patients appropriately on colorectal cancer. The practice focused question for this project was designed to explore whether a culturally-sensitive clinical practice guideline to increase colorectal cancer screening among African Americans could be developed using best practices. The health belief model informed the background, development, and implementation of this project. Evidence from peer-reviewed nursing literature was synthesized in a literature review matrix and then used to develop a clinical practice guideline to increase colorectal cancer screening. It is anticipated that this guideline will improve nursing practice by equipping nurses with the knowledge and skill to provide culturally-sensitive education on colorectal cancer and screening. Through the patient education and enhanced nursing practice stipulated in the clinical practice guideline, health care providers may work to eliminate disparities in colorectal cancer screening among African Americans.

There are many approaches taken by teachers in order to effectively teach students the information they will need to be successful. One of these approaches is that of brain-based instruction. No one single definition is the same as another when it comes to brain-based teaching and learning. Definitions may include incorporating music and movement into lessons, using techniques to reach both hemispheres of the brain, and differentiating instruction to teach to the needs of the individual students. This study takes a closer look at the perspective of teachers when it comes to what brain-based instruction strategies are. Teachers were given a survey to voice their opinions about brain-based instruction and how they incorporate it into their classrooms. This study gathered information about how teachers perceive and understand brain-based instruction. The use of brain-based instruction is quickly becoming vital to the education field. Understanding more about it will help teachers effectively teach students.

No / Sheila Payne and colleagues examine the differences and similarities in end-of-life care provided in different countries which, while broadly based on the same models, varies according to resources, cultural attitudes and public health policies This article introduces palliative care and palliative care nursing. It goes on to consider models of palliative care delivery and provide a more detailed account of the three elements of palliative care nursing–working directly with patients and families, working with other health and social care professionals to network and co-ordinate services, and working at an organisational level to plan, develop and manage service provision in local, regional and national settings. It concludes by detailing the challenges for palliative care nursing and outlines a possible way ahead.

The language children bring to the classroom (home language) is often different from the language that is expected or accepted in schools. These language differences are often met with a variety of reactions from teachers. The purpose of this research is threefold: (a) to apply a narrative inquiry design to explore how teachers respond to the language that children bring (home language) to the early childhood classroom and the effects this response has on their work with children; (b) to engage in research efforts that will explore how differences in language may affect or be affected by pedagogy, curriculum development, and teachers' expectations; (c) to understand how teachers feel about their preparation and capacity to address the issue of language diversity. The 4 participants in this study are either current or former teachers of children between the ages of 4 to 8 years. Through the use of narrative inquiry, I have acquired stories from each of the 4 participants. The stories provide insight into these teachers' perceptions of children's language in the classroom. The stories also open discussions on language diversity and the role it plays in early childhood education classrooms as well as how prepared teachers are to deal with language differences. With this study I hope to contribute to the research that focuses on language and language diversity in early childhood education. I would also hope to prompt further research on issues such as teachers' approaches to children's language differences within the classroom, the affects of different approaches to language diversity on pedagogy and curriculum, and finally on culturally sensitive pedagogy.

The ultimate goal of this research was to provide a tool to adequately examine the relationship that parenting style has with Hispanic youths' academic and behavioral outcomes. A review of the literature reveals that the field is lacking an appropriate, culturally sensitive, paper-and-pencil measure of parenting of Hispanic adolescents with adolescents reporting on their parents' behavior. Current measures were not developed with Hispanic families in mind, but rather were evaluated for use with Hispanic populations after the development phase. Therefore, the current study sought to fill this gap in the research on parenting by constructing a measure of parenting that was not only culturally sensitive in its use, but also culturally sensitive in its development. This study consisted of three phases, each using a Hispanic-only sample. First, 4 group interviews informed the item content and development of this new scale. Four focus groups consisted of 4-7 parents each, and 6 focus groups consisted of 6-8 middle school adolescents each. The information collected in the focus groups was used to develop 60 items intended to measure parenting behaviors in Hispanic families. In the second phase, 314 Hispanic students completed the new 60-item scale. Reliability estimates, item analyses and factor analyses were conducted to reduce the items to a total of 32 items and to determine emerging factors. In the final phase, 131 Hispanic students completed the revised 32-item scale and 105 of these students were retained for the analyses. Regression equations were used to predict academic and behavioral outcomes, and the new reduced-item parenting scale was compared to an established parenting scale originally developed for majority non-Hispanic American culture. Analyses also explored the new measure's relationship with acculturation, ethnic identity, SES, and generational status. The new 32-item measure provided unique information above and beyond the established parenting measure when predicting Global Self-Worth, suggesting that the new measure may better capture the relationship between parenting and student outcomes. On the other hand, future studies need to address methodological limitations of this study by using a larger sample size and increasing sample heterogeneity while maintaining consistency in demographic variables across within-study samples.

An efficacious treatment is diminished in value if clients will not seek it out and adhere to it (Kazdin, 1978). Thus, the acceptability of a treatment to consumers is an important indicator of the quality/effectiveness of the treatment (APA, 2002). The purpose of this study was to examine acceptability of treatments for depression to adolescent females and to explore factors that might be associated with acceptability. Sixty-seven high school students (36 Hispanic and 31 non-Hispanic White) were recruited from communities in New Jersey and Florida, and interviewed by telephone. Participants were presented with a vignette describing a depressed adolescent and asked to use the Abbreviated Acceptability Rating Profile to indicate their opinion of four single treatments (cognitive-behavioral therapy, interpersonal therapy, family therapy, and pharmacotherapy) for depression and three treatment combinations. Consistent with hypotheses, psychotherapy approaches were generally more acceptable to adolescents than combinations of psychotherapy and pharmacotherapy. Pharmacotherapy used alone was not acceptable, on average. There was preliminary evidence to support the hypotheses that treatment acceptability is related to ethnicity, acculturation, and perceived causes of depression; however, contrary to expectations, treatment acceptability was not associated with symptom severity in this study. Implications for increasing the utilization of mental health services in this population are discussed and directions for future research are offered.

The main focus of this study was to explore how personal constructions, consisting of latent and conscious schema, and obtained from a culturally sensitive interpretation of the RCS, informed the transactional resilience of Black South African adolescents. This study was motivated in view of limited knowledge available about the (i) processes that are generic to the resilience-promoting transactions of Black South African adolescents and (ii) to potentiate insight into an adolescent’s construction of personal meaning of her conscious and unconscious experiences that may not always be easily recognised in her overt behaviour or by self-report measures often used in South African resilience research. Six Black South African adolescents aged 14 to 16 years volunteered to take part in this multiple case study. The participants were identified as resilient by an advisory panel consisting of learners and educators at an English-medium school in the Vaal Triangle area. In this essentially qualitative study, qualitative data obtained from an unstructured individual interview, unstructured observations, and a follow-up interview were integrated with the data obtained from a culturally sensitive, conceptual interpretation of these Black adolescents’ Rorschach protocols. The structural, quantitative data obtained from specific indicators in Exner’s Comprehensive System were interpreted in a culturally sensitive manner and integrated with the qualitative data obtained from the Rorschach protocols. A culturally sensitive, conceptual framework for interpreting Rorschach indicators associated with adolescents’ transactional resilience was provided. These findings indicated individual and ecological protective resources well known within South African resilience research. Findings that contributed new understanding of the transactional processes associated with Black South African adolescent resilience were also obtained. Four case-specific self-reflective strategies were identified, namely, emotional stoicism, frequent introspection, honouring the past, and adopting a new identity. These selfreflective strategies served as the participants’ unique ways of compensating for their adversity-informed schema as well as encouraging them to navigate towards the sustained support of specific significant others and resilience-promoting ecological resources. The participants indicated that attachment challenges brought about repressed feelings and specific security needs, which shaped their resilience-promoting navigation and enabled them to self-knit in a resilient way. / Thesis (Ph.D. (Education))--North-West University, Vaal Triangle Campus, 2011

The main focus of this study was to explore how personal constructions, consisting of latent and conscious schema, and obtained from a culturally sensitive interpretation of the RCS, informed the transactional resilience of Black South African adolescents. This study was motivated in view of limited knowledge available about the (i) processes that are generic to the resilience-promoting transactions of Black South African adolescents and (ii) to potentiate insight into an adolescent’s construction of personal meaning of her conscious and unconscious experiences that may not always be easily recognised in her overt behaviour or by self-report measures often used in South African resilience research. Six Black South African adolescents aged 14 to 16 years volunteered to take part in this multiple case study. The participants were identified as resilient by an advisory panel consisting of learners and educators at an English-medium school in the Vaal Triangle area. In this essentially qualitative study, qualitative data obtained from an unstructured individual interview, unstructured observations, and a follow-up interview were integrated with the data obtained from a culturally sensitive, conceptual interpretation of these Black adolescents’ Rorschach protocols. The structural, quantitative data obtained from specific indicators in Exner’s Comprehensive System were interpreted in a culturally sensitive manner and integrated with the qualitative data obtained from the Rorschach protocols. A culturally sensitive, conceptual framework for interpreting Rorschach indicators associated with adolescents’ transactional resilience was provided. These findings indicated individual and ecological protective resources well known within South African resilience research. Findings that contributed new understanding of the transactional processes associated with Black South African adolescent resilience were also obtained. Four case-specific self-reflective strategies were identified, namely, emotional stoicism, frequent introspection, honouring the past, and adopting a new identity. These selfreflective strategies served as the participants’ unique ways of compensating for their adversity-informed schema as well as encouraging them to navigate towards the sustained support of specific significant others and resilience-promoting ecological resources. The participants indicated that attachment challenges brought about repressed feelings and specific security needs, which shaped their resilience-promoting navigation and enabled them to self-knit in a resilient way. / Thesis (Ph.D. (Education))--North-West University, Vaal Triangle Campus, 2011