The purpose of this qualitative study was to determine the cultural competence of district leaders and their potential resulting influence on campus leaders in the face of a rapidly changing educational and community landscape. A secondary purpose was to ascertain district and school leaders' placement on the cultural proficiency continuum to gain a greater understanding of (a) the potential effect, if any, that district leaders' level of cultural competency had on the cultural competency of campus leaders, and (b) how the cultural competency level of both district and campus leaders influenced district policies, practices, and school climate. The analysis and interpretation of findings of this research study were based on a conceptual framework, informed by the six constructs of the cultural proficiency continuum as developed by R. Lindsey, Nuri-Robins, D. Lindsey and Terrell. Four district office leaders and three campus principals, from the same district, were selected as participants. The campus principals represented elementary, middle, and high schools. Data were gathered from semi-structured face-to-face interviews with each participant, three meeting observations, and document analysis. Findings revealed evidence of a strong relationship between district leaders' cultural competence, campus principals' cultural competence, and district policies and procedures. There was also a direct relationship between the district leaders' cultural competence levels and their direct reports' level of cultural competence. This study can afford school districts an opportunity to recognize the value and implications of culturally proficient leaders, as they serve all students.

Bakgrund: Globaliseringen i samhället ökar och i dagsläget är strax över två miljoner av Sveriges befolkning utrikesfödda. Sjuksköterskans krav på kulturell kompetens ökar då mötet med människor från olika kulturer förekommer i större utsträckning än tidigare. Kulturell kompetens är viktigt för att tillhandahålla en individanpassad omvårdnad. En sjuksköterska ska visa respekt för en människas kultur och vara medveten om att uttryck för respekt och omsorg skiljer sig mellan personer och kulturer. Syfte: Att beskriva sjuksköterskans erfarenheter av att ge transkulturell omvårdnad. Metod: En litteraturstudie med deskriptiv design. Resultatet sammanställdes med hjälp av elva vetenskapliga artiklar med kvalitativ ansats. Huvudresultat: Resultatet av litteraturstudien påvisade att kulturell kompetens hos sjuksköterskor hade stor betydelse för kvalitén på omvårdnaden. Sjuksköterskor upplevde transkulturell omvårdnad som utmanande men även lärorikt, då de ansåg att den kulturella kompetensen och förståelsen för andra kulturer ökade i samband med att de vårdade patienter från andra kulturer. Sjuksköterskor upplevde att patientsäkerheten blev lidande eftersom det många gånger förekom språkförbistringar och svårigheter att kommunicera med patienter och närstående. Resultatet visade att det fanns en stor efterfrågan hos sjuksköterskor beträffande utbildning inom transkulturell omvårdnad för att utöka deras kulturella kompetens. Slutsats: Möten med människor från olika kulturer blir en större del av sjuksköterskeprofessionen på grund av den ökade globaliseringen. Sjuksköterskans centrala roll i omvårdnaden gör att detta ställer högre krav på den kulturella kompetensen hos sjuksköterskan för att kunna tillgodose en individanpassad vård utifrån kulturella önskemål. / Background: Globalization in society is increasing and at present, just over two million of Sweden's population are foreign-born. The nurse's requirements for cultural competence increase as encounters with people from different cultures occur to a greater extent than before. Cultural competence is important for providing individualized care. A nurse must show respect for a person's culture and be aware that expressions of respect and care differ between people and cultures. Aim: To describe the nurse's experiences of providing transcultural care. Method: A literature study with descriptive design. The results were compiled with the help of eleven scientific articles with a qualitative approach. Main result: The results of the literature study showed that cultural competence in nurses is of great importance for the quality of nursing. Nurses experienced transcultural nursing as challenging but also instructive as they felt that the cultural competence and understanding of other cultures increased in connection with the care of patients from other cultures. Nurses experienced that patient safety suffered because there were often language confusions and difficulties in communicating with patients and relatives. The results showed that there was a great demand among nurses regarding training in transcultural nursing to expand their cultural competence. Conclusion: Meetings with people from different cultures are becoming a bigger part of the nursing profession due to the increasing globalization. The nurse's central role in nursing means that this places higher demands on the nurse's cultural competence in order to be able to satisfy an individualized care based on cultural wishes.

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Bakgrund: I tidigare forskning framkommer komplexiteten i tvärkulturell vård. Felbedömningar sker kopplat till kulturella uttryck. Ökad kulturkompetens hos vårdaren kan bidra till mer jämlik vård. Kulturkompetens är en ständigt pågående process men måste användas med en ödmjuk inställning till det egna kunnandet. Behov finns av mer studier kring patienters erfarenheter av tvärkulturell vård. Syfte: Att beskriva patienters och sjuksköterskors erfarenheter av tvärkulturella möten i rättspsykiatrisk vård. Metod: 14 semistrukturerade intervjuer genomfördes med patienter och sjuksköterskor på en rättspsykiatrisk klinik. En kvalitativ innehållsanalys med induktiv ansats följt av ett abduktionssprång genomfördes. Resultat: Patienternas erfarenheter redogörs för i Att inte höra till, Att inte bli förstådd, Att känna sig välkomnad, Att skapa relationer och känna samhörighet, Att anpassa sig på gott och ont samt Att sträva mot samförstånd. Sjuksköterskornas erfarenheter presenteras i Att blunda för kulturen, Att uppleva kulturen som hinder, Att försöka skapa relationer och Att utvecklas som person. Ett övergripande tema identifierades som Att sträva efter ömsesidig förståelse. Slutsats: Synen på kultur skiljer mellan patienter och sjuksköterskor. Det finns behov av ökad medvetenhet om kulturens påverkan. Omvårdnaden skulle vinna på att patientens kultur och erfarenheter beaktas. Kulturkompetens behöver uppmärksammas i både verksamhet och utbildning. / Background: Previous research shows the complexity of cross-cultural care. There are misjudgements linked to cultural expressions. Increased cultural competence among caregivers can contribute to a more equal care. Cultural competence is an ongoing process, but it must be used with a humble attitude to one's own knowledge. There is a need for more studies on patients' experiences of cross-cultural care. Aim: To describe patients' and nurses' experiences of cross-cultural encounters in forensic psychiatric care. Method: 14 semi-structured interviews were conducted with patients and nurses at a forensic psychiatric clinic. A qualitative content analysis with an inductive approach and an abductive leap was conducted. Results: The patients' experiences are described as To not belong, To not being understood, To feel welcome, To establish relationships and feel affinity, To adapt for better or worse and To strive for consensus. The nurses' experiences are presented in To wink at culture, To experience culture as an obstacle, To try to establish relationships and To develop as a person. An overarching theme is identified as To strive for mutual understanding. Conclusion: The view on culture differs between patients and nurses. There is a need for increased awareness of the impact of culture. Nursing would benefit from the patients culture and experiences being taken into account. Cultural competence needs attention in both work and education.

The lesbian, gay, bisexual, and transgender (LGBT) community continues to experience worse health outcomes than their heterosexual counterparts. Inequities in health care include low health insurance rates, high rates of stress due to systemic discrimination and stigma, and a lack of cultural competency in the health care system. Gender and sexual minority (GSM) people are at higher risk of mental health disorders, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), substance use and abuse, cancer, suicide, and other disorders/diseases. A lack of cultural competency in health care systems perpetuates these health disparities and inequities in care that burden the LGBT community. This project?s purpose was to evaluate the effectiveness of an online educational intervention on enhancing health professionals? cultural competence of GSM health. This study used a one-group pre-, post-, and follow-up survey intervention, quasi-experimental design to evaluate the effectiveness of an educational intervention on improving health professionals? knowledge, clinical preparedness, and attitudinal awareness of GSM health. The study?s setting was at a primary care center with clinics spread across three rural counties in North Dakota with a combined population of less than 14,000. This study used convenience sampling, and the recruitment of participants included a project presentation at the health care organization where the project would take place and an email invitation. Thirty-six participants completed the pre-survey, 11 of those 36 participants completed the educational intervention and post-survey, and six of those 11 participants completed the follow-up survey four weeks after completing the educational intervention. The instrument used for the presurvey, post-survey, and follow-up survey was the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS). A paired sample t-test was used to compare pre, post, and four-week follow-up LGBT-DOCSS mean scores. The results indicated a statistically significant improvement in LGBT-DOCSS mean score on the post-survey (p = 0.0011) and four-week follow-up (p = 0.01) compared to the pre-survey. Additionally, the majority of participants reported that this educational intervention was valuable to their practice. This project revealed that an online educational intervention effectively enhanced health professionals? cultural competence of GSM health.

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Syfte: Syftet med studien var att skapa djupare förståelse kring sjuksköterskors upplevelse av mellanmänsklig kommunikation med patienter med annan kulturell bakgrund. Bakgrund: Kommunikation spelar en viktig roll i kulturen och är en stor del av relationen mellan individer. Kommmunikation är en grundbult i sjuksköterskans arbete och är av högsta vikt för att kunna erbjuda en patientcentrerad och säker vård. Transkulturell medvetenhet är essentiellt för god vård, speciellt som världen blir alltmer mångkulturell. Såväl sjukvårdsturism som utökade globala samarbeten inom Hälso- och sjukvården ökar kraven på kulturell kompetens bland sjuksköterskor. Indien är ett föregångarland inom sjukvårdsturism och människor från olika kulturell bakgrund reser dit för sjukvård. Metod: Semistrukturerade intervjuer genomfördes med 12 sjuksköterskor mellan 23 och 53 år från två indiska sjukhus. Sjuksköterskorna möter ofta patienter med olika kulturell bakgrund. En tematisk innehållsanalys utfördes på det insamlade materialet. Resultat: Två tematiska inriktningar framkom från materialet; ett tema med fokus på praktiska verktyg och tekniker för att arbeta med patienter med annan kulturell bakgrund och det andra temat handlar om att bibehålla vårdkvaliteten. Utökade språkkunskaper och kommunikationsverktyg skulle underlätta sjuksköterskans arbete. Kulturell medvetenhet leder till ett ökat självförtroende hos sjuksköterskan och hjälper denna förutse eventuella behov hos patienten. Slutsats: Transkulturell medvetenhet och kommunikationsverktyg bidrar till en säkrare och mer effektiv vård. Sjuksköterskeutbildningen behöver lägga mer fokus på kulturell mångfald inom hälso- och sjukvård. Mer forskning krävs inom detta område då vården globaliseras allt mer. / Aim: The aim of the study was to gain a deeper understanding of interpersonal communication as experienced by nurses working in culturally diverse hospitals in India. Background: Communication is an important part of culture and a base in any interpersonal relationship. Communication is a foundation in the nursing occupation in order to give patient centered care which is safe and effective. Transcultural awareness in nursing is an important factor in order to give good care, especially as the world is becoming more multicultural. Medical tourism along with the expanding network of global interactions in healthcare ads to the necessity of developing culturally competent nursing care. India in one of the forerunners in medical tourism and cares for patients from many different cultural backgrounds. Method: Semi-structured interviews were conducted on a sample of 12 nurses between the age of 23 and 53, working with diverse patients at two different hospitals in India. A thematic content analysis was performed. Results: The developed themes focus on specific tools and techniques for working with culturally diverse patients and how to sustain the quality of care in diverse hospital settings. Language resources and tool which aid in communication would alleviate the nurses work. Cultural knowledge helps the nurses gain confidence and foresee possible needs of the patient. Conclusion: Highlighting transcultural interpersonal communication techniques within nursing leads to a safer and more productive practice of nursing care. Nursing education needs to prioritize cultural diversity in health care. More research needs to be conducted on the subject of interpersonal communication in culturally diverse hospital settings since healthcare is a continuously growing globalized organization.

Bakgrund: Enligt sjuksköterskans kompetensbeskrivning är det viktigt attuppmärksamma och möta patienten med hänsyn till olika aspekter, däribland kulturen. Detta innebär att höga krav ställs på sjuksköterskans förmåga att utöva transkulturell omvårdnad. En viktig aspekt för att uppnå god omvårdnad är en fungerande kommunikation mellan sjuksköterska och patient. Om hänsyn inte tas till patientens kulturella behov och önskningar kan detta resultera i ett vårdlidande för patienten. Syfte: Att beskriva sjuksköterskors och sjuksköterskestudenters upplevelser av att vårda patienter med annan kulturell bakgrund än den egna. Metod: Genom en allmän litteraturöversikt har 11 artiklar granskats och sammanställts utifrån likheter och skillnader till fem stycken kategorier och fyra huvudkategorier. Resultat: Fyra huvudkategorier: Vårda den enskilde, Kulturspecifika behov och uttryck, Utmaningar i kommunikationen och Kunskap om kultur. Sjuksköterskorna identifierade olika aspekter som kunde skilja sig mellan kulturer och påverka omvårdnaden, såsom matkultur, religion, närståendes roll samt smärta och känslouttryck. Slutsats: I mötet med patienter med annan kulturell bakgrund upplevde sjuksköterskor och sjuksköterskestudenter många utmaningar som i sin tur hade inverkan på omvårdnaden. Klinisk betydelse: Resultatet kan ge upphov till ökad kunskap samt väcka nyfikenhet hos läsaren. Ämnet i sig är högst relevant i nutid då hänsyn till individens kulturella bakgrund är en viktig del för att uppnå en holistisk bild, någonting som är en grundsten i dagens sjukvård. / Background: According to the competence description for nurses, it is important to draw attention to and face patients from different aspects, including culture. This means that high demands are placed on nurse's ability to practice transcultural nursing. An important aspect to achieve good nursing care is appropriate communication between nurse and patient.  If consideration of the patient's cultural needs and desires isn't taken, it could result in suffering for the patient. Purpose: To describe nurses and nursing students' experiencesin caring for patients with different cultural backgrounds than their own. Method: In a general literature review 11 articles has been examined and summarized from similarities and differences into five categories and four main categories. Results: Four main categories: Nurture the individual, Culturally specific needs and expressions, Challenges in communication and Cultural knowledge. Nurses identified various aspects that could differ between cultures and affect care, such as food culture, religion, families, as well as pain and emotional expressions. Conclusion: In the encounter with patients with different cultural backgrounds, nurses and nursing students experienced many challenges which had an effect on the nursing care. Clinical significance: The results may lead to increased knowledge as well as to arise the readers’ curiosity. The topic itself is very relevant today because of the account of the individual's cultural background is an important part of achieving a holistic picture, and this is something that is a cornerstone of today's healthcare.

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health nurses at a local health department. Survey participants remained anonymous. Data were collected on demographics. A paired t test was conducted to compare the statistical significance of the results. A quantitative software tool was used to analyze the data. Study results showed a confidence interval of 95% at p = 0.15, indicating that cultural competence informational modules made a significant difference between the pretest and the posttest of the Cultural Competence Self-Assessment Checklist. Thus, cultural competence informational modules make a difference in public health nurses' awareness, knowledge, and skills, which can enhance their ability to provide culturally competent care to racial and ethnic minorities. The implications of this project for social change include supporting health care professionals' ability to promote and implement cultural competence practices for all populations to decrease health disparities