In healthcare, cultural competence is an essential skill identified as one of the most modifiable factors in resolving health disparities. Through the lens of multiple frameworks, including the Process of Cultural Competence in the Delivery of Healthcare Services, multicultural education, and reflective practitioner, this study seeks to explore how students understand the concept of cultural competence in an entry-level physical therapy program and where in the curriculum they locate their learning experiences of the idea. Third-year students from a single entry-level physical therapy program are recruited to participate in individual interviews, online questionnaires, and focus group discussions. The study used a qualitative case study approach with a constructivist grounded theory data collection and data analysis methodology. The cyclical data collection and analysis methods with an initial, focused, and theoretical coding scheme were adopted to generate themes to answer the research questions. Drawing on participants’ understanding of cultural competence, this study illustrates that, although students exhibit analogous motivations and definitions of cultural competence, there exists a variation in their skills and knowledge pertinent to cultural competence. Moreover, the results advocate for continuous integration of classroom learning with practical clinical experiences, complemented by intentional learning experiences, to enhance students’ cultural competence. The findings implicate the critical need for curricular revisions that emphasize cultural competence, ensuring students are adequately equipped to navigate society’s rapidly diversifying demographic landscape.

This qualitative phenomenological study examined central Florida's nursing home administrators' knowledge and perception of cultural competence and how they perceive that their knowledge and perceptions impact residents, families, and healthcare. The theoretical framework for this study was explained through Campinha-Bacote's interdisciplinary model of The Process of Cultural Competence in the Delivery of Healthcare Services. The theoretical framework was used to guide research questions, and individual interview questions to obtain nursing home administrator's knowledge and perception of cultural competence. The study explored the level of cultural competence reported by nursing home administrators, their individual perception of cultural competence, their degree of confidence in cultural competence, and how nursing home administrators describe their proficiencies and skills in cultural competence. Interviews with six nursing home administrators included licensed nursing home administrators (NHA) and assistant nursing home administrators, and the director of nursing (DON). The findings identified and analyzed the diverse levels of nursing home administrator's knowledge and perception of cultural competence. Some participants demonstrated difficulty expressing their knowledge and perception of cultural competence. Findings indicate that various factors influenced participants' overall degree of confidence in their knowledge and perception of cultural competence. Nursing home administrators also had a difficult time articulating particular skills that demonstrate their ability to adapt to the diverse residents in their facilities, and how they promote cultural competence in their nursing home facilities. This study identified the need for additional research and continuing education about cultural competence in healthcare.

Yes / The aim of this paper is to describe the conceptualisation and development of an inclusive educational model. The model is designed to facilitate pre-registration midwifery students' learning around the health and social care needs of pregnant women seeking asylum in the United Kingdom. current literature has identified a concern about the standard of maternity care experienced by asylum seeking women accessing maternity services in the United Kingdom. In response to this, a doctorate study was undertaken which focused on examining the way in which a group of midwifery students approached the provision of care for asylum seekers. This study revealed difficulties that these students had both in identifying these women's needs and also in the wider care issues in practice. Consequently, one of the recommendations was to ameliorate these difficulties through midwifery education. Methods: the key findings from this study were used together with relevant supporting literature to construct “the pregnant woman within the global context” model for midwifery education. Results: The model is designed to facilitate a holistic assessment of need rather than focusing on the physical assessment at the expense of other aspects of care. It incorporates wider factors, on a global level, which could impact on the health and social care needs of a pregnant woman seeking asylum. It also prompts students to consider the influence of dominant discourses on perceptions of asylum seek;ing and is designed to encourage students' to question these discourses. Recommendations: this model can be used in midwifery education to prepare students in caring for pregnant women seeking asylum. It may be especially helpful when students have close contact with pregnant women seeking asylum, for example through caseloading. Further research is recommended to evaluate the effectiveness of this model in enhancing the care of asylum seeking women in the United Kingdom.

Bakgrund: I ett alltmer mångkulturellt samhälle blir det märkbart hur förutsättningarna för en god hälsa skiljer sig mellan olika samhällsgrupper. Hälso- och sjukvården har som uppgift att främja hälsan hos alla patienter oavsett bakgrund. Detta ställer nya krav på den svenska sjukvården, då en mångkulturell utveckling leder till fler transkulturella möten i vården. Dessa möten innehåller ofta hinder som kan vara svåra att överbrygga, vilket kräver en kunskap om vilka faktorer som påverkar mötet och en medvetenhet om kulturens betydelse hos sjuksköterskan.   Syfte: Syftet med studien var att utifrån ett sjuksköterskeperspektiv belysa de faktorer som påverkar vårdrelationen i transkulturella möten.   Metod: En litteraturstudie baserad på 13 vetenskapliga artiklar var av nio kvalitativa och fyra kvantitativa. Resultatet analyserades och sammanställdes genom ett kvalitativt analysinnehåll.  Som teoretiska utgångspunkter användes en definition av kulturell kompetens och vårdrelation.   Resultat: Resultatet visar att kommunikation och språkbarriärer utgör det största hindret i den transkulturella omvårdnaden. Användning av tolk som hjälpmedel visade sig ha både för- och nackdelar. Organisatoriska hinder försvårade förutsättningen för en fungerande vårdrelation och kulturella skillnader visade sig kunna leda till konflikter i vårdmötet. Sjuksköterskan använde sig av olika strategier som hjälpmedel vilket illustrerade en viss kulturell medvetenhet, medan bristen på förståelse ledde till generaliseringar som resulterade i en diskriminering av patienter. Många sjuksköterskor saknar utbildning i transkulturell omvårdnad, vilket efterfrågades av merparten. De sjuksköterskor som genomgått en utbildning i kulturell kompetens uppgav positiva effekter som lett till en ökad medvetenhet.   Diskussion: Sjuksköterskan behöver bli medveten om de negativa konsekvenser som en bristande kommunikation och kulturella konflikter har för etablerandet av en vårdrelation till patienten. Enligt de dokument som styr professionen har sjuksköterskan en skyldighet att skapa de bästa förutsättningarna för en god omsorg om patienten. Okunskap och oförståelse leder till en diskriminering av patienten som inte hör hemma i vården. Utbildning i kulturell kompetens har bevisligen positiva effekter för att motverka generaliseringar och öka medvetenheten hos sjuksköterskan. För att främja en kulturell medvetenhet bör mer fokus läggas på dessa frågor i sjuksköterskans grund – och fortutbildning.

Indiana University-Purdue University Indianapolis (IUPUI) / The increase in diverse populations with unique, culturally specific needs, along with the lack of diverse healthcare providers to deliver culturally competent care, has escalated the need for non-diverse practitioners to gain the knowledge, skills, and attitudes to deliver culturally competent care. Culturally competent care cannot be offered to patients unless nurses understand how cultural values, attitudes, and beliefs impact patients' response to care. Nurses must develop cultural competence to accurately access, develop, and implement effective nursing interventions. The purpose of this exploratory, quasi-experimental, pretest-posttest study was to explore the impact of an intercultural service learning experience (domestic or international) on pre-licensure nursing students' perceived development of transcultural self-efficacy. A convenience sample of senior semester nursing students enrolled in a private, faith-based, baccalaureate degree nursing program in the Midwest United States completed the Transcultural Self-Efficacy Tool (TSET), Cultural Competence Clinical Evaluation Tool-Student Version (CCCET-SV), and reflective journals. All students were immersed in an intercultural service learning experience. Eighteen students traveled domestically and 38 traveled internationally. The data revealed that there was not a statistical difference in TSET scores based on location of the intercultural experience. However, there was a statistically significant difference from pretest to posttest for perceived Cognitive, Practical, and Affective dimensions of transcultural self-efficacy, in change scores (pretest to posttest), and pretest to posttest for pre-licensure BSN students’ perceived clinical competence behaviors (culturally sensitive and professionally appropriate attitudes, values, and beliefs) following an intercultural service learning experience.

Bakgrund: På en intensivvårdsavdelning ökar kontakten med närstående då patienten är svårt sjuk och oftast sederad. Närstående kan ses som en resurs med sin kunskap om patienten samtidigt som de behöver stöd då de ofta befinner sig i kris. Tidigare forskning lyfter hur intensivvårdssjuksköterskan upplever hinder i interaktionen med närstående från olika kulturer där språkbarriärer, sjukdomsförståelse och kulturella vanor försvårar interaktionen. För att optimera interaktionen har intensivvårdssjuksköterskan en viktig roll där behov av kulturell kompetens föreligger. Nationella studier som berör intensivvårdssjuksköterskans kulturella kompetens i samspel med närstående saknas. Syfte: Studiens syfte var att undersöka intensivvårdssjuksköterskors upplevelser av interaktionen med närstående från olika kulturer. Metod: Studien genomfördes med en kvalitativ design och datainsamlingen skedde genom nio intervjuer där en semistrukturerad intervjuguide användes. Intervjuerna analyserades med manifest innehållsanalys. Resultat: Intensivvårdssjuksköterskornas upplevelser av interaktionen med närstående beskrivs genom fyra huvudkategorier med underkategorier: Intensivvårdssjuksköterskans kulturella kompetens, kommunikation, närstående och närståendes närvaro. Slutsats: Kommunikation påverkar alla aspekter av interaktionen med närstående från olika kulturer. För att optimera interaktionen behövs ökad kunskap hos intensivvårdssjuksköterskor. / Background: In an intensive care unit the contact with the patients family increases since the patient is seriously ill and often sedated. The family can be seen as a resource, with their knowledge of the patient while they need support as they often are in crisis. Previous research highlights how intensive care nurses experiencing obstacles in meeting with families from diverse cultures where language barriers, understanding of disease and cultural habits complicate the interaction. In order to optimize the interaction with the patient’s family the intensive care nurse has an important role where the need for cultural competence exists. There is a lack of national studies involving intensive care nurses' cultural competence in interaction with families. Objective: The aim of this study was to examine the intensive care nurses' experiences of interaction with relatives from diverse cultures. Method: The study was conducted with a qualitative design and data was collected through nine interviews where a semi-structured interview guide was used. Interviews were analyzed using manifest content analysis. Results: Intensive care nurses' experiences of interaction with relatives are described by four main categories with subcategories: The intensive care nurses cultural competence, communication, families and presence of families. Conclusion: Communication affects all aspects of the interaction with families from diverse cultures. Intensive care nurses require increased knowledge in order to optimize the interaction.

Background. Obesity has been associated with a number of negative health consequences (e.g., hypertension/heart disease, type-2 diabetes, osteoarthritis, and respiratory illnesses). Despite health communication campaigns to reduce overweight/obesity by encouraging lifestyle changes (e.g., eating healthier foods and exercising), the rates of overweight and obesity levels have continued to rise. Studies indicate that the rate of overweight and obesity in the U.S. is highest among Blacks. Messages targeted toward “Blacks” (African-Americans) in the United States treat this segment of the population as a homogenous group and fail to account for within-group cultural differences. Cultural values and beliefs related to food, physical activity, and ideal body size may contribute to overweight and obesity. Objective. This study was designed to gain a deeper understanding of the similarities and differences between African-American and Afro-Caribbean immigrant women living in the Metro Atlanta, Georgia, in terms of the role that culture and social environments play in forming obesity-related—food, physical activity, and body image—attitudes, values, and behaviors. Method. A social cognitive theory (SCT) framework informed the design of semi-structured interview guides. Study participants were comprised of 13 African-American women and 12 Afro-Caribbean women who recently immigrated to the United States from English-speaking countries. All participants were living in Atlanta, Georgia at the time of the study. They were recruited through convenience and snowball sampling and interviewed between October 5 and December 26, 2014. Data from audio-recorded in-depth interviews were transcribed and analyzed using textual analysis software package NVivo9. Results. African-American and Afro-Caribbean participants were similar in terms of some food-, physical activity- and body-image related attitudes and behaviors. Health-related concerns and matrilineal influence affected the food-related behaviors of both groups of participants. Physical activity and body image-related attitudes and behaviors of women in both groups were affected by the norms of their childhood and current social environments. Although a healthy physical activity lifestyle was important to women in both groups, not all women were consistently physically active. The study also revealed some differences between African-American and Afro-Caribbean participants. In general, the African-American women described the food-related norms of their childhood environments in negative terms and were more likely to have changed their food-related behaviors for health reasons. The Afro-Caribbean women described their childhood food-related norms in positive terms, and thus, strove to maintain healthy behaviors from their childhood. The norms of the current social environments of African-Americans, but the childhood social environments of Afro-Caribbean participants, influenced them more toward healthier food-, physical activity- and body image-related attitudes and behaviors. In terms of body ideals, Afro-Caribbean women typically identified a smaller “ideal body size” than African-American women. African-Americans from the South, or those with parents from the South tended to choose larger figures than women from the North. Conclusion. Consistent with other SCT studies, this study found attitudes and behaviors that were consistent with those modeled within the participants’ social environments. There are more cultural differences than similarities between African-American and Afro-Caribbean women. The similarities and differences revealed in this study have implications for the design of culturally relevant obesity-related messages.

Background. Obesity has been associated with a number of negative health consequences (e.g., hypertension/heart disease, type-2 diabetes, osteoarthritis, and respiratory illnesses). Despite health communication campaigns to reduce overweight/obesity by encouraging lifestyle changes (e.g., eating healthier foods and exercising), the rates of overweight and obesity levels have continued to rise. Studies indicate that the rate of overweight and obesity in the U.S. is highest among Blacks. Messages targeted toward “Blacks” (African-Americans) in the United States treat this segment of the population as a homogenous group and fail to account for within-group cultural differences. Cultural values and beliefs related to food, physical activity, and ideal body size may contribute to overweight and obesity. Objective. This study was designed to gain a deeper understanding of the similarities and differences between African-American and Afro-Caribbean immigrant women living in the Metro Atlanta, Georgia, in terms of the role that culture and social environments play in forming obesity-related—food, physical activity, and body image—attitudes, values, and behaviors. Method. A social cognitive theory (SCT) framework informed the design of semi-structured interview guides. Study participants were comprised of 13 African-American women and 12 Afro-Caribbean women who recently immigrated to the United States from English-speaking countries. All participants were living in Atlanta, Georgia at the time of the study. They were recruited through convenience and snowball sampling and interviewed between October 5 and December 26, 2014. Data from audio-recorded in-depth interviews were transcribed and analyzed using textual analysis software package NVivo9. Results. African-American and Afro-Caribbean participants were similar in terms of some food-, physical activity- and body-image related attitudes and behaviors. Health-related concerns and matrilineal influence affected the food-related behaviors of both groups of participants. Physical activity and body image-related attitudes and behaviors of women in both groups were affected by the norms of their childhood and current social environments. Although a healthy physical activity lifestyle was important to women in both groups, not all women were consistently physically active. The study also revealed some differences between African-American and Afro-Caribbean participants. In general, the African-American women described the food-related norms of their childhood environments in negative terms and were more likely to have changed their food-related behaviors for health reasons. The Afro-Caribbean women described their childhood food-related norms in positive terms, and thus, strove to maintain healthy behaviors from their childhood. The norms of the current social environments of African-Americans, but the childhood social environments of Afro-Caribbean participants, influenced them more toward healthier food-, physical activity- and body image-related attitudes and behaviors. In terms of body ideals, Afro-Caribbean women typically identified a smaller “ideal body size” than African-American women. African-Americans from the South, or those with parents from the South tended to choose larger figures than women from the North. Conclusion. Consistent with other SCT studies, this study found attitudes and behaviors that were consistent with those modeled within the participants’ social environments. There are more cultural differences than similarities between African-American and Afro-Caribbean women. The similarities and differences revealed in this study have implications for the design of culturally relevant obesity-related messages.

Graduate social work students are mandated to be cultural competent to work with lesbian, gay, and bisexual (LGB) clients. This exploratory study examined how best to teach graduate social work students to be culturally competent in working with LGB clients by assessing their perceived competence of attitudes, knowledge and skills as well as their demonstrated competence through case vignettes. The study compared a current pedagogical method of infusing LGB material across the curricula with two types of brief trainings (didactic lecture and experiential) . This mixed methods study utilized a pretest/posttest design to examine the effects of the trainings as well as qualitative responses from the participants. Results offer suggestions as to which pedagogical approach might be most effective in helping social work students gain competence for working with LGB individuals.

This study examined the extent to which teachers’ levels of cultural competence is a factor in the nomination/referral process for gifted identification of culturally and linguistically diverse students. Specifically, this study compared the self-assessed perceptions of second and third grade elementary teachers’ cultural competence to the various factors included in the gifted referral process. A quasi-experimental quantitative study was used. However, this study superficially included some qualitative exploration due to the nature of the open-ended survey questions and secondary data set analysis. Quantitative data were collected via an adapted version of the Cultural Competence Self-Assessment for Teachers survey created by Lindsey, Robins, & Terrell (2009). Descriptive statistics, analysis of variance, independent samples t-test, and correlation analysis were conducted. Results revealed that there were no significantly statistical differences in the relationship between teachers’ levels of cultural competence and nomination/referral patterns for gifted identification. Yet, the results also indicated that the district’s second and third grade teachers were generally high on the cultural competence continuum. An overwhelming majority of the teachers believed themselves to be culturally competent however, cultural competence sub-scale scores in institutionalizing cultural knowledge and interacting with CLD students were lower percentages when compared to the other sub-scale scores. In general, this study may have important practical implications for the ongoing process of becoming culturally competent, gifted education practices and policy, teacher preparation, and professional practice.