BACKGROUND Public Health Nurses (PHNs) in the Province of Eastern Finland are facing a new situation when the families attending maternal and child health (MCH) services represent increasingly diverting cultural backgrounds. Cultural competency is a part of PHNs’ qualification demands in Finland, however little is known on the phenomenon in the study area at the moment. AIM This study aims to describe how cultural competence is understood and constructed among PHNs and PHN students working and training in the MCH clinics in the Province of Eastern Finland. METHODS Qualitative design was employed. Data were collected in five semi-structured individual interviews and two focus group discussions conducted in Finnish by author. Data were audio-recorder, transcribed and analysed through qualitative content analysis (QCA). Translation to English took place during the QCA process. The total number of participants was 15. FINDINGS The participants perceived culture as a multi-dimensional phenomenon, and that specific skills are needed when meeting clients from different cultures. Cultural competence in this sample refers to a four-staged process which is highly affected by social processes and interaction between the PHNs, students, clients and other stakeholders in MCH care and community. CONCLUSION This study can serve as an explanatory material to fill the knowledge-gap between the previously published theoretical studies on cultural competence and the grass-root level MCH work. The findings represent perceptions and experiences of highly educated, native Finnish sample working in a relatively rural province, and thus their transferability should be viewed with criticism.

Despite the fact that the United States spends more per capita than any other nation on healthcare for its citizens, the quality of American health outcomes lags well behind every other developed country in the world. This paper proposes that it is no coincidence that the United States is also the only developed nation that does not guarantee the right comprehensive coverage of medical services for its citizens. Instead, we rely on a fee-for-service system which functionally denies quality health care to those without the means to pay for it. In this paper I document the experiences of various clients and staff of the Center, a torture survivor treatment and support agency, the majority of whose clients are or were refugees or political asylees, with the healthcare systems in the United States and elsewhere. I also analyze documented differences in the efficiency, efficacy, and levels of satisfaction with these foreign health care systems to that of the United States. The barriers to good quality health care experienced by the participants in this research are systemic, rather than individualistic, in nature. I therefore argue that the American ideology of health as a commodity to be bought and sold directly contributes to the inferior health outcomes of the United States health care delivery system, as compared to other nations whose ideology of health holds it to be a universal human right.

This embedded case study examined middle school principals' self-reported cultural awareness, teachers' self-reported cultural awareness, and principals' influence on cultural awareness in the school. In addition, the study focused on how principals influenced teachers' cultural awareness and implementation of multicultural education, and culturally responsive curriculum and pedagogy in classrooms.The conceptual framework for the study was based on theoretical perspectives of Banks' (1999) Eight Characteristics of the Multicultural School, Gay's (2003) Culturally Responsive Curriculum and Pedagogy, and Lindsey, Roberts, and CampbellJones' (2005) Cultural Competence Continuum. Two principals and 10 teachers from two schools volunteered to participate in the study. The methodology included the development and use of semi-structured principal and teacher interview instruments, a teacher classroom observation instrument, and an instrument for analysis of curriculum documents. Findings revealed variable levels of participants' cultural awareness and competence, pedagogical practices, and curriculum implementations. A triangulation of data sources from interviews, observations, and documents suggested that the two principals' leadership conveyed similarities and differences in influencing teachers' cultural awareness and supporting their implementation of culturally responsive curriculum and pedagogy within classrooms.

The U.S. Census bureau projects that by 2023, minorities will comprise more than half of all children. The population of school-aged Hispanic children is already the largest ethnic group, and the sheer number and rate of increase of these linguistically and culturally different students creates unfamiliar cultural challenges for school leaders. School districts are confronted with diversity-related issues and school leaders, who are predominantly white and middle class, are often ill-prepared to meet the challenges. Effective professional development aimed at preparing school leaders to better understand the social and academic needs of culturally diverse students is a topic receiving much attention in recent years. Studying the social, cultural, and political circumstances of diversity in its natural setting offers particular advantages that other methods cannot replicate. One suggestion is for school leaders to spend time in the local communities of their Hispanic students. Another option for learning about culture, albeit a more difficult and costly one to achieve, is to have school leaders visit the home country of their Hispanic students and immerse themselves in the local culture for a short period of time. A school district in Georgia decided to provide authentic culture learning for some of its school leaders through a short term cultural immersion experience. The purpose of this study was to examine the effects of an eight-day cultural immersion trip to Xalapa, Mexico on school leaders from the Mary County School District in Georgia. Because this short-term cultural immersion experience was aimed at increasing the cultural awareness of school leaders and improving relationships with Hispanic students and their families, the primary focus of this study is to explore the meanings attached to the experiences of administrators participating in the trip.

Bakgrund: I sjuksköterskans kompetensbeskrivning ingår att tillgodose patienters olika behov, däribland de kulturella behoven. Detta ställer höga krav på att sjuksköterskor ska besitta kulturell kompetens för att behärska att arbeta i den mångkulturella vården. God kommunikation mellan sjuksköterska och patient är grundläggande för en god omvårdnad. Syfte: Att beskriva sjuksköterskans erfarenheter av faktorer som påverkar ett kulturmöte mellan en sjuksköterska och patient. Metod: En litteraturstudie med grund i analys av kvalitativ forskning genomfördes. Resultat: Resultatet presenteras i tre kategorier och sju underkategorier: kommunikation med underkategorierna språkbarriärer och bristen på tolk, kulturskillnader med underkategorierna olika sätt att hantera traumatiska händelser, skilda matvanor, fördelar och nackdelar med anhörigas medverkan i omvårdnaden och sjuksköterskors upplevelser i vårdarroller med underkategorierna värdet av kulturell kompetens och kulturell medvetenhet hos sjuksköterskor och etnocentrism – ett hinder för individanpassad vård. Slutsats: De faktorer som präglade den mångkulturella vården var ofta kopplat till sjuksköterskors brist på kulturell kompetens. Denna studies resultat påvisar att språkbarriärer är det största hindret i kulturmöten, vilket bekräftas av tidigare studier. Klinisk betydelse: Sjuksköterskor möter dagligen patienter med annan kulturell bakgrund än sin egen. Detta ställer ökade krav på sjuksköterskor att de besitter kulturell kompetens för att kunna utföra en professionell omvårdnad oavsett patientens kulturella bakgrund. / Background: Included in the description of competence for registered nurses is catering to the different needs of patients including their cultural needs. This puts high demands on nurses to possess cultural competence in order to master working in multicultural health care. Good communication between nurse and patient is essential in order to provide good care. Aim: To describe the nurse’s experiences of factors affect encounters between a nurse and a patient from different cultures. Method: A literature review with a basis in qualitative analyses was conducted. Results: The results are presented in three main themes and seven sub themes: communication with sub themes language barriers and nurses' experiences of difficulties with interpreters, cultural differences with sub themes various ways of coping with traumatic events, cultural eating habits, the families participation in the care and nurses' experiences of being in the role of carer with sub themes the value of cultural competence and cultural awareness for nurses and ethnocentrism – an obstacle for individualized care. Conclusion: The factors that characterized the multicultural care were often related to nurses’ lack of cultural competence. This study shows that language barriers are the biggest obstacles in encounters with patients from different cultures, which is verified by previous studies. Clinical significance: On a daily basis nurses encounter patients with a different cultural background than their own. This puts increased demands on nurses to possess cultural competence in order to practice professional care regardless of the cultural background of the patient.

SAMMANFATTNING Introduktion: Statistiska centrabyrån (SBC) prognostiserar en växande andel utlandsfödda bland Sveriges befolkning. Detta medför en ökad kulturell mångfald i det svenska samhället och därmed fler tvärkulturella möten inom vården. Denna studie sökte att utforska primärvårdssjuksköterskors upplevelser av möten med patienter från utomskandinaviska kulturer, vilka svårigheter de kan stöta på samt vilka aspekter de upplever som viktiga vid vårdandet av dessa patienter. Metod: En kvalitativ intervjustudie med deskriptiv design. Åtta primärvårdssjuksköterskor som arbetar på olika vårdcentraler i Stockholmsområdet och som har erfarenhet av kontakt med patienter från andra kulturer än den skandinaviska intervjuades med en semi-strukturerad intervjuguide. Innehållsanalys enligt Graneheim & Lundman användes för att analysera data. Resultat: Primärvårdssjuksköterskor upplever dessa möten som spännande, utmanande och lärorika. Kulturell samt etisk kompetens är nödvändigt för arbetet inom detta område och behov av formell utbildning identifierades.  Slutsats: Den växande kulturella mångfalden i Sverige medför fler tvärkulturella möten inom vården. Primärvårssjuksköterskors upplevda svårigheter, deras negativa och positiva upplevelser vid dessa möten samt deras synsätt på utbildning inom området stärker betydelsen av att besitta tillräcklig kulturell kompetens för vårdandet av dessa patienter. Detta innefattar bland annat sjuksköterskans lärande om de olika kulturerna som finns representerade i samhället där sjuksköterskan tjänstgör och en anpassning av omvårdnaden utifrån patientens behov. Således är det angeläget för sjuksköterskor att genom formell utbildning införskaffa sig denna kompetens. / ABSTRACT Introduction: The statistics centers Agency (SBC) forecasts a growing proportion of people born in foreign countries among the Swedish population. This results in increased cultural diversity in Swedish society and thus more cross-cultural encounters in health care. This study sought to explore primary care nurses’ experiences of encounters with patients from non-Scandinavian cultures, the difficulties they may encounter and what aspects they consider to be important in the care of these patients. Method: A qualitative interview study with descriptive design. Eight primary care nurses who work in various primary health care centers in the Stockholm area and have experience of contact with patients from other cultures than the Scandinavian were interviewed with a semi-structured interview guide. Content Analysis according Graneheim & Lundman was used for data analysis. Results: Primary care nurses perceive these meetings as exciting, challenging and educational. Cultural competence is necessary for work in this area and a need for formal education was identified. Conclusion: The growing cultural diversity in Sweden entails more cross-cultural encounters in health care. Primary care nurses’ perceived difficulties, their negative and positive experiences from these meetings and their approaches to education in the field strengthen the importance of possessing sufficient cultural competence for the care of these patients. This includes the nurse’s learning about the different cultures that are present in the community in which he or she serves and an adaptation of the nursing care based on the patient’s needs. Thus, it is of significance that nurses seek to acquire this competence through formal education.

This thesis explores the relevance of Bio Data verses Personality for predicting Cultural Competence among Industrial and Organisational Psychology and Human Resource Management professionals and students in New Zealand. It also explores the relevance of the model (D.W. Sue, 2001) of Cultural Competence currently in use by the New Zealand Psychologists board and also the relevance of a four factor model of Cultural Intelligence (Early & Ang, 2003). The sample consisted of 113 participants drawn from a population of Industrial and Organisational Psychology, and Human Resource Management professionals and students. A questionnaire which measures the predictors of the Big Five Personality Factors (Goldberg, 1999), and Bio Data, and the criterion variables of Cultural Intelligence (Earley & Ang, 2003) and questions constructed specifically for this thesis was distributed online. The criterion variables were based on an existing three part (Awareness, Knowledge and Skills) Multidimensional Model for Developing Cultural Competence by D.W. Sue (2001). The results of this research were obtained through exploratory factor analysis and subsequent multiple regression analysis. A new model was constructed to represent the tested predictor and criterion relationship. Results suggest that overall Personality is a better predictor of Cultural Competence, with the Personality Factor of Agreeableness being the highest weighted Personality Factor. D.W Sue’s (2001) Multidimensional Model for Developing Cultural Competence maintained its three part structure in the analysis and consequently seems relevant to the unique socio-cultural, organisational and professional setting of the tested group. Ang and colleagues (Ang, Van Dyne, Koh, Ng, Templer, Tay & Chandraseker, 2007) Cultural Intelligence Scale maintained its four part factor structure and was reliable for this thesis.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. / Includes bibliographical references (p. 155-158).

Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2009. / Directed by Judith Niemeyer; submitted to the Dept. of Specialized Education Services. Title from PDF t.p. (viewed Jun. 7, 2010). Includes bibliographical references (p. 202-213).

Thesis (Psy.D.)--James Madison University, 2010. / Includes bibliographical references.