The increasing migration of population in the 21 century causes development of multicultural societies. With the increasing number of foreigners in individual countries it is possible to also presume an increasing number of patients/clients from different cultures in medical facilities. These facts require modern attitude to nursing, developing of transcultural nursing, implementing multi- and transcultural education in the health care education and propagation of multicultural conception of nursing between the nursing personnel. The result of these necessary changes should be the ability to provide effective nursing care which is culturally adjusted to the patient/client that would also take their specifics, customs and traditions of their culture into account and that would saturate all their biological, psychological, social and spiritual needs according to their race, nationality or belief. This thesis deals with multicultural nursing and confronts cultural competence of the nursing staff in Czech Republic with that in German-speaking countries. This thesis aim is to state the level of multicultural competence of the nursing staff and explore conditions provided to the nursing personnel of the hospital for giving culturally adapted care to patients-foreigners. The results of the research give an overview of the state of culturally competent care in comparable medical facilities in Czech Republic, Germany, Austria and Switzerland. They will also give a feedback to the questioned hospitals. Such information may alert their management to possible lack of knowledge of their nursing personnel and help them direct its further education. The theoretical part of the theses defines the basic concepts regarding culture, ethnic groups, race or nation, formulates the difference between the terms "multicultural" and "transcultural" nursing, multicultural education and culturally competent care, compile the most common sections of specific cultural needs of the individuals. In short it also processes J. Campinha-Bacote's model of cultural competence in health care delivery, the Papadopoulos, Tilki and Taylor Model for developing cultural competence and the Purnell Model for cultural competence. It also shortly deals with nursing frameworks for acquiring cultural data, such as the Sunrise model from M. Leininger, the Giger and Davidhizar Transcultural assessment model and Bloch's ethnic/cultural assessment guide. The empirical part processes and evaluates data obtained during the quantitative research. The accumulation of the data was conducted through anonymous questionnaires that were distributed between the nursing personnel of internal and surgical wards of the hospitals in Czech Republic and in German-speaking countries. In Czech Republic these were hospitals in Prague and in Tábor, in Germany a hospital in Dortmund and one in Cottbus, in Austria the hospitals in Salzburg and in Weiz and in Switzerland a hospital in Aarau and one in St. Gallen. The collection of the data was conducted either on-line or by way of printed questionnaire forms. The acquired data were valorized and sorted into diagrams and tables for further clarity. From the respondent´s answers follows that the queried medical facilities in Czech Republic do not provide sufficient conditions for their workers to give culturally competent nursing care on such a level, as it is at the facilities questioned in the German-speaking areas. The results also show that language skills of the nursing personnel in these hospitals in Czech Republic are worse than those in the German-speaking countries. With the level of multicultural competence the situation is similar; in this field Czech nursing personnel does not match their foreign counterpart. It is necessary to remark that this research sample of two hospitals from each of the countries is insufficient for the results to be applied on the whole Czech Republic or German speaking countries.

Medical staff and therefore also nurses may currently more and more often meet patients from foreign countries. It is beyond question that these clients have their own specific biological, psychological and social needs which the nurses should respect. Theoretical part of this assignment describes the issue of trans-cultural nursing, defines it and explains its importance and historical development. It also deals with some of the multi-cultural care models, i.e. the models by Leininger, Giger-Davidhizar, Campinhy-Bacote and Bloch's Ethnic Nursing Care. In general it also mentions conceptual nursing models, their definitions, origin and importance. The following goals were set for this dissertation: Goal 1: Map the issues related to the Leininger's and Giger-Davidhizar's models and their practical use in selected hospitals in the Czech Republic. Goal 2: Find out if nurses use aspects of multi-cultural nursing within their nursing care for foreign patients. Goal 3: Find out how the nurses benefit from using the trans-cultural nursing models for foreign patients within their nursing process. Goal 4: Formulate nursing documents suitable for application of nursing care for foreign patients. Based on the above goals, several research questions were defined: 1. What nursing models are used in selected hospitals in the Czech Republic? 2. How do nursing documents in selected hospitals in the Czech Republic respect nursing process specifics when foreign patients are concerned? 3. Are nurses aware (and in what scope) of the principles of the Leininger's and Giger-Davidhizar's models? 4. How do nurses use trans-cultural nursing models when caring for foreign patients? 5. How do nurses, in their opinion, satisfy foreign patients' biological, psychological and social needs with respect to their cultural differences? 6. How do nurses educate themselves in multi-cultural care? In practical part of the work, nursing documents or anamneses from selected hospitals in the Czech Republic were collected and their content was analysed with focus on multi-cultural aspects identification. Gathered results were then plot in charts. In the next phase of the investigation, semi-structured interviews were held with ten nurses working in standard wards of selected health-care facilities which provided nursing anamneses. Each of the nurses worked in different hospital. The outcome of my dissertation is a draft of nursing anamnesis based on the Leininger's model which is suitable for data collection from patients coming from different cultural backgrounds.

The dissertation aims at the issue of transcultural care in the practice of midwives with a specific focus on Mongolian women, who currently represent the fifth largest group in terms of the number of births of foreigners in the Czech Republic. The theoretical framework of the text consists of chapters on nursing with subsequent differentiation of the field with regard to specialized care in the field of gynecology-obstetrics, as well as the divided subdiscipline of transcultural nursing care. An integral part of the theoretical part of the work are the basic general information about Mongolia and the Mongols. The practical part of the work is represented by my own qualitative and quantitative research. Qualitative research was carried out in the field through in-depth interviews with Mongolian women living in the Czech Republic and having experience with their own childbirth in a Czech maternity hospital. The aim of the research was to uncover possible peculiarities and requirements that a midwife may encounter from Mongolian women in the provision of transcultural care related to pregnancy, childbirth and the postnatal period. Additional quantitative research was conducted in the form of a questionnaire survey among Prague midwives and was focused on finding out the awareness, previous experience...

Bakgrund Idag beräknas 200 miljoner flickor och kvinnor världen över ha utsatts för könsstympning. Det utövas med hänvisning till kultur men fyller inget medicinskt syfte utan orsakar somatiska såväl som psykiska komplikationer och kan i värsta fall leda till död. Övergreppet står i kontrast med mänskliga rättigheter. I dagens globaliserade värld sker transkulturella möten och som sjuksköterska världen över finns en sannolikhet att möta kvinnor som utsatts för könsstympning. Större förståelse och respekt för kulturella skillnader hos sjuksköterskan skulle kunna öka upplevelsen av en god och trygg vård. Sjuksköterskan har möjlighet att uppfylla patienternas behov genom ett transkulturellt omvårdnadsperspektiv och därav finns intresse att belysa vad som har betydelse för att transkulturell omvårdnad ska kunna genomföras för kvinnor som har utsatts för könsstympning. Syfte Syftet var att belysa vad som har betydelse för att transkulturell omvårdnad ska kunna genomföras för kvinnor som har utsatts för könsstympning. Metod I förevarande studie har en icke-systematisk litteraturöversikt genomförts med sökningar i databaserna PubMed och CINAHL. De 17 artiklar som inkluderades i resultatet har kvalitetsgranskats enligt Sophiahemmets bedömningsunderlag och analyserats genom en integrerad analysprocess. Både kvantitativa och kvalitativa vetenskapliga artiklar inkluderades. Resultat Huvudfynden var att bristande kunskap förekom kring kvinnlig könsstympning och förståelse för kulturella aspekter, att relationen var ett viktigt verktyg för att kunna ge en kulturell och individanpassad omvårdnad, kommunikation behövdes för att etablera god relation och kunna identifiera omvårdnadsbehov, och delaktighet kunde bidra till att kvinnorna kände sig trygga inför omvårdnaden. Slutsats Den slutsats som kunde dras baserat på resultaten var att sjuksköterskan kan applicera studiens huvudfynd för att möjliggöra en god transkulturell omvårdnad för kvinnor som utsatts för könsstympning.

Bakgrund: Sverige blir alltmer mångkulturellt, vilket präglar hälso- och sjukvården idag. Sjuksköterskans profession handlar om att ge en god omvårdnad till alla och sjuksköterskan förväntas inneha en allt större kulturkompetens. Trots detta visar studier på att det finns brister i kommunikation och bemötande i den transkulturella omvårdnaden. Syfte: Att beskriva sjuksköterskans upplevelser av den transkulturella vårdrelationen. Metod: En litteraturstudie där materialet från tio kvalitativa studier användes. Resultat: Resultatet presenteras i form av tre teman och fem subteman: Hinder för att utföra en god omvårdnad med subteman språksvårigheter, känslor och dramatik och organisatoriska faktorer, Närstående - en utmaning, Sjuksköterskans syn på transkulturell omvårdnad med subteman avsaknad av utbildning i transkulturell omvårdnad och att vara självmedveten och medveten om kulturella skillnader Slutsats: Även denna studies resultat bekräftar det tidigare studier har sagt om att språkbarriärer är ett stort hinder i den transkulturella vårdrelationen. Språkbarriärerna kunde övervinnas med hjälp av tolk. Då tillgången till tolk inte alltid fanns använde sig sjuksköterskorna av närstående. Närståendes närvaro upplevdes både som något positivt men även som ett hinder i omvårdnadsarbetet. Utbildning i religion och kultur behövs för att bli mer kulturkompetent. Utöver detta behövs livserfarenhet tillsammans med erfarenhet av att arbeta i en mångkulturell miljö. Klinisk betydelse: Det finns ett behov av mer utbildning inom området transkulturell omvårdnad i sjuksköterskans grundutbildning. Tillgängligheten till en auktoriserad tolk bör även underlättas i sjuksköterskans omvårdnadsarbete för att patientens omvårdnadsbehov ska kunna tillgodoses. / Background: Sweden is becoming increasingly multicultural, which characterizes health care today. Nursing profession is all about providing good health care for all, and the nurse is expected to hold an increasing cultural competence. Despite this, studies show that there are gaps in communication and response in transcultural nursing. Purpose: To describe nurses' experiences of the transcultural caring relationship. Method: A literature review where the materials from ten qualitative studies were used. Results: The results are presented in terms of three themes and five subthemes: Obstacles to perform a good nursing with subthemes language difficulties, emotions and drama and organizational factors, Relatives - a challenge, nurse's views on transcultural nursing with subthemes, lack of training in transcultural nursing and being self-conscious and aware of cultural differences. Conclusion: This study's results confirm what previous studies have said that the language barrier is a major obstacle in the transcultural caring relationship. Language barriers could overcome with the help of an interpreter. Since the nurses did not always have access to an interpreter they used relatives. Family’s presence felt both positive, but also as an obstacle in nursing. Education in religion and culture is needed to be more cultural competent. In addition to this life experience along with experience of working in a multicultural environment is necessary. Clinical significance: There is a need for more training in the area of transcultural nursing in nursing education. The availability of a qualified interpreter should also be facilitated in nursing so patients’ needs can be met.

Abstrakt  Bakgrund: Vårdpersonalen möter ständigt individer med en annan bakgrund. Det transkulturella vårdmötet är med andra ord oundvikligt. Detta skapar utmaningar som kräver kompetens hos personer och speciellt i vårdsammanhang inom det mångkulturella samhället. Att vara kulturellt kompetent inom omvårdnad bidrar till att säkerställa personcentrerad vård samt positiva resultat inom arbetet.  Syfte: Syftet med studien var att beskriva vårdpersonalens erfarenheter av det transkulturella vårdmötet.  Metod: Studien var en litteraturstudie baserad på tio kvalitativa artiklar. Databassökningarna genomfördes i PUBMED och Cinahl. Analysen genomfördes med hjälp av Fribergs femstegsmodell.  Resultat: Analysen resulterade i tre huvudkategorier och sju subkategorier. Erfarenheterna som författaren kom fram till i resultatet var att vårdpersonalen kunde uppleva att språkbarriärer orsakade svårigheter med vårdandet av patienter från en annan kulturell bakgrund. Det framkom även att patienter med en annan kulturell bakgrund har ett starkare känslomässigt uttryck och mannen är hushållets överhuvud, närstående kunde även upplevas som störande ibland. Dock har vårdpersonalen en positiv syn och vill lära sig mer om det transkulturella mötet.  Konklusion: Resultaten av denna studie beskriver kommunikation som en stor utmaning såväl som oväntat beteende på grund av kulturella skillnader mellan vårdpersonal och patienter. Effektiv kommunikation visar att en säkrare vård utvecklas och en samsyn bildas. Resultaten visar också att vårdpersonal anser att kulturella kompetenser ständigt är i behov av utveckling. / Abstract  Background: The care staff constantly meets individuals with a different background. In other words, the transcultural care encounter is inevitable. This creates challenges that require competence in people and especially in care contexts within the multicultural society. Being culturally competent in nursing contributes to ensuring person-centered care and positive results in the work.  Aim: The aim of the study was to describe the health care staff's experiences in the transcultural care meeting.  Methods: The study is a literature study based on ten qualitative articles. The database searches were performed in PUBMED and Cinahl. The analysis was performed using Friberg's five-step model.  Results: The analysis resulted in three main categories and seven subcategories. The experiences that the author came to in the result were that the care staff could experience that language barriers caused difficulties with the care of patients from a different cultural background. It also emerged that patients with a different cultural background have a stronger emotional expression and the man is the head of the household, relatives could also be perceived as disturbing at times. However, the care staff has a positive view and wants to learn more about the transcultural encounter.  Conclusion: The results of this study describe communication as a major challenge as well as unexpected behavior due to cultural differences between healthcare staff and patients. Effective communication shows that safer care is developed, and a consensus is formed. The results also show that healthcare professionals believe that cultural competencies are constantly in need of development.

Bakgrund: I dagens mångkulturella värld möter sjuksköterskor personer med olika kulturella bakgrunder och sjuksköterskestudenter behöver utveckla sin transkulturella kompetens för att möta de kulturella behoven som detta medför. Transkulturell omvårdnad innebär att en persons kultur inverkar på omvårdnaden. Fenomenet är nära sammankopplat med personcentrerad vård, i vilka relationsskapande och kommunikation är betydelsefulla aspekter. Sjuksköterskeutbildningen brister i utlärningen av transkulturell omvårdnad och behöver förbättras såväl praktiskt som teoretiskt för att uppnå god omvårdnad. Syfte: Syftet var att beskriva sjuksköterskestudenters kompetens inom transkulturell omvårdnad. Metod:Studien genomfördes som en allmän litteraturstudie med induktiv ansats utifrån elva resultatartiklar. Resultat: Databearbetningen mynnade ut i de två huvudkategorierna Sjuksköterskestudenters upplevda utmaningar under verksamhetsförlagd utbildning samt Sjuksköterskestudenters positiva upplevelser av transkulturell omvårdnad med respektive underkategori Kommunikationsutmaningar och Drivkraft att utveckla transkulturell kompetens. Konklusion: Sjuksköterskestudenter upplever sin transkulturella kompetens som bristande och möter flera utmaningar med att tillhandahålla transkulturell omvårdnad men också positiva aspekter när den tillgodoses. Transkulturell omvårdnad behöver integreras i sjuksköterskeutbildningen för att bättre förbereda studenter för arbetslivet. / Background: In today’s multicultured world nurses will meet people from different cultural backgrounds and nursing students will have to develop their transcultural competence to meet the cultural needs this leads to. Transcultural nursing means that a person’s culture affects the nursing care. The phenomenon is closely connected to personcentered care in which establishing relationships and communication are meaningful aspects. The nurse education lacks in teaching transcultural nursing and needs to improveits practical and theoretical education to attain good nursing care. Aim: The aim was to describe nursing students’ competence within transcultural nursing. Method: The study was made as a general literature review with an inductive approach from eleven result studies. Result: The data analysis ledto the two main categories Nursing students experienced challenges during clinical training education and Nursing students positive experiences of transcultural nursing with respective subcategory Communication challenges and Will to develop transcultural competence. Conclusion: Nursing students experience their transcultural competence as lacking and they meet several challenges to provide transcultural nursing but also positive aspects when it is being accommodated. Transcultural nursing needs to be integrated in the nursing education to better prepare students for working life.

This dissertation reports on the findings of a qualitative, exploratory, descriptive and contextual study into the health beliefs and practices of urban Pares, living in Moshi, Kilimanjaro Region, in Tanzania. The study utilised aspects of the transcultural nursing framework. Semi-structured interviews were used for data gathering with a sample of nine urban Pare informants. Data were analysed thematically. The major findings indicate that health beliefs arise from magico-religious, holistic and scientific paradigms. It was also found that beliefs and behaviour patterns are changing. These findings are discussed in terms of the two major themes, namely, multiple world views and change and continuity. Recommendations arising from the findings are made which may assist health workers to provide culturally congruent care. / Health Studies / (M.A. (Health Studies))

The need for nurses to become culturally competent is well documented in transcultural nursing literature. The subjective multidimensional nature of pain makes it imperative for nurses to use assessment methods that are culturally congruent. This study set out to explore the differences and similarities in conceptualization, experience, expression and management of pain between nurses and clients in the United Arab Emirates. The purpose of the study was to develop guidelines in the cultural pain assessment in the UAE context. The findings confirmed that nurses rely on biomedical approaches in assessment and relief of pain; clients were found to rely on the family for emotional support and on nurses for pharmacological interventions. Clients used sensory descriptors, and analogy when describing pain, nurses relied on the technical background and experience. Religious factors had a significant impact on clients' pain behavior. This study offers nurses new insights into cultural assessment of pain. / Health Studies / M. A. (Health Studies)

South African nurses have accepted the challenge that was brought about by the Health Reform Policy of 1990 which opened health service centres to people of all racial and cultural groups. However, recent studies on multicultural nursing have revealed that problems have occurred when delivering care across cultural barriers. Most of these studies have approached these problems from the patients point of view, where issues of dehumanized care, labelling and discrimination have been reported. Therefore, this study was an attempt to look into these problems from the nurses point of view, by exploring the source of these problems, their effect on health care delivery and possible solutions. The researcher focussed on three critical issues, namely, lack of cultural knowledge, negative attitudes, as well as difficulty in communication. Through focus group interviews (FGI) and responses to given scenarios, student nurses who had experienced problems with culturally different patients were given a chance to reflect on their experiences, report on these experiences and recommend possible solutions to the experienced problems. The results revealed that: 1. The major source of the problems was lack of experience due to inadequate exposure to culturally diverse groups which in tum led to inappropriate decisions and actions at care delivery level. 2.Difficult perceptions and negative attitudes lead to the formation of stereotypes which block the delivery of culturally congruent care. 3 .Inability to communicate due to differences in spoken language lead to difficulty in building the trust relationship and hence inadequate care delivery. / Health Studies / M.A. (Nursing Science)