Syfte: Syftet var att studera sjuksköterskors upplevelser av att arbeta med tolksamtal iasylhälsan.Bakgrund: Senaste årens ökande flyktingströmmar har skapat ökat tryck på primärvårdensasylhälsa och behovet av tolkar. Bristande kommunikation kan hindra sjuksköterskansomvårdnad och kunskap om upplevelsen av tolksamtalet i primärvården är därför viktig,något som saknas generellt i forskningen. Socialstyrelsens kartläggning beskrev problem medtillgängligheten av auktoriserade tolkar och en ojämlik situation över landet.Metod: Studien genomfördes som en kvalitativ intervjustudie med sju sjuksköterskor,intervjuerna spelades in, transkriberades och analyserades med manifest kvalitativinnehållsanalys med en induktiv ansats.Resultat: Tre huvudkategorier identifierades: Att tolkens roll påverkar samtalet beskrev hurtolkens professionalitet kunde främja eller störa samtalet samt hur tolkens genus och kulturkunde påverka samtalet. Att sjuksköterskans roll påverkar samtalet beskrev sjuksköterskansprofessionalitet som en förutsättning då de tvingades hitta egna lösningar i arbetet och sinsträvan efter ett vårdande samtal med kontakt och förståelse med patienten. Attorganisationen påverkar samtalet beskrev respondenterna en begränsande organisation medbrist på tolkar, avsaknad av struktur och samarbete mellan vården, tolkförmedlingar ochmyndigheter. Respondenterna beskrev en pressad arbetssituation och behovet av utbildningsom nödvändigt för kvalitetssäkrad vård.Slutsats: Sjuksköterskorna behöver tolken som en brygga för sin röst för att kunna ge godvård. Det finns ett behov av ett systematiskt sätt att arbeta med tolk, med utbildning ochträning för tolkar och sjuksköterskor. Detta skulle kvalitetssäkra vården och förbättraarbetssituationen för sjuksköterskorna. Kompetens inom transkulturell omvårdnad är viktigför rättvis vård i det mångkulturella Sverige. / Aims: The aim was to study nurses' experience of working with interpreter conversations inmigrant health.Background: The last years increase in refugees has created rising demands on migranthealth and interpreters in primary healthcare. Lack of communication can hinder nurses' careand knowledge of the experience of interpreter conversations is therefore important,something lacking in research. The National Board of Health and Welfares survey describedproblems of availability of medical interpreters and an unequal situation nationwide.Methods: The study was a qualitative interview study with seven nurses. Interviews wererecorded, transcribed and analyzed with qualitative content analysis.Results: Three main categories were identified: The interpreter’s role affects the conversationdescribed how interpreter professionality could enable or disable the conversation as couldinterpreter sex and culture. The nurses' role affects the conversation described how theprofessionality of the nurse was essential as they needed to find own solutions workwise aswell as the pursuit of a caring conversation with the patient. The organization affects theconversation described a limiting organization with a lack of interpreters, structure andcooperation between healthcare and authorities. Education was stressed as quality-assurance.Conclusions: Nurses need the interpreter as bridge for their voice to enable good care. Thereis need for a systematic way to work with interpreters through education and Nurse-Interpreter training. This would quality-assure healthcare and improve working conditions.Competence in transcultural nursing is important for equal health care in today's multiculturalSweden

This diploma thesis analyzes if there is communication barrier with foreign patients at the selected intensive care units. We dealt with question whether hospital employees perceive communication with foreigners as a problem or not and how can they solve the problem. The first (theoretical) part is devoted to the role of communication in nursing process and to the definition of term communication barrier. In next chapters we have analyzed the profile of multicultural nursing. Then we focus on the issues of cross-cultural communication and communication barriers in contact with foreigners and the most common causes and techniques used to deal with such situations. We pay great attention to prevention and potential solutions to barriers between cultures and ethnic groups. The motivation for the thesis was supposed effecto of communication gaps on health and higher psychological burden on staff, especially when one of the basic activities of nurses is to educate patients. Research interprets the information obtained from a self-designed questionnaire survey. Questionnaires were distributed to intensive care and resuscitation units in four hospitals in Prague. Statistical evaluation of the questionnaires either confirms or refuses the hypothesis that I set at the beginning of the research. According to...

O presente estudo qualitativo teve como objetivo descrever e compreender o cuidado das crianças no processo saúde-doença sob a perspectiva das famílias de uma comunidade nativa do Peru. O Modelo para Competência Cultural de Purnell foi a base teórica que deu sustentação ao estudo. O método etnográfico com ênfase na etnoenfermagem, utilizando as técnicas da observação participante e da entrevista etnográfica, com cinco famílias durante um período de convivência de quatro meses em uma comunidade nativa; permitiu a compreensão da perspectiva dos informantes sobre o cuidado das crianças. Emergiram três temas culturais do conjunto dos dados: A estrutura sociocultural da comunidade Kabano e seu cotidiano, na qual a função desempenhada por cada membro representa um papel preponderante na estrutura sociocultural e no cotidiano da cultura. A promoção e preservação da saúde na comunidade Kabano é caracterizada por um cotidiano de limitações e dificuldades. Os papéis dos membros da família nuclear, da família ampliada, e do curandeiro e da parteira, referentes às atividades de cuidado cotidianas, visam à promoção da saúde e a vida do coletivo. As práticas no adoecimento das crianças são permeadas por grandes dificuldades apesar do suporte da rede social. As dificuldades são de natureza econômica e provêm das falhas no relacionamento e na comunicação do profissional de saúde com os membros da cultura e os déficits estruturais do estabelecimento de saúde. A assistência à saúde na cultura Kabano se encontra nas etapas iniciais do Modelo para Competência Cultural de Purnell, ou seja, um cuidado caracterizado pela inconsciência incompetente. Os resultados descritos neste estudo, se considerados, podem levar os profissionais a se aproximarem da competência inconsciente para o cuidado cultural da pessoa, da família e da comunidade. / This qualitative study aimed to describe and understand the care of children in the health-illness process from the perspective of the families of a native community in Peru. The Purnell Model for Cultural Competence was the theoretical framework that had supported the study. The ethnographic method with emphasis in the ethnonursing using the participant observation and ethnographic interview techniques with five families, during four months of coexistence in a native community; allowed to understand the informants perspective about the care of children. Three cultural themes emerged from the data set: The socio-cultural structure of Kabano\'s community and their everyday, in which the role played by each member represents a preponderant role in the socio-cultural structure and in the everyday of the culture. The promotion and preservation of health in Kabanos community is characterized by daily limitations and difficulties. The roles of the members of the nuclear family, extended family, and the healer and midwife, regarding the daily care activities, aim at promoting health and life of the collective. Practices in childrens illness are permeated by great difficulties despite the support of social network. The difficulties are of economic kind and come from failures in the relationship and communication between the health professional and the members of the culture and from the structural deficits of the health center. The health care in the Kabano culture is in the early stages of the Purnell Model for Cultural Competence, and characterized by a careful unconscious incompetent. The results described in this study, if they can bring to the professional approach the unconscious competence for cultural care of the person, family and community.

With an increasing migrant population there is a growing need to organize interpreting practices in healthcare in order to deliver equitable high-quality care. This thesis focuses on healthcare institutions’ organization of interpreting services. The aim of the study was to explore interpreting practices in a healthcare context by comparing two different healthcare areas – elderly and emergency healthcare. The study aimed to highlight the impact of the organizational and institutional context. This study was designed as an explorative and descriptive qualitative study including 79 healthcare professionals with experience of interpreting practices recruited via purposeful sampling in elderly and emergency healthcare. Data were collected through individual and focus-group interviews and analysed with inductive qualitative content analysis. The main findings show that the processes and structures around interpreting practices were complex and mainly linked to individual and interpersonal levels and, to a limited extent, to the institutional level. On the institutional level the Public Procurement Act was the only formal policy to follow. On individual and interpersonal level interpreting practices were structured by self-established informal workplace routines developed by the professional groups. The norms and routines used was determined by access to interpreters, time aspects, characteristics of the care given, health conditions and the person’s problem, expectations and requests from the person and also from healthcare professionals. There were wishes for improvement, with better flexibility in access to professional interpreters, training for users and interpreters, and also better technical solutions and equipment. In conclusion, the use of interpreters was rooted in the organizational environment of interpreting practice, including the availability of laws, policy and guidelines, and closely related to individuals’ language skills, cultural values and social factors. The use of professional interpreters was based on the nature of care in context and access to interpreters and determined by health professionals’ estimation of the person’s current health status in order to deliver fast and individualized care based on humanistic values. Thus, it is important to consider organizational framework and cultural awareness when formulating interpreting practices adapted to the context, and formal guidelines in order to achieve the aim of personcentered and equal health care.

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INTRODUKTION Sverige tar emot en stor andel flyktingar och flera kommer till glesbygd. Ett bra mottagande är avgörande för flyktingarnas hälsa. De har rätt till hälsoundersökning, akut sjukvård samt sjukvård som inte kan vänta. Kulturella skillnader innebär utmaningar för vården och distriktssköterskorna som möter flyktingarna. SYFTE Syftet med studien var att undersöka distriktssköterskors upplevelser av faktorer som påverkar mötet med flyktingar på hälsocentraler utan specifik flyktingmottagning i glesbygd. METOD Studien genomfördes med kvalitativ design. Åtta distriktssköterskor med erfarenhet av flyktingmottagande i glesbygd valdes ut och intervjuades. Semistrukturerade intervjuer genomfördes och insamlad data analyserades med kvalitativ innehållsanalys. RESULTAT Ett bra bemötande är viktigt när flyktingar söker vård samt tilltro till flyktingarna när de söker vård som inte kan anstå. Bedömningar av vad som är vård som inte kan vänta har beskrivits som svåra. Kännedom om kulturer har beskrivits som önskvärt. Att prioritera hälsosamtalen har betonats som viktigt. Uppdraget kring flyktingmottagning är tydligt, men resurser saknas och kunskapsutveckling var önskvärd. Positiv utveckling i arbetet med flyktingar i glesbygd har setts och tron är att antalet kommer att öka. Relationerna upplevs mer personliga i glesbygd. KONKLUSION I glesbygd upplevs mötet mer personligt och distriktssköterskorna vill utvecklas och arbeta gränsöverskridande. Flyktingarna har förtroende för vårdpersonalen vilket möjliggör att integration främjas om distriktssköterskan ser det som sitt ansvar och ges resurser. Behovet av kunskap i transkulturell omvårdnad är högst aktuellt och för att tillgodose detta efterfrågas möjligheter till eftertanke och utbyte av erfarenheter. / INTRODUCION Sweden receives a large number of refugees and many of them come to the rural area. A good reception is crucial for the health of the refugees who are entitled to a health assessment, emergency care and care that cannot wait. Cultural differences imply challenges for the health care and primary health care nurses who meet the refugees. OBJECTIVE The aim of this study was to investigate the factors that affect the experience of primary health care nurses meeting with refugees at community health centers without specific care refugee centers in rural areas. METHOD The study was performed with a qualitative design. Eight primary health care nurses with experiences working with refugees in rural areas were sampled and interviewed. Data was collected from semi structured interviews and analyzed using qualitative content analysis. RESULTS A good attitude is important when refugees seek care, and to credence the refugees when they seek health care that cannot wait. Assessments to characterize 'what is care that cannot wait' described as difficult. The knowledge of cultures was expressed as desirable. Prioritizing health assessments were emphasized as important. The assignment in refugee reception is clear, but there is a lack of resources and the wish for knowledge was expressed. Positive development in working with refugees exists and the number of refugees is believed to increase in rural areas. The relationships are perceived more personal in rural areas. CONCLUSION In rural areas, the meeting felt more personal and primary health care nurses wish to develop and operate transboundary. The refugees have confidence in the nursing staff which enables integration and could be promoted by the primary health care nurses if they saw this as their responsibility and were provided proper resources. Knowledge of trans-cultural nursing is needed today in health care and to develop that it demands the opportunity for reflection and exchange of experiences.

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)

The early years of a child's life, especially the first two, are characterized by accelerated growth and significant acquisitions in the development process. The priority in the health care of the child of 0-2 years is recognized by the Ministry of Health with the proposal to protect and foster the integral development of the child in this critical and sensitive period of early childhood. Thus, it is fundamental to investigate how care of children occurs in the family environment, since the family is the first social institution that, together with others, seeks to ensure the continuity and well-being of its members and the community, including protection and The well-being of the child. The objective was to analyze the knowledge and practices of family care in the health care of the quilombola child under 2 years in light of the Leininger Transcultural Theory. Qualitative research, supported by Ethnonursing and the theoretical framework of the Theory of Diversity and Universality of Care of Madeleine Leininger, held in the Quilombola community of Muquém, in the municipality of União dos Palmares-AL. Participants were the main caregivers of children under 2 years of age in this community, totaling sixteen, codenames were used in honor of personalities who were part of the history of the Brazilian quilombola culture in order to preserve their identity. The data collection took place from April to July 2016 in a locus with immersion of the researchers in the field following the four phases of observation, participation and reflection proposed by Leininger. The instruments used in the collection were: field diary, socio-demographic form, observation guide and semi-structured interview, which were recorded. The research was approved by Plataforma Brasil with n ° 1,500,684. The analysis was organized according to the four phases of Leininger's ethnonursing. The first two include recording all data and encoding. The third phase requires the researcher to identify recurrent patterns and the fourth phase the themes. The results were structured in three themes: 1. Knowing the participants of the study 2. Knowledge and practices popular in the daily care of quilombola children; 3. Knowledge and popular practices of care in sickness situations. In the category of Knowledge and Popular Practices in Daily Quilombola Care, the daily care of children from zero to two years of age is predominantly performed by the women of this community. According to the caregivers, the care with hygiene, food and prevention are influenced by the beliefs, customs and rites that are passed on from generation to generation. In the category Knowledge and popular practices of care in situations of illness, it was verified that in these situations the family initially cares for the home, counting on the support network made up of family and friends. These practices are mainly based on the use of medicinal plants and religious practices that are carried out by healers of the community itself. It is concluded that the transcultural theory allows the opportunity to re-signify nursing practice, combining scientific knowledge with popular knowledge. / Fundação de Amparo a Pesquisa do Estado de Alagoas / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Os primeiros anos de vida de uma criança, especialmente os dois primeiros, são caracterizados pelo crescimento acelerado e significativas aquisições no processo de desenvolvimento. A prioridade na atenção à saúde da criança de 0 a 2 anos é reconhecida pelo Ministério da Saúde tendo como proposta a proteção e o fomento ao desenvolvimento integral da criança neste período crítico e sensível da primeira infância. Assim, é fundamental investigar como ocorre o cuidado das crianças no ambiente familiar, pois a família é a primeira instituição social que, em conjunto com outras, busca assegurar a continuidade e o bem-estar dos seus membros e da coletividade, incluindo a proteção e o bem-estar da criança. Objetivou-se analisar os saberes e práticas de cuidado da família na atenção à saúde da criança quilombola menor de 2 anos à luz da Teoria Transcultural de Leininger. Pesquisa qualitativa, apoiada na Etnoenfermagem e no referencial teórico da Teoria da Diversidade e Universalidade do Cuidado de Madeleine Leininger, realizada na comunidade quilombola do Muquém, no município de União dos Palmares-AL. Aprovada pela Plataforma Brasil com n° 1.500.684. Os participantes foram os principais cuidadores das crianças menores de 2 anos dessa comunidade, totalizando dezesseis, foram utilizados codinomes em homenagem a personalidades que fizeram parte da história da cultura quilombola brasileira para preservar a identidade. A coleta de dados ocorreu de abril a julho de 2016, em lócus, com imersão dos pesquisadores no campo, seguindo as quatro fases de observação, participação e reflexão propostas por Leininger. Os instrumentos utilizados na coleta foram: diário de campo, formulário sociodemográfico, guia de observação e entrevista semiestruturada, as quais foram gravadas. A análise foi organizada conforme as quatro fases de Leininger da etnoenfermagem. As duas primeiras incluem a gravação de todos os dados e a codificação. A terceira fase exige que o pesquisador identifique padrões recorrentes e a quarta fase os temas. Os resultados foram estruturados em três temáticas: 1. Conhecendo os participantes do estudo 2. Saberes e práticas populares no cuidado diário à criança quilombola; 3. Saberes e práticas populares de cuidado nas situações de adoecimento. Na categoria Saberes e práticas populares no cuidado diário à criança quilombola, revelou-se os cuidados realizados diariamente às crianças de zero a dois anos são desempenhados predominantemente pelas mulheres dessa comunidade. De acordo com as cuidadoras, os cuidados com higiene, alimentação e prevenção sofrem influência das crenças, costumes e ritos que são repassados de geração a geração. Na categoria Saberes e práticas populares de cuidado nas situações de adoecimento, verificou-se que a família inicialmente realiza os cuidados no domicílio, contando com a rede de apoio constituída por familiares e amigos. Essas práticas fundamentam-se majoritariamente pela utilização de plantas medicinais e práticas religiosas que são realizadas por curandeiras da própria comunidade. Conclui-se que a Teoria transcultural possibilita a oportunidade de ressignificar a prática de enfermagem aliando o saber científico ao saber popular.

Abstract The Giger and Davidhizar Transcultural Assessment Model. Because of the globalization we live in the world where {\clqq}the borders are getting closer`` which also means to live our lives in more multicultural society. That is why a nurse must react to modern nursing care and must be well prepared to cope with specific problems of various communities in their health and illnesses. In my diploma work we deal with transcultural evaluation of nursing care according to the J. N. Giger and R. Davidhizar Nursing Care Models. These models are about regardful and tailored care which we apply to members of Vietnamese community living in the Czech Republic. The theoretic part contains problems of the globalization, migration of foreign people, transcultural nursing, the Giger and Davidhizar nursing care models, information about Vietnam and the model application to members of Vietnamese community living in the Czech Republic. In the practical part we created standard of nursing care named Nursing of Vietnamese patient/client in health care institutions and we are interested in its using in the working practice. Then we found out opinions of people working in health care institutions who work with this standard and found out expectation of Vietnamese patients/clients hospitalized in health care institutions whose findings could help with prevention of hospitalization problems. The goals of the work: 1. Using of modification the Giger and Davidhizar nursing care models with giving care to Vietnamese people in health care institutions 2. To find out cultural changes in nursing process and their influence on behaviour of Vietnamese people in an illness 3. To identify problems and expecting of hospitalized Vietnamese people The research was conducted with the help of quasiexperiment and interview in the Regional Hospital Příbram. We addressed 10 nurses and 6 Vietnamese patients/clients. We must point out that in the year 2007 only 6 Vietnamese people were hospitalized there. The goals of the work were achieved. We hope that our work may help to increase quality and efectivity of the nursing care given to Vietnamese people.