<p>The number of people with another culture is</p><p>increasing in Sweden. This change in society brings</p><p>consequences in health care that has not any methods</p><p>to manage. The Muslim woman’s meeting with the</p><p>health care is one of those areas. The aim with this</p><p>study was to describe the nurses meeting with female</p><p>Muslim patient. The study carried out as a literature</p><p>study and the results which based on 9 articles</p><p>showed the lack of knowledge about culture and</p><p>religion among health care staff. The authors further</p><p>believed that to achieve an adequate result with</p><p>meeting between staff and patient requires</p><p>knowledge about different culture and religion. The</p><p>study shows furthermore a necessity for nurses</p><p>training individually to create instinct in how their</p><p>own cultural opinion affects the nurse in her/his</p><p>profession. The patients felt like nurses had a</p><p>stereotype to doing their job and got very difficult to</p><p>satisfy patients with the needs. In view of the</p><p>circumstances it notifies proposals to improvement in</p><p>the existing health care through curses and seminars</p><p>about culture and religion but even concrete</p><p>information about Islam and Muslim female patient’s</p><p>needed in an institutional care. Madeleine</p><p>Leininger’s theory of culture care was used as the</p><p>conceptual framework and support for the study.</p>

Cultural competence is a topic that concerns social scientists and medical anthropologists who pay attention to demographic changes and health disparities. This study demonstrates practical approaches to developing cultural competence in medical education by using factors from the social environment to develop protocols for action. With current concerns in domestic and global health care, it is evident that health care organizations struggle to deliver culturally appropriate services. Additionally, educational institutions also struggle to evaluate culturally applied medical practices and competencies. Unlike medical competence, cultural competence is seldom evaluated, and as a result, a gap exists in health care delivery. The purpose of this research is to examine the changes in self-assessment of physician assistant (PA) medical students and graduates, as indications of changes in their medical practice and attitudes. Key objectives explore how PA medical students self-assess their own cultural competence; what factors impact their evaluation, and if change indicates cultural competence. The methodology consisted of a qualitative approach designed to conduct focus group discussions, in-depth interviews, and field work, while results of existing quantitative data was used to inform the study. Triangulation methods substantiated the findings along with environmental and data analysis to provide rigor to this investigation. Participants were students and graduates from a Physician Assistant Studies Program in Oregon. Major findings showed changes in participants' cultural competence self assessment due to a change in self-awareness, exposure and experiences with diverse underserved populations, in domestic and international encounters with the real world. In conclusion, change in self assessment had actually occurred, but the change in the quantitative results really portrayed a level of development on a cultural competency continuum, but not cultural competence itself. It followed from these findings that using components which influenced change along with external and internal environmental factors, provided a basis for a model to establish procedures for action. This strategic model, the praxis of cultural competence, takes critical elements or protocols to move medical students from theory to practice. From the results of this study we can see evidence of closing the gap between the theory of cultural competence and culturally competent practices. / Graduation date: 2005

The number of people with another culture is increasing in Sweden. This change in society brings consequences in health care that has not any methods to manage. The Muslim woman’s meeting with the health care is one of those areas. The aim with this study was to describe the nurses meeting with female Muslim patient. The study carried out as a literature study and the results which based on 9 articles showed the lack of knowledge about culture and religion among health care staff. The authors further believed that to achieve an adequate result with meeting between staff and patient requires knowledge about different culture and religion. The study shows furthermore a necessity for nurses training individually to create instinct in how their own cultural opinion affects the nurse in her/his profession. The patients felt like nurses had a stereotype to doing their job and got very difficult to satisfy patients with the needs. In view of the circumstances it notifies proposals to improvement in the existing health care through curses and seminars about culture and religion but even concrete information about Islam and Muslim female patient’s needed in an institutional care. Madeleine Leininger’s theory of culture care was used as the conceptual framework and support for the study.

Actualmente uno de los grandes retos de los sistemas de salud es responder a la creciente prevalencia de enfermedades crónicas. A pesar de los importantes avances en su diagnóstico y tratamiento, su control no se corresponde con el esperado. Explorar la percepción que las personas tienen de su enfermedad permite identificar sus creencias y desarrollar intervenciones más efectivas que tengan en cuenta sus perspectivas y preferencias. Existen diferentes modelos para explicar la percepción de la enfermedad, entre los que destaca el de Autorregulación de Sentido Común que ha generado un creciente interés dando lugar a diversos instrumentos, como el Illness Perception Questionnaire Revised (IPQ‐R), el más utilizado internacionalmente, y el Brief Illness Perception Questionnaire (BIPQ), una versión breve del mismo. Ambos han demostrado tener buenas propiedades psicométricas. El objetivo de este trabajo fue adaptar culturalmente ambos cuestionarios a la población española para disponer de nuevas herramientas en el abordaje de las EC, evaluar su aplicabilidad y profundizar en el conocimiento de la representación de la enfermedad en nuestra cultura. Siguiendo la cronología del proyecto, el texto se estructura en tres estudios: Estudio I. Validación lingüística: Se siguió un método estandarizado utilizando técnicas cualitativas, obteniéndose versiones conceptual y lingüísticamente equivalentes a los cuestionarios originales. Estudio II. Validación psicométrica: Se utilizaron diversas técnicas cuantitativas. Ambos cuestionarios requirieron un alto porcentaje de hetero‐administración. Respecto a la validez, la versión adaptada del IPQ‐R mostró una estructura similar al cuestionario original, excepto por la unificación de las dimensiones representaciones emocionales‐consecuencias. Se destaca relación entre esta dimensión, la identidad y la duración cíclica, y también entre el control de tratamiento, control personal y coherencia, y además, la dificultad de reproducir la estructura del apartado Causas. Los resultados del BIPQ mostraron un agrupamiento de los ítems en dos factores que reforzaron la evidencia de la relación existente entre las dimensiones mencionadas. Las dimensiones del primer grupo mostraron una mayor relación con el estado de salud percibido, en menor grado, con algunas de las medidas de utilización de servicios estudiadas y una escasa asociación con la adherencia a la medicación. Por otra parte, las puntuaciones de ambos grupos permitieron distinguir a las enfermedades estudiadas en dos grupos con un patrón de respuesta similar. Respecto a la fiabilidad, la versión adaptada del IPQ‐R mostró valores de consistencia interna y reproducibilidad menores que el cuestionario original en algunas dimensiones, que podrían deberse a su menor cantidad de ítems, el alto porcentaje de heteroadministración y dificultades en la comprensión de algún ítem. El BIPQ también evidenció una reproducibilidad ligeramente menor en algunos ítems, probablemente relacionada con los aspectos mencionados. Estudio III. Aportación de un grupo focal de entrevistadores al proceso de adaptación cultural: Los entrevistadores proporcionaron nuevas evidencias de validez e identificaron áreas de mejora en el procedimiento de administración y en el contenido de los cuestionarios. Asimismo se comprobó la utilidad de dos estrategias de análisis de los datos textuales, una cualitativa y otra cuantitativa. Los resultados de estos estudios tienen interés tanto para la práctica clínica como para la investigación. A partir de los mismos se dispone de dos instrumentos con puntuaciones válidas y una consistencia aceptable, aplicables en nuestro contexto, para medir la percepción de la enfermedad y tener en cuenta su representación en las personas con EC. A nivel metodológico se han llevado a cabo diversas triangulaciones de métodos y técnicas que han contribuido a enriquecer y garantizar la calidad del proceso. Asimismo, se aportan datos que coinciden con los resultados de otros autores y que plantean interrogantes e hipótesis para avanzar en el conocimiento del modelo teórico de la representación de la enfermedad en nuestra cultura. / One of the major challenges currently confronting health systems is how to cope with the growing prevalence of chronic diseases. Despite the important advances made in their diagnosis and treatment, the degree of control achieved has failed to meet the expectations. Exploring patients' perceptions of their illnesses would enable to identify their beliefs and to develop interventions that take their points of view and preferences into account Among the different models developed to explain illness perception, the Common Sense Model of Self‐ Regulation has generated growing interest and has led to a number of instruments, such as the Illness Perception Questionnaire Revised (IPQ‐R), the most internationally widely use, and the Brief Illness Perception Questionnaire (BIPQ), an abbreviated version of it. Both instruments have proved to have good psychometric properties. The aim of this study was to culturally adapt both questionnaires to the Spanish population, to have new tools for the management of chronic illnesses, to evaluate their applicability and to achieve a deeper understanding of illness representation in our culture. Following the chronology of the project, the text is structured in three studies: Study I. Linguistic validation: A standardized method was followed predominantly using qualitative techniques. Versions conceptually and lingüistically equivalent to original instruments were obtained. Study II. Psychometric validation: Various quantitative techniques were developed. Both questionnaires required a high percentage of interviewer‐based administration. Regarding validity, the adapted version of IPQ‐R displayed a similar structure to that of the original questionnaire, except for the grouping of emotional representation and consequences dimensions. We highlight the relation between this dimension and the identity and cyclical timeline, and also between treatment control, personal control and coherence and, otherwise, the difficulty of reproducing the structure of the Causes section. The BIPQ results provide further evidence of the relationship between the mentioned dimensions Scores of dimensions in first group showed a greater relation with external variables, especially with quality of life and, to a lesser extent, with some measures of health services use, and poor relation with treatment adherence. Otherwise, scores of dimensiones in both groups allowed to distinguish studied illnesses in two groups with a similar response pattern. Regarding reliability, the adapted version of the IPQ‐R showed smaller scores of internal consistency and reproducibility than the original questionnaire in some dimensions, which could be due to some aspects of administration and comprehension. The BIPQ also showed a slightly lower reproducibility in some of its items, probably also related with the mentioned aspects. Study III. Analysis of a focus group of interviewers to the cultural adaptation process: The interviewers provided new evidence of validity and identified potential areas for improvement in the administration procedure and in the content of the questionnaires. Moreover, it showed the usefulness of two strategies for textual data analysis, with qualitative and quantitative approaches respectively, which converged substantially in their key findings. The findings/results of this study have implications for clinical practice and research alike. As a consequence of the presented studies, two instruments are available with valid test scores and acceptable consistency, applicable in our context, to measure the illness perception and consider its representation in people with chronic illnesses. At the methodological level, a number of triangulations of methods and techniques were carried out, that contributed to enrich and ensure the quality of the process. On the other hand, the findings of this work are in line with other authors’ results and raise questions and hypothesis that enable further knowledge of the theoretical model of illness representation in our culture.

The aim of this study is to investigate the transcultural communication experienced by ten registered nurses (RNs) who all have worked in humanitarian aid projects in a transcultural context. I will use communication parameters based on already existing theories and I will also use parameters defined in the Swedish discrimination law to investigate the RNs experiences of transcultural communication. I have used a semi-structured interview method where I have conducted interviews with all ten informants separately. The interview questions have been constructed by myself and are shaped out of the communication parameters and the parameters defined in the Swedish discrimination law. The Result will show which differences the RNs experienced in the transcultural contexts in which they worked. Also that the RNs experiences are a measure of their identity based in Swedishness and their identity as care-providers through the way that they present their transcultural experiences.

Thesis (MA)--University of Montana, 2009. / Contents viewed on November 25, 2009. Title from author supplied metadata. Includes bibliographical references.

Not available / text

Sammanfattning Bakgrund: Allt fler människor immigrerar till Sverige och de flesta av dem kommer att komma i kontakt med sjukvården. När människor från olika kulturer interagerar med varandra ifrågasätts normer och traditioner. Det ligger i en sjuksköterskas intresse att identifiera detta i omvårdnadssituationer, för att ge ett professionellt bemötande och en god omvårdnad.Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av transkulturell omvårdnad i Sverige. Syftet är dessutom att beskriva hur datasamlingen gått till i de granskade artiklarna.Design: Studien har utförts som en beskrivande litteraturstudie.Metod: Tolv vetenskapliga artiklar har granskats och analyserats.Resultat: Vikten av att se individen i omvårdnadssituationen påtalades i flera artiklar och beskrivningar av kulturella skillnader som påverkade sjuksköterskors erfarenheter belystes. Till exempel var sjuksköterskors erfarenheter av kulturell omvårdnad i Sverige till viss del kopplade till rädslor och fördomar i bemötandet av personer från andra kulturer. Genom utbildning kunde sjuksköterskors syn på transkulturell omvårdnad förändras. I resultatet av den metodologiska frågeställningen framkommer det att semistrukturerade intervjuer var den typ av datainsamlingsmetod som användes mest i föreliggande studie.Slutsats: Rädslor och fördomar kunde ses som hinder mellan sjuksköterskor och patienter. En källa till dessa rädslor och fördomar var de kulturella skillnader som kunde förekomma mellan dessa två parter. Det var därför viktigt att sjuksköterskor hade ett holistiskt synsätt som inbegrep människans kulturella bakgrund, oavsett ursprung. Behovet av utökad kunskap och fortsatt utbildning av transkulturell omvårdnad underströks. / ABSTRACT Background: In our contemporary society there have been an increasing number of people migrating to Sweden. Most of these migrants will at some stage seek medical attentions. Norms and traditions might be questioned when people from different cultures interact with each other; it is in the nurses’ best interest to identify and allay possible conflicts, in a professional way, in order to provide a good care.Aim: The aim of this study was to describe nurses’ experiences of transcultural care in Sweden. Furthermore, it also shows how the reviewed articles collected their data.Design: The study is a literature study.Method: Twelve scientific papers were reviewed and analyzed for this study.Result: The literature study urged the importance of the individuality of each patient in order to avoid consternation in either side. Moreover, the study showed the readers on how to identify possible cultural differences that could reflect and/or model nurses’ transcultural experiences. Nurses’ negative experiences of encountering patients from other cultures in Sweden were partially linked to their fears and prejudices; through transcultural education the nurses’ experience of transcultural care would then be positively changed. The result of the methodological aim proves that semi-structured interviews were most commonly used in the following study.Conclusion: Fears and prejudices could possibly create obstacles between patients and their nurses. One of the main sources of these fears and prejudices is the cultural gap between caregivers and their patients. Therefore, it is crucial for a nurse to have a holistic view while adapting their care depending on their patient’s cultural values. Nonetheless, further education and practice in transcultural care are considered necessary.

This thesis explores the relations between Japanese Brazilian youths’ identity development and language use in their transcultural environment. After the amendment of Immigration Control and Refugee Recognition Act in 1990, a number of Nikkei- foreign nationals of Japanese ancestry- came to Japan to work as blue-collar laborers. The majority of those Nikkei were from Brazil since they had suffered an economic collapse since the early 1980s. Japanese Brazilian families are often called as “transcultural/ transnational community” by researchers of Japanese Brazilians as they are frequently forced to move around cities in Japan or between Japan and Brazil in order to find new employment. Applying the theoretical framework of narrative and qualitative content analysis, this thesis listens to the voices of Japanese Brazilian youths living in Japan who have accompanied their sojourner parents. Examining how Japanese Brazilian youths who were raised in Japan developed their sense of belongingness and identity both in the host and immigrant societies is crucial since they have the potential to play an important role in the future of globalization by taking advantage of their multiple language ability and their transcultural background. The voices of Japanese Brazilian youths in this study reveal five main themes related to their transcultural experiences. / Graduate

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