Advances in technology have made globalization and internationalization a reality in the world. National borders are becoming more permeable and migration of goods, services, and health care workers takes place more readily. Higher Education Institutions (HEIs) have become competitors and vendors in the global knowledge economy and are expected to develop job seekers that are responsible and engaged global citizens and employees. Offering study abroad programmes is one of the ways that HEIs achieve this goal. It is estimated that in 2010, 4.7 million people studied abroad (OECD, 2012:360), and it is anticipated that this number will grow to 15 million by the year 2025 (Altbach & Knight, 2006:9). South Africa is emerging as a regional hub for study and research in sub-Saharan Africa (UNESCO: 2012b). Many organizations that train nurses are internationalizing their curriculum which effectively means that Schools of Nursing are seeking placement for students to study, gain insight into other cultures and practices, and to gain clinical experience in other countries. Students, the customers of the Higher Education Institutions, often pay large sums of money to undertake these study abroad programmes and therefore expect good quality learning experiences in return. The aim of this qualitative, contextual, exploratory, and descriptive study was to explore and describe the expectations and experiences of international nursing students and faculty members at a Higher Educational Institution in South Africa in order to develop standards that will enable HEIs to optimize the experiences of short-term study abroad nursing students. An in-depth contextual investigation was conducted on globalization and internationalization, as well as the higher education and health systems of three countries to understand the context of the study abroad programmes. Qualitative data was gathered from students and faculty members using focus groups and individual interviews to establish their expectations and experiences of the programme. Thematic synthesis was carried out on the contextual data and the qualitative data. Thereafter, thematic synthesis analysis was conducted using both sets of results to develop standards that can be used to optimize the experience of short-term study abroad nursing students at a HEI. A total of 35 standards were developed around the following main themes: the objectives of study abroad programmes should be stated clearly before arrival and include the expectations of the global, national, and local communities, the higher education institution and the staff and students; study abroad programmes should be managed in an ethical manner and in an enabling environment, as part of their strategic goals and plans of a HEI; students should be exposed to a variety of experiences and differences between the sending and hosting countries during their study abroad programmes; Standards to Facilitate Optimal Experiences of Short-term Study Abroad Nursing Students at a HEI; study abroad programmes should be evaluated at different intervals and levels to ensure quality of the programmes and to ensure that the objectives/outcomes are met. A limitation of the study was the sampling of the clinical mentors which did not include representatives from the overseas universities. It is recommended that the standards that were developed in this study be introduced and tested in HEIs and that more research be conducted on different levels and groups with regard to study abroad programmes in future.

Marketers attempting to please a large part of the population in order to gain more customers, already have a demanding job. However, things get even more complicated when the population consists of a variety of cultures, such as in Sweden. With the aim to appeal to people belonging to different cultures, more and more campaigns of transcultural and multicultural content are created. Those campaigns, being controversial, do not go unnoticed and generate a division in views. We have therefore decided to investigate: “How do consumers perceive trans-cultural and multicultural marketing campaigns?” ​and “What are the dimensions of these types of campaigns on buyer behaviour?”. This study will attempt to answer the research questions by exploring the themes of culture and ethics alongside. This is done to clarify the reasons behind the differences among customers’ perceptions on the campaigns chosen. In order to explain the difference between transcultural and multicultural campaigns, two campaigns, one by Åhléns and one by H&M, were used. A qualitative research was conducted by interviewing twelve people, six for each campaign. Based on our results, all of the interviewees stated that culture is directly correlated with ethics. The different perspectives on the campaigns were due to matters of ethicality. Half supported the campaigns due to their inclusiveness while the other half deemed them unethical for different reasons. While everyone associated the campaigns with ethicality, the majority does not take ethics into consideration while shopping. Furthermore, corporate social responsibility proved to have a smaller impact on buyer behaviour than a company’s involvement in an unethical activity that weighs more in consumers’ eyes. Last but not least, even though the customer perceptions on these types of campaigns are divided, there is no direct effect on buyer behaviour, but more towards brand loyalty.

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem, 2015. / Made available in DSpace on 2016-05-24T17:45:42Z (GMT). No. of bitstreams: 1 338818.pdf: 4234834 bytes, checksum: d4a9ec734d90134e99927541b29787ec (MD5) Previous issue date: 2015 / São necessárias iniciativas de segurança do paciente na assistência obstétrica, pois existe uma escassez de dados de segurança e qualidade da assistência nesta área. Esse estudo teve como objetivos: identificar e analisar as abordagens teóricas e propostas processuais utilizadas na adaptação transcultural de instrumentos em estudos desenvolvidos pela enfermagem brasileira; realizar a adaptação transcultural do Maternity Safety Thermometer, para o português do Brasil; e estimar a prevalência instantânea de danos maternos e neonatais e do indicador assistência livre de danos medicante aplicação da versão adaptada transculturalmente do Maternity Safety Thermometer para o português brasileiro (Termômetro de Segurança na Maternidade). Para o primeiro objetivo, realizou-se revisão integrativa. Com a busca na PubMed-Medlilne, CINAHL, SCOPUS, Web of science, LILACS, BDENF e SciELO, incluiu-se 25 artigos, que descreviam o processo de adaptação transcultural de instrumentos usados na prática hospitalar, publicados entre 2005-2014. Para o segundo objetivo, realizou-se pesquisa metodológica de adaptação transcultural, realizando-se os estágios de tradução do instrumento para o português, síntese das traduções, retrotradução, avaliação por um Comitê de 11 experts e o pré-teste. Os dados do pré-teste foram coletados de junho à julho de 2015, mediante entrevista com 30 puérperas e avaliação do instrumento por 40 enfermeiros, em duas maternidades e um Centro de Parto Normal no Rio Grande do Norte. Os dados foram analisados utilizando-se o à ndice de Validade de Conteúdo (valor de referência 0,8) e a média de compreensão global, por meio da Escala de Likert (0 a 2). Para o terceiro objetivo, realizou-se estudo descritivo, quantitativo, nos mesmos locais do pré-teste, com 269 puérperas e 275 neonatos, de julho a agosto de 2015. Os dados foram coletados com o instrumento Termômetro de Segurança na Maternidade e analisados por estatística descritiva e cálculo dos indicadores propostos pelo National Health Service. Apresentam-se os resultados em três manuscritos. No manuscrito 1, destacou-se pontos fortes dos estudos: o cumprimentodos estágios do processo, detalhamento dos procedimentos adotados, validação de conteúdo, e avaliação psicométrica. A ausência de informações importantes do processo de adaptação transcultural foi a fragilidade mais encontrada. No manuscrito 2, o Termômetro de Segurança na Maternidade, foi julgado pelo Comitê de Experts como equivalente do ponto de vista idiomático, semântico, cultural e conceitual e considerado compreensível ao ser pré-testado com puérperas e enfermeiros. No manuscrito 3, a maioria das mulheres teve parto normal (54,6%) e sofreu traumas perineais (77,3%). A episiotomia foi feita em 32,6% e em 0,7% ocorreram lacerações perineais severas; 3,7% puérperas foram admitidas em Unidade de Terapia Intensiva. A hemorragia pós-parto ocorreu em 1,5% mulheres e as infecções em 13,0%. Dos neonatos, 1,1% tiveram escore de Apgar no 5º minuto = 6, 14,9% foram transferidos para Unidade de Terapia Intensiva e 1,5% foram natimortos. Das puérperas, 0,7% referiram terem sido separadas do bebê, 3,7% ter sido deixada sozinha quando preocupada por 17,5% não ter sido levada a sério ao expressar preocupações. Conclui-se que a adoção é exequível do Termômetro de Segurança na Maternidade pelos serviços de saúde, para produzir indicadores de segurança e qualidade da assistência obstétrica.<BR> / Abstract : Initiatives for patient safety in obstetric care are necessary as data on safety and care quality in this area is scarce. The aims of this study were to: identify and analyze the theoretical approaches and procedural proposals used in the cross-cultural adaptation of instruments in studies developed by Brazilian nursing staff; realize the cross-cultural adaptation of the Maternity Safety Thermometer to Brazilian Portuguese; estimate the instantaneous prevalence of maternal and neonatal damage and of the assistance indicator free of injury after application of the cross-culturally adapted version of the Maternity Safety Thermometer to Brazilian Portuguese (Termômetro de Segurança na Maternidade). To achieve the first aim, an integrative review was performed. After a search on PubMed-Medlilne, CINAHL, SCOPUS, Web of science, LILACS, BDENF and SciELO, 25 articles were included which described the process of cross-cultural adaptation of instruments used in hospital practices, published between 2005-2014. For the second objective, methodological research on cross-cultural adaptation was conducted, realizing the stages of translation of the instrument into Portuguese, translation synthesis, back translation, assessment by a Committee of 11 experts and the pilot test. Data from the pilot test was collected between June and July, 2015 through interviews with 30 mothers and assessment of the instrument was carried out by 40 nurses, in two maternity hospitals and a alongside birth center in Rio Grande do Norte. The data was analyzed using the Content Validity Index (reference value 0.8) and the global comprehension average, using the Likert Scale (0 to 2). For the third aim, a descriptive quantitative study was conducted in the same places as the pilot test, with 269 mothers and 275 newborns, from July to August, 2015. The data was collected using the Maternity Safety Thermometer and analyzed by descriptive statistics and calculation of the indicators proposed by the National Health Service. The results are presented in three articles. In article 1, the strengths of the studies are outlined: compliance of the process stages, detailing of the adopted procedures, content validity, and psychometric assessment. The weakness mostencountered during this study was the absence of important information on the cross-cultural adaptation process. In article 2, the Maternity Safety thermometer was deemed equivalent by the Experts committee in the idiomatic, semantic, cultural and conceptual sense and it was considered comprehensible when pre-tested on mothers and nurses. In article 3, the majority of women had a natural birth (54.6%) and suffered perineal trauma (77.3%). An episiotomy was performed on 32.6% and in 0.7% severe perineal tears occurred; 3.7% of mothers were admitted to the Intensive Care Unit. Postpartum hemorrhage occurred in 1.5% of women and infections occurred in 13.0%. Of newborns, 1.1% had an Apgar score in the 5th minute = 6, 14.9% were transferred to the ICU and 1.5% were stillborn. Of the mothers, 0.7% reported being separated from their baby, 3.7% reported being left alone when worried and 17.5% reported not being taken seriously when expressing concerns. It can be concluded that adoption of the Maternity Safety Thermometer by the health services is advisable in order to produce safety and quality indicators for obstetric care.

During the preliminary phase of analytical discourse on South Asia’s medieval history, the scholarship rigidly demarcated the material cultures of the pre-Islamic societies from those of the Muslim communities that were only introduced to the region’s landscapes once the Islamic political rule was established. This was done to simplify the process of examining the regional, religious, ethnic, political, and cultural disparities in the Indian subcontinent’s medieval milieu. Consequently, the exceedingly broad categories of “Muslim” and “Hindu” were conceived to portray the identities of South Asian societies and cultures. However, these categories remain in use even in the current art-historical scholarship that shows a tendency to classify the historical artifacts based on either geographic or sectarian identities. To that end, the sites developed by Muslim rulers are termed as “Islamic/Muslim,” and Hindu temples as “Indian.” Such simplistic classifications, which identify the social and material cultures with singular monolithic identities, overlook the dynamics of intercultural and interfaith interactions between the diverse co-existing communities of South Asian regions that played an active role in shaping those cultures. The Samma dynastic architecture in the vast necropolis of Makli – a UNESCO world heritage site located in the city Thatta (in present-day Sindh province of Pakistan) – presents an opportunity to examine this key methodological issue. Modern scholars classify Samma architecture under the polarities such as “Sindhi,” “Islamic,” and “Indo-Islamic.” The present research challenges these classifications to demonstrate that the overall artistic program of Samma architecture does not reflect any single culture, religion or region. In fact, it evinces a hybridization of style and character, and hence, transcends the standard categorization of architectural artifacts from South Asia. Therefore, by actively engaging with the architecture, decoration, and epigraphy, this study allows for the formulation of important conclusions on the meanings attached to the Samma dynastic architecture, which was a key medium of presenting their social, religious, political and cultural programs. Additionally, this study demonstrates where Samma monuments fit within the broader categories of artistic productions from South Asia as well as the wider Islamic world. Hence, where this research augments the overly broad and simplified classifications, it also aims to produce a more meaningful analytical framework that moves beyond visual analysis, iconography, and typology. / Graduate / 2021-11-15

Public health nurses are required to communicate important communicable disease and preventative health information to an increasing number of immigrants and refugees accessing the American public health system. They must also obtain information on a broad scope of topics about clients and/or their children. Little attention has been paid to the study of intercultural communication between public health nurses and their diverse clientele. The purpose of this study was to identify barriers affecting communication between public health nurses and their immigrant and refugee clients. The Developmental Model of Intercultural Sensitivity developed by Milton Bennett provided a conceptual framework for review and analysis of study results. Data were collected using semi-structured formal interviews with a network sample of 17 nurses. Analysis of the data indicated four major themes: (1) common use of a Western- European, ethnocentric communication style; (2) insufficient recognition of how the dominant culture's values, beliefs, and behaviors affect those from non-dominant cultures; (3) inadequate or irrelevant prior diversity training; and ( 4) lack of available and competent interpreters necessary for translation of information during interviews. These categories capture the essential barriers preventing effective communication with culturally diverse clients. From the perspective of the nurses, communication barriers due to cultural or language differences result in difficulty obtaining compliance with public health mandates such as childhood immunization and medication regimens, and limit understanding of preventative healthcare practices. The results of this study provide information and insight for the development of intercultural sensitivity training for public health nurses. A training program that demonstrates cultural training theory, methods, and suggested sequencing is included. An additional sample training outline follows that offers public health nurses culture specific information regarding Hmong refugees.

Bakgrund: Globaliseringen i samhället ökar och i dagsläget är strax över två miljoner av Sveriges befolkning utrikesfödda. Sjuksköterskans krav på kulturell kompetens ökar då mötet med människor från olika kulturer förekommer i större utsträckning än tidigare. Kulturell kompetens är viktigt för att tillhandahålla en individanpassad omvårdnad. En sjuksköterska ska visa respekt för en människas kultur och vara medveten om att uttryck för respekt och omsorg skiljer sig mellan personer och kulturer. Syfte: Att beskriva sjuksköterskans erfarenheter av att ge transkulturell omvårdnad. Metod: En litteraturstudie med deskriptiv design. Resultatet sammanställdes med hjälp av elva vetenskapliga artiklar med kvalitativ ansats. Huvudresultat: Resultatet av litteraturstudien påvisade att kulturell kompetens hos sjuksköterskor hade stor betydelse för kvalitén på omvårdnaden. Sjuksköterskor upplevde transkulturell omvårdnad som utmanande men även lärorikt, då de ansåg att den kulturella kompetensen och förståelsen för andra kulturer ökade i samband med att de vårdade patienter från andra kulturer. Sjuksköterskor upplevde att patientsäkerheten blev lidande eftersom det många gånger förekom språkförbistringar och svårigheter att kommunicera med patienter och närstående. Resultatet visade att det fanns en stor efterfrågan hos sjuksköterskor beträffande utbildning inom transkulturell omvårdnad för att utöka deras kulturella kompetens. Slutsats: Möten med människor från olika kulturer blir en större del av sjuksköterskeprofessionen på grund av den ökade globaliseringen. Sjuksköterskans centrala roll i omvårdnaden gör att detta ställer högre krav på den kulturella kompetensen hos sjuksköterskan för att kunna tillgodose en individanpassad vård utifrån kulturella önskemål. / Background: Globalization in society is increasing and at present, just over two million of Sweden's population are foreign-born. The nurse's requirements for cultural competence increase as encounters with people from different cultures occur to a greater extent than before. Cultural competence is important for providing individualized care. A nurse must show respect for a person's culture and be aware that expressions of respect and care differ between people and cultures. Aim: To describe the nurse's experiences of providing transcultural care. Method: A literature study with descriptive design. The results were compiled with the help of eleven scientific articles with a qualitative approach. Main result: The results of the literature study showed that cultural competence in nurses is of great importance for the quality of nursing. Nurses experienced transcultural nursing as challenging but also instructive as they felt that the cultural competence and understanding of other cultures increased in connection with the care of patients from other cultures. Nurses experienced that patient safety suffered because there were often language confusions and difficulties in communicating with patients and relatives. The results showed that there was a great demand among nurses regarding training in transcultural nursing to expand their cultural competence. Conclusion: Meetings with people from different cultures are becoming a bigger part of the nursing profession due to the increasing globalization. The nurse's central role in nursing means that this places higher demands on the nurse's cultural competence in order to be able to satisfy an individualized care based on cultural wishes.

Bakgrund: Med ökad globalisering kommer sjuksköterskor möta personer med annan kulturell bakgrund än sin egen. Statistik har visat att många personer födda utanför Europa som immigrerat upplever nedsatt psykiskt välbefinnande. Det har visat sig att medvetenheten för kulturella skillnader inom vården är låg. Det finns därmed en risk för att denna omedvetenhet påverkar emigranters redan nedsatta psykiska hälsa ytterligare. Med hjälp av kunskap genererad i aktuell forskning önskat vi att synliggöra sjuksköterskans upplevelser av att möta personer med annan kulturell bakgrund än sjuksköterskans egen eftersom det är i synliggörandet som beteenden kan ändras. Syfte: Syftet var att belysa hur sjuksköterskan beskrev omvårdnad av patient med annan kulturell/etnisk bakgrund inom hälso- och sjukvården. Metod: En litteraturöversikt med kvalitativ ansats gjordes genom att söka artiklar på PubMed och CINAHL. Resultatet baserades på 15 artiklar.  Resultat: Sjuksköterskorna beskrev kommunikationshinder och svårigheter med kulturella skillnader i omvårdnaden av patienter med annan kulturell bakgrund. De kommunikationshinder beskrevs som tidskrävande och ledde till vårdrelaterade utmaningar. De svårigheterna med kulturella skillnader speglade olika syn på död, manligt och kvinnligt och anhöriga. Slutsats: Hög arbetsbelastning och liten förståelse för kulturella skillnader leder till att patienter med annan kulturell bakgrund inte får lika vård på lika villkor. / Background: With increased globalization, nurses will meet people with a different cultural background than her own. Statistics have shown that many immigrating people born outside Europe experience reduced mental well-being. A problem arises when awareness of cultural differences is low. With the help of knowledge generated in current research, it is needed to make the nurse's expectation and way of meeting people with a different cultural background positive, as it is in the nurses behaviors that this can be changed. Aim: The purpose was to shed light on how the nurse described caring for patient with different cultural / ethnic background in health care. Methods: A litteratur review with a qualitative design, based om 15 scientific articles found on PubMed and CINALH.  Result: The nurses described communication barriers and difficulties with cultural differences in the care of patients with different cultural backgrounds than their own. The communication barriers were described as time-consuming and led to healthrelated challenges. The difficulties with cultural differences described reflected different views on death, male and female gender and relatives. Conclusion: High workload and little understanding of cultural differences mean that patients with different cultural backgrounds do not receive equal care on equal terms.

The thesis deals with pregnancy and childbirth among Roma women in the context of transcultural care. In the theoretical part, three main topics relevant to the subject of the thesis are addressed: (i) transcultural care and its development both abroad and in the Czech Republic, (ii) the Roma way of life with a special focus on those aspects affecting the way of perceiving and experiencing the pregnancy and childbirth by Roma women, and (iii) recent trends in providing care to pregnant and labouring women. The empirical part includes a qualitative research into how Roma women perceive and experience pregnancy and childbirth, and what characteristics from the perspective of midwives make them different from the majority society women. Using qualitative research based on interviews with Roma women and midwives I gained valuable data upon which I have identified cultural differences which may affect Roma women's access to prenatal care, the manner of pregnancy planning, and the perception of pregnancy or parturition itself. Based on these findings, I have analysed the applicability of the transcultural care model to Roma women. The main objective is to help midwives to better understand different situations they may encounter during the caregiving Roma women. Key words: culture, transcultural care,...

Background: Due to a high influx of refugees in the last decades, which will most likely continue to increase, a need for the healthcare to be involved in taking care of these refugees has been established. People on the run has often lived under difficult circumstances for a long period of time which leaves them exposed which in turn can lead to vulnerable situations. According to the code of ethics it is therefore important that the nurses therefore treat all people with respect and dignity, regardless of their cultural origin or background, in order for everyone to receive the care they are entitled to. Aim: The aim of this study was to describe nurses experiences encountering refugees within the healthcare system. Method: 11 scientific articles, ten articles was qualitative and one was a mixed method, was the base of this literature study. Results: The main findings of this study showed that nurses do find it challenging to deal with people from different backgrounds and the cultural variances that comes with it. This is not made easier by the constant time pressure they are being under. Difficulties when it comes to working with interpreters was also seen as a subject that determined the nurses experiences. The relationship between the nurse and the refugee was seen as important but could complemented by guidelines that doesn´t correspond with the code of ethics. Discussion: Based on these results it was apparent that nurse´s did not have enough competence when it comes to handling cultural differences when meeting with refugees which displayed a need for an expanded education with main focus being on culture and the nurse´s approach. As communication and culture was fundamental throughout the result it was discussed with the support of Madeleine Leininger's transcultural nursing theory.

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