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Results for “Cultural Competency”

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PubMed2005

Cultural competence of nurse practitioner students: a consortium's experience.

Professional standards require culturally competent care, but competencies are rarely assessed. An instrument adapted from the work of cultural competence experts was used to assess the cultural competence of nurse practitioner students (n = 122). The 30-item instrument indicated adequate reliability scores (.78 to .87). Students reported high levels of comfort with people who are different from themselves and felt that cultural knowledge was important. Students scored fairly low on engaging in community-related culturally relevant behaviors. Predictors of culturally competent behaviors in clinical practice and the community were: comfort with others who are different from themselves, the degree of importance attached to cultural knowledge, and likelihood of future practice in rural areas. Nurse practitioner programs need to concentrate on increasing students' comfort with culturally diverse client groups and stressing a deeper cultural knowledge in clinical practice.

Adult↗

PubMed2000

Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model.

This article develops a conceptual model of cultural competency's potential to reduce racial and ethnic health disparities, using the cultural competency and disparities literature to lay the foundation for the model and inform assessments of its validity. The authors identify nine major cultural competency techniques: interpreter services, recruitment and retention policies, training, coordinating with traditional healers, use of community health workers, culturally competent health promotion, including family/community members, immersion into another culture, and administrative and organizational accommodations. The conceptual model shows how these techniques could theoretically improve the ability of health systems and their clinicians to deliver appropriate services to diverse populations, thereby improving outcomes and reducing disparities. The authors conclude that while there is substantial research evidence to suggest that cultural competency should in fact work, health systems have little evidence about which cultural competency techniques are effective and less evidence on when and how to implement them properly.

Acculturation↗

PubMed2004

Race, place, space: meanings of cultural competence in three child welfare agencies.

Despite a consensus on the need to take culture into account in social services delivery, remarkably little data is available on the processes of culturally competent organizational development. This article addresses how workers, supervisors, and managers involved in culturally competent organizational change perceive the goals and dilemmas of these efforts during the initial stages. Data are drawn from three nonprofit child and family agencies in one metropolitan area. The data demonstrate that cultural competence means disparate and conflicting things to differently positioned members of each organization. The authors argue that conflicts may be inherent in the process of culturally competent organizational development, particularly to the extent that such efforts attempt to redistribute power in the workplace. Efforts to develop cultural competence must identify, surface, and renegotiate these conflicts.

Attitude of Health Personnel↗

PubMed1999

Indigenous people and the social work profession: defining culturally competent services.

During the past decade much has been said about the need to include cultural issues as a factor in the helping process. The discussion in social work literature has moved from cultural sensitivity to cultural competence, the ability to integrate cultural knowledge and sensitivity with skills for a more effective and culturally appropriate helping process. This article reports the results of a study of culturally competent helping practices with Native Americans. Sixty-two Native American social workers and social work students completed a survey on knowledge, skills, and values necessary for culturally competent service provision to Native American clients. As both Native Americans and helping professionals, the survey respondents are in an ideal position to articulate how best to serve the Native American population. This article fills a gap in the literature by providing empirical information on culturally competent social work with Native Americans.

Cultural Diversity↗

PubMed2001

Cultural competence for critical care nursing practice.

Cultural information should be critically examined and appropriately used in the context of individual relationships. The increased ethnic minority population in the health care system mandates that differences be recognized and responded to. Furthermore, the linear and technologic environment of the critical care unit intensifies the potential for cultural dissonance and disempowerment of ethnic minorities. CCNs must be creative and willing to transform nursing care to meet the needs of all. Knowing one's self, being aware of limitations, and understanding the influence of culture on others are essential to being culturally competent and an effective CCN. Because nursing remains dominated by individuals from the majority culture, many have little experience with persons of diverse ethnicity. Increasing cultural knowledge and the numbers of minority nurses and translators in the ICU are only the start to providing holistic care to this country's diverse population. Patient outcomes should improve and nurses are greatly enriched from an understanding and achievement of cultural competency.

Clinical Competence↗

PubMedDate not supplied

Cultural competence case scenarios for critical care nursing education.

Cultural competence is a part of professional nursing practice and should be integrated into each course of nursing education. In a rural Midwest community, the clinical opportunities for cultural encounters in critical care may be limited. One strategy to promote cultural competence in the critical care nursing class of a baccalaureate program was to assign narrative responses to case scenarios. These case scenarios were discussed in the context of cultural competence.

Clinical Competence↗

PubMedDate not supplied

Cultural competence in hospice.

Research shows that ethnic minorities access hospice care significantly less often than Caucasians. In part, this has been attributed to the lack of cultural competence among hospice staff. To assess cultural competence among hospice workers, this article evaluates the results of a descriptive, exploratory survey that was submitted to 125 interdisciplinary hospice employees and completed by 113 of those employees. Cultural-competence behavior scores varied widely based on two factors: increased education and previous cultural-diversity training. The results of this study provide information regarding cultural competence in hospice. In their efforts to provide culturally appropriate end-of-life care, hospices can use the information in this study to implement intervention plans aimed at increasing cultural competence among hospice staff.

Adult↗

PubMed2007

Current approaches to integrating elements of cultural competence in nursing education.

Cultural competence in nursing education is receiving renewed emphasis. Curricular input to incorporate such knowledge, attitudes, and skills encompasses a wide variety of teaching and learning methods. Five are described here: specialty focus, required courses, models, immersion experiences, and distance learning or simulation. Despite progress in incorporating cultural content into nursing curricula, several issues characterize all levels of nursing programs, including lack of consensus on what should be taught, lack of standards, limited and inconsistent formal evaluation of effectiveness, a decline of curricular specialty courses on culture, a focus on the microlevel of the nurse-patient encounter, and the need for, support of, and preparation of faculty.

Attitude of Health Personnel↗

PubMed2002

Primary care resident, faculty, and patient views of barriers to cultural competence, and the skills needed to overcome them.

INTRODUCTION: Primary care residencies are expected to provide training in cultural competence. However, we have insufficient information about the perceptions of stakeholders actually involved in healthcare (i.e. residents, faculty and patients) regarding commonly encountered cross-cultural barriers and the skills required to overcome them. METHOD: This study used a total of 10 focus groups to explore resident, faculty and patient attitudes and beliefs about what culturally competent doctor-patient communication means, what obstacles impede or prevent culturally competent communication, and what kinds of skills are helpful in achieving cultural competence. A content analysis was performed to identify major themes. RESULTS: Residents and faculty defined culturally competent communication in terms of both generic and culture-specific elements, however, patients tended to emphasize only generic attitudes and skills. Residents and patients were liable to blame each other in explaining barriers; faculty were more likely to consider systemic influences contributing to resident-patient difficulties. All groups emphasized appropriate skill and attitude development in learners as the key to successful communication. However, residents were sceptical of sensitivity and communication skills training, and worried that didactic presentations would result in cultural stereotyping. DISCUSSION: All stakeholders recognized the importance of effective doctor-patient communication. Of concern was the tendency of various stakeholders to engage in person-blame models.

Clinical Competence↗

PubMed1999

Culturally competent nursing care during the perinatal period.

Effective nursing interventions require culturally competent nursing practice. Nurses can develop the skill sets needed to provide culturally competent care. These skills derive from nursing principles and practice that support respect for individual dignity and self-determination. Sweeping changes in health care delivery have shortened the length of client exposure to nursing care, especially in perinatal nursing. Moreover, changes in the United States population challenge the nurse's ability to respond appropriately to the expectations, values, and beliefs of many diverse cultural groups. Nursing theoretical frameworks provide a basis for cultural competence in practice.

Adult↗

PubMedDate not supplied

Culture competence and the primary care provider.

Nurse practitioners and other primary care health providers in the United States increasingly interact with clients of diverse cultures, races, and ethnic backgrounds. If this interaction is not culturally competent, underutilization of health care services, perceived noncompliance, frustration, anger, and, ultimately, inequities in the health status of clients can result. Providing culturally competent care that fosters positive health outcomes is a challenge. This article reviews concepts of culture and cultural competence and describes six elements essential to mastering cultural competence in clinical encounters with multicultural clients. Cultural competence is seen as a continuous process, rather than an end in itself. Culturally competent care requires a change of world view for both the provider and client, with the interaction creating a new cultural reality for both within the context of health care.

Humans↗

PubMed2004

Cultural competency education in American nursing programs and the approach of one school of nursing.

The importance of cultural competency in all areas of American society is well accepted. Indeed, the evolving demographics of the country make it imperative. A wide range of educational and work settings has addressed the concept, from business and government to education and health. Cultural competency is particularly critical in the realm of healthcare, as the potential impact on quality of health and life is at stake. Nursing is a leader in this field, with a long theoretical and practice history of attention to, and respect for, individual differences. This article reviews cultural competency education in nursing and its respective educational settings. Common threads and different models are discussed. The program components of cultural competency education in one School of Nursing are highlighted. Future directions towards refining cultural competency education are presented.

Clinical Competence↗

PubMed2001

Beyond cultural competence: teaching about race, gender, class, and sexual orientation.

Teaching cultural competence to nursing students has been a goal of nursing education for many years. Culturally competent care has been defined as "sensitive to issues related to culture, race, gender, and sexual orientation." However, teaching cultural competence to nursing students has commonly emphasized cultural or ethnic beliefs, values, and practices, rather than issues of race, gender, class, or sexual orientation. The authors use the theory of "relational positionalty" to help students recognize that everyone has a perspective through which they view the world as "normal"; and that normal as defined by the dominant group can create situations of oppression for others.

Cultural Diversity↗

PubMed1999

A taxonomy for developing cultural competence.

This paper proposes a taxonomy to develop culturally competent practitioners. Arguments about what this might mean and how this could be achieved are discussed first, identifying problems with multicultural and antiracist approaches. The model follows the cognitive, emotional and behavioural levels of Steinaker and Bell's experiential taxonomy. Five elements are proposed: cultural awareness, cultural knowledge, cultural understanding, cultural sensitivity and cultural competence. These could address, in increasingly sophisticated and increasingly praxis-oriented ways, issues of power and the construction of meanings and identities which go beyond essentialist notions of ethnicity.

Clinical Competence↗

PubMed2005

Knowledge of cultural competence among third-year medical students.

An increasingly diverse population and ongoing health disparities have brought national attention to cultural competence training in medical schools. However, few data exist on medical students' knowledge in cultural competence. The purpose of this study is to assess medical students' knowledge in cultural competence to identify training areas for curriculum development. All third-year medical students at a single institution during the period of November 2001 to February 2004 completed a questionnaire to assess their knowledge of cultural competence during their medicine clerkship. The 40-item questionnaire measured several domains of cultural competence: health disparities, stereotyping, exploring culture, perceptions of health and illness, and communication/language. The mean knowledge score was 55%, and no student scored >80%. Race and prior cultural training were not predictors of overall performance.

Adult↗

PubMed2004

Cultural competence among physicians treating Mexican Americans who have diabetes: a structural model.

Latinos, who constitute the fastest growing ethnically distinct US group, experience disproportionately high rates of type 2 diabetes. At the same time, linguistic and economic barriers, differing cultural expectations between patients and physicians, provider reactions based on stereotypes, and managed healthcare shortfalls limit diabetes care. Such trends highlight physicians' need to consider culture in the delivery of effective services. To address these issues we investigated predictors of culturally competent actions among a sample of 134 practicing San Diego County physicians. They provided demographic information and completed questions assessing their cultural knowledge, cultural awareness, and culturally competent actions specific to Mexican Americans with diabetes. We then developed a structural cultural competence model. Results indicated that participation in diverse medical education settings and experience in community clinics predicted cultural knowledge. Participation in diverse educational settings, Latino ethnicity, bilingual skills, and cultural knowledge predicted cultural awareness. An internal medicine specialty predicted less cultural awareness. Culturally competent actions were only predicted by cultural awareness. Goodness-of-fit statistics supported the overall model's acceptability. The number of Mexican Americans physicians see in practice did not predict any tested cultural competence dimension. Our model supports a number of conclusions. First, knowledge of cultural factors per se and simple exposure to Mexican Americans in practice do not directly facilitate culturally competent care. Rather, such care is most strongly predicted by recognition that cultural factors and awareness of personal biases are important. Results further support medical education that does not solely focus on basic information about Mexican Americans but also explores provider biases and preconceptions. Diverse educational experiences appear particularly helpful in this process. Community clinic settings also help practitioners gain cultural knowledge. While Latino ethnicity predicted cultural awareness, results also suggest that all physicians can take steps towards increasing their cultural competence.

Adult↗

PubMed2003

Culturally competent treatment of African American clients among a national sample of outpatient substance abuse treatment units.

This study measures the level of cultural competency with respect to African American clients that exists among a national sample of outpatient substance abuse treatment (OSAT) units and determines the relationship of cultural competency to various characteristics of these units and their clients. The study utilizes cross-sectional data from the 1995 National Drug Abuse Treatment System Survey (NDATSS). The sample for NDATSS was randomly selected from a comprehensive list of OSAT programs compiled by the Institute for Social Research at the University of Michigan in 1994. Of the nationally representative, stratified sample of 699 units, 618 (88%) participated. Spearman correlation, analysis of variance, Behrens-Fisher t-tests, and chi-square were used for bivariate comparisons. Culturally competent units are typically public, federal-funded organizations. Staffs of culturally competent units are typically college-educated with specialized treatment certification. High severity of illness as well as increased social distresses is pervasive among the clients of culturally competent units. Consideration of this client profile may be a key determinant in evaluating the effectiveness of cultural competency for African American substance abusers.

Black or African American↗

PubMed2006

Evaluation of a cultural competence educational programme.

AIM: This paper reports a study, which evaluated the effectiveness of a cultural competence educational programme to increase Public Health Nurses' cultural knowledge. BACKGROUND: Cultural competence has great significance for practising nurses and has become a priority and commitment of the Nursing profession. Public Health Nurses interact regularly with clients from a variety of culturally diverse backgrounds. Thus, there is a need for an integrated programme with theoretical and experiential knowledge related to cultural competence for PHNs to enhance their knowledge and skills to better meet the needs of the population. DESIGN: This study used a combination of quantitative and qualitative methods for data collection. A one-group Repeated Measures design was used to evaluate the effectiveness of the educational programme. METHOD: The sample consisted of 76 Public Health Nurses who attended a cultural competence educational programme, which was offered over five consecutive weeks, of 2 hours duration and reinforced by a booster session at 1 month postimplementation of the programme. Cultural knowledge was measured on the Cultural Knowledge Scale, which was a valid, reliable, 25-item Likert scale. Data were collected at four points in time and were analysed with repeated measures analysis of variance. Qualitative data were content analysed. RESULTS: Findings revealed that the intervention was effective [Wilks' Lambda was F(3,69) = 142.02, P < 0.01] in increasing the nurses' cultural knowledge. Qualitative results complemented the quantitative findings. Participants reported that the programme was effective in increasing their cultural knowledge. CONCLUSION: Although Public Health Nurses, who attended the educational programme increased their cultural knowledge, these findings are not generalizable to nurses working in other settings. However, the programme has clinical utility and could be adapted and given to nurses in other settings.

Adult↗