WorldWideScience

Sample records for culturally responsive care

  1. Immigrant Children Promoting Environmental Care: Enhancing Learning, Agency and Integration through Culturally-Responsive Environmental Education

    Science.gov (United States)

    Blanchet-Cohen, Natasha; Reilly, Rosemary C.

    2017-01-01

    This paper examines the potential of culturally-responsive environmental education to engage immigrant early adolescents. Our study suggests that environmental involvement can become a means and an end for children to bridge their school and home in agential ways. Drawing from a multi-phase study involving focus groups with children, parents, and…

  2. Culturally Responsive Caring and Expectations for Academic Achievement in a Catholic School

    Science.gov (United States)

    Dallavis, Christian

    2014-01-01

    This article draws from a larger dissertation study that applied ethnographic and historical research methods to explore the intersection of culturally responsive pedagogy and Catholic schooling in immigrant communities. In particular, this article presents qualitative data analysis to describe student achievement expectations at a contemporary…

  3. La mujer responsable de la salud de la familia: Constatando la universalidad cultural del cuidado Women in charge of family health-verifying cultural universality of care

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    María Concepción Pezo Silva

    2004-11-01

    a family member, the woman takes responsibility for their treatment adopting domestic, mystic practices and/or searches for prompt and effective medical service. The researches also showed that it is the woman who notices alterations in their health pattern. Conclusion: The different cultural contexts have similarities that approximate them and both indicate the need for health care providers' attention towards a kind of care focused on the women considering their culture.

  4. [The cultural barrier in care].

    Science.gov (United States)

    Djadaoudjee, Lisa

    2013-11-01

    French cultural diversity is evident within French hospitals, where nurses are confronted with communication problems resulting from the language barrier. While communication is indeed essential, there is another important aspect of caring for a patient for behind the language barrier lies a cultural barrier which must be taken into account in order to provide high-quality care.

  5. Culturally Responsive Teaching: Understanding Disability Culture

    Science.gov (United States)

    Darrow, Alice-Ann

    2013-01-01

    To be culturally responsive teachers, we must first have an understanding of other cultures and how students from these cultures differ from one another. As we consider the many cultures represented in our classrooms, we might also consider students with disabilities as a cultural group. Within any main culture are subgroups differentiated by…

  6. Cultural care of older Greek Canadian widows within Leininger's theory of culture care.

    Science.gov (United States)

    Rosenbaum, J N

    1990-01-01

    Cultural care themes were abstracted from a large scale study of older Greek Canadian widows conceptualized within Leininger's theory of Cultural Care Diversity and Universality. Ethnonursing, ethnographic, and life health-care history methods were used. Data were collected using observation-participation and interviews in three Greek Canadian communities with 12 widowed key informants and 30 general informants. Enabling tools used were interview inquiry guides, Leininger's Life History Health Care Protocol, Leininger's Acculturation Rating and Profile Scale of Traditional and Non-Traditional Lifeways, and field journal recordings. Data were analyzed using Leininger's phases of analysis for qualitative data. The two major cultural care themes which were abstracted from the raw data and patterns were: (1) Cultural care for Greek Canadian widows meant responsibility for, reciprocation, concern, love, companionship, family protection, hospitality, and helping, primarily derived from their kinship, religious, and cultural beliefs, and values, and (2) Cultural care continuity diminished the spousal care void and contributed to the health of Greek Canadian widows. These findings will stimulate future nursing research related to cultural care of diverse populations and guide nursing practice to provide culturally congruent care which will assist widows to reduce their spousal care void. The author thanks Dr. Madeleine Leininger, Dr. Judith Floyd, Dr. Marjorie Isenberg, and Dr. Bernice Kaplan for their guidance in completing the large scale study on which this article is based.

  7. Culture, palliative care and multiculturalism.

    Science.gov (United States)

    Nyatanga, Brian

    2002-05-01

    The frequently asked question, 'Why do minority ethnic groups not access palliative care?' needs closer analysis. This article sets out to revisit the context and principles of palliative care and discuss why palliative care services are not accessed equally by all cultural groups in western, particularly UK, society. The conceptual basis of culture, together with cultural diversity, will be discussed to foster greater understanding of multiculturalism with a view to offering recommendations for the provision of culturally sensitive palliative care. These recommendations will seek to be challenging but realistic, both for practitioners providing such care and for educationalist disseminating 'knowledge'. I will highlight what I believe are the challenges of providing palliative care that is acceptable to minority ethnic groups based on personal experience and literature, and emphasize that these challenges should be seen as potential opportunities. It is hoped that this article will set a platform for honest and open discussion about the way forward in providing culturally sensitive palliative care for minority ethic groups. I will pose a challenging call to all members of minority ethnic groups to adopt a more proactive approach to their own care by preparing themselves to be in an influential position in palliative care provision through academic and clinical endeavours.

  8. Cultural diversity in adolescent health care.

    Science.gov (United States)

    Bennett, David L; Chown, Peter; Kang, Melissa S-L

    2005-10-17

    In Australia, where about 16% of young people are born overseas and 24% are from a non-English-speaking background, adolescent health care is a multicultural challenge. "Cultural competency" involves challenging one's own cultural assumptions and beliefs, developing empathy for people from other cultures, and applying specific communication and interaction skills in clinical encounters. For health professionals, sensitivity to the cultural, ethnic, linguistic and social diversity among young people helps to avert problems and misunderstandings, improves satisfaction for all concerned and leads to better outcomes. Engaging the family and gaining the trust of parents is critical in treating young people from cultural backgrounds in which participation in health care is a family concern rather than an individual responsibility.

  9. Exploring a culture of caring.

    Science.gov (United States)

    Carter, Lisa C; Nelson, Joyce L; Sievers, Beth A; Dukek, Sarah L; Pipe, Teri B; Holland, Diane E

    2008-01-01

    The delivery of patient-centered care is basic to a large midwestern healthcare institution's mission and highly valued by the department of nursing. Even so, nurses on one medical unit questioned whether caring behaviors were devalued in a technology-oriented environment of providing care. The nursing leadership on the unit responded to the inquiry by conducting a research study. This study explored the state of patient-centered nursing care on a medical unit as perceived by the nursing staff and patients, using Watson's Theory of Human Caring as a framework. The study utilized surveys for both nursing staff (n = 31) and patients (n = 62), and included a focus group of nursing staff (n = 8) to explore ideas for innovation. Both nurses and patients perceived a high level of caring on the unit. The overall theme from the focus group was that "caring begets caring," with 2 subthemes: "relationships of care" and "the context of caring." Caring for each other was identified as essential to keep staff energized and able to work lovingly with patients. Nursing leadership brought the research findings to all staff on the unit for discussion and implementation of structural support for the unit culture of caring.

  10. [Neonatal palliative care and culture].

    Science.gov (United States)

    Bétrémieux, P; Mannoni, C

    2013-09-01

    The period of palliative care is a difficult time for parents and caregivers because they are all weakened by the proximity of death. First of all, because of religious and cultural differences, parents and families cannot easily express their beliefs or the rituals they are required to develop; second, this impossibility results in conflicts between the caregiver team and the family with consequences for both. Caregivers are concerned to allow the expression of religious beliefs and cultural demands because it is assumed that they may promote the work of mourning by relating the dead child to its family and roots. However, caregivers' fear not knowing the cultural context to which the family belongs and having inappropriate words or gestures, as sometimes families dare not, cannot, or do not wish to describe their cultural background. We attempt to differentiate what relates to culture and to religion and attempt to identify areas of potential disagreement between doctors, staff, and family. Everyone has to work with the parents to open a space of freedom that is not limited by cultural and religious assumptions. The appropriation of medical anthropology concepts allows caregivers to understand simply the obligations imposed on parents by their culture and/or their religion and open access to their wishes. Sometimes help from interpreters, mediators, ethnopsychologists, and religious representatives is needed to understand this reality. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. The Cultural Geography of Health Care Delivery.

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    Gesler, Wilbert M.

    1987-01-01

    This article shows how health care delivery is related to cultural or human geography. This is accomplished by describing health care delivery in terms of 12 popular themes of cultural geography. (JDH)

  12. Connecting care competencies and culture during disasters

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    Chhabra Vivek

    2009-01-01

    Full Text Available Connecting care Competencies and Culture are core fundamentals in responding to disasters. Thick coordination between professionals, communities and agencies in different geographical areas is crucial to the happening of appropriate preparedness and thus efficient response and mitigation of a disaster. In the next few articles, we present diverse examples related to the preparedness and recovery process to adverse disasters across the globe

  13. Nurse leaders as managers of ethically sustainable caring cultures.

    Science.gov (United States)

    Salmela, Susanne; Koskinen, Camilla; Eriksson, Katie

    2017-04-01

    The aim of this study was to identify the distinctive foundations of the care culture and how nurse leaders (NL) can manage and strengthen these in a quest for ethically sustainable caring cultures. Sustainability presupposes an ethical leadership, a management of the good care and a well-educated staff, but research on NLs as managers of ethically sustainable caring cultures is not available. The study has a quantitative design with elements of a qualitative research approach. Data were collected through a web-based questionnaire sent to staff at eight selected units at a hospital in western Finland during September 2013; the reply rate was 32%. The data material was comprised of opinion questions, the ranking of values and two open-ended questions on lodestars in care and ethical principles in care work. NLs manage a care culture that rests on a solid foundation, where staff are co-creators of an ethically sustainable caring culture that includes good traditions for the praxis of care. NLs as managers are therefore responsible for realizing and passing on ethically sustainable caring cultures and creating prerequisites for staff's growth and development. The basis of good care, patient safety and sustainability is comprised of ethics with a respectful and dignified care that is evidence-based and economically stable. Through their management NLs have a responsibility to nurture and protect the core of caring and create contextual, professional and cultural prerequisites to maintain the core and art of caring as well as care staff's ethical and professional competence. © 2016 John Wiley & Sons Ltd.

  14. Culture and religion in nursing: providing culturally sensitive care.

    Science.gov (United States)

    Mendes, Aysha

    Last month, Aysha Mendes discussed the impact on care of personal beliefs held by both nurses and patients. This month, she delves into the aspects of culture and religion, which form important pieces of this puzzle, as well as the importance of culturally appropriate care provision in nursing practice.

  15. Culture brokerage as a form of caring

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    Saidy Eliana Arias-Murcia

    2013-12-01

    Full Text Available Objective. To identify the meanings, uses, and contexts of applying the culture brokerage concept in nursing articles published from 1995 to 2011. Methodology. A total of 32 articles were identified from the following databases: Cuiden, SciElo, Ovid Nursing, Ovid, Medline and Pubmed. Results. It was found that 56.2% of the articles were about research, 37.5% on reflection, and 6.2% topic revision. Five categories emerged from the analysis: culture brokerage concepts, culture brokerage and cultural competence, culture brokerage and the performers, culture brokerage in the care of immigrants, and culture brokerage in the care of individuals with chronic diseases. Conclusion. Culture brokerage is a type of emerging care; it has various approaches and applications in both the community and hospital environments. Its conceptualization helps in the development of the nursing discipline.

  16. Patient safety culture in primary care

    NARCIS (Netherlands)

    Verbakel, N.J.

    2015-01-01

    Background A constructive patient safety culture is a main prerequisite for patient safety and improvement initiatives. Until now, patient safety culture (PSC) research was mainly focused on hospital care, however, it is of equal importance in primary care. Measuring PSC informs practices on their s

  17. Who is in Your Waiting Room? Health Care Professionals as Culturally Responsive and Trauma-Informed First Responders to Human Trafficking.

    Science.gov (United States)

    Rollins, Rochelle; Gribble, Anna; Barrett, Sharon E; Powell, Clydette

    2017-01-01

    Evidence-based practice standards are not yet well defined for assisting potential victims of human trafficking. Nonetheless, health care professionals are learning to be first responders in identifying, treating, and referring potential victims. As more public and private sector resources are used to train health care professionals about human trafficking, more evaluation and research are needed to develop an effective standard of care. Adopting a public health lens and using the "National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care" can guide critical decision making and actions. Through collaboration between researchers and policymakers, lessons learned in health care settings can inform future evidence-based standards of care so that all patients receive the services that they need.

  18. Cultural aspects of communication in cancer care.

    Science.gov (United States)

    Surbone, Antonella

    2008-03-01

    Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and practices of communication of the truth and of decision-making styles throughout the world. Cultural competence always presupposes oncology professionals' awareness of their own cultural beliefs and values. To be able to communicate with cancer patients in culturally sensitive ways, oncologists should have knowledge of the concept of culture in its complexity and of the risks of racism, classism, sexism, ageism, and stereotyping that must be avoided in clinical practice. Oncologists should develop a sense of appreciation for differences in health care values, based on the recognition that no culture can claim hegemony over others and that cultures are evolving under their reciprocal influence on each other. Medical schools and oncology training can teach communication skills and cultural competence, while fostering in all students and young doctors those attitudes of humility, empathy, curiosity, respect, sensitivity, and awareness that are needed to deliver effective and culturally sensitive cancer care.

  19. Creating a culture for health care quality and safety.

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    Roberts, Velma; Perryman, Martha M

    2007-01-01

    Approximately 67% of hospital quality indicators require some type of laboratory testing to monitor compliance. Unfortunately, in many hospitals, laboratory data information systems remain an untapped resource in eliminating medical errors and improving patient safety. Using case scenarios, this article demonstrates potential consequences for patient safety and quality of care when information sharing between medical technologists and nurses is not a part of a hospital's culture. The outcome for this patient could have been avoided if a more inclusive health care quality and safety culture existed. Creating a culture for health care quality and safety requires consensus building by clinical and administrative leaders. Consensus building occurs by managing relationships among and between a team of independent, autonomous physicians, nurses, allied health professionals, and health care administrators. These relationships are built on mutual respect and effective communication. Creating a quality culture is a challenging but necessary prerequisite for eliminating medical errors and ensuring patient safety. Physician leaders promoting and advancing cultural change in clinical care from one of exclusive decision making authority to a culture that is based on shared decision making are a necessary first step. Shared decision making requires mutual respect, trust, confidentiality, responsiveness, empathy, effective listening, and communication among all clinical team members. Physician and administrative leaders with a focus on patient safety and a willingness to change will ensure a culture of health care quality and safety.

  20. Social responsibility in health care

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    Tjaša

    2014-06-01

    Full Text Available Research Question (RQ: What is socially responsible behavior in the Slovenian health care system, where we have three main entities which they are actively involved in so called health care system. Purpose: Through the article, I would like for all three entities in the health sector to present, what is socially responsible behavior, which contributes to improving mutual cooperation for each of them and the wider society. Method: The results I achieved by studying domestic and foreign literature, laws and regulations that define social responsibility to the other two entities in the health care and the integration of literature in practice. Results: Each social responsibility within the organization, starting with superiors or managers, whose activities transferred the positive impact of social responsibility on employees and therefore the wider society. Society: By being aware of our role in society or position in the health system, any individual with a positive socially responsible actions have a positive impact on the wider community and to improve the benefits, at least in theoretical terms. Originality: I have not registered any discussions that would include mutual social responsibility - related conduct that contributes to the overall satisfaction of all. Most are present in one entity in health and his social responsibility in the internal and external environment, where they performance. Limitations/Future Research: Accessibility of data nature, from which it was evident social responsibility to other entities in the health system. The lack of literature covering social responsibility in Slovenia.

  1. Educating Gerontologists for Cultural Proficiency in End-of-Life Care Practice

    Science.gov (United States)

    Stein, Gary L.; Sherman, Patricia A.; Bullock, Karen

    2009-01-01

    An educational program was developed to train practitioners to provide care for patients and families that are responsive to cultural concerns. The aim was to increase knowledge and improve attitudes toward providing culturally proficient and culturally sensitive care for patients and families facing life-threatening illnesses. The program…

  2. Catching the spirit of cultural care: a midwifery exemplar.

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    Jesse, D Elizabeth; Kirkpatrick, Mary K

    2013-01-01

    Midwives provide an integral part of health care in underserved, rural areas of the United States. To meet the health care needs of people from diverse cultures, they need to learn culturally competent care. This article describes efforts by a university and its college of nursing to adapt to a changing cultural climate and prepare faculty and students to become culturally competent in practice encounters with diverse populations. Culturally competent care is infused in the midwifery curriculum through self-directed inquiry and discovery approaches. Outcomes of these approaches are evident in the nurse-midwifery program, which can serve as a model for integration of culturally competent care throughout the nursing curriculum.

  3. Cultural and religious aspects of care in the intensive care unit within the context of patient-centred care.

    Science.gov (United States)

    Danjoux, Nathalie; Hawryluck, Laura; Lawless, Bernard

    2007-01-01

    On January 31, 2007, Ontario's Critical Care Strategy hosted a workshop for healthcare providers examining cultural and religious perspectives on patient care in the intensive care unit (ICU). The workshop provided an opportunity for the Ministry of Health and Long-Term Care (MOHLTC) to engage service providers and discuss important issues regarding cultural and religious perspectives affecting critical care service delivery in Ontario. While a favourable response to the workshop was anticipated, the truly remarkable degree to which the more than 200 front-line healthcare providers, policy developers, religious and cultural leaders, researchers and academics who were in attendance embraced the need for this type of dialogue to take place suggests that discussion around this and other "difficult" issues related to care in a critical care setting is long overdue. Without exception, the depth of interest in being able to provide patient-centred care in its most holistic sense--that is, respecting all aspects of the patients' needs, including cultural and religious--is a top-of-mind issue for many people involved in the healthcare system, whether at the bedside or the planning table. This article provides an overview of that workshop, the reaction to it, and within that context, examines the need for a broad-based, non-judgmental and respectful approach to designing care delivery in the ICU. The article also addresses these complex and challenging issues while recognizing the constant financial and human resource constraints and the growing demand for care that is exerting tremendous pressure on Ontario's limited critical care resources. Finally, the article also explores the healthcare system's readiness and appetite for an informed, intelligent and respectful debate on the many issues that, while often difficult to address, are at the heart of ensuring excellence in critical care delivery.

  4. Health care provider and consumer understandings of cultural safety and cultural competency in health care: an Australian study.

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2007-01-01

    There is increasing recognition in Australia that racial and ethnic minority groups experience significant disparities in health and health care compared with the average population and that the Australian health care system needs to be more responsive to the health and care needs of these groups. The paper presents the findings of a year long study that explored what providers and recipients of health care know and understand about the nature and implications of providing culturally safe and competent health care to minority racial and ethnic groups in Victoria, Australia. Analysis of the data obtained from interviewing 145 participants recruited from over 17 different organizational sites revealed a paucity of knowledge and understanding of this issue and the need for a new approach to redress the status quo.

  5. Politics and care: a study of Czech Americans within Leininger's theory of culture care diversity and universality.

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    Miller, J

    1997-01-01

    The domain of inquiry for this study was the influence of the American political environmental context on professional and generic care patterns, expressions, and meanings of Czech American immigrants. The purpose of the research was to document, describe, interpret, and analyze the diversities and universalities of professional and generic care for this cultural group, to provide culturally congruent care to Czech Americans, and to explicate the role of politics as an influence on care patterns, health, and well being. The researcher's former transcultural ethnonursing study in Prague, Czechoslovakia in 1991 served as a stimulus for this in-depth study on politics and care. Twelve key and twenty general informants were interviewed. Five major themes were identified. The researcher discovered that the capitalist economic market structure of the United States influenced informant lifeways in all dimensions of Leininger's Theory of Culture Care Diversity and Universality, as depicted in the Sunrise Model. Specific care patterns discovered included care as choice, care as responsibility, and care as helping each other. Findings related to professional and generic care supported researcher predictions that generic culture care patterns would be important to immigrants. Provisions for culturally congruent nursing care were articulated based on research findings.

  6. Adaptation of health care for migrants: whose responsibility?

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    Dauvrin, Marie; Lorant, Vincent

    2014-07-08

    In a context of increasing ethnic diversity, culturally competent strategies have been recommended to improve care quality and access to health care for ethnic minorities and migrants; their implementation by health professionals, however, has remained patchy. Most programs of cultural competence assume that health professionals accept that they have a responsibility to adapt to migrants, but this assumption has often remained at the level of theory. In this paper, we surveyed health professionals' views on their responsibility to adapt. Five hundred-and-sixty-nine health professionals from twenty-four inpatient and outpatient health services were selected according to their geographic location. All health care professionals were requested to complete a questionnaire about who should adapt to ethnic diversity: health professionals or patients. After a factorial analysis to identify the underlying responsibility dimensions, we performed a multilevel regression model in order to investigate individual and service covariates of responsibility attribution. Three dimensions emerged from the factor analysis: responsibility for the adaptation of communication, responsibility for the adaptation to the negotiation of values, and responsibility for the adaptation to health beliefs. Our results showed that the sense of responsibility for the adaptation of health care depended on the nature of the adaptation required: when the adaptation directly concerned communication with the patient, health professionals declared that they should be the ones to adapt; in relation to cultural preferences, however, the responsibility felt on the patient's shoulders. Most respondents were unclear in relation to adaptation to health beliefs. Regression indicated that being Belgian, not being a physician, and working in a primary-care service were associated with placing the burden of responsibility on the patient. Health care professionals do not consider it to be their responsibility to adapt

  7. Developing cultural competence in palliative care.

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    McGee, Paula; Johnson, Mark R D

    2014-02-01

    Increasing ethnic or cultural diversity in the population served by health-care services requires improved competence and updated provision. Both individual staff and institutions need to reflect on and prepare to meet new challenges. Three key elements-reflective self-awareness, knowledge of others, and skills in managing difference-must be developed. Recognition of diversity and a database of appropriate information are essential for both workers and management of organisations. Above all, some preparedness for continual change and learning is essential. This article provides some suggestions and examples to assist with this.

  8. Social justice: a framework for culturally competent care.

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    Clingerman, Evelyn

    2011-10-01

    Nurse scholars with expertise in global health and culturally competent care recently proposed standards of practice for culturally competent nursing care that are founded on social justice as a broad framework. The purpose of this article is to respond to invited dialogue about the standards and to offer commentary on social justice and its relationship with context, advocacy, leadership, and culturally competent care. A model of culturally competent care for vulnerable groups informs this discussion. The context and culture that surround migrant and seasonal farmworkers illustrate how social justice illuminates their health inequities and necessitates their need for culturally competent care. The article concludes with recommendations for culturally competent education, practice, and research and offers suggestions for developing culturally competent interventions for migrant and seasonal farmworkers.

  9. Don't neglect cultural diversity in oncology care.

    Science.gov (United States)

    Muñoz-Antonia, Teresita

    2014-05-01

    The growing Hispanic population in the United States mandates the need for oncology providers to become more familiar with disease patterns and cultural belief systems that can impact cancer care. "Culturally competent care" should be the mandate of all providers. This comprises awareness of cultural differences, communication in a manner that the patient understands, and respect.

  10. Conceptualizations of culture and cultural care among undergraduate nursing students: an exploration and critique of cultural education.

    Science.gov (United States)

    Vandenberg, Helen; Kalischuk, Ruth Grant

    2014-01-01

    Culture and cultural care have become important concepts in nursing education. However, little is known about what nursing students learn about these complex concepts. The purpose of this study was to explore and critique what nursing students learn about culture and cultural care. First and fourth year students were invited to participate in a focused ethnography to explore how nursing education might shape student knowledge of culture over time. Findings revealed that both groups of students supported the essentialist view of culture. Although students supported the ideals of cultural care, students remained unaware of critical views of culture.

  11. From a blame culture to a just culture in health care.

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    Khatri, Naresh; Brown, Gordon D; Hicks, Lanis L

    2009-01-01

    A prevailing blame culture in health care has been suggested as a major source of an unacceptably high number of medical errors. A just culture has emerged as an imperative for improving the quality and safety of patient care. However, health care organizations are finding it hard to move from a culture of blame to a just culture. We argue that moving from a blame culture to a just culture requires a comprehensive understanding of organizational attributes or antecedents that cause blame or just cultures. Health care organizations need to build organizational capacity in the form of human resource (HR) management capabilities to achieve a just culture. This is a conceptual article. Health care management literature was reviewed with twin objectives: (a) to ascertain if a consistent pattern existed in organizational attributes that lead to either blame or just cultures and (2) to find out ways to reform a blame culture. On the basis of the review of related literature, we conclude that (a) a blame culture is more likely to occur in health care organizations that rely predominantly on hierarchical, compliance-based functional management systems; (b) a just or learning culture is more likely to occur in health organizations that elicit greater employee involvement in decision making; and (c) human resource management capabilities play an important role in moving from a blame culture to a just culture. Organizational culture or human resource management practices play a critical role in the health care delivery process. Health care organizations need to develop a culture that harnesses the ideas and ingenuity of health care professional by employing a commitment-based management philosophy rather than strangling them by overregulating their behaviors using a control-based philosophy. They cannot simply wish away the deeply entrenched culture of blame nor can they outsource their way out of it. Health care organizations need to build internal human resource management

  12. Culturally and linguistically responsive teaching: part I.

    Science.gov (United States)

    Billings, Diane M

    2015-02-01

    As increasing numbers of culturally and linguistically diverse learners are enrolled in nursing programs and employed in nursing service agencies, nurse educators must be aware of their own culture and how it influences their teaching and understand the learning needs of a diverse group of learners. This article offers strategies for nurse educators for being culturally and linguistically responsive while also establishing an inclusive learning environment.

  13. Cultural competency and diversity among hospice palliative care volunteers.

    Science.gov (United States)

    Jovanovic, Maja

    2012-05-01

    This case study examines the current state of cultural competence in hospice and palliative care in the Greater Toronto Area (GTA). Because of changing demographic trends and ethnic minorities underutilizing hospice palliative care services, this research examined the current state of culturally competent care in a hospice setting, and the challenges to providing culturally competent care in a hospice in the GTA. A case study was conducted with a hospice and included in-depth interviews with 14 hospice volunteers. The findings reveal that volunteers encountered cultural clashes when their level of cultural competency was weak. Second, volunteers revealed there was a lack of adequate cultural competency training with their hospice, and finally, there was a lack of ethnic, cultural, and linguistic diversity among the hospice volunteers.

  14. Assisting Preservice Teachers toward Becoming Culturally Responsive

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    Starker, Tehia V.; Fitchett, Paul G.

    2013-01-01

    In this qualitative study, researchers inquired about preservice teachers' (PST) experience in becoming culturally responsive in a graduate teacher-licensure social studies methods class (N = 20). Researchers examined PST lesson plans and reflections, and rated them based on Geneva Gay's (2002) framework for preparing culturally responsive…

  15. Towards a Culturally Situated Reader Response Theory

    Science.gov (United States)

    Brooks, Wanda; Browne, Susan

    2012-01-01

    This article describes a theory of how culture enables literary interpretations of texts. We begin with a brief overview of the reader response field. From there, we introduce the theory and provide illustrative participant data examples. These data examples illustrate the four cultural positions middle grade students in our research assumed when…

  16. Culture and Crisis Response in New Zealand

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    Annan, Jean; Dean, Shelley; Henry, Geoff; McGhie, Desiree; Phillipson, Roger

    2010-01-01

    New Zealand is a bicultural nation, founded on the signing of the Treaty of Waitangi by the native Maori and the British Crown. It is also home to people from many countries, cultures and ethnicities. Therefore, culturally-relevant response to crisis events has become a significant aspect of the Ministry of Education's interdisciplinary Traumatic…

  17. Culture change in care homes: development and facilitation.

    Science.gov (United States)

    Wild, Deidre; Kydd, Angela

    2016-09-29

    This article is the second of a two-part series that explores a programme of culture change in care homes. In this article, the authors describe their independent development and facilitation of a flexible learning programme for care homes, designed to meet a quality improvement request made by a care home company. The two selected care homes' staff conducted a review of their care culture, as a precursor to their creation of a new care philosophy. These activities provided a firm foundation from which the homes could, in theory, become a Remedial Enterprise Active Learning care home. Although the learning programme was not completed due to unavoidable circumstances, the staff's experiences highlight some of the challenges and successes that may be experienced when seeking to improve care homes' learning culture and practice.

  18. Culturally Sensitive Health Care and Counseling Psychology: An Overview

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    Herman, Keith C.; Tucker, Carolyn M.; Ferdinand, Lisa A.; Mirsu-Paun, Anca; Hasan, Nadia T.; Beato, Cristina

    2007-01-01

    This article introduces the Major Contribution, which focuses on counseling psychologists' roles in addressing health disparities through culturally sensitive health care research and interventions. First, the authors provide a rationale for conducting research focused on culturally sensitive health care and then offer definitions of…

  19. Cultural diversity and conflict in the health care workplace.

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    Lowenstein, A J; Glanville, C

    1995-01-01

    Cultural diversity issues affect the health care workplace and nursing practice. The Lowenstein-Glanville conflict model can be used for assessing and intervening in racial and status conflict in hospital settings. Implications for nursing practice include recognizing that cultural diversity will continue to grow in the health care workplace. Nurses must increase sensitivity, become aware of cultural nuances and issues, and make cultural assessment a routine part of their assessment and planning, not only for patient care, but also with their co-workers and subordinates.

  20. DIAGNOSING THE CORPORATE SOCIAL RESPONSIBILITY CULTURE

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    Žana Prutina

    2015-12-01

    Full Text Available The contemporary business environment places demands on companies to go beyond economic survival and self-interest and satisfy the needs of various stakeholders. Organizations embark on the path of responsibility and sustainability, but many argue that CSR becomes embedded in an organization when it permeates all aspects of organization, including the organizational culture. Existing organizational culture typologies only provide the framework for analysis within the traditional business paradigm, but they are of limited use in the context of corporate social responsibility. After the analysis of major scholarship in the field, this paper defines CSR culture and identifies four types of organizational cultures based on companies’ CSR orientations, namely CSR-related values and strategy. In order to fully embed CSR culture, CSR has to be both strategic and value driven. This paper explores different CSR orientations and makes recommendations needed in order to achieve the desired state. Furthermore, through exploratory factor analysis, it identifies two cultural elements, CSR values and employee engagement in CSR, which indicate the existence of CSR culture. Identification of these cultural elements is intended to help in analyzing the direct and indirect effect of CSR culture on organizational outcomes, especially employee attitudinal and behavioral outcomes.

  1. Cross-Cultural Obstetric and Gynecologic Care of Muslim Patients.

    Science.gov (United States)

    Shahawy, Sarrah; Deshpande, Neha A; Nour, Nawal M

    2015-11-01

    With the growing number of Muslim patients in the United States, there is a greater need for obstetrician-gynecologists (ob-gyns) to understand the health care needs and values of this population to optimize patient rapport, provide high-quality reproductive care, and minimize health care disparities. The few studies that have explored Muslim women's health needs in the United States show that among the barriers Muslim women face in accessing health care services is the failure of health care providers to understand and accommodate their beliefs and customs. This article outlines health care practices and cultural competency tools relevant to modern obstetric and gynecologic care of Muslim patients, incorporating emerging data. There is an exploration of the diversity of opinion, practice, and cultural traditions among Muslims, which can be challenging for the ob-gyn who seeks to provide culturally competent care while attempting to avoid relying on cultural or religious stereotypes. This commentary also focuses on issues that might arise in the obstetric and gynecologic care of Muslim women, including the patient-physician relationship, modesty and interactions with male health care providers, sexual health, contraception, abortion, infertility, and intrapartum and postpartum care. Understanding the health care needs and values of Muslims in the United States may give physicians the tools necessary to better deliver high-quality care to this minority population.

  2. Investing in organisational culture: nursing students' experience of organisational learning culture in aged care settings following a program of cultural development.

    Science.gov (United States)

    Grealish, Laurie; Henderson, Amanda

    2016-10-01

    Concerns around organisational learning culture limit nursing student placements in aged care settings to first year experiences. Determine the impact of an extended staff capacity building program on students' experiences of the organisational learning culture in the aged care setting. Pre and post-test design. A convenience sample of first, second and third year Bachelor of Nursing students attending placements at three residential aged care facilities completed the Clinical Learning Organisational Culture Survey. Responses between the group that attended placement before the program (n = 17/44; RR 38%) and the group that attended following the program (n = 33/72; RR 45%) were compared. Improvements were noted in the areas of recognition, accomplishment, and influence, with decreases in dissatisfaction. Organisational investment in building staff capacity can produce a positive learning culture. The aged care sector offers a rich learning experience for students when staff capacity to support learning is developed.

  3. The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain1

    Science.gov (United States)

    Morales-Moreno, Isabel; Giménez-Fernández, Maravillas; Echevarría-Pérez, Paloma

    2015-01-01

    Objectives: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain). Method: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied. Results: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation. Conclusions: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health. PMID:26487131

  4. The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain

    Directory of Open Access Journals (Sweden)

    Isabel Morales-Moreno

    2015-10-01

    Full Text Available Objectives: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain.Method: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied.Results: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation.Conclusions: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health.

  5. Bridging generic and professional care practices for Muslim patients through use of Leininger's culture care modes.

    Science.gov (United States)

    Wehbe-Alamah, Hiba

    2008-04-01

    The purpose of this article is to provide knowledge of traditional Muslim generic (folk) care beliefs, expressions and practices derived from research and descriptive sources, in order to assist nurses and other health care professionals to integrate generic (folk) into professional care practices. Muslim generic (folk) care beliefs and practices related to the caregiving process, health, illness, dietary needs, dress, privacy, modesty, touch, gender relations, eye contact, abortion, contraception, birth, death and bereavement were explored. A discussion involving the use of Leininger's culture care preservation and/or maintenance, culture care accommodation and/or negotiation and culture care repatterning and/or restructuring action modes to bridge the gap between generic (folk) and professional (etic) care practices and to consequently promote culturally congruent care is presented.

  6. Culture and Listeners' Gaze Responses to Stuttering

    Science.gov (United States)

    Zhang, Jianliang; Kalinowski, Joseph

    2012-01-01

    Background: It is frequently observed that listeners demonstrate gaze aversion to stuttering. This response may have profound social/communicative implications for both fluent and stuttering individuals. However, there is a lack of empirical examination of listeners' eye gaze responses to stuttering, and it is unclear whether cultural background…

  7. Culture and Listeners' Gaze Responses to Stuttering

    Science.gov (United States)

    Zhang, Jianliang; Kalinowski, Joseph

    2012-01-01

    Background: It is frequently observed that listeners demonstrate gaze aversion to stuttering. This response may have profound social/communicative implications for both fluent and stuttering individuals. However, there is a lack of empirical examination of listeners' eye gaze responses to stuttering, and it is unclear whether cultural background…

  8. Dealing with Difference: Building Culturally Responsive Classrooms

    Directory of Open Access Journals (Sweden)

    Nina Burridge

    2009-11-01

    Full Text Available Australia continues to develop as a multicultural society with levels of immigration increasing significantly over recent years as a result of government policies. More recently, the new period of financial turmoil, continuing threats from terrorism and environmental concerns, have all exacerbated the challenges of dealing with difference in our society. In response, schools continue to face the challenges of the impact of a range of different cultures, languages and religions among their student and school communities. How effectively schools deal with difference and how well they are supported in their endeavours to build culturally response classrooms is a perennial issue for both teachers and educators. A major challenge for teachers is to at a minimum, understand cultural differences as they manifest in their particular school settings and to draw on approaches that support student learning in culturally appropriate ways so to assist them to better realise their full potential. In this paper we will consider cultural diversity in the context of recent school policies, highlight a number of frameworks for addressing cultural diversity in the classroom, in particular the approaches by Kalantzis and Cope’s (1999 and Hickling-Hudson (2003. We also draw on the findings from a recent qualitative study of representations of cultural diversity in a number of Sydney metropolitan schools to discuss the need for more greater resource and policy support for progressive teaching approaches that support the development of a more tolerant and inclusive multicultural society. Key words: cultural diversity, schools, teacher education, classroom practice, social inclusion

  9. Cultural safety as an ethic of care: a praxiological process.

    Science.gov (United States)

    McEldowney, Rose; Connor, Margaret J

    2011-10-01

    New writings broadening the construct of cultural safety, a construct initiated in Aotearoa New Zealand, are beginning to appear in the literature. Therefore, it is considered timely to integrate these writings and advance the construct into a new theoretical model. The new model reconfigures the constructs of cultural safety and cultural competence as an ethic of care informed by a postmodern perspective. Central to the new model are three interwoven, co-occurring components: an ethic of care, which unfolds within a praxiological process shaped by the context. Context is expanded through identifying the three concepts of relationality, generic competence, and collectivity, which are integral to each client-nurse encounter. The competence associated with cultural safety as an ethic of care is always in the process of development. Clients and nurses engage in a dialogue to establish the level of cultural safety achieved at given points in a care trajectory.

  10. Child care work. Organizational culture and health and safety.

    Science.gov (United States)

    Calabro, K S; Bright, K A; Cole, F L; Mackey, T; Lindenberg, J; Grimm, A

    2000-10-01

    A nonrandom sample of child care workers was surveyed to assess whether child care work represented an "at risk" health and safety culture and to measure the organizational dimensions contributing to the health and safety culture. The child care workers in Houston, Texas, were surveyed by mail, using an instrument developed by the research team. The sample population represented 34 child care centers (n = 240 respondents). The analysis yielded five factors related to determinants of health and safety culture. The participants had a favorable perception of the five health and safety determinants. The participants also reported high levels of injury and illness in their environments, suggesting a less than favorable situation. A culture, work, and health model was useful in examining the relationship between health and safety and organizational culture.

  11. The influence of organizational culture on patient care restructuring.

    Science.gov (United States)

    Grzyb-Wysocki, T; Enriquez, M G

    1996-03-01

    University Medical Center in Tucson, Arizona, embarked on a 3-year patient care restructuring project that altered all the patient care delivery systems throughout the organization. In the patient care services areas, patient care managers faced many new challenges in dealing with changes in professional practice and the introduction of multiskilled workers. The influence of the existing organizational culture on patient care restructuring was identified as an important factor to assess early into the project to ensure successful change. The Cultural Assessment Survey (CAS) was used to evaluate unit culture on the four pilot units (two Adult Health and two Pediatric). The results of the survey, implications for managers, and organizational culture are discussed.

  12. Culture moderates children's responses to ostracism situations

    OpenAIRE

    Over, Harriet; Uskul, Ayse K.

    2016-01-01

    Across a series of studies, we investigate cultural differences in children’s responses to ostracism situations. Working with the children of farmers and herders, we focus on how painful children estimate ostracism to be. Study 1a showed that that 3- to 8-year-old children from a socially interdependent farming community estimated ostracism to be less painful than did children from an independent herding community. Study 1b showed that this cultural difference was specific to social pain and ...

  13. Culture moderates children's responses to ostracism situations.

    Science.gov (United States)

    Over, Harriet; Uskul, Ayse K

    2016-05-01

    Across a series of studies, we investigated cultural differences in children's responses to ostracism situations. Working with the children of farmers and herders, we focused on how painful children estimate ostracism to be. Study 1a showed that 4- to 8-year-old children from a socially interdependent farming community estimated ostracism to be less painful than did children from an independent herding community. Study 1b showed that this cultural difference was specific to social pain and did not apply to physical pain. Study 2 replicated the results of Study 1a and showed that individual differences in parents' level of social interdependence mediated the relationship between cultural group and how painful children estimate ostracism to be. Study 3 replicated this effect again and showed that children's tendency to recommend seeking social support following ostracism mediated the relationship between cultural group and the perceived pain of being excluded. Finally, Study 4 investigated cultural differences in moral responses to ostracism and showed that children from the farming community punished an individual who ostracized someone else less harshly than did children from the independent herding community. Thus different economic cultures are associated with striking differences in social interdependence and responses to ostracism from early in development. (PsycINFO Database Record

  14. [Comprehensive cross-cultural care: an exploration of the immigrant care barriers and cross-cultural care competency of community nurses].

    Science.gov (United States)

    Huang, Yu-Chu

    2012-04-01

    Advanced information technologies and increasingly convenient transportation links have drawn countries forward into the current era of globalization, while growing transnational migration has encouraged multicultural trends. The difficulties new immigrants have in adapting to their adopted culture is an issue to which healthcare must be sensitive and responsive. Information on approaches to cross-cultural healthcare is sparse in the Taiwan literature. In this paper, the author reviews relevant domestic and overseas articles to assess historical and government policy trends as well as cross-cultural care competency development. As different ethnic populations increase, each should be provided with proper health education supported by medical volunteers from their own ethnicities. In terms of policy, healthcare personnel should understand their own culture and develop sensitivity to the needs and concerns of others. As part of their training, healthcare staff should gain a second language competency in order to enhance cultural literacy and enhance cross-cultural sensitivity and overall sensitivity within the healthcare system to the needs of the global community.

  15. Creating a collaborative culture in maternity care.

    Science.gov (United States)

    Downe, Soo; Finlayson, Kenny; Fleming, Anita

    2010-01-01

    Effective collaboration between professional groups is increasingly seen as an essential element in good quality and safe health care. This is especially important in the context of maternity care, where most women have straightforward labour and birth experiences, but some require rapid transfer between care providers and settings. This article presents current accounts of collaboration--or lack of it--in maternity care in the United Kingdom, United States, and Australia. It then examines tools designed to measure collaboration and teamwork within general health care contexts. Finally, a set of characteristics are proposed for effective collaboration in maternity care, as a basis for further empirical work in this area. Copyright (c) 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.

  16. A meta-ethnography of organisational culture in primary care medical practice.

    Science.gov (United States)

    Grant, Suzanne; Guthrie, Bruce; Entwistle, Vikki; Williams, Brian

    2014-01-01

    Over the past decade, there has been growing international interest in shaping local organisational cultures in primary healthcare. However, the contextual relevance of extant culture assessment instruments to the primary care context has been questioned. The aim of this paper is to derive a new contextually appropriate understanding of the key dimensions of primary care medical practice organisational culture and their inter-relationship through a synthesis of published qualitative research. A systematic search of six electronic databases followed by a synthesis using techniques of meta-ethnography involving translation and re-interpretation. A total of 16 papers were included in the meta-ethnography from the UK, the USA, Canada, Australia and New Zealand that fell into two related groups: those focused on practice organisational characteristics and narratives of practice individuality; and those focused on sub-practice variation across professional, managerial and administrative lines. It was found that primary care organisational culture was characterised by four key dimensions, i.e. responsiveness, team hierarchy, care philosophy and communication. These dimensions are multi-level and inter-professional in nature, spanning both practice and sub-practice levels. The research contributes to organisational culture theory development. The four new cultural dimensions provide a synthesized conceptual framework for researchers to evaluate and understand primary care cultural and sub-cultural levels. The synthesised cultural dimensions present a framework for practitioners to understand and change organisational culture in primary care teams. The research uses an innovative research methodology to synthesise the existing qualitative research and is one of the first to develop systematically a qualitative conceptual framing of primary care organisational culture.

  17. Culturally Responsive Physics Teaching: Content or Conveyance?

    Science.gov (United States)

    Stewart, Taquan Seth

    2011-12-01

    This study, in response to the achievement gap in science and the lack of significant numbers of ethnic minorities in science fields, examined the effects of a Cultural Responsiveness Workshop and intervention on teacher practice, teacher discourse, and student perceptions and connectedness to physics. The sample was comprised of three high school physics teachers---2 teaching five 12th grade sections and one teaching five 9th grade sections of physics---in two separate urban schools in the same section of South Los Angeles. My research design was qualitative and examined eight culturally responsive indicators that, when applied, may increase student engagement and level of connectedness in urban high school physics classrooms: (1) proximity to students, (2) the ways in which they encouraged students, (3) positive reinforcement techniques, (4) modifications for individual learning types, (5) use of children's strengths, (6) scaffolding, (7) displaying an understanding of diverse cultures, and (8) displaying a personal regard for students of diverse cultures. When the study was completed and data was collected, I identified trends in the change in teacher discourse, behaviors, instructional practice, and perceptions of student engagement. My findings, discovered through classroom observations and focus groups, indicated a positive shift in each. Accompanying these shifts were positive shifts in level of student engagement and level of connectedness. There were also the unexpected findings of the need for teachers to receive feedback in a safe collaborative space and the use of culturally responsive teaching as a tool for behavioral management. My study found that there is a definite relationship between the use of the culturally responsive indicators observed, student engagement and student level of connectedness to physics when implemented in urban high school science classrooms.

  18. The Culture of General Palliative Nursing Care in Medical Departments

    DEFF Research Database (Denmark)

    Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi

    2015-01-01

    and the nurses' reflections on GPNC: (1) GPNC provided in a treatment setting, (2) transition to loving care and the licence to perform palliative care (PC) and (3) potential for team improvement. Conclusions: GPNC as a culture in medical departments seemed to be embedded in a setting not suited for dying...... patients. Palliative care was still practised according to the transition model of care, sharply dividing curative from palliative care, and was inappropriately conducted in a fragmented and individual-based way. The term ‘loving care’ was used as a ‘gate-opener’ to provide palliative care for the dying......Background: In many countries, approximately half of the population dies in hospital, making general palliative nursing care (GPNC) a core nursing task. GPNC in the hospital setting is described as challenging, however little is known about its actual practice. Aim: To explore the GPNC culture...

  19. Culture change and nursing home quality of care.

    Science.gov (United States)

    Grabowski, David C; O'Malley, A James; Afendulis, Christopher C; Caudry, Daryl J; Elliot, Amy; Zimmerman, Sheryl

    2014-02-01

    Culture change models are intended to improve the quality of life for nursing home residents, but the impact of these models on quality of care is unknown. We evaluated the impact of the implementation of nursing home culture change on the quality of care, as measured by staffing, health-related survey deficiencies, and Minimum Data Set (MDS) quality indicators. From the Pioneer Network, we have data on whether facilities were identified by experts as "culture change" providers in 2004 and 2009. Using administrative data, we employed a panel-based regression approach in which we compared pre-post quality outcomes in facilities adopting culture change between 2004 and 2009 against pre-post quality outcomes for a propensity score-matched comparison group of nonadopters. Nursing homes that were identified as culture change adopters exhibited a 14.6% decrease in health-related survey deficiency citations relative to comparable nonadopting homes, while experiencing no significant change in nurse staffing or various MDS quality indicators. This research represents the first large-scale longitudinal evaluation of the association of culture change and nursing home quality of care. Based on the survey deficiency results, nursing homes that were identified as culture change adopters were associated with better care although the surveyors were not blind to the nursing home's culture change efforts. This finding suggests culture change may have the potential to improve MDS-based quality outcomes, but this has not yet been observed.

  20. Toward a More Culturally Responsive General Music Classroom

    Science.gov (United States)

    Abril, Carlos R.

    2013-01-01

    This article seeks to characterize culturally responsive teaching; consider how it differs from other pedagogical approaches in music education informed by culture, such as multicultural music education; and offer ideas for making the general music classroom more culturally responsive.

  1. Toward a More Culturally Responsive General Music Classroom

    Science.gov (United States)

    Abril, Carlos R.

    2013-01-01

    This article seeks to characterize culturally responsive teaching; consider how it differs from other pedagogical approaches in music education informed by culture, such as multicultural music education; and offer ideas for making the general music classroom more culturally responsive.

  2. Cultural history and aesthetics of nursing care.

    Science.gov (United States)

    Siles González, José; Ruiz, Maria del Carmen Solano

    2011-01-01

    The aim of this study was to clarify the role of aesthetics in the organization and motivation of care through history. The guiding questions were: What values and aesthetic feelings have supported and motivated pre-professional and professional care? and Based on what structures has pre-professional and professional care been historically socialized? Primary and secondary sources were consulted, selected according to established criteria with a view to avoiding search and selection bias. Data analysis was guided by the categories: "habitus" and "logical conformism". It was found that the relation between social structures and pre-professionals (motherhood, religiosity) and professional aesthetic standards (professionalism, technologism) of care through history is evidenced in the caregiving activity of the functional unit, in the functional framework and the functional element. In conclusion, in social structures, through the socialization process, "logical conformism" and "habitus" constitute the aesthetic standards of care through feelings like motherhood, religiosity, professionalism, technologism and humanism.

  3. Schools and Marketization: Cultural Challenges and Responses.

    Science.gov (United States)

    Foskett, Nicholas H.

    1998-01-01

    Develops an analytical methodology for service organizations by examining four key cultural and managerial developments: understandings of markets and marketing held within the school; organizational responses to the market; use of analytical tools; and development of appropriate marketing strategies. Shows variations in schools' development of a…

  4. Culturally Responsive Computing: A Theory Revisited

    Science.gov (United States)

    Scott, Kimberly A.; Sheridan, Kimberly M.; Clark, Kevin

    2015-01-01

    Despite multiple efforts and considerable funding, historically marginalized groups (e.g., racial minorities and women) continue not to enter or persist in the most lucrative of fields--technology. Understanding the potency of culturally responsive teaching (CRT), some technology-enrichment programs modified CRP principles to establish a…

  5. Practical strategies for providing culturally sensitive, ethical care in developing nations.

    Science.gov (United States)

    Crigger, Nancy J; Holcomb, Lygia

    2007-01-01

    Providing health care in developing nations results in cultural and ethical challenges for health care professionals. The authors' intent is to raise readers' awareness of how to maintain an ethical and culturally sensitive approach to practice in developing nations. Four practical approaches to ethical decision-making, developed from the literature and praxis, in conjunction with traditional moral theory and guidelines from professional and international organizations are discussed. Ethical multiculturalism, a view that combines universalism and multiculturalism undergirds culturally appropriate and ethically responsive decisions.

  6. Guide for identifying cultural features in nursing care

    Directory of Open Access Journals (Sweden)

    Gülbu Tanrıverdi

    2009-05-01

    Full Text Available Use of cultural models and guides is useful in accessing cultural data in a more systematical and standardized manner and in increasing information accumulated on inter-cultural nursing field. Thus, nurses know cultural factors underlying health- and disease-related attitudes of individual, whom they provide healthcare, and occurrence of any possible cultural shock between nurse and cared individual is avoided. As a consequence, quality of care provided by nurses to individuals is increased. Although it is not common in our country, models and guides are used in nursing care. However, these are not adequate for collecting cultural data from individuals. In our country, a model of guide is required to remove this deficiency in nursing care. For this purpose, “Guide for Identifying Cultural Features in Nursing Care” is developed. This guide is consisted of four fields identifying cultural features. These are as follows: personal features, communication features, familial and social roles as well as healthcare procedures. Use of this guide in clinics and in the field and also use and development of present guide by other healthcare professionals can be recommended.

  7. Exploring patient safety culture in Dutch primary care.

    NARCIS (Netherlands)

    Verbakel, N.J.; Melle, M. van; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.

    2014-01-01

    Objective: To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences. Design Cross-sectional survey: Setting: Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands. Participants:

  8. Improving Patient Safety Culture in Primary Care: A Systematic Review

    NARCIS (Netherlands)

    Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J. M.; Wagner, Cordula; Zwart, Dorien L. M.

    2016-01-01

    Background: Patient safety culture, described as shared values, attitudes and behavior of staff in a health-care organization, gained attention as a subject of study as it is believed to be related to the impact of patient safety improvements. However, in primary care, it is yet unknown, which effec

  9. Cross-cultural aspects of depression management in primary care.

    Science.gov (United States)

    Hails, Katherine; Brill, Charlotte D; Chang, Trina; Yeung, Albert; Fava, Maurizio; Trinh, Nhi-Ha

    2012-08-01

    Major depressive disorder (MDD) is a prevalent illness in minority populations. Minority patients with MDD are often unrecognized and untreated. This review examines promising interventions to address MDD in primary care settings, where minority groups are more likely to seek care. Since 2010, eleven interventions have been developed to address patient-specific and provider-specific barriers, many of which are adaptations of the collaborative care model. Other promising interventions include cultural tailoring of the collaborative care model, as well as the addition of telepsychiatry, motivational interviewing, cultural consultation, and innovations in interpreting. Overall, collaborative care was found feasible and improved satisfaction and treatment engagement of depressed minority patients in primary care. It remains inconclusive whether these newer intervention models improve MDD treatment outcomes. Future research will be needed to establish the effectiveness of these intervention models in improving the treatment outcomes of minority populations with MDD.

  10. Leadership: key to creating a caring culture.

    Science.gov (United States)

    Gilster, Susan D

    2002-01-01

    The subject of leadership is rarely addressed in the health care literature and the field is essentially silent to the need for leadership in long-term care. In this article, leadership is defined as the art of influencing and engaging colleagues to serve collaboratively toward a shared vision. The leadership model includes passion; commitment; vision; service; education; inclusion of staff patients, andfamilies; and self-knowledge.

  11. Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice.

    Science.gov (United States)

    Young, Susan; Guo, Kristina L

    2016-01-01

    The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

  12. CNE article: safety culture in Australian intensive care units: establishing a baseline for quality improvement.

    Science.gov (United States)

    Chaboyer, Wendy; Chamberlain, Di; Hewson-Conroy, Karena; Grealy, Bernadette; Elderkin, Tania; Brittin, Maureen; McCutcheon, Catherine; Longbottom, Paula; Thalib, Lukman

    2013-03-01

    Workplace safety culture is a crucial ingredient in patients' outcomes and is increasingly being explored as a guide for quality improvement efforts. To establish a baseline understanding of the safety culture in Australian intensive care units. In a nationwide study of physicians and nurses in 10 Australian intensive care units, the Safety Attitudes Questionnaire intensive care unit version was used to measure safety culture. Descriptive statistics were used to summarize the mean scores for the 6 subscales of the questionnaire, and generalized-estimation-equations models were used to test the hypotheses that safety culture differed between physicians and nurses and between nurse leaders and bedside nurses. A total of 672 responses (50.6% response rate) were received: 513 (76.3%) from nurses, 89 (13.2%) from physicians, and 70 (10.4%) from respondents who did not specify their professional group. Ratings were highest for teamwork climate and lowest for perceptions of hospital management and working conditions. Four subscales, job satisfaction, teamwork climate, safety climate, and working conditions, were rated significantly higher by physicians than by nurses. Two subscales, working conditions and perceptions of hospital management, were rated significantly lower by nurse leaders than by bedside nurses. Measuring the baseline safety culture of an intensive care unit allows leaders to implement targeted strategies to improve specific dimensions of safety culture. These strategies ultimately may improve the working conditions of staff and the care that patients receive.

  13. Vigilance as a caring expression and Leininger's theory of cultural care diversity and universality.

    Science.gov (United States)

    Carr, J M

    1998-01-01

    Vigilance, or the close, protective involvement of families caring for hospitalized relatives, was explored in this study using holistic ethnography. Leininger's theory of cultural care diversity and universality provided direction for the researcher to generate substantive data about the meanings, patterns, and day-to-day experience of vigilance. Five categories of meaning were derived from the data: commitment to care, emotional upheaval, dynamic nexus, transition, and resilience. The research findings expand understanding of vigilance as a caring expression, suggest direction for nursing practice, and contribute to Leininger's theory of cultural care diversity and universality and the development of nursing science.

  14. Intercultural palliative care: do we need cultural competence?

    Science.gov (United States)

    Gunaratnam, Yasmin

    2007-10-01

    Recognition of the importance of 'cultural competence' is now central to health care policy and to nurse education and training across the international spectrum. Detailed engagement with models of cultural competence is comparatively recent in palliative care nursing. This article presents the findings from a development project on elders and carers from 'minority ethnic' groups, funded by the Department of Health, to increase awareness of palliative care and to improve understanding of the needs of these groups of service users. The article describes the experiences of nurses involved in the delivery of palliative care who were interviewed in focus groups as a part of the project. It draws attention to the complicated relationships between cultural knowledge and practice and to the non-rational and visceral dimensions of intercultural care. These aspects of nursing are marginalised in current approaches to cultural competence, which emphasise the rational acquisition and application of cultural knowledge and skills by practitioners. It is suggested that recognition of these marginalised experiences can contribute to the development of new approaches to intercultural nursing that are also more attuned to the ethos and values of palliative care.

  15. Comparability of Health Care Responsiveness in Europe

    Science.gov (United States)

    Sirven, Nicolas; Santos-Eggimann, Brigitte; Spagnoli, Jacques

    2012-01-01

    The aim of this paper is to measure and to correct for the potential incomparability of responses to the SHARE survey on health care responsiveness. A parametric approach based on the use of anchoring vignettes is applied to cross-sectional data (2006-2007) in eleven European countries. More than 7,000 respondents aged 50 years old and over were…

  16. Patient-centered care: the key to cultural competence.

    Science.gov (United States)

    Epner, D E; Baile, W F

    2012-04-01

    Much of the early literature on 'cultural competence' focuses on the 'categorical' or 'multicultural' approach, in which providers learn relevant attitudes, values, beliefs, and behaviors of certain cultural groups. In essence, this involves learning key 'dos and don'ts' for each group. Literature and educational materials of this kind focus on broad ethnic, racial, religious, or national groups, such as 'African American', 'Hispanic', or 'Asian'. The problem with this categorical or 'list of traits' approach to clinical cultural competence is that culture is multidimensional and dynamic. Culture comprises multiple variables, affecting all aspects of experience. Cultural processes frequently differ within the same ethnic or social group because of differences in age cohort, gender, political association, class, religion, ethnicity, and even personality. Culture is therefore a very elusive and nebulous concept, like art. The multicultural approach to cultural competence results in stereotypical thinking rather than clinical competence. A newer, cross cultural approach to culturally competent clinical practice focuses on foundational communication skills, awareness of cross-cutting cultural and social issues, and health beliefs that are present in all cultures. We can think of these as universal human beliefs, needs, and traits. This patient centered approach relies on identifying and negotiating different styles of communication, decision-making preferences, roles of family, sexual and gender issues, and issues of mistrust, prejudice, and racism, among other factors. In the current paper, we describe 'cultural' challenges that arise in the care of four patients from disparate cultures, each of whom has advanced colon cancer that is no longer responding to chemotherapy. We then illustrate how to apply principles of patient centered care to these challenges.

  17. Corporate Social Responsibility and Managing Ethical Culture

    OpenAIRE

    Yeney Widya Prihatiningtias

    2012-01-01

    This essay argues that the promotion of Corporate Social Responsibility (CSR) and ethical business conduct is very important. CSR nowadays has become crucial issue as major companies are expected to demonstrate their commitment to society’s values through actions. The current article explains, evaluates, and applies to relevant examples of the narrow, broader socio-economic, as well as broad maximal view of CSR. It also critically describes how organizations can develop ethical cultures and c...

  18. Responsibility and care in the collaborative economy

    DEFF Research Database (Denmark)

    Dredge, Dianne

    2017-01-01

    concepts such as ethics, responsibility and moral action in the collaborative economy. The traditional approach is for governments to adopt universal rules to determine who is responsible for what consequences and to prescribe remedies so that actors can ‘earn’ the claim of being responsible. However......, the global and liquid nature of the collaborative economy operating across jurisdictions and the difficulty and lack of interest in implementing strict regulatory frameworks that contradict neoliberal free market ideology suggest that utilitarian and rule bound approaches to defining and apportioning...... responsibilities are unlikely. A care ethics approach to responsibility, that relies on articulating values, establishing emotional connections to place and people/communities, and that encourages public-private collaborative action towards a caring end is argued to be a potential way forward....

  19. [Aspects of economic responsibility in health care].

    Science.gov (United States)

    Hauke, Eugen

    2007-01-01

    According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.

  20. Demystifying and improving organizational culture in health-care.

    Science.gov (United States)

    Pellegrin, Karen L; Currey, Hal S

    2011-01-01

    Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.

  1. Ethno-cultural diversity in home care work in Canada: issues confronted, strategies employed

    Directory of Open Access Journals (Sweden)

    John Naslund

    2011-01-01

    Full Text Available Worldwide, immigrant workers are responsible for much of the care provided to elderly people who require assistance with personal care and with activities of daily living. This article examines the characteristics of immigrant home care workers, and the ways in which they differ from non-migrant care workers in Canada. It considers circumstances wherein the labor of care is framed by ethno-cultural diversity between client and worker, interactions that reflect the character of this ethno-cultural diversity, and the strategies employed by workers to address issues related to this diversity. Findings from a mixed methods study of 118 workers in the metropolitan area of Vancouver, British Columbia, Canada, indicate that while the discriminatory context surrounding migrant home care workers persists, issues of ethno-cultural diversity in relationships are complex, and can also involve non-foreign born workers. Multi-cultural home care is not always framed in a negative context, and there often are positive aspects.

  2. Cultur(ally) Jammed: Culture Jams as a Form of Culturally Responsive Teaching

    Science.gov (United States)

    Martinez, Ulyssa

    2012-01-01

    Does the person become the name or does the name become the person? This question was asked by a participant of my culture jam entitled, "What's my name?" In this culture jam, I asked people to discern the name of a person based solely on their appearance and a list of possible names below their picture. This article aims to show how culture jams…

  3. Patient Care Partnership: Understanding Expectations, Rights and Responsibilities

    Science.gov (United States)

    ` e Patient Care Partnership Understanding Expectations, Rights and Responsibilities What to expect during your hospital stay: • High ... e Patient Care Partnership Understanding Expectations, Rights and Responsibilities W hen you need hospital care, your doctor ...

  4. Shared responsibility for children in care

    DEFF Research Database (Denmark)

    Schwartz, Ida

    2014-01-01

    The responsibility of children in care is shared by a number of professionals placed in different contexts. Parents are responsible for the “big issues” in these children’s lives, while many professionals are involved in the children´s everyday life across home, residential home, schools...... and institutions. These groups of professionals contribute to the children’s everyday lives according to historically developed divisions of responsibility. It is a daily challenge to professionals, how they jointly support children in care so the children can be part of children´s communities in the places where...... or inclusion is analysed as a part of the distribution of responsibility situated in the interplay between professionals across institutions and municipal authorities. The professionals who possess the highest authority in children´s lives are for example furthest away from the children´s everyday life...

  5. Cultural and communicative competence in the caring relationship with patients from another culture.

    Science.gov (United States)

    Hemberg, Jessica Anne Viveka; Vilander, Susann

    2017-02-24

    The global and multicultural society of today creates challenges that require multicultural competence among individuals, especially within caring contexts. This study assumes an intercultural perspective, and the aim is to uncover a new understanding of the caring community between nurses and patients when these do not speak the same language. The research question is: What is the significance of communication in a caring community when nurses and patients do not speak the same language? This qualitative study uses a hermeneutical approach. The material was collected through questionnaires with eight nurses and two adults from another culture. The texts were analysed through latent content analysis. Study participation, data storage and handling for research purposes were approved by the participants when they provided their informed consent. Permission to conduct the study was granted by an ethical committee of a hospital organisation. Human love is the basis for a caring relationship since it reaches beyond the limits of cultural differences. Integrity is vital for cultural respect and especially for the consideration of spiritual needs in the caring relationship. An affirming presence is essential for communion. Creative courage is fundamental for communication, and continuous information is vital for establishing trust within the caring relationship. One limitation to this study might be the limited number of participants (ten). Caring for a patient from another culture requires that nurses are open-minded and have the courage to encounter new challenges. It is essential for nurses to respect the patient's integrity but also to acquire knowledge in order to improve their cultural competence. Further research within this area should focus on the role of next of kin in intercultural caring and on how leadership may contribute to improving cultural competence within health organisations. © 2017 Nordic College of Caring Science.

  6. The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.

    Science.gov (United States)

    Shaw, Susan J; Armin, Julie

    2011-06-01

    Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace.

  7. Patient-centered care or cultural competence: negotiating palliative care at home for Chinese Canadian immigrants.

    Science.gov (United States)

    Nielsen, Lisa Seto; Angus, Jan E; Howell, Doris; Husain, Amna; Gastaldo, Denise

    2015-06-01

    The literature about Chinese attitudes toward death and dying contains frequent references to strong taboos against open discussion about death; consequently, there is an assumption that dying at home is not the preferred option. This focused ethnographic study examined the palliative home care experiences of 4 Chinese immigrants with terminal cancer, their family caregivers, and home care nurses and key informant interviews with 11 health care providers. Three main themes emerged: (1) the many facets of taboo; (2) discursive tensions between patient-centered care and cultural competence; and (3) rethinking language barriers. Thus, training on cultural competence needs to move away from models that portray cultural beliefs as shared, fixed patterns, and take into account the complicated reality of everyday care provision at end of life in the home.

  8. Development of a culture of sustainability in health care organizations.

    Science.gov (United States)

    Ramirez, Bernardo; West, Daniel J; Costell, Michael M

    2013-01-01

    This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

  9. Cultural aspects in the care of the orthodox Jewish woman.

    Science.gov (United States)

    Berkowitz, Bayla

    2008-01-01

    This article offers an overview and explanation of some of the main customs and laws in the Jewish religion surrounding the reproductive health care of the Torah-observant woman. By understanding the religious and spiritual needs and preferences of a patient, the midwife is better able to provide optimal, culturally-competent care. Some of the aspects discussed include procreation, menstruation, modesty, contraception, abortion, genetic testing, induction, the Sabbath, Kosher diet, circumcision, and naming of the child.

  10. Motivation of chemical industry social responsibility through Responsible Care.

    Science.gov (United States)

    Givel, Michael

    2007-04-01

    Advocates of corporate social responsibility argue corporations should not only meet the needs of shareholders, but other key stakeholders including the community, customers, suppliers, and employees. Since 1988, the chemical industry has engaged in a major self-regulatory "Responsible Care" industry-wide social responsibility campaign to ensure environmental, public health, safety, and security performance among member companies. Contrary to the arguments of advocates of corporate social responsibility that such efforts meet the needs of stakeholders other than shareholders such as the community, the primary goal of the Responsible Care effort has been to change public concerns and opinion about chemical industry environmental and public health practices while also opposing support for stronger and more expensive public health and environmental legislation and regulation of chemical products, even if warranted.

  11. Cell Culture Assay for Human Noroviruses [response

    Energy Technology Data Exchange (ETDEWEB)

    Straub, Tim M.; Honer Zu Bentrup, Kerstin; Orosz Coghlan, Patricia; Dohnalkova, Alice; Mayer, Brooke K.; Bartholomew, Rachel A.; Valdez, Catherine O.; Bruckner-Lea, Cindy J.; Gerba, Charles P.; Abbaszadegan, Morteza A.; Nickerson, Cheryl A.

    2007-07-01

    We appreciate the comments provided by Leung et al., in response to our recently published article “In Vitro Cell Culture Infectivity Assay for Human Noroviruses” by Straub et al. (1). The specific aim of our project was to develop an in vitro cell culture infectivity assay for human noroviruses (hNoV) to enhance risk assessments when they are detected in water supplies. Reverse transcription (RT) qualitative or quantitative PCR are the primary assays for waterborne NoV monitoring. However, these assays cannot distinguish between infectious vs. non-infectious virions. When hNoV is detected in water supplies, information provided by our infectivity assay will significantly improve risk assessment models and protect human health, regardless of whether we are propagating NoV. Indeed, in vitro cell culture infectivity assays for the waterborne pathogen Cryptosporidium parvum that supplement approved fluorescent microscopy assays, do not result in amplification of the environmentally resistant hard-walled oocysts (2). However, identification of life cycle stages in cell culture provides evidence of infectious oocysts in a water supply. Nonetheless, Leung et al.’s assertion regarding the suitability of our method for the in vitro propagation of high titers of NoV is valid for the medical research community. In this case, well-characterized challenge pools of virus would be useful for developing and testing diagnostics, therapeutics, and vaccines. As further validation of our published findings, we have now optimized RT quantitative PCR to assess the level of viral production in cell culture, where we are indeed finding significant increases in viral titer. The magnitude and time course of these increases is dependent on both virus strain and multiplicity of infection. We are currently preparing a manuscript that will discuss these findings in greater detail, and the implications this may have for creating viral challenge pools

  12. [Application of the cultural competence model in the experience of care in nursing professionals Primary Care].

    Science.gov (United States)

    Gil Estevan, María Dolores; Solano Ruíz, María Del Carmen

    2017-06-10

    To know the experiences and perceptions of nurses in providing care and health promotion, women belonging to groups at risk of social vulnerability, applying the model of cultural competence Purnell. Phenomenological qualitative study. Department of Health Elda. A total of 22 primary care professional volunteers. Semi-structured interviews and focus groups with recording and content analysis, according to the theory model of cultural competence. Socio-cultural factors influence the relationship between professionals and users of the system. The subtle racism and historical prejudices create uncomfortable situations and mistrust. The language barrier makes it difficult not only communication, but also the monitoring and control of the health-disease process. The physical appearance and stereotypes are determining factors for primary care professionals. Although perceived misuse of health services are also talking about changes. The spiritual aspects of religious beliefs alone are taken into account in the case of Muslim women, not being considered as important in the case of Gypsy women and Romanian women. To provide quality care, consistent and culturally competent, it is necessary to develop training programs for professionals in cultural competence, to know the culture of other, and work without preconceived ideas, and ethnocentric; since the greater the knowledge of the cultural group being served, the better the quality of care provided. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. Understanding the workplace culture of a special care nursery.

    Science.gov (United States)

    Wilson, Valerie J; McCormack, Brendan G; Ives, Glenice

    2005-04-01

    This paper presents findings from the first phase of a research study focusing on implementation and evaluation of emancipatory practice development strategies. Understanding the culture of practice is essential to undertaking effective developments in practice. Culture is a dominant feature of discussions about modernizing health care, yet few studies have been undertaken that systematically evaluate the development of effective practice cultures. The study intervention is that of emancipatory practice development with an integrated evaluation approach based on Realistic Evaluation. The aim of Realistic Evaluation is to evaluate relationships between Context (setting), Mechanism (process characteristics) and Outcome (arising from the context-mechanism configuration). This first phase of the study focuses on uncovering the context (in particular the culture) of the Special Care Nursery in order to evaluate the emancipatory practice development processes and outcomes. Data collection methods included survey, participant observation and interview. Cognitive mapping, constant comparative method and coding were used to analyse the data. Findings. Four key categories were identified: Teamwork, Learning in Practice, Inevitability of Change and Family-Centred Care and collectively these formed a central category of Core Values and Beliefs. A number of themes were identified in each category, and reflected tensions that existed between differing values and beliefs within the culture of the unit. Understanding values and beliefs is an important part of understanding a workplace culture. Whilst survey methods are capable of outlining espoused workplace characteristics, observation of staff interactions and perceptions gives an understanding of culture as a living entity manifested through interpersonal relationships. Attempts at changing workplace cultures should start from the clarification of values held among staff in that culture.

  14. Corporate Social Responsibility and Managing Ethical Culture

    Directory of Open Access Journals (Sweden)

    Yeney Widya Prihatiningtias

    2012-04-01

    Full Text Available This essay argues that the promotion of Corporate Social Responsibility (CSR and ethical business conduct is very important. CSR nowadays has become crucial issue as major companies are expected to demonstrate their commitment to society’s values through actions. The current article explains, evaluates, and applies to relevant examples of the narrow, broader socio-economic, as well as broad maximal view of CSR. It also critically describes how organizations can develop ethical cultures and corporate ethics programs for CSR.

  15. Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians.

    Science.gov (United States)

    Kruske, Sue; Kildea, Sue; Barclay, Lesley

    2006-09-01

    To discuss cultural safety and critique the provision of culturally appropriate maternity services to remote Aboriginal and Torres Strait Islander women in Australia. The literature and policies around 'culture' and 'cultural safety' are discussed and applied to the provision of maternity services to Aboriginal and Torres Strait Islander women in remote areas of Australia. The current provision of maternity services to Aboriginal and Torres Strait Islander women, particularly those living in remote Australia, appears largely inadequate. The provision of culturally safe maternity care requires health system reform at all levels including: the individual practitioner response; the educational preparation of practitioners; the delivery of maternity services and the development of policy at local, state and national level. This paper considers the changes that can be made from the individual practitioner through to the design and implementation of maternity services. Cultural safety provides a useful framework to improve the delivery of maternity services to remote Aboriginal and Torres Strait Islander women and their families.

  16. Organizational culture, intersectoral collaboration and mental health care.

    Science.gov (United States)

    Mitchell, Penelope Fay; Pattison, Philippa Eleanor

    2012-01-01

    This study aims to investigate whether and how organizational culture moderates the influence of other organizational capacities on the uptake of new mental health care roles by non-medical primary health and social care services. Using a cross-sectional survey design, data were collected in 2004 from providers in 41 services in Victoria, Australia, recruited using purposeful sampling. Respondents within each service worked as a group to complete a structured interview that collected quantitative and qualitative data simultaneously. Five domains of organizational capacity were analyzed: leadership, moral support and participation; organizational culture; shared concepts, policies, processes and structures; access to resource support; and social model of health. A principal components analysis explored the structure of data about roles and capacities, and multiple regression analysis examined relationships between them. The unit of analysis was the service (n = 41). Organizational culture was directly associated with involvement in two types of mental health care roles and moderated the influence of factors in the inter-organizational environment on role involvement. Congruence between the values embodied in organizational culture, communicated in messages from the environment, and underlying particular mental health care activities may play a critical role in shaping the emergence of intersectoral working and the uptake of new roles. This study is the first to demonstrate the importance of organizational culture to intersectoral collaboration in health care, and one of very few to examine organizational culture as a predictor of performance, compared with other organizational-level factors, in a multivariate analysis. Theory is developed to explain the findings.

  17. Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers

    Directory of Open Access Journals (Sweden)

    Seeleman Conny

    2012-07-01

    Full Text Available Abstract Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years with paediatricians (n = 13 and nurses (n = 3 in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters. Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.

  18. Organizational culture during the accident response process

    Energy Technology Data Exchange (ETDEWEB)

    Shurberg, D.A.; Haber, S.B.

    1992-01-01

    The ability of an organization to effectively move from an anticipatory to an ad hoc strategy may well depend on the organization having the ability to balance these two apparently dichotomous cultural styles. The organization which is most capable of making the necessary transition in an optimal manner may well exhibit some aspects of both cultural styles during normal operations. Data collected at one NPP does exhibit this pattern of results, with the organization exhibiting a clear hierarchical chain of command and perceived conventional behavioral expectations as well as exhibiting a more decentralized and collegial approach to decisionmaking, a team work orientation, and informal communications. Thus, it is expected that this organization possesses the capabilities to make a successful transition from an anticipatory to an ad hoc strategy. Data collected at a second NPP more strongly exhibits the traditional style suggested as being important during the anticipatory strategy, with more formal communications and bureaucratically controlled decision-making. This organization may experience difficulty if faced with the need to make a transition from an anticipatory to an ad hoc strategy. These conclusions are further validated based on observation of Emergency Preparedness Exercise Inspections, which suggest that the more anticipatory types of behaviors actually inhibit successful performance during an ad hoc response. The final validation of these hypotheses needs to be demonstrated with cultural data collected during emergency simulations. The mechanism to obtain such data during these types of situations is an area for future research.

  19. Organizational culture during the accident response process

    Energy Technology Data Exchange (ETDEWEB)

    Shurberg, D.A.; Haber, S.B.

    1992-08-01

    The ability of an organization to effectively move from an anticipatory to an ad hoc strategy may well depend on the organization having the ability to balance these two apparently dichotomous cultural styles. The organization which is most capable of making the necessary transition in an optimal manner may well exhibit some aspects of both cultural styles during normal operations. Data collected at one NPP does exhibit this pattern of results, with the organization exhibiting a clear hierarchical chain of command and perceived conventional behavioral expectations as well as exhibiting a more decentralized and collegial approach to decisionmaking, a team work orientation, and informal communications. Thus, it is expected that this organization possesses the capabilities to make a successful transition from an anticipatory to an ad hoc strategy. Data collected at a second NPP more strongly exhibits the traditional style suggested as being important during the anticipatory strategy, with more formal communications and bureaucratically controlled decision-making. This organization may experience difficulty if faced with the need to make a transition from an anticipatory to an ad hoc strategy. These conclusions are further validated based on observation of Emergency Preparedness Exercise Inspections, which suggest that the more anticipatory types of behaviors actually inhibit successful performance during an ad hoc response. The final validation of these hypotheses needs to be demonstrated with cultural data collected during emergency simulations. The mechanism to obtain such data during these types of situations is an area for future research.

  20. Culture change in care homes: a literature review.

    Science.gov (United States)

    Wild, Deirdre; Kydd, Angela

    2016-08-01

    This article is the first of a two-part series that explores a programme of culture change in care homes. A UK care home company sought the authors' expertise to design and facilitate an independent programme of learning to encourage and support staff in two of its homes to become the architects of their own quality improvement. The article reviews the literature that was an essential information base for the authors in their dual roles as designers of the learning programme and facilitators of its delivery to participant staff. The literature is necessarily broad in reflecting the nature and context of care homes, residents' needs and wants from care, and the particular challenges that might be faced by care home staff and managers when making quality improvements. In the second article, the reality of running the programme in the two homes is described.

  1. Primary care units in Emilia-Romagna, Italy: an assessment of organizational culture.

    Science.gov (United States)

    Pracilio, Valerie P; Keith, Scott W; McAna, John; Rossi, Giuseppina; Brianti, Ettore; Fabi, Massimo; Maio, Vittorio

    2014-01-01

    This study investigates the organizational culture and associated characteristics of the newly established primary care units (PCUs)-collaborative teams of general practitioners (GPs) who provide patients with integrated health care services-in the Emilia-Romagna Region (RER), Italy. A survey instrument covering 6 cultural dimensions was administered to all 301 GPs in 21 PCUs in the Local Health Authority (LHA) of Parma, RER; the response rate was 79.1%. Management style, organizational trust, and collegiality proved to be more important aspects of PCU organizational culture than information sharing, quality, and cohesiveness. Cultural dimension scores were positively associated with certain characteristics of the PCUs including larger PCU size and greater proportion of older GPs. The presence of female GPs in the PCUs had a negative impact on collegiality, organizational trust, and quality. Feedback collected through this assessment will be useful to the RER and LHAs for evaluating and guiding improvements in the PCUs.

  2. Transforming Cultures of Care: A Case Study in Organizational Change

    Science.gov (United States)

    Purvis, Karyn; Cross, David; Jones, Daren; Buff, Gary

    2012-01-01

    The authors report on a small organizational case study highlighting the dimensions of trauma-informed care, the processes of organizational change, and the growth of caregiver expertise. The article is framed by the notion of caregiving cultures, which refers to the beliefs, languages, and practices of caregivers and caregiving organizations.…

  3. Organizational culture, job satisfaction, and clinician turnover in primary care.

    Science.gov (United States)

    Hall, Charles B; Brazil, Kevin; Wakefield, Dorothy; Lerer, Trudy; Tennen, Howard

    2010-04-01

    The purpose of this study is to examine how organizational culture and job satisfaction affect clinician turnover in primary care pediatric practices. One hundred thirty clinicians from 36 primary care pediatric practices completed the Primary Care Organizational Questionnaire (PCOQ), which evaluates interactions among members of the practice and job-related attributes measuring 8 organizational factors, along with a separate 3-item instrument measuring job satisfaction. Random effects logistic models were used to assess the associations between job satisfaction, the organizational factors from the PCOQ, and clinician turnover over the subsequent year. All 8 measured organizational factors from the PCOQ, particularly perceived effectiveness, were associated with job satisfaction. Five of the 8 organizational factors were also associated with clinician turnover. The effects of the organizational factors on turnover were substantially reduced in a model that included job satisfaction; only 1 organizational factor, communication between clinicians and nonclinicians, remained significant (P = .05). This suggests that organizational culture affects subsequent clinician turnover primarily through its effect on job satisfaction. Organizational culture, in particular perceived effectiveness and communication, affects job satisfaction, which in turn affects clinician turnover in primary care pediatric practices. Strategies to improve job satisfaction through changes in organizational culture could potentially reduce clinician turnover.

  4. Transforming Cultures of Care: A Case Study in Organizational Change

    Science.gov (United States)

    Purvis, Karyn; Cross, David; Jones, Daren; Buff, Gary

    2012-01-01

    The authors report on a small organizational case study highlighting the dimensions of trauma-informed care, the processes of organizational change, and the growth of caregiver expertise. The article is framed by the notion of caregiving cultures, which refers to the beliefs, languages, and practices of caregivers and caregiving organizations.…

  5. Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background As the diversity of the European population evolves, measuring providers’ skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. Methods A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians’ and nurses’ mean composite scores and proportion of “3-good/4-very good” responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit “sensitized” to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Results Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = −0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force

  6. An ethical framework for the responsible leadership of accountable care organizations.

    Science.gov (United States)

    McCullough, Laurence B

    2012-01-01

    Using the ethical concepts of co-fiduciary responsibility in patient care and of preventive ethics, this article provides an ethical framework to guide physician and lay leaders of accountable care organizations. The concept of co-fiduciary responsibility is based on the ethical concept of medicine as a profession, which was introduced into the history of medical ethics in the 18th century. Co-fiduciary responsibility applies to everyone who influences the processes of patient care: physicians, organizational leaders, patients, and patients' surrogates. A preventive ethics approach to co-fiduciary responsibility requires leaders of accountable care organizations to create organizational cultures of fiduciary professionalism that implement and support the following: improving quality based on candor and accountability, reasserting the physician's professional role in the informed consent process, and constraining patients' and surrogates' autonomy. Sustainable organizational cultures of fiduciary professionalism will require commitment of organizational resources and constant vigilance over the intellectual and moral integrity of organizational culture.

  7. Culture and spirituality: essential components of palliative care.

    Science.gov (United States)

    Speck, Peter

    2016-06-01

    Palliative care advocates a holistic, multiprofessional approach to the care of people with life-threatening disease. In addition to the control of physical symptoms attention should also be paid to psychosocial, cultural and spiritual aspects of the patient's experience of illness. Guidance documents and research evidence reflect the complexity of the patient's journey and the need to regularly assess these areas of need over time. Cultural background can shape how patients respond to life-threatening illness, as can the beliefs held by the patients, whether religious or more broadly spiritual. Research evidence shows the importance of identifying and addressing cultural and spiritual aspects of care held by patients, families and staff. These are often neglected in clinical practice due to the focus on biomedical concerns and staff discomfort in engaging with beliefs and culture. Recent studies have highlighted gaps in the research, and some methodological difficulties and indicate many patients welcome healthcare staff enquiring about the importance of their beliefs and culture. Identifying research priorities is necessary to guide future research and strengthen the evidence base.

  8. Perceptions and employment intentions among aged care nurses and nursing assistants from diverse cultural backgrounds: A qualitative interview study.

    Science.gov (United States)

    Gao, Fengsong; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony; Newcombe, Peter

    2015-12-01

    The residential aged care industry faces shortages and high turnover rates of direct care workers. This situation is further complicated by the increasing cultural diversity of residents and staff. To retain direct care workers, it is crucial to explore their perceptions of the rewards and difficulties of care work, and their employment intentions in multicultural environments. A qualitative descriptive study was used to understand perceptions of the rewards and difficulties of residential aged care work for core direct care workers (i.e. nurses and nursing assistants), how these were related to their intentions to stay or leave, and how these varied between nurses and nursing assistants, and between locally and overseas born workers. Individual interviews were conducted between June and September 2013 with 16 direct care workers in an Australian residential aged care facility with a specific focus on people from culturally and linguistically diverse backgrounds. It was found that direct care workers' employment intentions were related to their perceptions and management of the rewards and difficulties of care work. Their experiences of care work, the employment characteristics, and the organizational resources that fitted their personality, ability, expectations, and essential needs were viewed as rewards. Evaluating their jobs as meaningful was a shared perception for direct care workers who intended to stay. Individual workers' perceptions of the rewarding aspects of care work served to counterbalance the challenges of care work, and promoted their intentions to stay. Perceptions and employment intentions varied by occupational groups and by cultural backgrounds. Overseas born direct care workers are valuable resources in residential aged care facility rather than a limitation, but they do require organizational support, such as cultural awareness of the management, English language support, a sense of family, and appropriate job responsibility. The findings

  9. Organizational and cultural changes for providing safe patient care.

    Science.gov (United States)

    Odwazny, Richard; Hasler, Scott; Abrams, Richard; McNutt, Robert

    2005-01-01

    To describe an approach and experience with fostering a culture of patient safety. (1) Organizational Change-The Department of Medicine established a patient safety committee (PSC) and charged it with reviewing adverse events. (2) Cultural Change-PSC sponsors and participants work to promote a culture of collaboration, study, learning, and prevention versus a culture of blame. (3) Collaboration-The PSC includes chief residents and members from medical informatics, nursing, pharmacy, quality assurance, risk management, and utilization management. (4) Evolution-The duties of the PSC progressed from merely learning from adverse event reports to implementing patient safety and quality improvement projects. (5) Standardization-The PSC uses standard definitions and procedures when reviewing cases of adverse events, and when conducting patient safety and quality improvement projects. (1) Developed an online adverse event reporting system, shortening the average report collection time by 2 days and increasing the number of adverse events reported. (2) Established a model for change using (a) safety rounds with residents, (b) e-mail safety alerts, and, in some cases, (c) decision alerts using electronic order entry. These changes in culture and capability led to improvements in care and improved financial results. Senior management support of a culture of learning and prevention and an organizational structure that promotes collaboration has provided an environment in which patient safety initiatives can flourish by providing not only safer and higher quality patient care but also a positive financial return on investment.

  10. Organisational culture and change: implementing person-centred care.

    Science.gov (United States)

    Carlström, Eric D; Ekman, Inger

    2012-01-01

    The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person-centred care (PCC) for patients with chronic heart failure. Surveys were sent out to 170 nurses. The survey included two instruments--the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC). The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well-defined framework. An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes. Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units--i.e. the health workers in different hospital wards--was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.

  11. Culture-bound syndromes in Hispanic primary care patients.

    Science.gov (United States)

    Bayles, Bryan P; Katerndahl, David A

    2009-01-01

    We sought to document Hispanic primary care patients' knowledge and experience of five culture-bound syndromes (CBS), as well as the basic socio-cultural correlates of these disorders. A convenience sample of 100 adult Hispanic patients presenting in an urban South Texas primary care clinic was recruited to complete a brief cross-sectional survey, presented in an oral format. Interviews sought information concerning five culture-bound syndromes--susto, empacho, nervios, mal de ojo, and ataques de nervios. Additional demographic, socio-economic, and acculturation data was collected. Descriptive and bivariate statistics (chi square, Fisher's) were used to assess relationships among variables and experience with each CBS. A multivariate logistic analysis was conducted to determine the possible contributions of age, gender, acculturation, and education to the personal experience of a culture-bound syndrome. Results indicate that 77% of respondents had knowledge of all five syndromes, with 42% reporting having personally experienced at least one CBS. Nervios was the most commonly suffered disorder, being reported by 30 respondents. This was followed, in declining order ofprevalence, by susto, mal de ojo, empacho, and ataques de nervios. Multivariate logistic regression analysis found that higher education beyond high school was associated with a slightly decreased likelihood of reporting having suffered from any culture-bound syndrome. While co-occurrence among these disorders occurred, the patterns of predictors suggest that the co-occurrence is not a reflection of mislabeling of one common syndrome. Knowledge of and experience with culture-bound syndromes is common among Hispanic primary care patients in South Texas. Healthcare providers ought to consider discussing these illnesses in a non-judgmental manner with patients who present with symptoms that are consistent with these syndromes. Future studies, with larger sample sizes, are warranted to elucidate the nature

  12. Developing Culturally Responsive Leaders through Online Learning and Teaching Approaches

    Science.gov (United States)

    Taliaferro, Alisa

    2011-01-01

    The article will discuss culturally responsive leadership theory as a means to developing pre-service Master of School Administration (MSA) students as culturally responsive leaders who understand and are able to bridge differences that arise in diverse educational settings. The issues explored include those related to the cultural heritages and…

  13. Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

    Science.gov (United States)

    Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

    2014-01-30

    As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p diversity efforts in the work force, particularly among physicians.

  14. How to change organisational culture: Action research in a South African public sector primary care facility

    Science.gov (United States)

    De Sa, Angela; Christodoulou, Maria

    2016-01-01

    Background Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim To explore how to transform the organisational culture in line with the desired values. Setting Retreat Community Health Centre, Cape Town, South Africa. Methods Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Results Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group. PMID:27608671

  15. How to change organisational culture: Action research in a South African public sector primary care facility.

    Science.gov (United States)

    Mash, Robert; De Sa, Angela; Christodoulou, Maria

    2016-08-31

    Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. To explore how to transform the organisational culture in line with the desired values. Retreat Community Health Centre, Cape Town, South Africa. Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  16. Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making.

    Science.gov (United States)

    Brown, Edwina A; Bekker, Hilary L; Davison, Sara N; Koffman, Jonathan; Schell, Jane O

    2016-08-10

    Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo-American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients' responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient's specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs.

  17. The impact of organizational culture on the outcome of hospital care: after the implementation of person-centred care.

    Science.gov (United States)

    J Alharbi, Tariq Saleem; Olsson, Lars-Eric; Ekman, Inger; Carlström, Eric

    2014-02-01

    To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. The regression analysis showed that; 16% (R(2) = 0.02) of a decreased health status, 22% (R(2) = 0.05) of pain/discomfort and 13% (R(2) = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.

  18. Organisational culture matters for system integration in health care.

    Science.gov (United States)

    Munir, Samina K; Kay, Stephen

    2003-01-01

    This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the 'Actual Usefulness' of the system and the 'Organisational Culture'. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated.

  19. Acute-care surgical service: a change in culture.

    Science.gov (United States)

    Parasyn, Andrew D; Truskett, Philip G; Bennett, Michael; Lum, Sharon; Barry, Jennie; Haghighi, Koroush; Crowe, Philip J

    2009-01-01

    The provision of acute surgical care in the public sector is becoming increasingly difficult because of limitation of resources and the unpredictability of access to theatres during the working day. An acute-care surgical service was developed at the Prince of Wales Hospital to provide acute surgery in a more timely and efficient manner. A roster of eight general surgeons provided on-site service from 08.00 to 18.00 hours Monday to Friday and on-call service in after-hours for a 79-week period. An acute-care ward of four beds and an operating theatre were placed under the control of the rostered acute-care surgeon (ACS). At the end of each ACS roster period all patients whose treatment was undefined or incomplete were handed over to the next rostered ACS. Patient data and theatre utilization data were prospectively collected and compared to the preceding 52-week period. Emergency theatre utilization during the day increased from 57 to 69%. There was a 11% reduction in acute-care operating after hours and 26% fewer emergency cases were handled between midnight and 08.00 hours. There was more efficient use of the entire theatre block, suggesting a significant cultural change. Staff satisfaction was high. On-site consultant-driven surgical leadership has provided significant positive change to the provision of acute surgical care in our institution. The paradigm shift in acute surgical care has improved patient and theatre management and stimulated a cultural change of efficiency.

  20. Defining culturally responsive teaching: The case of mathematics

    Directory of Open Access Journals (Sweden)

    Jenni L. Harding-DeKam

    2014-12-01

    Full Text Available Elementary classroom teachers in eight school districts across Colorado, United States, share the knowledge of their students’ home and community life, define culturally responsive mathematics based on the children they instruct, and give examples of how students learn math through culture in their classrooms. Findings from two interviews, classroom observations, and student artifacts reveal that teachers have an intimate cultural knowledge of the students in their classrooms, define culturally responsive mathematical practices consistent with research, use culturally responsive mathematics teaching for authentic learning, and express a need for additional professional development and curriculum support for culturally responsive mathematics instruction. Culturally responsive mathematics is important in elementary classrooms because it allows students to make personal connections to mathematics content.

  1. Culturally Responsive Dispositions in Prospective Mathematics Teachers

    Science.gov (United States)

    Williams, Desha L.; Edwards, Belinda; Kuhel, Karen A.; Lim, Woong

    2016-01-01

    Sustaining teachers in culturally and linguistically diverse schools has been a prominent issue for years. This qualitative study focused on the impact of an enhanced preparation program on the cultural dispositions of five pre-service mathematics teachers. It is postulated that if positive cultural dispositions are developed in teacher…

  2. Development of a high-value care culture survey: a modified Delphi process and psychometric evaluation.

    OpenAIRE

    Gupta, R.(Panjab University, Chandigarh, India); Moriates, C; Harrison, JD; Valencia, V; Ong, M; Clarke, R.; Steers, N; Hays, RD; Braddock, CH; De Wachter, R

    2016-01-01

    Organisational culture affects physician behaviours. Patient safety culture surveys have previously been used to drive care improvements, but no comparable survey of high-value care culture currently exists. We aimed to develop a High-Value Care Culture Survey (HVCCS) for use by healthcare leaders and training programmes to target future improvements in value-based care.We conducted a two-phase national modified Delphi process among 28 physicians and nurse experts with diverse backgrounds. We...

  3. Culturally capable and culturally safe: Caseload care for Indigenous women by Indigenous midwifery students.

    Science.gov (United States)

    West, R; Gamble, J; Kelly, J; Milne, T; Duffy, E; Sidebotham, M

    2016-12-01

    Evidence is emerging of the benefits to students of providing continuity of midwifery care as a learning strategy in midwifery education, however little is known about the value of this strategy for midwifery students. To explore Indigenous students' perceptions of providing continuity of midwifery care to Indigenous women whilst undertaking a Bachelor of Midwifery. Indigenous Bachelor of Midwifery students' experiences of providing continuity of midwifery care to Indigenous childbearing women were explored within an Indigenous research approach using a narrative inquiry framework. Participants were three Indigenous midwifery students who provided continuity of care to Indigenous women. Three interconnected themes; facilitating connection, being connected, and journeying with the woman. These themes contribute to the overarching finding that the experience of providing continuity of care for Indigenous women creates a sense of personal affirmation, purpose and a validation of cultural identity in Indigenous students. Midwifery philosophy aligns strongly with the Indigenous health philosophy and this provides a learning platform for Indigenous student midwives. Privileging Indigenous culture within midwifery education programs assists students develop a sense of purpose and affirms them in their emerging professional role and within their community. The findings from this study illustrate the demand for, and pertinence of, continuity of care midwifery experiences with Indigenous women as fundamental to increasing the Indigenous midwifery workforce in Australia. Australian universities should provide this experience for Indigenous student midwives. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  4. Cultural affiliation and the importance of health care attributes. Marketers can develop segmentation strategies for targeted patient groups.

    Science.gov (United States)

    Dolinsky, A L; Stinerock, R

    1998-01-01

    Culturally based values are known to influence consumer purchase decisions, but little is known about how those values affect health care choices. To rectify that situation and provide health care marketers with a framework for developing culturally based segmentation strategies, the authors undertook an exploratory research project in which Hispanic-, African-, and Anglo-Americans were asked to rate the importance of 16 different health care attributes. Those attributes can be grouped under five categories: quality of physician, quality of nurses and other medical staff, economic issues, access to health care, and nonmedically related experiential aspects. Survey responses identified distinct differences in the importance attached to the various attributes by the three cultural groups. The study also looks at the impact of six demographic and social characteristics on the evaluations made by each cultural group. Those characteristics are educational level, gender, age, health status, marital status, and number of people living in the household.

  5. Is workplace culture an excuse for poor care?

    Science.gov (United States)

    Mee, Steve

    This article looks at the issue of nurses' own responsibility for their actions. Negative behaviour can be explained by external factors, such as culture and the influence of others, or by internal ones, including a person's own moral compass. Within the context of the Francis report, this article raises questions about how we can ensure that nurses adhere to their code of conduct.

  6. What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand.

    Science.gov (United States)

    Frey, Rosemary; Boyd, Michal; Foster, Sue; Robinson, Jackie; Gott, Merryn

    2016-07-01

    Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal.

  7. Medical anthropology and Ebola in Congo: cultural models and humanistic care.

    Science.gov (United States)

    Hewlett, B S; Epelboin, A; Hewlett, B L; Formenty, P

    2005-09-01

    Seldom have medical anthropologists been involved in efforts to control high mortality diseases such as Ebola hemorrhagic fever (EHF) This paper describes the results of two distinct but complementary interventions during the first phases of an outbreak in the Republic of Congo in 2003. The first approach emphasized understanding local peoples cultural models and political-economic explanations for the disease while the second approach focused on providing more humanitarian care of patients by identifying and incorporating local beliefs and practices into patient care and response efforts.

  8. Insurance Accounts: The Cultural Logics of Health Care Financing.

    Science.gov (United States)

    Mulligan, Jessica

    2016-03-01

    The financial exuberance that eventually culminated in the recent world economic crisis also ushered in dramatic shifts in how health care is financed, administered, and imagined. Drawing on research conducted in the mid-2000s at a health insurance company in Puerto Rico, this article shows how health care has been financialized in many ways that include: (1) privatizing public services; (2) engineering new insurance products like high deductible plans and health savings accounts; (3) applying financial techniques to premium payments to yield maximum profitability; (4) a managerial focus on shareholder value; and (5) prioritizing mergers and financial speculation. The article argues that financial techniques obfuscate how much health care costs, foster widespread gaming of reimbursement systems that drives up prices, and "unpool" risk by devolving financial and moral responsibility for health care onto individual consumers. © 2015 by the American Anthropological Association.

  9. Can Hospital Cultural Competency Reduce Disparities in Patient Experiences with Care?

    Science.gov (United States)

    Weech-Maldonado, Robert; Elliott, Marc N.; Pradhan, Rohit; Schiller, Cameron; Hall, Allyson; Hays, Ron D.

    2013-01-01

    Background Cultural competency has been espoused as an organizational strategy to reduce health disparities in care. Objective To examine the relationship between hospital cultural competency and inpatient experiences with care. Research Design The first model predicted Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores from hospital random effects, plus fixed effects for hospital cultural competency, individual race/ethnicity/language, and case-mix variables. The second model tested if the association between a hospital’s cultural competency and HCAHPS scores differed for minority and non-Hispanic white patients. Subjects The National CAHPS® Benchmarking Database’s (NCBD) HCAHPS Surveys and the Cultural Competency Assessment Tool of Hospitals (CCATH) Surveys for California hospitals were merged, resulting in 66 hospitals and 19,583 HCAHPS respondents in 2006. Measures Dependent variables include ten HCAHPS measures: six composites (communication with doctors, communication with nurses, staff responsiveness, pain control, communication about medications, and discharge information), two individual items (cleanliness, and quietness of patient rooms), and two global items (overall hospital rating, and whether patient would recommend hospital). Results Hospitals with greater cultural competency have better HCAHPS scores for doctor communication, hospital rating, and hospital recommendation. Furthermore, HCAHPS scores for minorities were higher at hospitals with greater cultural competency on four other dimensions: nurse communication, staff responsiveness, quiet room, and pain control. Conclusions Greater hospital cultural competency may improve overall patient experiences, but may particularly benefit minorities in their interactions with nurses and hospital staff. Such effort may not only serve longstanding goals of reducing racial/ethnic disparities in inpatient experience, but may also contribute to general quality improvement

  10. Culturally Responsive Social Skill Instruction for Latino Male Students

    Science.gov (United States)

    Lo, Ya-yu; Correa, Vivian I.; Anderson, Adrienne L.

    2015-01-01

    Cross-cultural friendships and peer interactions are important skills for Latino students to become socially adjusted in U.S. schools. Culturally responsive social skill instruction allows educators to teach essential social skills while attending to the native culture and personal experiences of the students. The present study examined the…

  11. Culturally Responsive Pain Management for Black Older Adults.

    Science.gov (United States)

    Robinson-Lane, Sheria G; Booker, Staja Q

    2017-03-02

    pain for Black older adults has received inadequate attention by health care professionals despite evidence of greater pain intensity, depressive symptoms, and functional disability compared with White American older adults. Pain management for this population may be significantly improved with more careful attention to the provision of culturally responsive care. As professionals concerned with the optimization of health and reduction of suffering throughout the lifespan, nurses have an ethical, moral, and professional responsibility to provide culturally responsive care to the populations they serve-particularly when clear disparities in health exist. By considering how culture affects important health beliefs, values, preferences, and customs, and integrating this understanding into practice, quality of life is likely to be improved. [Journal of Gerontological Nursing, xx(x), xx-xx.]. Copyright 2017, SLACK Incorporated.

  12. Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

    Science.gov (United States)

    Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

    2015-01-01

    In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

  13. Creating a Culture of Ethical Practice in Health Care Delivery Systems.

    Science.gov (United States)

    Rushton, Cynda Hylton

    2016-09-01

    Undisputedly, the United States' health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty-five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about the balance of benefits and burdens associated with these advances. Every day on every shift, nurses at the bedside feel an intense array of ethical issues. At the same time, administrators, policy-makers, and regulators struggle to balance commitments to patients, families, staff members, and governing boards. Ethical responsibilities and the fiduciary, regulatory, and community service goals of health care institutions are not mutually exclusive; they must go hand in hand. If they do not, our health care system will continue to lose valued professionals to moral distress, risk breaking the public's trust, and potentially undermine patient care. At this critical juncture in health care, we must look to new models, tools, and skills to confront contemporary ethical issues that impact clinical practice. The antidote to the current reality is to create a new health care paradigm grounded in compassion and sustained by a culture of ethical practice.

  14. How Language Supports Adaptive Teaching through a Responsive Learning Culture

    Science.gov (United States)

    Johnston, Peter; Dozier, Cheryl; Smit, Julie

    2016-01-01

    For students to learn optimally, teachers must design classrooms that are responsive to the full range of student development. The teacher must be adaptive, but so must each student and the learning culture itself. In other words, adaptive teaching means constructing a responsive learning culture that accommodates and even capitalizes on diversity…

  15. Becoming Culturally Responsive: A Framework for Teacher Development

    Science.gov (United States)

    Kagle, Melissa

    2013-01-01

    This paper proposes a framework for the development of culturally responsive practices in beginning teachers to meet the needs of diverse students in multicultural classrooms. The framework describes the trajectory beginning teachers undergo toward becoming culturally responsive and discusses how teacher educators in liberal arts colleges can…

  16. The Development of Novice Teachers' Culturally Responsive Classroom Management Practice

    Science.gov (United States)

    Patish, Yelena

    2016-01-01

    While extensive research has been conducted on classroom management little research exists on culturally responsive classroom management. The primary purpose of this qualitative study was to examine how four novice teachers developed their culturally responsive management practice (CRCM) to better meet the needs of their students. My analysis was…

  17. How Language Supports Adaptive Teaching through a Responsive Learning Culture

    Science.gov (United States)

    Johnston, Peter; Dozier, Cheryl; Smit, Julie

    2016-01-01

    For students to learn optimally, teachers must design classrooms that are responsive to the full range of student development. The teacher must be adaptive, but so must each student and the learning culture itself. In other words, adaptive teaching means constructing a responsive learning culture that accommodates and even capitalizes on diversity…

  18. The Culturally Responsive Teacher Preparedness Scale: An Exploratory Study

    Science.gov (United States)

    Hsiao, Yun-Ju

    2015-01-01

    The purpose of this study was to investigate the competencies of culturally responsive teaching and construct a Culturally Responsive Teacher Preparedness Scale (CRTPS) for the use of teacher preparation programs and preservice teachers. Competencies listed in the scale were identified through literature reviews and input from experts. The…

  19. The Development of Novice Teachers' Culturally Responsive Classroom Management Practice

    Science.gov (United States)

    Patish, Yelena

    2016-01-01

    While extensive research has been conducted on classroom management little research exists on culturally responsive classroom management. The primary purpose of this qualitative study was to examine how four novice teachers developed their culturally responsive management practice (CRCM) to better meet the needs of their students. My analysis was…

  20. Nurturing Cultural Change in Care for Older People: Seeing the Cherry Tree Blossom.

    Science.gov (United States)

    Snoeren, Miranda M W C; Janssen, Bienke M; Niessen, Theo J H; Abma, Tineke A

    2016-12-01

    There is a need for person-centred approaches and empowerment of staff within the residential care for older people; a movement called 'culture change'. There is however no single path for achieving culture change. With the aim of increasing understandings about cultural change processes and the promotion of cultural values and norms associated with person-centred practices, this article presents an action research project set on a unit in the Netherlands providing care for older people with dementia. The project is presented as a case study. This study examines what has contributed to the improvement of participation of older people with dementia in daily occupational and leisure activities according to practitioners. Data was collected by participant observation, interviews and focus groups. The results show that simultaneous to the improvement of the older people's involvement in daily activities a cultural transformation took place and that the care became more person-centred. Spontaneous interactions and responses rather than planned interventions, analysis and reflection contributed to this. Furthermore, it proved to be beneficial that the process of change and the facilitation of that process reflected the same values as those underlying the cultural change. It is concluded that changes arise from dynamic, interactive and non-linear processes which are complex in nature and difficult to predict and to control. Nevertheless, managers and facilitators can facilitate such change by generating movement through the introduction of small focused projects that meet the stakeholders' needs, by creating conditions for interaction and sense making, and by promoting the new desired cultural values.

  1. Evaluation of a Video-Based Seminar to Raise Health Care Professionals' Awareness of Culturally Sensitive End-of-Life Care.

    Science.gov (United States)

    Cruz-Oliver, Dulce M; Malmstrom, Theodore K; Roegner, Michael; Yeo, Gwen

    2017-07-15

    Health care workers serve diverse communities and face challenges in delivering culturally responsive EOL care, especially when caring for Latino elders. The objective of this study was to investigate the effect of a newly developed telenovela, or video soap opera, on health care professionals (HCPs)' awareness of caregivers' stress and patients' cultural approaches to end-of-life (EOL) care decisions. A multicenter cross-sectional study among three communities in New York, Miami, and Missouri. Participants from a convenience sample of multidisciplinary HCPs were randomly assigned to view power point presentation with either a control video or an intervention-telenovela about caregiving as part of a one-hour audiovisual seminar and completed a pre- and post-test questionnaire to evaluate reaction and learning. Participants (N = 142) were mostly female (80%) nurses (54%) with a mean age of 44.5 ± 12.4 years and from non-Hispanic white (41%) or Hispanics (37%) ethnicity. In both control and intervention groups, post-test responses demonstrated a high level (87%) of satisfaction with seminar and an increase in openness to discuss EOL issues with culturally diverse patients (P educate HCPs on cultural sensitivity to help ethnically diverse caregivers and their patients benefit from EOL care. Copyright © 2017. Published by Elsevier Inc.

  2. The relationship between organizational culture of nursing staff and quality of care for residents with dementia: questionnaire surveys and systematic observations in nursing homes.

    Science.gov (United States)

    van Beek, A P A; Gerritsen, D L

    2010-10-01

    Since the 1990s, several studies have shown that organizational culture is an important characteristic in long-term care. However, at the moment little is known about organizational culture and its relationship with quality of care. In this study, the relationship between organizational culture and quality of care in long-term care was investigated using the competing values framework. Thereto, two independent measurements of quality of care were applied: the perceived quality of care by nursing staff of dementia units and the observed quality of care on the units by researchers. The study used a cross-sectional design. Data were collected on 11 dementia units in 11 Dutch nursing homes. All nursing staff on the units were asked to complete a questionnaire, of whom 248 staff members responded. The average response rate on the 11 units was 63%. Data were collected during two days of field-work on each unit. Systematic observations were performed, and questionnaires were distributed among nursing staff. Data were analyzed using multilevel analyses. Organizational culture was related to both perceived and observed quality of care on the units. Units that are characterized by a clan culture provide better quality of care, both in the eyes of the nursing staff as in the eyes of outsiders. Market culture, compared to clan culture, is negatively related to quality of care in this sample. The results indicate that organizational culture in long-term dementia care is important for organizational performance. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  3. Designing for culturally responsive science education through professional development

    Science.gov (United States)

    Brown, Julie C.; Crippen, Kent J.

    2016-02-01

    Educational stakeholders across the globe are demanding science education reform that attends simultaneously to culturally diverse students' needs and promotes academic excellence. Although professional development programs can foster science teachers' growth as culturally responsive educators, effective supports to this end are not well identified. This study examined associations between specific Science Teachers are Responsive to Students (STARTS) program activities and United States high school life science teachers' understanding and enactment of culturally responsive science teaching. Findings suggest: (a) critically examining their practices while learning of students' needs and experiences enabled teachers to identify responsive instructional strategies and relevant science topics for culturally responsive teaching; (b) evaluating culturally responsive exemplars while identifying classroom-based needs allowed teachers to identify contextually appropriate instruction, thereby yielding a robust understanding of the purpose and feasibility of culturally responsive science teaching; and (c) by justifying the use of responsive and reform-based instructional strategies for their classrooms, teachers made purposeful connections between students' experiences and science instruction. We propose a set of empirically based design conjectures and theoretical conjectures to generate adaptable knowledge about preparing culturally responsive science teachers through professional development.

  4. Innovative practice: exploring acculturation theory to advance rehabilitation from pediatric to adult "cultures" of care.

    Science.gov (United States)

    Nguyen, Tram; Baptiste, Sue

    2015-01-01

    This perspective paper explores the application of acculturation and the inherent concepts and ideas associated with this theory in rehabilitation to provide a framework for interpreting patient circumstances, responses and behaviours as they move from one culture to the next. Traditionally acculturation theory has been use to examine changes in culture in an ethnic or country sense, however, this paper is among the first to apply acculturation theory to the rehabilitation service cultures from pediatric to adult care for youth with chronic health conditions. The objectives of this paper are threefold: (1) to critically appraise key literature in the development of acculturation theory, (2) to discuss how acculturation theory can be applied in rehabilitation practice through a clinical vignette, and finally (3) to discuss how acculturation theory can advance rehabilitation by enhancing client-centered practice. Acculturation theory can provide insight into how patients are experiencing a change in health care "cultures", in the context of their overarching life circumstances. This, coming from a broader societal perspective can in turn inform an optimal approach to client-centered practice, and the application of rehabilitation-specific team inputs. This theoretical framework can heighten practitioners' awareness of patients' unique worldviews related to their expectations for care and treatment thus reducing fear of diversity to establish positive partnerships between patients and clinicians. An understanding of patients' acculturation processes will add new insight into how we can best deliver services and supports to optimise health, opportunities and experiences for youth with chronic conditions.

  5. Culturally responsive instruction for english language learners with learning disabilities.

    Science.gov (United States)

    Orosco, Michael John; O'Connor, Rollanda

    2014-01-01

    This case study describes the culturally responsive instruction of one special education teacher with Latino English language learners (ELLs) with learning disabilities in an urban elementary school setting. This study was situated in a social constructivist research based framework. In investigating this instruction with ELLs, this study focused on how one teacher's knowledge of culturally responsive pedagogy affected her special education instruction. Findings resulted in three major themes that were aligned with the current literature in this area: Cultural Aspects of Teaching Reading, Culturally Relevant Skills-Based Instruction, and Collaborative Agency Time. The results indicated that the success of special education with ELLs at the elementary education level might be dependent on how well the special education teacher integrates culturally responsive instruction with ELLs' cultural and linguistic needs. © Hammill Institute on Disabilities 2013.

  6. Interação social e responsividade em ambientes doméstico e de creche: cultura e desenvolvimento Social interaction and responsiveness in home and day-care centres environments: culture and development

    Directory of Open Access Journals (Sweden)

    Eulina da Rocha Lordelo

    2002-07-01

    Full Text Available Visando descrever e comparar os níveis de interação em ambientes doméstico e de creche, incluindo diferentes indicadores de interação, o estudo observou 148 crianças em situação de brinquedo livre, 58 em creches e 90 em ambiente doméstico, de nível sócio econômico baixo e médio. As observações foram filmadas e segmentadas em 30 intervalos de 10 segundos, registrando-se as interações com adultos e outras crianças. Os resultados encontrados sugerem que casa e creche são diferentes quanto às oportunidades de interação, a casa favorecendo mais interações corporais, uma diferença não encontrada nas interações verbais. O conceito de interação, em sua relação com um quadro teórico de referência, emerge como crucial nesse estudo. Os resultados encontrados sugerem que os estudos na área problematizem os critérios de interação adotados, no sentido de buscar uma descrição mais abrangente do ambiente de desenvolvimento, em que o papel da cultura seja equacionado.Aiming to describe and compare the interactional levels in home and day-care centres environments, including different indicators of interaction, this study observed 148 children in free play situations, 58 in day-care centres and 90 in home environment, from low and medium SES. The observations were filmed and segmented in 30 intervals of 10 seconds. All adult-child and child-child interactions were coded. The results found suggest that home and day-care centres are different about the opportunity of interactions; at home, there are more body interactions, but this difference is not found in verbal interactions. The interaction concept seems crucial at this study. The results suggest that studies in the area should discuss the interaction criteria used, aiming a more comprehensive description about the development environment, in which the role of culture may be considered included.

  7. The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities.

    Science.gov (United States)

    Ascoli, Micol; Palinski, Andrea; Owiti, John Arianda; De Jongh, Bertine; Bhui, Kamaldeep S

    2012-09-28

    Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS) that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering "culture" in the presentation and expression of mental distress. The narratives reveal an overall "culture of understanding cultural issues" and specific "cultures of care". These emerged as necessary foci of intervention to improve service user outcomes. Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery.

  8. How to change organisational culture: Action research in a South African public sector primary care facility

    Directory of Open Access Journals (Sweden)

    Robert Mash

    2016-03-01

    Full Text Available Background: Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA and had 6 months of coaching. Results: Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion: Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  9. How to change organisational culture: Action research in a South African public sector primary care facility

    Directory of Open Access Journals (Sweden)

    Robert Mash

    2016-03-01

    Full Text Available Background: Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA and had 6 months of coaching. Results: Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion: Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  10. The relationship between the nursing environment and delivering culturally sensitive perinatal hospice care.

    Science.gov (United States)

    Mixer, Sandra J; Lindley, Lisa; Wallace, Heather; Fornehed, Mary Lou; Wool, Charlotte

    2015-09-01

    Wide variations exist among perinatal hospices, and barriers to perinatal palliative care exist at the healthcare level. Research in the area of culturally sensitive perinatal palliative care has been scarce, a gap which this study addresses. To evaluate the relationship between the nurse work environment and the delivery of culturally sensitive perinatal hospice care. This retrospective, correlational study used data from the National Home and Hospice Care Survey, which includes a nationally representative sample of hospice care providers. A multivariate logistic regression model was used to estimate the relationship between the delivery of culturally sensitive care and the nurse work environment. Accreditation, teaching status, and baccalaureate-prepared registered nurse staff had an impact on the provision of culturally sensitive perinatal care Conclusions: The hospice and nursing unit environments, specifically in regards to education and technology, may be important contributors to the delivery of culturally sensitive care.

  11. The intersection of culture in the provision of dementia care: A systematic review.

    Science.gov (United States)

    Brooke, Joanne; Cronin, Camille; Stiell, Marlon; Ojo, Omorogieva

    2017-08-09

    To understand the intersection of healthcare professionals' and care workers' culture and their provision of person-centred care for people with dementia. Due to the nature of global immigration and recruitment strategies, healthcare is provided by a culturally diverse workforce. Consequently, there is a need to understand healthcare professionals' and care workers' cultural values of illness, disease and dementia. Cultural values and beliefs regarding dementia and care of the older person differ, and currently there is a lack of clarity regarding the intersection of culture in the provision of person-centred dementia care. A search of the following databases was completed: Medline, CINAHL, Psychology and Behavioural Sciences, PsycINFO and PubMed for papers published from 1(st) January 2006 to 31(st) July 2016. A total of seven qualitative studies met the inclusion and exclusion criteria, all explored the impact of healthcare professionals' and care workers' culture in relation to their provision of person-centred dementia care. A meta-synthesis of the data from these studies identified four themes: cultural perceptions of dementia, illness and older people, impact of cultural perceptions on service use, acculturation of the workforce, and cross cultural communication. Limited evidence was found on the impact of healthcare professionals' and care workers' culture on their provision of person-centred dementia care. The intersection of culture and dementia included the understanding of dementia, care and family roles. Acculturation of migrant healthcare workers to the culture of the host country, workplace, and support with the communication was identified as necessary for the provision of person-centred dementia care. Open access education and training to support communication is required, alongside the development of robust interventions to support the process of acculturation of migrant healthcare professionals and care workers to provide culturally competent

  12. Cell response of Chlamydomonas actinochloris culture to repeated microwave irradiation

    Directory of Open Access Journals (Sweden)

    OLESIA O. GRYGORIEVA

    2015-05-01

    Full Text Available Abstract. Grygorieva OO, Berezovsjka MA, Dacenko OI. 2015. Cell response of Chlamydomonas actinochloris culture to repeated microwave irradiation. Nusantara Bioscience 7: 38-42. Two cultures of Chlamydomonas actinochloris Deason et Bold in the lag-phase were exposed to the microwave irradiation. One of them (culture 1 was not treated beforehand, whereas the other (culture 2 was irradiated by microwaves 2 years earlier. The measurement of cell quantity as well as measurement of change of intensities and spectra of cultures photoluminescence (PL in the range of chlorophyll a emission was regularly conducted during the cell cultures development. Cell concentration of culture 1 exposed to the microwave irradiation for the first time has quickly restored while cell concentration of culture 2 which was irradiated repeatedly has fallen significantly. The following increasing of cell concentration of culture 2 is negligible. Cell concentration reaches the steady-state level that is about a half of the cell concentration of control culture. Initially the PL efficiency of cells of both cultures decreases noticeable as a result of irradiation. Then there is the monotonic increase to the values which are significantly higher than the corresponding values in the control cultures. The ratio of the intensities at the maxima of the main emission bands of chlorophyll for control samples of both cultures remained approximately at the same level. At the same time effect of irradiation on the cell PL spectrum appears as a temporary reduction of this magnitude.

  13. Spiritual care : implications for nurses' professional responsibility

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Post, Doeke; Jochemsen, Henk

    2006-01-01

    Aim. This paper aimed to gain insight into the spiritual aspects of nursing care within the context of health care in the Netherlands and to provide recommendations for the development of care in this area and the promotion of the professional expertise of nurses. Background. International nursing l

  14. Spiritual care : implications for nurses' professional responsibility

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Post, Doeke; Jochemsen, Henk

    Aim. This paper aimed to gain insight into the spiritual aspects of nursing care within the context of health care in the Netherlands and to provide recommendations for the development of care in this area and the promotion of the professional expertise of nurses. Background. International nursing

  15. An Empirical Perspective on the Culture - Corporate Social Responsibility Relationship

    Directory of Open Access Journals (Sweden)

    Dumitru ZAIȚ

    2013-12-01

    Full Text Available Business competition and pressure of European directives put Romanian company in a position to find answers to issues related to long-term survival and development. In this context we believe it is necessary to analyze some of the most important components that should be taken into consideration at the strategic level: national and organizational culture. The results indicate that corporate social responsibility is supported by learning and change-oriented organizational culture, but also by a favorable cultural and national economic framework. Based on these theoretical considerations we intent to emphasize the relationships between national culture / corporate culture and corporate social responsibility (CSR, elaborating an empirical argument by analyzing the results provided by Global 100, an annual project initiated by Corporate Knights Inc. (Davos. Starting with 2005, it has the largest database in the world and an appropriate evaluation methodology that provides a ranking of the top 100 most responsible companies in the world.

  16. Climate Change, Individual Responsibilities and Cultural Frameworks

    National Research Council Canada - National Science Library

    Thomas Heyd

    2010-01-01

    .... On the assumption that, in the light of accelerating climate change, individuals have both ethical and prudential responsibilities, the limited advances in mitigation and adaptation of international...

  17. Crisis and Man: Literary Responses Across Cultures

    OpenAIRE

    Krishnaswami, Mallika

    2012-01-01

    Myth of Sisyphus exemplifies the situation man finds himself in irrespective of his ethnic and geographical background. Art and cultural forms gave expression to this situation and the intensity of the expression depended upon the political and social dimensions. War or peace, man is always condemned to struggle with his problems, moral or otherwise. Post war English writers focused on the social problems the British society found itself in and its helplessness in dealing with them. It was th...

  18. Religious culture and health promotion: care, practice, object

    Directory of Open Access Journals (Sweden)

    Viola Timm

    2015-06-01

    Full Text Available At the margins of modern medical practice, pushing the very limits of science, and indefatigably rendering the precincts of public discourse, still functional remnants of Christian civilization continue to provide care for the hopeless, perform healing sacraments for the incurable, and curate objects of votive devotion for the suffering and needy. These public services go largely unaccounted for, though they secure an ordered world, structure perception, and serve as ontological anchors. Lost in the vague, scientifically unrarified notions of spirituality that brace a general, undifferentiated worldwide metaphysical experience and disregard immense cultural, functional, geographic and performative distinctness, Catholic sacramental practices aimed at alleviating suffering and promoting healthy lifestyles are receiving only marginal mention in scientific literature(1, despite the fact that they make up daily reality in large parts of contemporary Europe and Latin America. Writing this editorial from the Northeast of Brazil, where traditional religious practice has sustained generations through the calamities of severe droughts, slavery, extreme poverty, high child mortality, failed political orders, and a harsh global economic reality, it is difficult to underestimate the power of sacramental experience to sustain a cultural identity. It was defined the concept of care of the sick in the context of the religious experience of the Northeast of Brazil which is historically relevant to health promotion. Until the emergence of national health care in the late nineteenth century, it was largely the order of the Franciscan friars that was charged with promoting healthy lives in the region. The Catholic concept of care that guided their efforts structures three procedural reality principles: the psychological reality of the transference to the person in one’s charge (care/caritas, the performative practice of religious sacrament such as the anointment

  19. A Validation Study of the Culturally Responsive Teaching Survey

    Science.gov (United States)

    Rhodes, Christy M.

    2017-01-01

    Amidst the ethnic and linguistic diversity in adult English language classes, there is heightened importance to using culturally responsive teaching practices. However, there are limited quantitative examinations of this approach in adult learning environments. The purpose of this investigation was to describe patterns of culturally responsive…

  20. Identity Affirmed, Agency Engaged: Culturally Responsive Performance-Based Assessment

    Science.gov (United States)

    Rosa, Ricardo

    2017-01-01

    Performance-based assessment is unquestionably superior to the instrumental rationality of high-stakes standardized testing and the audit culture that testing regimes inspire. It is more likely to engender opportunities to witness the un-measureable: vision, imagination, and compassion. Performance assessments must be culturally responsive in…

  1. Culturally Responsive Collegiate Mathematics Education: Implications for African American Students

    Science.gov (United States)

    Jett, Christopher C.

    2013-01-01

    In this article, the author utilizes the culturally congruent work of Gay (2010) and Ladson-Billings (2009) to highlight culturally responsive teaching as a viable option for African American students in higher education mathematics spaces. He offers translations of Gay and Ladson-Billings' work to Africana mathematics and argues that these…

  2. Celebrating Difference: Best Practices in Culturally Responsive Teaching Online

    Science.gov (United States)

    Woodley, Xeturah; Hernandez, Cecilia; Parra, Julia; Negash, Beyan

    2017-01-01

    Culturally responsive teaching and design practices flip the online classroom by creating an environment that acknowledges, celebrates, and builds upon the cultural capital that learners and teachers bring to the online classroom. Challenges exist in all phases of online course design, including the ability to create online courses that reflect…

  3. Culturally Responsive Dance Pedagogy in the Primary Classroom

    Science.gov (United States)

    Melchior, Elizabeth

    2011-01-01

    Dance has an important place in multicultural education and the development of culturally responsive pedagogy. Through dance, children can explore and express their own and others' cultures and share their stories in ways other than the spoken and written word. This paper presents a case study concerning a professional development programme in…

  4. Should we learn culture in chemistry classroom? Integration ethnochemistry in culturally responsive teaching

    Science.gov (United States)

    Rahmawati, Yuli; Ridwan, Achmad; Nurbaity

    2017-08-01

    The papers report the first year of two-year longitudinal study of ethnochemistry integration in culturally responsive teaching in chemistry classrooms. The teaching approach is focusing on exploring the culture and indigenous knowledge in Indonesia from chemistry perspectives. Ethnochemistry looks at the culture from chemistry perspectives integrated into culturally responsive teaching has developed students' cultural identity and students' engagement in chemistry learning. There are limited research and data in exploring Indonesia culture, which has around 300 ethics, from chemistry perspectives. Students come to the chemistry classrooms from a different background; however, their chemistry learning disconnected with their background which leads to students' disengagement in chemistry learning. Therefore this approach focused on students' engagement within their differences. This research was conducted with year 10 and 11 from four classrooms in two secondary schools through qualitative methodology with observation, interviews, and reflective journals as data collection. The results showed that the integration of ethnochemistry in culturally responsive teaching approach can be implemented by involving 5 principles which are content integration, facilitating knowledge construction, prejudice reduction, social justice, and academic development. The culturally responsive teaching has engaged students in their chemistry learning and developed their cultural identity and soft skills. Students found that the learning experiences has helped to develop their chemistry knowledge and understand the culture from chemistry perspectives. The students developed the ability to work together, responsibility, curiosity, social awareness, creativity, empathy communication, and self-confidence which categorized into collaboration skills, student engagement, social and cultural awareness, and high order thinking skills. The ethnochemistry has helped them to develop the critical self

  5. Cultured articular chondrocytes sheets for partial thickness cartilage defects utilizing temperature-responsive culture dishes

    Directory of Open Access Journals (Sweden)

    N Kaneshiro

    2007-05-01

    Full Text Available The extracellular matrix (ECM of articular cartilage has several functions that are unique to joints. Although a technique for transplanting cultured chondrocytes has already been introduced, it is difficult to collect intact ECM when using enzymes to harvest samples. Temperature-responsive culture dishes have already been clinically applied in the fields of myocardial and corneal transplantation. Earlier studies have shown that a sheet of cultured cells with intact ECM and adhesive factors can be harvested using such culture dishes, which allow the surface properties of the dish to be reversibly altered by changing the temperature. Human chondrocytes were subjected to enzymatic digestion and then were seeded in temperature-responsive culture dishes. A sheet of chondrocytes was harvested by only reducing the temperature after the cultured cells reached confluency. A real-time PCR analysis of the chondrocyte sheets confirmed that type II collagen, aggrecan, and fibronectin were present. These results suggested that, although chondrocytes undergo dedifferentiation in a monolayer culture, multilayer chondrocyte sheets grown in a similar environment to that of three-dimensional culture may be able to maintain a normal phenotype. A histological examination suggested that multilayer chondrocyte sheets could thus prevent the loss of proteoglycans because the area covered by the sheets was well stained by safranin-O. The present experiments suggested that temperature-responsive culture dishes are useful for obtaining cultured chondrocytes, which may then be clinically employed as a substitute for periosteal patches because such sheets can be applied without a scaffold.

  6. Does health care role and experience influence perception of safety culture related to preventing infections?

    Science.gov (United States)

    Braun, Barbara I; Harris, Anthony D; Richards, Cheryl L; Belton, Beverly M; Dembry, Louise-Marie; Morton, David J; Xiao, Yan

    2013-07-01

    Growing evidence reveals the importance of improving safety culture in efforts to eliminate health care-associated infections. This multisite, cross-sectional survey examined the association between professional role and health care experience on infection prevention safety culture at 5 hospitals. The findings suggest that frontline health care technicians are less directly engaged in improvement efforts and safety education than other staff and that infection prevention safety culture varies more by hospital than by staff position and experience.

  7. Improving Culturally Appropriate Care Using a Community-Based Participatory Research Approach: Evaluation of a Multicomponent Cultural Competency Training Program, Arkansas, 2015–2016

    Science.gov (United States)

    Long, Christopher R.; Rowland, Brett; Moore, Sarah; Wilmoth, Ralph; Ayers, Britni

    2017-01-01

    Introduction The United States continues to become more racially and ethnically diverse, and racial/ethnic minority communities encounter sociocultural barriers to quality health care, including implicit racial/ethnic bias among health care providers. In response, health care organizations are developing and implementing cultural competency curricula. Using a community-based participatory research (CBPR) approach, we developed and evaluated a cultural competency training program to improve the delivery of culturally appropriate care in Marshallese and Hispanic communities. Methods We used a mixed-methods evaluation approach based on the Kirkpatrick model of training evaluation. We collected quantitative evaluation data immediately after each training session (March 19, 2015–November 30, 2016) and qualitative data about implementation at 2 points: immediately after each session and 6 months after training. Individuals and organizational units provided qualitative data. Results We delivered 1,250 units of in-person training at 25 organizations. Participants reported high levels of changes in knowledge (91.2%), competence (86.6%), and performance (87.2%) as a result of the cultural competency training. Organizations reported making policy and environmental changes. Conclusion Initial outcomes demonstrate the value of developing and implementing cultural competency training programs using a CBPR approach. Additional research is needed to determine the effect on long-term patient outcomes. PMID:28771402

  8. Uncompensated care: hospitals' responses to fiscal pressures.

    Science.gov (United States)

    Mann, J; Melnick, G; Bamezai, A; Zwanziger, J

    1995-01-01

    This Data Watch examines the impact of hospital competition, the Medicare prospective payment system (PPS), and Medi-Cal selective contracting on the provision of uncompensated care by private hospitals in California during 1980-1989. It finds that hospitals subject to more intense competition and greater fiscal pressure from Medicare and Medi-Cal reduced their provision of uncompensated care relative to hospitals facing less pressure from these sources. We estimate that had hospitals not been subjected to increasing price competition from growth of managed care plans and financial tightening in public programs, they would have provided 36 percent more uncompensated care than was actually provided in 1989.

  9. The relationship between drivers and policy in the implementation of cultural competency training in health care.

    Science.gov (United States)

    Dogra, Nisha; Betancourt, Joseph R; Park, Elyse R; Sprague-Martinez, Linda

    2009-02-01

    In recent years, cultural competence has appeared on the agendas of the medical profession as well as other health care providers. Through semistructured interviews with staff at different types of health care institutions, we explored the motivation for and barriers against the implementation of cultural competence training. The findings show that while some progress has been made, there is still work to be done in making cultural competency an integral part of the organizational fabric of health care. National organizations need to consider their leadership role in helping health care organizations translate broad statements of cultural competence into meaningful action.

  10. Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations

    Science.gov (United States)

    Andrulis, Dennis P.; Brach, Cindy

    2016-01-01

    Objective To understand the interrelationship of literacy, culture, and language and the importance of addressing their intersection. Methods Health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed. Results Strategies to improve health literacy for low-literate individuals are distinct from strategies for culturally diverse and individuals with limited English proficiency (LEP). The lack of integration results in health care that is unresponsive to some vulnerable groups’ needs. A vision for integrated care is presented. Conclusion Clinicians, the health care team, and health care organizations have important roles to play in addressing challenges related to literacy, culture, and language. PMID:17931131

  11. Political, cultural and economic foundations of primary care in Europe.

    Science.gov (United States)

    Kringos, Dionne S; Boerma, Wienke G W; van der Zee, Jouke; Groenewegen, Peter P

    2013-12-01

    This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda, economy, prevailing values, and type of healthcare system are all important factors that influence the development of strong PC. Wealthier countries are associated with a weaker PC structure and lower PC accessibility, while Eastern European countries seemed to have used their growth in national income to strengthen the accessibility and continuity of PC. Countries governed by left-wing governments are associated with a stronger PC structure, accessibility and coordination of PC. Countries with a social-security based system are associated with a lower accessibility and continuity of PC; the opposite is true for transitional systems. Cultural values seemed to affect all aspects of PC. It can be concluded that strengthening PC means mobilising multiple leverage points, policy options, and political will in line with prevailing values in a country.

  12. Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland.

    Science.gov (United States)

    Mander, Sarah; Miller, Yvette D

    2016-03-01

    Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland's health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically diverse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified; however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.

  13. [Organisational responsibility versus individual responsibility: safety culture? About the relationship between patient safety and medical malpractice law].

    Science.gov (United States)

    Hart, Dieter

    2009-01-01

    The contribution is concerned with the correlations between risk information, patient safety, responsibility and liability, in particular in terms of liability law. These correlations have an impact on safety culture in healthcare, which can be evaluated positively if--in addition to good quality of medical care--as many sources of error as possible can be identified, analysed, and minimised or eliminated by corresponding measures (safety or risk management). Liability influences the conduct of individuals and enterprises; safety is (probably) also a function of liability; this should also apply to safety culture. The standard of safety culture does not only depend on individual liability for damages, but first of all on strict enterprise liability (system responsibility) and its preventive effects. Patient safety through quality and risk management is therefore also an organisational programme of considerable relevance in terms of liability law.

  14. Cultural Consensus Theory: Aggregating Continuous Responses in a Finite Interval

    Science.gov (United States)

    Batchelder, William H.; Strashny, Alex; Romney, A. Kimball

    Cultural consensus theory (CCT) consists of cognitive models for aggregating responses of "informants" to test items about some domain of their shared cultural knowledge. This paper develops a CCT model for items requiring bounded numerical responses, e.g. probability estimates, confidence judgments, or similarity judgments. The model assumes that each item generates a latent random representation in each informant, with mean equal to the consensus answer and variance depending jointly on the informant and the location of the consensus answer. The manifest responses may reflect biases of the informants. Markov Chain Monte Carlo (MCMC) methods were used to estimate the model, and simulation studies validated the approach. The model was applied to an existing cross-cultural dataset involving native Japanese and English speakers judging the similarity of emotion terms. The results sharpened earlier studies that showed that both cultures appear to have very similar cognitive representations of emotion terms.

  15. The ethical dimensions of delivering culturally congruent nursing and health care.

    Science.gov (United States)

    Zoucha, R; Husted, G L

    2000-01-01

    This article discusses the ethical parameters of giving culturally congruent care to individual patients by health care professionals. Leininger's Cultural Care Diversity and Universality theory (Leininger, 1995) is used to demonstrate the importance of culture in a person's life and Husted's and Husted's (1995) bioethical theory is used to create a mind-set of ethical interaction and to direct the analysis of a bioethical dilemma involving cultural differences between persons of the same culture, a depressed Mexican-American woman and her husband. The differences between transculturalism and multiculturalism are explored. We defend the position that a patient's culture is only a useful tool in caring for a patient if the individual person is made the primary focus of care.

  16. Culture care theory: a framework for expanding awareness of diversity and racism in nursing education.

    Science.gov (United States)

    Lancellotti, Katherine

    2008-01-01

    As American society becomes increasingly diverse, and the nursing profession does not, there has been a focus on promoting both cultural competence and diversity within the profession. Although culture and diversity are widely discussed in nursing education, the issue of racism may be avoided or suppressed. Institutionalized racism within nursing education must be acknowledged and discussed before nursing education may be transformed. Madeleine Leininger's Culture Care Theory is an established nursing theory that emphasizes culture and care as essential concepts in nursing. Theoretical frameworks abound in nursing, and Culture Care Theory may be underutilized and misunderstood within nursing education. This article examines the issue of racism in nursing education and recommends Culture Care Theory as a relevant framework for enhancing both cultural competence and diversity.

  17. Realizing good care within a context of cross-cultural diversity: an ethical guideline for healthcare organizations in Flanders, Belgium.

    Science.gov (United States)

    Denier, Yvonne; Gastmans, Chris

    2013-09-01

    In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks.

  18. Measurement and Analysis of Individualized Care Inventory Responses Comparing Long-Term Care Nurses and Care Aides

    Science.gov (United States)

    O'Rourke, Norm; Chappell, Neena L.; Caspar, Sienna

    2009-01-01

    Purpose: Motivating and enabling formal caregivers to provide individualized resident care has become an increasingly important objective in long-term care (LTC) facilities. The current study set out to examine the structure of responses to the individualized care inventory (ICI). Design and Methods: Samples of 242 registered nurses (RNs)/licensed…

  19. Cultural differences in responses to a Likert scale.

    Science.gov (United States)

    Lee, Jerry W; Jones, Patricia S; Mineyama, Yoshimitsu; Zhang, Xinwei Esther

    2002-08-01

    Cultural differences in responses to a Likert scale were examined. Self-identified Chinese, Japanese, and Americans (N=136, 323, and 160, respectively) recruited at ethnic or general supermarkets in Southern California completed a 13-question Sense of Coherence scale with a choice of either four, five, or seven responses in either Chinese, Japanese, or English. The Japanese respondents more frequently reported difficulty with the scale, the Chinese more frequently skipped questions, and both these groups selected the midpoint more frequently on items that involved admitting to a positive emotion than did the Americans, who were more likely to indicate a positive emotion. Construct validity of the scale tended to be better for the Chinese and the Americans when there were four response choices and for the Japanese when there were seven. Although culture affected response patterns, the association of sense of coherence and health was positive in all three cultural groups. Copyright 2002 Wiley Periodicals, Inc.

  20. Connecting Cultural Models of Home-Based Care and Childminders' Career Paths: An Eco-Cultural Analysis

    Science.gov (United States)

    Tonyan, Holli A.; Nuttall, Joce

    2014-01-01

    Family day care or childminding involves a particularly transient workforce. This paper introduces Eco(logical)-Cultural Theory (ECT) to examine the cultural organisation of childminding and presents an ECT analysis of pilot survey results: asking minders about their daily routines and their career paths. Reasons for becoming a minder and…

  1. Acculturation process: a collaborative strategy of integration in attaining culturally congruent nursing care.

    Science.gov (United States)

    Nelson, Deborah B

    2009-01-01

    The author describes a strategic partnership effort in pursuit of culturally congruent care: the professional model of nursing practice. The organizing framework is an integrated strategy of acculturation based in cultural care theory. The professional health system's department of staff development and a vendor partnered to develop and implement the framework in acculturating Philippine nurses. The author also presents recommendations for future consideration.

  2. Culture and end of life care: a scoping exercise in seven European countries

    NARCIS (Netherlands)

    Gysels, M.; Evans, N.; Meñaca, A.; Andrew, E.; Toscani, F.; Finetti, S.; Pasman, H.R.; Higginson, I.; Harding, R.; Pool, R.

    2012-01-01

    Aim: Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence

  3. Culture and end of life care: a scoping exercise in seven European countries

    NARCIS (Netherlands)

    Gysels, M.; Evans, N.; Meñaca, A.; Andrew, E.; Toscani, F.; Finetti, S.; Pasman, H.R.; Higginson, I.; Harding, R.; Pool, R.

    2012-01-01

    Aim: Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence

  4. Do consumers care about ethics? A cross-cultural study

    Directory of Open Access Journals (Sweden)

    Alexandra Malheiro

    2010-08-01

    Full Text Available Discussion towards an understanding about ethical and social responsible corporate behaviours has increased over last two decades. Both marketers and academicians emphasize the interest of the topic. Developed research has been focusing the understanding of a few organizational practices, but consumer’s dyad of the problem calls for further investigation. This work presents some of the main theoretical contributions about consumer ethics, emphasizing the way how purchase attitude may be influenced by consumers’ perceptions about firms’ behaviour. The study aims to fill two important gaps in the burgeoning literature on marketing ethics: by looking at the consumer side of the marketing exchange dyad, and comparing consumer perspectives on ethics across cultures. As such, levels of consumer ethical awareness and expectations, and their impact on purchasing behaviours are measured in the contexts of Portugal and Cape Verde, one of its former colonies in Africa. Both qualitative and quantitative analyses were developed.

  5. Cultural health capital and the interactional dynamics of patient-centered care.

    Science.gov (United States)

    Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

    2013-09-01

    As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Organisational culture: pursuing a theoretical foundation within the Finnish public oral health-care context.

    Science.gov (United States)

    Kasila, Kirsti; Poskiparta, Marita

    2004-01-01

    At the moment, Finnish oral health care is undergoing many changes. Little attention has been paid to issues of organisational culture and communication in Finnish oral health care. Yet the question of culture is of primary importance for changes in an organisation and for planning and reconstructing the rational functioning of an organisation. The purpose of this paper is to examine Finnish public oral health care within a theoretical framework of organisational culture and to identify the various cultural traits that appear to characterise Finnish oral health care. Using a cultural point of view, we develop an orientation for understanding more profoundly and specifically the processes concerning the functioning and change of oral health care.

  7. Social and cultural dimensions of hygiene in Cambodian health care facilities

    Directory of Open Access Journals (Sweden)

    Faurand-Tournaire Anne-Laure

    2011-02-01

    Full Text Available Abstract Background The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings. Methods We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors and with patients who attended the study health facilities. Results Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1 informal and formal social rapports in hospitals, (2 major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff. Conclusion Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.

  8. Cultural democracy: the way forward for primary care of hard to reach New Zealanders.

    Science.gov (United States)

    Finau, Sitaleki A; Finau, Eseta

    2007-09-01

    The use of cultural democracy, the freedom to practice one's culture without fear, as a framework for primary care service provision is essential for improved health service in a multi cultural society like New Zealand. It is an effective approach to attaining health equity for all. Many successful health ventures are ethnic specific and have gone past cultural competency to the practice of cultural democracy. That is, the services are freely taking on the realities of clients without and malice from those of other ethnicities. In New Zealand the scientific health service to improve the health of a multi cultural society are available but there is a need to improve access and utilization by hard to reach New Zealanders. This paper discusses cultural democracy and provide example of how successful health ventures that had embraced cultural democracy were implemented. It suggests that cultural democracy will provide the intellectual impetus and robust philosophy for moving from equality to equity in health service access and utilization. This paper would provide a way forward to improved primary care utilization, efficiency, effectiveness and equitable access especially for the hard to reach populations. use the realities of Pacificans in New Zealand illustrate the use of cultural democracy, and thus equity to address the "inverse care law" of New Zealand. The desire is for primary care providers to take cognizance and use cultural democracy and equity as the basis for the design and practice of primary health care for the hard to reach New Zealanders.

  9. Assessment of Patient Safety Culture in Primary Health Care Settings in Kuwait

    Directory of Open Access Journals (Sweden)

    Maha Mohamed Ghobashi

    2014-01-01

    Full Text Available Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue.Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 276 participants (response rate = 74.79%.Results: Five safety dimensions with lowest positivity (less than 50% were identified and these are; the non – punitive response to errors, frequency of event reporting, staffing, communication openness, center handoffs and transitions with the following percentages of positivity 24%, 32%, 41%, 45% and 47% respectively. The dimensions of highest positivity were teamwork within the center’s units (82% and organizational learning (75%.Conclusion: Patient safety culture in primary healthcare settings in Kuwait is not as strong as improvements for the provision of safe health care. Well-designed patient safety initiatives are needed to be integrated with organizational policies, particularly the pressing need to address the bioethical component of medical errors and their disclosure, communication openness and emotional issues related to them and investing the bright areas of skillful organizational learning and strong team working attitudes.    

  10. Developing a collective future: creating a culture specific nurse caring practice model for hospitals.

    Science.gov (United States)

    MacDonald, M R; Miller-Grolla, L

    1995-01-01

    Nurses continue to struggle with the knowledge that practice within a conceptual context is imperative, yet operationalizing theory-based practice has been fraught with challenges and frustrations. It is timely, given the current environment, for nurses to reflect personally and collectively on the processes and meanings of nursing. Caring theories have been examined with increasing frequency recently, as nurse leaders and theorists explore the profession using alternative frames of reference. The authors discuss the concepts central to development of a practice-based nurse caring model in a community hospital and review the process of nurse-caring model development. Concepts central to the development of the model include: individual;-collective experience as theory; cargiver-client congruence in perceptions of nurse caring; institutions as culture-specific environments. The ongoing process of theory development was initiated by data collection through focus group discussions on nurse-caring experiences and definitions. Twenty-four staff RNs and RNAs were interviewed by a trained facilitator. Audiotaped data were later transcribed and subjected to content analysis for initial theme and definition development. A parallel exercise was carried out with hospital patients using the same methodology. Subsequent analysis included validation of findings by both groups. Examinations of constructs as the theory development evolves will be expedited by both staff and in consultation with Dr. Madeleine Leininger and other external nurse-caring theorists. The Health Centre intends to operationalize and implement its nurse-caring model as an outcome of this long term project. Assumptions integral to the purpose of the project have been validated by staff response. Concepts and their relationships appear to achieve acceptance and be congruent with this nursing group's values and the way in which they practice. Observations to date indicate that collective development of a

  11. Cultural issues and ethical dilemmas in palliative and end-of-life care in Spain.

    Science.gov (United States)

    Núñez Olarte, J M; Guillen, D G

    2001-01-01

    The concept of palliative care differs according to cultures and traditions. In Spain, palliative care programs have expanded in recent years. The European Commission Research Project in Palliative Care Ethics has sponsored ongoing research to analyze and clarify the conceptual differences in providing palliative care to patients in European countries with diverse cultures and backgrounds. The authors present key ethical issues in clinical practice in palliative and end-of-life care in Spain and how these issues are influenced by Spanish culture. They discuss typical characteristics of the Spanish conceptual approach to palliative care, which might be relevant in an even larger Latin palliative care context. The cultural tradition in Spain influences attitudes toward euthanasia, sedation, the definition of terminality, care in the last 48 hours of life, diagnosis disclosure, and information. The overall care of terminally ill patients with an Hispanic background includes not only the treatment of disease, but also the recognition and respect of their traditions and culture. The Spanish palliative care movement has shifted its focus from starting new programs to consolidating and expanding the training of the professionals already working in the existing programs. Although there is a general consensus that a new philosophy of care is needed, the interpretation and application of this general philosophy are different in diverse sociocultural contexts.

  12. Responsive Reading: Caring for Chicken Little

    Science.gov (United States)

    Maderazo, Catherine

    2009-01-01

    Media images and news about current events have the potential to strike like acorns. In these moments, children, like Chicken Little, need caring adults who can help them understand what is happening. As early childhood educators, one must recognize and provide opportunities to guide children's social and emotional well-being in addition to…

  13. Responsive Reading: Caring for Chicken Little

    Science.gov (United States)

    Maderazo, Catherine

    2009-01-01

    Media images and news about current events have the potential to strike like acorns. In these moments, children, like Chicken Little, need caring adults who can help them understand what is happening. As early childhood educators, one must recognize and provide opportunities to guide children's social and emotional well-being in addition to…

  14. Culture in Prenatal Development: Parental Attitudes, Availability of Care, Expectations, Values, and Nutrition

    Science.gov (United States)

    Bravo, Irene M.; Noya, Melissa

    2014-01-01

    Background: Culture is a universal phenomenon, but most interest about culture during pregnancy has focused on medical care, neglecting psychological aspects of normative development. Objective: The purpose of this article was to examine normative gestational experiences using the framework of a broaden and build model of culture, positive…

  15. Culture in Prenatal Development: Parental Attitudes, Availability of Care, Expectations, Values, and Nutrition

    Science.gov (United States)

    Bravo, Irene M.; Noya, Melissa

    2014-01-01

    Background: Culture is a universal phenomenon, but most interest about culture during pregnancy has focused on medical care, neglecting psychological aspects of normative development. Objective: The purpose of this article was to examine normative gestational experiences using the framework of a broaden and build model of culture, positive…

  16. Nurses' Experiences of Caring for Patients with Different Cultures in Mashhad, Iran.

    Science.gov (United States)

    Amiri, Rana; Heydari, Abbas

    2017-01-01

    Mashhad is a center of diverse cultures, where many local and foreign cultures live together in its context. One of the main needs of a society with cultural diversity is transcultural care of patients. Hence, the present study took the first step for care of culturally diversified and minority patients in Mashhad. This research has been conducted to explore the nurses' experience of caring from patients with different cultures. This study is a qualitative research using phenomenological hermeneutics approach. The participations include nurses who have been working 5 or less than 5 years in the hospitals affiliated to Medical University of Mashhad. They were selected using purposeful sampling method. For data collection, semi-structured, in-depth interview was used. For data analysis, interpretation method was used. The interviews continued until saturation of data was obtained. Data analysis resulted in extraction of 4 themes including ethnocentrism, contradicting perceptions of care, it is not our fault, and lack of cultural knowledge. The experience of nurses in taking care of patients with other cultures showed that minorities and small cultures have been neglected in Mashhad and hospitalization of such people in hospitals and other clinics is not specific. We recommend that an educational curriculum about transcultural care should be added to nursing courses. Also, necessary equipment and facilities should be considered and prepared for culturally different patients in hospitals.

  17. Stakeholders' roles and responsibilities regarding quality of care.

    Science.gov (United States)

    Huotari, Päivi; Havrdová, Zuzana

    2016-10-10

    Purpose The purpose of this paper is to describe how different stakeholders (society, managers, employees and clients) can together ensure the quality of care. Design/methodology/approach Qualitative data were collected from four focus group interviews conducted in three countries. All interviewees were pursuing a master's degree in social and/or health care management and had begun working in their field after completing their bachelor's degree. The data were analysed using inductive content analysis. Findings The society and managers are responsible for the care system as a whole and must apply system-oriented, rather than sector-oriented, thinking. Employees are responsible for ensuring the continuity of client services in their work, and managers and employees share the responsibility of achieving the organisational goals and quality standards. The clients are responsible for acting as responsible service users and providing the required information to obtain care. Communication was strongly emphasised in the data, and it necessitates cross-professional and organisational boundaries, professional and political boundaries, as well as boundaries between the professional and the client. Research limitations/implications Since the interviewees were all pursuing a master's degree in social and/or health care management, when reflecting on their work experience, they may have also been reflecting what they had learned in university. Practical implications This study emphasises the importance of collaboration and communication between stakeholders in ensuring the quality of care. Unpredictable economies, the ageing population and the ongoing integration and reorganisation of health and social care services in Europe highlight systematic and strategic approach in quality of care. Originality/value This paper claims that communication between different care stakeholders gives a more systematic and coherent framework for the quality of care. Quality of care is a

  18. How Do People Make Continence Care Happen? An Analysis of Organizational Culture in Two Nursing Homes

    Science.gov (United States)

    Lyons, Stacie Salsbury

    2010-01-01

    Purpose: Although nursing homes (NHs) are criticized for offering poor quality continence care, little is known about the organizational processes that underlie this care. This study investigated the influence of organizational culture on continence care practices in two NHs. Design and Methods: This ethnographic study explored continence care…

  19. EPEC-O Self-Study - Cultural Considerations When Caring for African Americans

    Science.gov (United States)

    The EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans is a free comprehensive multimedia curricula for health professionals caring for persons with cancer and their families.

  20. Care Partner Responses to the Onset of Mild Cognitive Impairment

    Science.gov (United States)

    Blieszner, Rosemary; Roberto, Karen A.

    2010-01-01

    Purpose: We examined characteristics, responses, and psychological well-being of care partners who support and assist older adults recently diagnosed with mild cognitive impairment (MCI). Design and Methods: Based on a sample of 106 care partners of community residents diagnosed with MCI at memory clinics, we conducted face-to-face interviews…

  1. Cultural variations in motivational responses to felt misunderstanding.

    Science.gov (United States)

    Lun, Janetta; Oishi, Shigehiro; Coan, James A; Akimoto, Sharon; Miao, Felicity F

    2010-07-01

    Three studies examined cultural variations in the motivational consequences of being misunderstood by others. Study 1 found that European American students who felt misunderstood by others performed progressively better academically, whereas Asian and Asian American students who felt misunderstood by others performed progressively worse. In Studies 2 and 3, felt misunderstanding was experimentally manipulated, and motivational responses were measured with a handgrip task (Study 2) and prefrontal electroencephalography (EEG) asymmetry (Study 3). Across the two studies, Asians and Asian Americans showed more withdrawal-related responses but European Americans showed either no difference (Study 2) or more motivated responses (Study 3) after being misunderstood versus being understood. Together, these studies demonstrate systematic cultural variations in motivational responses to felt misunderstanding.

  2. Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review

    Science.gov (United States)

    Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

    2016-01-01

    Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations’ use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations’ access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated. PMID:27190222

  3. Organizational culture, team climate and diabetes care in small office-based practices

    Directory of Open Access Journals (Sweden)

    van der Weijden Trudy

    2008-08-01

    Full Text Available Abstract Background Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary teamwork and different types of organizational culture are associated with high quality diabetes care in small office-based general practices. Methods We conducted cross-sectional analyses of data from 83 health care professionals involved in diabetes care from 30 primary care practices in the Netherlands, with a total of 752 diabetes mellitus type II patients participating in an improvement study. We used self-reported measures of team climate (Team Climate Inventory and organizational culture (Competing Values Framework, and measures of quality of diabetes care and clinical patient characteristics from medical records and self-report. We conducted multivariate analyses of the relationship between culture, climate and HbA1c, total cholesterol, systolic blood pressure and a sum score on process indicators for the quality of diabetes care, adjusting for potential patient- and practice level confounders and practice-level clustering. Results A strong group culture was negatively associated to the quality of diabetes care provided to patients (β = -0.04; p = 0.04, whereas a more 'balanced culture' was positively associated to diabetes care quality (β = 5.97; p = 0.03. No associations were found between organizational culture, team climate and clinical patient outcomes. Conclusion Although some significant associations were found between high quality diabetes care in general practice and different organizational cultures, relations were rather marginal. Variation in clinical patient outcomes could not be attributed to organizational culture or teamwork. This study therefore contributes to the discussion about the legitimacy of the widespread idea

  4. The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities

    Directory of Open Access Journals (Sweden)

    Ascoli Micol

    2012-09-01

    Full Text Available Abstract Introduction Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. Results These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering “culture” in the presentation and expression of mental distress. The narratives reveal an overall “culture of understanding cultural issues” and specific “cultures of care”. These emerged as necessary foci of intervention to improve service user outcomes. Conclusion Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery.

  5. Whistle-blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce.

    Science.gov (United States)

    Jones, Aled; Kelly, Daniel

    2014-09-01

    Inquiries in the UK into mistreatment of older people by healthcare employees over the last 30 years have focused on introducing or supporting employee whistle-blowing. Although whistle-blowers have made an important contribution to patient safety it remains a controversial activity. The fate of whistle-blowers is bleak, often resulting in personal and professional sacrifices. Here we draw on the views of healthcare and social care employees working with older people to explore perceptions of whistle-blowing as well as alternative strategies that may be used to raise concerns about the mistreatment of patients by co-workers. Whistle-blowing was perceived as a negative term. Managers said they promoted open cultures underpinned by regular team meetings and an open-door ethos. Others described workplace norms that were somewhat at odds with these open culture ideals. Whistle-blowing was considered risky, and this led to staff creating informal channels through which to raise concerns. Those who witnessed wrongdoing were aware that support was available from external agencies but preferred local solutions and drew upon personal ethics rather than regulatory edicts to shape their responses. We argue that the importance of workplace relationships and informal channels for raising concerns should be better understood to help prevent the mistreatment of vulnerable groups. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  6. Reducing Disparities through Culturally Competent Health Care: An Analysis of the Business Case

    Science.gov (United States)

    Brach, Cindy; Fraser, Irene

    2016-01-01

    Finding ways to deliver high-quality health care to an increasingly diverse population is a major challenge for the American health care system. The persistence of racial and ethnic disparities in health care access, quality, and outcomes has prompted considerable interest in increasing the cultural competence of health care, both as an end in its own right and as a potential means to reduce disparities. This article reviews the potential role of cultural competence in reducing racial and ethnic health disparities, the strength of health care organizations’ current incentives to adopt cultural competence techniques, and the limitations inherent in these incentives that will need to be overcome if cultural competence techniques are to become widely adopted. PMID:12938253

  7. Redirecting traditional professional values to support safety: changing organisational culture in health care

    OpenAIRE

    Carroll, J.; Quijada, M.

    2004-01-01

    Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to suppo...

  8. A Culturally Responsive Counter-Narrative of Effective Teaching

    Science.gov (United States)

    Gist, Conra D.

    2014-01-01

    How do you recognize an effective teacher's sociocultural consciousness? Tamara Wallace's and Brenda Brand's argument that sociocultural consciousness is the "brain" of effective culturally responsive instruction for students of color comes at a time when the system of teacher evaluation is being overhauled nationwide.…

  9. Examining Preservice Teachers' Culturally Responsive Teaching Self-Efficacy Doubts

    Science.gov (United States)

    Siwatu, Kamau Oginga; Chesnut, Steven Randall; Alejandro, Angela Ybarra; Young, Haeni Alecia

    2016-01-01

    This study was designed to add to the research on teachers' self-efficacy beliefs by examining preservice teachers' culturally responsive teaching self-efficacy doubts. We examined the tasks that preservice teachers felt least efficacious to successfully execute and explored the reasoning behind these self-efficacy doubts. Consequently, we were…

  10. German financial media's responsiveness to Deutsche Bank's cultural change

    NARCIS (Netherlands)

    Strauß, N.

    2015-01-01

    Based on first-order and second-order agenda building theory, this study analyzes the responsiveness of German financial media to frames of the "cultural change" proclaimed in the banking industry, exemplified by Deutsche Bank. Findings suggest a difference between the two major German financial med

  11. Preparing Special Educators for Culturally Responsive School-Community Partnerships

    Science.gov (United States)

    Ford, Bridgie A.

    2004-01-01

    Today's increasingly multicultural student population requires that school-community partnerships operate from culturally responsive frameworks. Incorporating significant resources from multicultural communities is an essential component within school-community partnership. Although such a partnership is an essential strategy, it has not been…

  12. Behavioral Theory and Culture Special Issue: Authors' Response to Commentaries

    Science.gov (United States)

    Pasick, Rena J.; Burke, Nancy J.; Joseph, Galen

    2009-01-01

    This article presents the authors' response to commentaries that focus on the "Behavioral Constructs and Culture in Cancer Screening" (3Cs) study. The 3Cs study had an unremarkable beginning, with two colleagues discussing their frustration over the narrow range of behavioral theories and the limited guidance the theories offered for a study…

  13. Fostering Culturally and Developmentally Responsive Teaching through Improvisational Practice

    Science.gov (United States)

    Graue, Elizabeth; Whyte, Kristin; Delaney, Kate Kresin

    2014-01-01

    In this article we explore an effort to rethink curricular decision-making with a group of public pre-K teachers working in a context of curriculum escalation and commitment to play-based pedagogy. Through a professional development program designed to support developmentally and culturally responsive early mathematics, we examine how teachers…

  14. Culturally Responsive Evaluation Meets Systems-Oriented Evaluation

    Science.gov (United States)

    Thomas, Veronica G.; Parsons, Beverly A.

    2017-01-01

    The authors of this article each bring a different theoretical background to their evaluation practice. The first author has a background of attention to culturally responsive evaluation (CRE), while the second author has a background of attention to systems theories and their application to evaluation. Both have had their own evolution of…

  15. Faculty Perspectives on Culturally Responsive Teaching Practices in Developmental Education

    Science.gov (United States)

    Raney, Kristen A.

    2013-01-01

    This mixed methods study examined the perspectives of developmental math faculty at a two-year technical college regarding culturally responsive beliefs and instructional practices. Thirteen faculty who taught the developmental class Elementary Algebra with Applications were surveyed. Nine of the 13 faculty responded. One section of Wisconsin's…

  16. Universities' Responses to Globalisation: The Influence of Organisational Culture

    Science.gov (United States)

    Burnett, Sally-Ann; Huisman, Jeroen

    2010-01-01

    This study sought to assess how and why some higher education institutions have responded to aspects of globalisation and, in particular how organisational culture influences universities' responses to globalisation. Using a predominantly qualitative, mixed-methods approach, empirical research was used to explore the impact of globalisation at…

  17. Culturally Responsive Online Design: Learning at Intercultural Intersections

    Science.gov (United States)

    Morong, Gail; DesBiens, Donna

    2016-01-01

    This article presents evidence-based guidelines to inform culturally responsive online learning design in higher education. Intercultural understanding is now a recognised core learning outcome in a large majority of Canadian public universities; however, supporting design methodology is underdeveloped, especially in online contexts. Our search…

  18. Culturally Responsive Education in Music Education: A Literature Review

    Science.gov (United States)

    Bond, Vanessa L.

    2017-01-01

    Demographic shifts in public school enrollment within the United States necessitate preparing preservice teachers to teach students with backgrounds that differ from their own ethnically, linguistically, racially, and economically. Culturally responsive education (CRE) is a pedagogy used to validate students' varied experiences, and to teach to…

  19. Improving cultural competency among hospice and palliative care volunteers: recommendations for social policy.

    Science.gov (United States)

    Jovanovic, Maja

    2012-06-01

    This case study of 14 hospice and palliative care volunteers looked for recommendations and suggestions on how to increase cultural competency among hospice volunteers. In-depth interviews were conducted with a hospice in Toronto, Canada, and findings reveal that volunteers have very specific and diverse recommendations on how they prefer to be briefed and educated on cultural competency issues surrounding their patients. Findings also reveal hospice volunteers want more cultural competency training and acknowledge the importance of being culturally competent. This article concludes with a précis on recommendations for increasing cultural competency in hospice and palliative care for both volunteers and agencies and discusses the top 4 future trends in cultural competency for hospice care.

  20. Redirecting traditional professional values to support safety: changing organisational culture in health care.

    Science.gov (United States)

    Carroll, J S; Quijada, M A

    2004-12-01

    Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to support change. We offer examples of organisations that drew upon cultural strengths to create new ways of working and gradually shifted the culture.

  1. Influence of national culture on the social construction of health care quality

    OpenAIRE

    Aldousari, Abdulrahman

    2015-01-01

    The purpose of this study is to examine how national culture influences the social constructions of health care quality in the Kuwaiti primary care. Kuwait has a well- developed primary care system, offering a wide range of services in practices distributed throughout the nation, throughout the day, and on a walk-in basis. Despite its extended hours, relative comprehensiveness and affordability, the primary care service in Kuwait appears to be poorly received by the public. This study employe...

  2. The Affordable Care Act: the ethical call to transform the organizational culture.

    Science.gov (United States)

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

  3. Paradoxes of Personal Responsibility in Mental Health Care.

    Science.gov (United States)

    Lakeman, Richard

    2016-12-01

    Personal responsibility is widely considered important in mental health recovery as well as in popular models of alcohol and drug treatment. Neo-liberal socio-political rhetoric around consumerism in health care often assumes that people are informed and responsible for their own choices and behaviour. In the mental health care context and especially in emergency or crisis settings, personal responsibility often raises particular paradoxes. People often present whose behaviour does not conform to the ideals of the responsible consumer; they may seek and/or be granted absolution from irresponsible behaviour. This paradox is explored and clinicians are urged to consider the context-bound nature of personal responsibility and how attributions of personal responsibility may conflict with policy and their own professional responsibilities to intervene to protect others.

  4. Digital Citizenship: Developing an Ethical and Responsible Online Culture

    Science.gov (United States)

    Oxley, Cathy

    2010-01-01

    Responsible and ethical use of the Internet is not something that teenagers, in particular, consider to be important, and serious consequences are beginning to emerge as a result of careless and offensive online behaviour. Teachers and teacher-librarians have a duty of care to make students aware of the potentially devastating effects of…

  5. Response to Cultures Continuum and the Development of Intercultural Responsiveness (IR)

    Science.gov (United States)

    Jones, Kathryn; Mixon, Jason R.; Henry, Lula; Butcher, Jennifer

    2017-01-01

    This qualitative phenomenological research study investigated the perceptions of pre-service teachers' intercultural responsiveness. Findings from this study affirmed that pre-service teachers believed that positive dispositions, being culturally aware, and responding by incorporating cultural differences is a key to achieving Intercultural…

  6. Temperament trait of sensory processing sensitivity moderates cultural differences in neural response.

    Science.gov (United States)

    Aron, Arthur; Ketay, Sarah; Hedden, Trey; Aron, Elaine N; Rose Markus, Hazel; Gabrieli, John D E

    2010-06-01

    This study focused on a possible temperament-by-culture interaction. Specifically, it explored whether a basic temperament/personality trait (sensory processing sensitivity; SPS), perhaps having a genetic component, might moderate a previously established cultural difference in neural responses when making context-dependent vs context-independent judgments of simple visual stimuli. SPS has been hypothesized to underlie what has been called inhibitedness or reactivity in infants, introversion in adults, and reactivity or responsivness in diverse animal species. Some biologists view the trait as one of two innate strategies-observing carefully before acting vs being first to act. Thus the central characteristic of SPS is hypothesized to be a deep processing of information. Here, 10 European-Americans and 10 East Asians underwent functional magnetic resonance imaging while performing simple visuospatial tasks emphasizing judgments that were either context independent (typically easier for Americans) or context dependent (typically easier for Asians). As reported elsewhere, each group exhibited greater activation for the culturally non-preferred task in frontal and parietal regions associated with greater effort in attention and working memory. However, further analyses, reported here for the first time, provided preliminary support for moderation by SPS. Consistent with the careful-processing theory, high-SPS individuals showed little cultural difference; low-SPS, strong culture differences.

  7. Culture and end of life care: a scoping exercise in seven European countries.

    Science.gov (United States)

    Gysels, Marjolein; Evans, Natalie; Meñaca, Arantza; Andrew, Erin; Toscani, Franco; Finetti, Sylvia; Pasman, H Roeline; Higginson, Irene; Harding, Richard; Pool, Robert

    2012-01-01

    Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. We scoped the literature for Germany, Norway, Belgium, The Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

  8. Culture and end of life care: a scoping exercise in seven European countries.

    Directory of Open Access Journals (Sweden)

    Marjolein Gysels

    Full Text Available AIM: Culture is becoming increasingly important in relation to end of life (EoL care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. METHODS: We scoped the literature for Germany, Norway, Belgium, The Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. RESULTS: A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries. The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. CONCLUSION: This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for

  9. Resident and Family Member Perceptions of Cultural Diversity in Aged Care Homes.

    Science.gov (United States)

    Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

    2016-08-03

    Similar to many developed nations, older people living in residential aged care homes in Australia and the staff who care for them have become increasingly multicultural. This cultural diversity adds challenges for residents in adapting to the care home. This study explores: (i) residents' and family members' perceptions about staff and cultural diversity, and (ii) culturally and linguistically diverse residents' and family members' experiences. An interpretive study design employing a thematic analysis was applied. Twenty-three residents and seven family members participated in interviews. Four themes were identified from interpreting residents and family members' perceptions of the impact of cultural diversity on their adaptation to aged care homes: (i) perceiving diversity as an attraction; (ii) adapting to cross-cultural communication; (iii) adjusting to diet in the residential care home; and (iv) anticipating individualized psychosocial interactions. The findings have implications for identifying strategies to support staff from all cultural backgrounds in order to create a caring environment that facilitates positive relationships with residents and supports residents to adjust to the care home.

  10. The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers.

    Science.gov (United States)

    O'Mahony, Joyce Maureen; Donnelly, Tam Truong

    2007-05-01

    It is well documented that serious mental health problems such as depression, schizophrenia, and post migration stress disorders exist among immigrant women. Informed by Kleinman's explanatory model, this qualitative exploratory study was conducted with seven health care providers who provided mental health services to immigrant women. Analysis of the data revealed that (a) immigrant women face many difficulties when accessing mental health care services due to cultural differences, social stigma, and unfamiliarity with Western biomedicine, (b) spiritual beliefs and practices that influence immigrant women's mental health care practices, and (c) the health care provider-client relationship, which exerts great influence on how immigrant women seek mental health care. The study also revealed that cultural background exerts both positive and negative influences on how immigrant women seek mental health care. We suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.

  11. Consumer directed health care: ethical limits to choice and responsibility.

    Science.gov (United States)

    Axtell-Thompson, Linda M

    2005-04-01

    As health care costs continue to escalate, cost control measures will likely become unavoidable and painful. One approach is to engage external forces to allocate resources--for example, through managed care or outright rationing. Another approach is to engage consumers to make their own allocation decisions, through "self-rationing," wherein they are given greater awareness, control, and hence responsibility for their health care spending. Steadily gaining popularity in this context is the concept of "consumer directed health care" (CDHC), which is envisioned to both control cost and enhance choice, by combining financial incentives with information to help consumers make more informed health care decisions and to appreciate the economic trade-offs of those decisions. While CDHC is gaining attention in the popular press, business publications, and academic journals, it is not without controversy about its relative merits and demerits. CDHC raises questions regarding the ethical limits of consumer responsibility for their choices. While the emphasis on consumer choice implies that autonomy is the ruling ethical principle in CDHC, it must be tempered by justice and beneficence. Justice must temper autonomy to protect disadvantaged populations from further widening disparities in health care access and outcomes that could arise from health care reform efforts. Beneficence must temper autonomy to protect consumers from unintended consequences of uninformed decisions. Thoughtful paternalism suggests that CDHC plans offer choices that are comprehensible to lay consumers, limited in their range of options, and carefully structured with default rules that minimize potential error costs.

  12. [Competency to provide cross-cultural nursing care for people with disability: a self-assessment instrument].

    Science.gov (United States)

    Pagliuca, Lorita Marlena Freitag; Maia, Evanira Rodrigues

    2012-01-01

    This study addresses the Cross-Cultural Nursing Theory, which develops foundations for care delivery, as the essence of nursing work, based on anthropology, which supports and explains culture and care aspects. This reflexive study was based on the Theory Analysis method to study the concepts aimed at constructing a Self-Assessment Instrument of Competencies for Cross-Cultural Care to Disabled People. After analyzing the main concepts, Culturally Competent Care and Cultural Communication, were analyzed, as well as the sub-concepts: assessment, values, bio-cultural diversity, skill, knowledge, identity, code and cultural empathy. The analysis cycle of cultural values supporting self-assessment was summarized. The Self-Assessment Instrument of Competencies for Cross-Cultural Nursing Care to Disabled People was constructed, specifically deafness, blindness or low sight, physical impairment and mental impairment, regarding greeting, accepting, helping, knowing and advocating. It is concluded that the theory joins characteristics for care delivery to disabled people.

  13. Dental Health Care Models of Southwest Cultures. Final Report.

    Science.gov (United States)

    Pettibone, Timothy J.; Solis, Enrique, Jr.

    The major goal of this research was the development and validation of cultural models of dental health practices. The specific objectives were to determine if 3 cultural groups (American Indians, Mexican Americans, and Anglo Americans) differ in the dental health hygiene indices, characteristics, psychological factors, or social factors; to…

  14. Creating Peaceful and Effective Schools through a Culture of Care

    Science.gov (United States)

    Cavanagh, Tom; Macfarlane, Angus; Glynn, Ted; Macfarlane, Sonja

    2012-01-01

    Many schools in New Zealand, the USA, and elsewhere, are searching for ways to respond positively to the educational achievement disparities that exist between majority culture students and students from minority ethnic and cultural communities. Most of the approaches and strategies that have been implemented to date have either failed, or had…

  15. Culturally Diverse Communities and End-of-Life Care

    Science.gov (United States)

    ... trusting physi- cians, and participating in decisions. Some cultures (e.g., Korean) expect the eldest son to decide about a ... language” (Phipps, True & Pomerantz, 200). For many reasons, Koreans ... them differently. Medical culture emphasizes a curative focus and a view of ...

  16. HIV health-care providers' burnout: can organizational culture make a difference?

    Science.gov (United States)

    Ginossar, Tamar; Oetzel, John; Hill, Ricky; Avila, Magdalena; Archiopoli, Ashley; Wilcox, Bryan

    2014-01-01

    One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p organizational culture (i.e., critical appraisal) was positively related to depersonalization (p < .005, R(2) = .18). These findings suggest that effective organizational communication interventions might protect HIV health-care providers from burnout.

  17. Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care.

    Science.gov (United States)

    Alharbi, Tariq Saleem J; Ekman, Inger; Olsson, Lars-Eric; Dudas, Kerstin; Carlström, Eric

    2012-12-01

    Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Childhood Development Cross Culturally:Implications for Designing Childhood Obesity Interventions and Providing Culturally Competent Care

    Institute of Scientific and Technical Information of China (English)

    Jiying Ling; PhD.MS.RN.Vicki Hines-Martin; PhD.CNS.RN.FAAN Hong Ji; MSN

    2013-01-01

    United States is experiencing significant growth in its foreign -born population , especially Chinese American population comprising of 1.2% of the U.S.population.Many healthcare providers are challenged in their efforts to provide culturally competent healthcare to this population. To provide culturally competent healthcare ,healthcare providers should understand variations in cultural at-tributes that impact health. One group in which cultural variation holds great influence is that of children. Culture influences a child's be-havior,development and health. This article provides a cross -cultural,comparative examination of important cultural influences on child behaviors development and health in China and the U. S.Using the findings about these two populations ,interventions for childhood obesity cross culturally are addressed through the analysis of a U. S.based Children's Obesity Program. The author suggests that uniquely different approaches to childhood obesity intervention research are needed based upon the cultural differences identified within this paper.

  19. Linking Cultural Competence to Functional Life Outcomes in Mental Health Care Settings.

    Science.gov (United States)

    Michalopoulou, Georgia; Falzarano, Pamela; Butkus, Michael; Zeman, Lori; Vershave, Judy; Arfken, Cynthia

    2014-01-01

    Minorities in the United States have well-documented health disparities. Cultural barriers and biases by health care providers may contribute to lower quality of services which may contribute to these disparities. However, evidence linking cultural competency and health outcomes is lacking. This study, part of an ongoing quality improvement effort, tested the mediation hypothesis that patients' perception of provider cultural competency indirectly influences patients' health outcomes through process of care. Data were from patient satisfaction surveys collected in seven mental health clinics (n=94 minority patients). Consistent with our hypothesis, patients' perception of clinicians' cultural competency was indirectly associated with patients' self-reported improvements in social interactions, improvements in performance at work or school, and improvements in managing life problems through the patients' experience of respect, trust, and communication with the clinician. These findings indicate that process of care characteristics during the clinical encounter influence patients' perceptions of clinicians' cultural competency and affect functional outcomes.

  20. Confucian bioethics and cross-cultural considerations in health care decision-making.

    Science.gov (United States)

    Kim, Su Hyun

    2005-01-01

    This article discusses the similarities and differences between Beauchamp and Childress's principlism and Confucian bioethics in terms of autonomy, beneficence, nonmaleficence, and justice. The author presents sensitive approaches for culturally diverse groups in health care areas and cautions against dichotomy in cross-cultural studies, which ignores the dynamic nature and intravariations of cultures. As a way of health care providers to become engaged in cultural diversity in nursing practice and research, the author suggests that they do not only have a general knowledge about the theoretical differences among groups through "normative analysis" but also learn to appreciate each individual's particular beliefs and values through narratives of morality. Health care providers as well as legal professionals need to cultivate "cultural humility," which is the willingness to explore the similarities and differences between their own and each client's priorities and values and to develop courses of action with patients.

  1. Boys, Girls, and "Two Cultures" of Child Care

    Science.gov (United States)

    Winer, Abby C.; Phillips, Deborah A.

    2012-01-01

    This study examined differences in the quality of child care experienced by toddler boys and girls. Boys were more likely to be in lower-quality child care than girls, assessed with both setting-level measures and observations of caregiver-child interaction. A possible explanatory mechanism for the gender differences is suggested by evidence that…

  2. Re-Imagining Language, Culture, and Family in Foster Care

    Science.gov (United States)

    Puig, Victoria I.

    2013-01-01

    Nearly half a million children in the United States are currently being served by the foster care system. Infants and toddlers represent the largest single group entering foster care. While these very young children are at the greatest peril for physical, mental health, and developmental issues and tend to spend the longest time in the foster care…

  3. Are we bridging the gap? A review of cultural diversity within stoma care.

    Science.gov (United States)

    Cooper-Gamson, Louise

    2017-09-28

    The aim of this article is to highlight the aspects of how religion, ethnic grouping, age, gender, and learning disabilities affect how stoma care is approached and supported. It will try to highlight the positive and negative approaches documented so far and how this has affected the quality of stoma care given. By following guidelines set out by the Nursing and Midwifery Council (NMC) (2015) and the Association of Stoma Care Nurses (ASCN) (2015) the aim of the article will be to expand cultural awareness in stoma care nursing. By learning about the multifaceted aspects of culture as it applies to stoma care and then being able to apply that knowledge, usefully and skilfully, expands the SCN's ability to provide services for any cultural diverse client group.

  4. Geoethics and geological culture: awareness, responsibility and challenges

    Directory of Open Access Journals (Sweden)

    Silvia Peppoloni

    2012-07-01

    Full Text Available The international debate in the field of geoethics focuses on some of the most important environmental emergencies, while highlighting the great responsibilities of geoscientists, whatever field they work in, and the important social, cultural and economic repercussions that their choices can have on society. The GeoItalia 2009 and 2011 conferences that were held in Rimini and Turin, respectively, and were organized by the Italian Federation of Earth Science, were two important moments for the promotion of geoethics in Italy. They were devoted to the highlighting of how, and with what tools and contents, can the geosciences contribute to the cultural renewal of society. They also covered the active roles of geoscientists in the dissemination of scientific information, contributing in this way to the correct construction of social knowledge. Geology is culture, and as such it can help to dispel misconceptions and cultural stereotypes that concern natural phenomena, disasters, resources, and land management. Geological culture consists of methods, goals, values, history, ways of thinking about nature, and specific sensitivity for approaching problems and their solutions. So geology has to fix referenced values, as indispensable prerequisites for geoethics. Together, geological culture and geoethics can strengthen the bond that joins people to their territory, and can help to find solutions and answers to some important challenges in the coming years regarding natural risks, resources, and climate change. Starting from these considerations, we stress the importance of establishing an ethical criterion for Earth scientists, to focus attention on the issue of the responsibility of geoscientists, and the need to more clearly define their scientific identity and the value of their specificities.

  5. Conflicting views on elder care responsibility in Japan.

    Science.gov (United States)

    Lee, Kristen Schultz

    2016-05-01

    I examine the attitudinal ambivalence created by conflicting social expectations regarding parent-child devotion, filial obligation and family membership, and gender norms in a national population of Japanese adults. I ask: in a context of rapidly changing family and elder care norms, how do different beliefs and attitudes overlap and conflict and how are they related to elder care preferences? I analyze data from the 2006 Japanese General Social Survey and use Latent Class Analysis to identify latent groups in the population defined by their beliefs and examine the relationship between class membership and elder care preferences. I found variation in the population with respect to the measured beliefs as well as a relationship between patterns of beliefs and choice of elder caregiver. I found conflicting expectations regarding elder care responsibility in one latent class and this class also expressed elder care preferences that conflict with at least some of their strongly held beliefs.

  6. Roles and responsibilities in the secondary level eye care model

    Directory of Open Access Journals (Sweden)

    Saibaba Saravanan

    2005-12-01

    Full Text Available In any secondary level eye care clinic, a number of tasks must be completed. In different countries and different settings, different people will carry out these tasks. The manager is responsible for ensuring that all the tasks are covered, that people are carefully selected to perform them, and that staff are supported and managed. The International Centre for Advancement of Rural Eye Care (ICARE, within the L.V. Prasad Eye Institute (LVPEI in India, has evolved an eye care team to provide secondary level eye care services to a population of 0.5 to 1 million. The ICARE model emphasises that all cadres of clinical and non-clinical personnel are equally important. Below is a description of the range of jobs at secondary level centres. The tertiary centre at LVPEI manages leadership and training for this model.

  7. Roles and Responsibilities in Newborn Care in four African Sites.

    OpenAIRE

    Iganus, R.; Hill, Z.; Manzi, F; Bee, M.; Amare, Y.; Shamba, D; Odebiyi, A.; Adejuyigbe, E.; Omotara, B.; Skordis-Worrall, J

    2015-01-01

    Objectives. To explore roles and responsibilities in newborn care in the intra- and postpartum period in Nigeria, Tanzania and Ethiopia. Methods. Qualitative data were collected using in-depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses. Results. We found that birth attendants were the main decision-makers and care takers in the intrapartum period. Birth attenda...

  8. The impact of work culture on quality of care in nursing homes--a review study.

    Science.gov (United States)

    André, Beate; Sjøvold, Endre; Rannestad, Toril; Ringdal, Gerd I

    2014-09-01

    The main aim of this review study was to identify which factors that characterise the relationship between work culture and quality of care in nursing homes. This review study was structured through systematic search methods to identify articles that describe the relationship between work culture and quality of care in nursing homes. The database search yielded 14510 hits. Closer examination showed that 10401 of these hits were duplicates. Of the remaining 4109 articles, only 10 were related to our aim for the study. A qualitative method were used to explain and understand phenomena of work culture and quality if care in nursing homes. Nine out of 10 articles in this review study emphasise the importance of leadership style and supportive management to increase quality of care in nursing homes. Increased empowerment, participation and influence were important factors for improving quality of care. Significant associations between work culture and quality of care and between empowerment and quality of care were reported. Nursing management and leaders must take in consideration that work culture is crucial for improving quality of care in nursing homes, and this study can be used to increase the focus on the work culture among healthcare personnel in nursing homes. Changes are necessary to increase healthcare personnel's job satisfaction, empowerment, autonomy and influence in nursing homes. Giving empowerment to the healthcare personnel working in nursing homes is both an organisational and an interpersonal issue. Being given empowerment and influence over their own work situation, the healthcare workers can be more committed and involved in the goal of obtaining best possible care to the residents. © 2013 Nordic College of Caring Science.

  9. The relationship between cultural competence and ethnocentrism of health care professionals.

    Science.gov (United States)

    Capell, Jen; Dean, Elizabeth; Veenstra, Gerry

    2008-04-01

    The study examined the relationship between cultural competence and ethnocentrism among health care professionals. Physical therapists, occupational therapists, and nurses ( N = 71) from three hospitals in Vancouver, British Columbia, Canada, participated in the survey research project. The survey questionnaire incorporated the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised and the Generalized Ethnocentrism Scale. Cultural competence scores and ethnocentrism scores were inversely related (r = -.28, p = .017). Results suggest that cultural competence may not be entirely distinct from ethnocentrism. The construct of cultural competence warrants further study vis-à-vis its correlates and its impact on clinical outcomes.

  10. Cultural responsiveness in EFL teaching: reflections from native instructors

    Directory of Open Access Journals (Sweden)

    Cinarbas H. Ibrahim

    2016-05-01

    Full Text Available In recent years, many international students from different parts of the world have been studying at Turkish universities, which creates a multicultural educational setting. Due to the multicultural educational setting, English has become the most widely used language for exchanging and sharing knowledge, therefore many international universities in Turkey put a great emphasis on English language education and offer English preparatory courses to students. In order to succeed at better language education, universities employ native English instructors to provide a richer language experience with cultural components embedded in language content. In this qualitative case study, cultural reflections of native English instructors at a Turkish university were investigated. Individual and focus group interviews were data sources for the study. Findings indicated that cultural responsiveness was considered to be constructed through time, and a necessity of orientation process was emphasized. However, the native instructors’ presumptions cause intolerance and underestimation of the host culture. In addition, educational issues and students’ misbehaviors, such as cheating and calling their instructors by their first name, were attributed to cultural background of the students.

  11. Roles and responsibilities in newborn care in four African sites.

    Science.gov (United States)

    Iganus, R; Hill, Z; Manzi, F; Bee, M; Amare, Y; Shamba, D; Odebiyi, A; Adejuyigbe, E; Omotara, B; Skordis-Worrall, J

    2015-10-01

    To explore roles and responsibilities in newborn care in the intra- and postpartum period in Nigeria, Tanzania and Ethiopia. Qualitative data were collected using in-depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses. We found that birth attendants were the main decision-makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first-time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision-maker in the family. Interventions should move beyond a focus on the mother-child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  12. Ownership and care in culturally significant architecture: Three case ...

    African Journals Online (AJOL)

    Figure 2: The medieval castle and cathedral surrounded by timber structure dwellings. Source: .... concepts of building culture and building material; it is also about .... Steinkopf was well established with a church, a small school and some.

  13. Promoting nursing students' understanding and reflection on cultural awareness with older adults in home care.

    Science.gov (United States)

    Mager, Diana R; Grossman, Sheila

    2013-01-01

    It is important for nursing programs to use culturally focused activities to increase student preparation in caring for diverse older adults in their homes. The purpose of this study was to examine strategies that promote students' reflection on cultural awareness using home care-focused case studies, simulations, and self-reflective writing activities. Cases and simulations were designed to depict diverse patients living at home with a variety of demographic characteristics, such as health history, age, culture, religion, dietary preferences, marital status, family involvement, and socioeconomic status. Qualitative data regarding student perceptions of cultural awareness was gathered via written surveys, and findings suggest that junior- and senior-year nursing students enhanced the depth and breadth of how they defined "cultural competence" after participating in culturally focused classroom and clinical laboratory activities. Levels of reflective writing using framework also improved by the semester's end for both groups of students.

  14. Towards a Cultural Framework of Audience Response and Television Violence

    OpenAIRE

    Császi, Lajos

    2008-01-01

    In his paper "Towards a Cultural Framework of Audience Response and Television Violence" Lajos Császi argues that media violence is not a reification of social violence; rather, a popular ritual allowing contemporary societies to sublimate, to substitute, and to discuss aggression in the public sphere. Császi reviews the central questions of contemporary debates about television violence including Stuart Hall's thought on this topic and introduces the ideas of Elias, Geertz, Turner, Bettelhei...

  15. Roots of Empathy: responsive parenting, caring societies.

    Science.gov (United States)

    Gordon, Mary

    2003-12-01

    What is common in aggression and in abusive/neglectful parenting is low levels of empathy. Fostering empathy--the ability to identify with another person's feelings--can serve as an antidote to aggression and is crucial to good parenting. Poor parenting and aggression cut across all socioeconomic levels of the community and, as such, empathy needs to be fostered in all children. During the period of rapid brain development, adversity has a devastating impact on the baby's developing brain. Repeated experiences of stress are hardwired into the brain, creating damaging pathways. Risk factors such as domestic violence, child abuse and neglect, maternal depression, maternal addictions, and poverty are not just additive to the vulnerable developing brain; they are multiplicative in their impact. The parent is the baby's lifeline, mitigating stress for them and helping them to learn to regulate their emotions. The impact of poor parenting on a child's life is profound, resulting in insecure attachments which lead to a spectrum of inadequate coping mechanisms, poor emotional regulation, diminished learning potential and low competence. Responsive and nurturing parenting is the key to optimal early childhood development; it allows the young brain to develop in a way that is less aggressive and more emotionally stable, social and empathic. Good early childhood development leads to good human development. We must match our investment where the opportunity is most ripe--building parenting capacity. The 'Roots of Empathy' program offers real hope in breaking the intergenerational transference of poor parenting and violence.

  16. A survey of cultural competence of critical care nurses in KwaZulu ...

    African Journals Online (AJOL)

    Nurses are primary caregivers and have a key role in providing care in a ... Nurses from non-English-speaking backgrounds scored significantly higher in cultural competence than English-speaking nurses. ... Cultural competence refers to the knowledge and skills nurses should .... they spoke a language other than English.

  17. Improving socially constructed cross-cultural communication in aged care homes: A critical perspective.

    Science.gov (United States)

    Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

    2017-06-14

    Cultural diversity between residents and staff is significant in aged care homes in many developed nations in the context of international migration. This diversity can be a challenge to achieving effective cross-cultural communication. The aim of this study was to critically examine how staff and residents initiated effective cross-cultural communication and social cohesion that enabled positive changes to occur. A critical hermeneutic analysis underpinned by Giddens' Structuration Theory was applied to the study. Data were collected by interviews with residents or their family and by focus groups with staff in four aged care homes in Australia. Findings reveal that residents and staff are capable of restructuring communication via a partnership approach. They can also work in collaboration to develop communication resources. When staff demonstrate cultural humility, they empower residents from culturally and linguistically diverse backgrounds to engage in effective communication. Findings also suggest that workforce interventions are required to improve residents' experiences in cross-cultural care. This study challenges aged care homes to establish policies, criteria and procedures in cross-cultural communication. There is also the challenge to provide ongoing education and training for staff to improve their cross-cultural communication capabilities. © 2017 John Wiley & Sons Ltd.

  18. The impact of market-based 'reform' on cultural values in health care.

    Science.gov (United States)

    Curtin, L L

    1999-12-01

    The many issues managed care poses for providers and health networks are crystallized in the moral problems occasioned by its shifting of the financial risks of care from insurer to provider. The issues occasioned by market-based reform include: the problems presented by clashes between public expectations and payer restrictions; the corporatization of health service delivery and the cultural shift from humanitarian endeavor to business enterprise the depersonalization of treatment as time and money constraints stretch resources, and the culture rewards efficient "business-like" behavior the underfunding of care for the poor and uninsured, even as these populations grow the restructuring of care and reengineering of healthcare roles as the emphasis shifts from quality of care to conservation of resources rapid mergers of both health plans and institutional providers with all the inherent turmoil as rules change, services are eliminated, and support services are minimized to save money the unhealthy competition inherent in market-based reform that posits profit taking and market share as the measures of successful performance the undermining of the professional ethic of advocacy the use of incentives that pander to greed and self-interest. The costs of sophisticated technologies and the ongoing care of increasingly fragile patients have pulled many other elements into what previously were considered "privileged" professional interactions. The fact that very few citizens indeed could pay out-of-pocket for the treatment and ongoing care they might need led to social involvement (few people remember that both widespread health insurance and public programs are relatively recent phenomena--only about 30 years old). However, whether in tax dollars or insurance premiums, other people's money is being spent on the patient's care. Clearly, those "other people" never intended to give either the patient or the professional open-ended access to their collective pocketbooks

  19. A qualitative study of the cultural changes in primary care organisations needed to implement clinical governance.

    Science.gov (United States)

    Marshall, Martin; Sheaff, Rod; Rogers, Anne; Campbell, Stephen; Halliwell, Shirley; Pickard, Susan; Sibbald, Bonnie; Roland, Martin

    2002-08-01

    It is commony claimed that changing the culture of health organisations is a fundamental prerequisite for improving the National Health Service (NHS). Little is currently known about the nature or importance of culture and cultural change in primary care groups and trusts (PCG/Ts) or their constituent general practices. To investigate the importance of culture and cultural change for the implementation of clinical governance in general practice by PCG/Ts, to identify perceived desirable and undesirable cultural attributes of general practice, and to describe potential facilitators and barriers to changing culture. Qualitative: case studies using data derived from semi-structured interviews and review of documentary evidence. Fifty senior non-clinical and clinical managers from 12 purposely sampled PCGs or trusts in England. Senior primary care managers regard culture and cultural change as fundamental aspects of clinical governance. The most important desirable cultural traits were the value placed on a commitment to public accountability by the practices, their willingness to work together and learn from each other, and the ability to be self-critical and learn from mistakes. The main barriers to cultural change were the high level of autonomy of practices and the perceived pressure to deliver rapid measurable changes in general practice. The culture of general practice is perceived to be an important component of health system reform and quality improvement. This study develops our understanding of a changing organisational culture in primary care; however, further work is required to determine whether culture is a useful practical lever for initiating or managing improvement.

  20. Cultural Adequecy of the Care Dependency Scale for Older Persons in Egypt : A Delphi Study

    NARCIS (Netherlands)

    Boggatz, Thomas; Farid, Tamer; Dijkstra, Ate; Lohrmann, Christa; Dassen, T.

    Purpose: The aim of this study is to determine the cultural adequateness of the Arabic version of the Care Dependency Scale (CDS), an internationally used instrument to measure care needs by either self-reports or external assessment. Method: A Delphi study in two rounds about the Arabic version was

  1. Integrating Compliance, Communication, and Culture: Delivering Health Care to an Aging Population

    Science.gov (United States)

    Langer, Nieli

    2008-01-01

    Older adults often get lost in the process of assessment, diagnosis and service brokering. If our concern as care providers is to enable older persons to remain independent or in the community for as long as possible, we must tap into their personal values, cultural identity and health beliefs in order to foster enhanced health care communication.…

  2. Note on a Cross-cultural Test of Gilligan's Ethic of Care

    Science.gov (United States)

    Vikan, Arne; Camino, Cleonice; Biaggio, Angela

    2005-01-01

    One hundred and twenty students from both Brazil and Norway were tested with Skoe's Ethic of Care Interview (ECI), which is a test of Gilligan's hypothesized gender-related ethic of care. Subjects were also tested with Bem's Sex Role Inventory and Triandis's Test of Cultural Orientations. The ECI was shown to be related neither to gender nor to…

  3. Cultural Adequecy of the Care Dependency Scale for Older Persons in Egypt : A Delphi Study

    NARCIS (Netherlands)

    Boggatz, Thomas; Farid, Tamer; Dijkstra, Ate; Lohrmann, Christa; Dassen, T.

    2009-01-01

    Purpose: The aim of this study is to determine the cultural adequateness of the Arabic version of the Care Dependency Scale (CDS), an internationally used instrument to measure care needs by either self-reports or external assessment. Method: A Delphi study in two rounds about the Arabic version was

  4. Overcoming health care disparities via better cross-cultural communication and health literacy.

    Science.gov (United States)

    Misra-Hebert, Anita D; Isaacson, J Harry

    2012-02-01

    Health care disparities have multiple causes; the dynamics of the physician-patient encounter is one of the causes that can be modified. Here, we discuss specific recommendations related to cross-cultural communication and health literacy as practical steps to providing more equitable health care to all patients.

  5. Is older adult care mediated by caregivers’ cultural stereotypes? The role of competence and warmth attribution

    Science.gov (United States)

    Fernández-Ballesteros, Rocío; Bustillos, Antonio; Santacreu, Marta; Schettini, Rocio; Díaz-Veiga, Pura; Huici, Carmen

    2016-01-01

    Purpose The purpose of this study is to examine, from the stereotype content model (SCM) perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers. Methods A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care approach and the other three providing standard geriatric care). In order to assess caregivers’ cultural stereotypical views, the SCM questionnaire was administered. To evaluate the role of caregivers’ cultural stereotypes in their professional performance as well as in older adult functioning, two observational scales from the Sistema de Evaluación de Residencias de Ancianos (assessment system for older adults residences)-RS (staff functioning and residents’ functioning) were applied. Results Caregivers’ cultural views of older adults (compared to young people) are characterized by low competence and high warmth, replicating the data obtained elsewhere from the SCM. Most importantly, the person-centered units predict better staff performance and better resident functioning than standard units. Moreover, cultural stereotyping of older adult competence moderates the effects of staff performance on resident functioning, in line with the findings of previous research. Conclusion Our results underline the influence of caregivers’ cultural stereotypes on the type of care, as well as on their professional behaviors and on older adult functioning. Caregivers’ cultural stereotypes could be considered as a central issue in older adult care since they mediate the triangle of care: caregivers/older adults/type of care; therefore, much more attention should be paid to this psychosocial care component. PMID:27217736

  6. Clinically applied medical ethnography: relevance to cultural competence in patient care.

    Science.gov (United States)

    Engebretson, Joan

    2011-06-01

    Medical anthropology provides an excellent resource for nursing research that is relevant to clinical nursing. By expanding the understanding of ethnographic research beyond ethnicity, nurses can conduct research that explores patient's constructions and explanatory models of health and healing and how they make meaning out of chronic conditions and negotiate daily life. These findings can have applicability to culturally competent care at both the organizational or systems level, as well as in the patient/provider encounter. Individual patient care can be improved by applying ethnographic research findings to build provider expertise and then using a cultural negotiation process for individualized patient care.

  7. Designing a patient care model with relevance to the cultural setting.

    Science.gov (United States)

    Robertson-Malt, Suzi; Herrin-Griffith, Donna M; Davies, Joanne

    2010-06-01

    Healthcare leaders are challenged to develop new approaches to care that better serve populations and use valuable resources in more effective and efficient ways. The authors discuss a model of care under development at Sidra Medical and Research Center, Qatar, with emphasis on how to translate the best available evidence in a way that is applicable and meaningful for the cultural setting. Strategies that nurse leaders can call upon to engage their team members' cultural intelligence during the planning and design of new processes of care are also discussed.

  8. Ethnic Swedish parents' experiences of minority ethnic nurses' cultural competence in Swedish paediatric care.

    Science.gov (United States)

    Tavallali, Azar G; Kabir, Zarina Nahar; Jirwe, Maria

    2014-06-01

    Sweden has a population of a little more than 9.4 million. The rapid growth of immigration in Sweden has resulted in an increased number of minority ethnic patients and minority ethnic nurses in the Swedish healthcare system. This also applies to paediatric care. The purpose of this study was to explore how parents with ethnic Swedish backgrounds experience minority ethnic nurses' cultural competence and the care the nurses provide in a Swedish paediatric care context. This exploratory qualitative study is of 14 parents with an ethnic Swedish background whose child was in a ward at a children's hospital in Stockholm County Council. Data were collected using semi-structured interviews to identify parents' perceptions and experiences of minority ethnic nurses' cultural competence. The interviews were analysed by qualitative content analysis. The analyses of the interviews led to four main categories: influence of nurses' ethnicity; significance of cross-cultural communication; cross-cultural skills; and the importance of nursing education. Nurses' ethnicity did not have much impact on parents' satisfaction with their child's care. The parents attached importance to nurses' language skills and to their adaptation and awareness of Swedish culture. They also attached weight to nurses' professional knowledge and personal attributes. The role of nursing education to increase nurses' cultural awareness was highlighted too. © 2013 Nordic College of Caring Science.

  9. Caring for LGBTQ patients: Methods for improving physician cultural competence.

    Science.gov (United States)

    Klein, Elizabeth W; Nakhai, Maliheh

    2016-05-01

    This article summarizes the components of a curriculum used to teach family medicine residents and faculty about LGBTQ patients' needs in a family medicine residency program in the Pacific Northwest region of the United States. This curriculum was developed to provide primary care physicians and physicians-in-training with skills to provide better health care for LGBTQ-identified patients. The curriculum covers topics that range from implicit and explicit bias and appropriate terminology to techniques for crafting patient-centered treatment plans. Additionally, focus is placed on improving the understanding of specific and unique barriers to competent health care encountered by LGBTQ patients. Through facilitated discussion, learners explore the health disparities that disproportionately affect LGBTQ individuals and develop skills that will improve their ability to care for LGBTQ patients. The goal of the curriculum is to teach family medicine faculty and physicians in training how to more effectively communicate with and treat LGBTQ patients in a safe, non-judgmental, and welcoming primary care environment. © The Author(s) 2016.

  10. Connecting organisational culture and quality of care in the hospital: is job burnout the missing link?

    Science.gov (United States)

    Montgomery, Anthony; Panagopoulou, Efharis; Kehoe, Ian; Valkanos, Efthymios

    2011-01-01

    To date, relatively little evidence has been published as to what represents an effective and efficient way to improve quality of care and safety in hospitals. In addition, the initiatives that do exist are rarely designed or developed with regard to the individual and organisational factors that determine the success or failure of such initiatives. One of the challenges in linking organisational culture to quality of care is to identify the focal point at which a deficient hospital culture and inadequate organisational resources are most evident. The accumulated evidence suggests that such a point is physician burnout. This paper sets out to examine this issue. The paper reviews the existing literature on organisational culture, burnout and quality of care in the healthcare sector. A new conceptual approach as to how organisational culture and quality of care can be more effectively linked through the physician experience of burnout is proposed. Recommendations are provided with regard to how future research can approach quality of care from a bottom-up organisational change perspective. In addition, the need to widen the debate beyond US and North European experiences is discussed. The present paper represents an attempt to link organisational culture, job burnout and quality of care in a more meaningful way. A conceptual model has been provided as a way to frame and evaluate future research.

  11. Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families.

    Science.gov (United States)

    Longo, Lianne; Slater, Serena

    2014-01-01

    Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.

  12. [The cultural history of palliative care in primitive societies: an integrative review].

    Science.gov (United States)

    Siles González, José; Solano Ruiz, Maria Del Carmen

    2012-08-01

    The objective of this study is to describe the evolution of palliative care in order to reflect on the possibility of its origin in primitive cultures and their relationship with the beginnings of the cult of the dead. It describes the change in the symbolic structures and social interactions involved in palliative care during prehistory: functional unit, functional framework and functional element. The theoretical framework is based on cultural history, the dialectical structural model and symbolic interactionism. Categorization techniques, cultural history and dialectic structuralism analyses were performed. Palliative care existed in primitive societies, mostly associated with the rites of passage with a high symbolic content. The social structures - functional unit, functional framework and functional element - are the pillars that supported palliative care in prehistory societies.

  13. Social justice, health disparities, and culture in the care of the elderly.

    Science.gov (United States)

    Dilworth-Anderson, Peggye; Pierre, Geraldine; Hilliard, Tandrea S

    2012-01-01

    Older minority Americans experience worse health outcomes than their white counterparts, exhibiting the need for social justice in all areas of their health care. Justice, fairness, and equity are crucial to minimizing conditions that adversely affect the health of individuals and communities. In this paper, Alzheimer's disease (AD) is used as an example of a health care disparity among elderly Americans that requires social justice interventions. Cultural factors play a crucial role in AD screening, diagnosis, and access to care, and are often a barrier to support and equality for minority communities. The "conundrum of health disparities" refers to the interplay between disparity, social justice, and cultural interpretation, and encourages researchers to understand both (1) disparity caused by economic and structural barriers to access, treatment, and diagnosis, and (2) disparity due to cultural interpretation of disease, in order to effectively address health care issues and concerns among elderly Americans.

  14. Corporate social responsibility and the future health care manager.

    Science.gov (United States)

    Collins, Sandra K

    2010-01-01

    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior.

  15. Validation of a provider self-report inventory for measuring patient-centered cultural sensitivity in health care using a sample of medical students.

    Science.gov (United States)

    Mirsu-Paun, Anca; Tucker, Carolyn M; Herman, Keith C; Hernandez, Caridad A

    2010-04-01

    The paper describes the construction and initial evaluation of the new Tucker-Culturally Sensitive Health Care Inventory (T-CSHCI) Provider Form, which was developed to address the shortcomings of existing similar measures. Two hundred seventeen (217) 3rd and 4th year medical students completed the T-CSHCI-Provider Form. Factor analysis was used to identify non-overlapping items. The final solution produced five factors: patient-centeredness, interpersonal skills, disrespect/disempowerment, competence, and cultural knowledge/responsiveness. The five T-CSHCI-Provider Form factors/subscales proved to be reliable and were associated with related constructs as hypothesized. This study provides initial evidence that the T-CSHCI-Provider Form measures independent dimensions of patient-centered culturally sensitive health care as perceived by medical students. Recommendations for ways in which the T-CSHCI Provider Form can be used to guide culturally sensitive health care training are provided.

  16. European higher health care education curriculum: development of a cultural framework.

    Science.gov (United States)

    Koskinen, Liisa; Kelly, Hélène Taylor; Bergknut, Eva; Lundberg, Pranee; Muir, Nita; Olt, Helen; Richardson, Eileen; Sairanen, Raija; De Vlieger, Lily

    2012-07-01

    This article concerns the European Curriculum in Cultural Care Project (2005-2009), which aimed at developing a curriculum framework for the enhancement of cultural competence in European health care education. The project was initiated and supported by the Consortium of Institutes in Higher Education in Health and Rehabilitation, whose goal is to nurture educational development and networking among member institutions. The framework is the result of a collaborative endeavor by nine nurse educators from five different European countries. The production of the framework will be described in accordance with the following tenets: developing cultural competence is a continuing process, cultural competence is based on sensitivity toward others, and cultural competence is a process of progressive inquiry. Critique concerning the framework will be presented.

  17. Organizational culture and climate for patient safety in Intensive Care Units.

    Science.gov (United States)

    Santiago, Thaiana Helena Roma; Turrini, Ruth Natalia Teresa

    2015-02-01

    Objective To assess the perception of health professionals about patient safety climate and culture in different intensive care units (ICUs) and the relationship between scores obtained on the Hospital Survey on Patient Safety Culture (HSOPSC) and the Safety Attitudes Questionnaire (SAQ). Method A cross-sectional study conducted at a teaching hospital in the state of São Paulo, Brazil, in March and April 2014. As data gathering instruments, the HSOPSC, SAQ and a questionnaire with sociodemographic and professional information about the staff working in an adult, pediatric and neonatal ICU were used. Data analysis was conducted with descriptive statistics. Results The scales presented good reliability. Greater weaknesses in patient safety were observed in the Working conditions andPerceptions of management domains of the SAQ and in the Nonpunitive response to error domain of the HSOPSC. The strengths indicated by the SAQ wereTeamwork climate and Job satisfactionand by the HSOPC, Supervisor/manager expectations and actions promoting safety and Organizational learning-continuous improvement. Job satisfaction was higher among neonatal ICU workers when compared with the other ICUs. The adult ICU presented lower scores for most of the SAQ and HSOPSC domains. The scales presented moderate correlation between them (r=0.66). Conclusion There were differences in perception regarding patient safety among ICUs, which corroborates the existence of local microcultures. The study did not demonstrate equivalence between the SAQ and the HSOPSC.

  18. Developing cultural competence and social responsibility in preclinical dental students.

    Science.gov (United States)

    Rubin, Richard W

    2004-04-01

    Dental student development of cultural competence and social responsibility is recognized by educators as an important element in the overall shaping of minds and attitudes of modem dental practitioners. Yet training modalities to achieve these competencies are not clearly defined, and outcome measurements are elusive. This article shows an effective method to meet these desired outcomes. Sixty-one freshmen (class of 2005) participated in forty hours of nondental community service, and reflective journals were completed by the end of second year. Competency outcomes were measured by selecting key words and phrases found in the individual journals. Key phrases were related to compassion, righteousness, propriety, and wisdom. Also, phrases had to be accompanied by written indications of direct program causation. The combination of active-learning (based upon service learning models) in public health settings outside of the dental realm, accompanied by reflective journaling, enhanced cultural understanding and community spirit in the majority of students.

  19. My Name Is Not Michael: Strategies for Promoting Cultural Responsiveness in Schools

    Science.gov (United States)

    Schulz, Lisa L.; Hurt, Kara; Lindo, Natalya

    2014-01-01

    With the changing cultural demographics in U.S. classrooms, school counselors must develop innovative approaches to promote culturally responsive school climates and organizational change. A vision is offered of systemic cultural responsiveness and culturally relevant teaching practices that nurture and engage all learners. The role of the school…

  20. Perceived Cultural Responsiveness and Effectiveness of a Speech and Language Program for Indigenous Preschool Students

    Science.gov (United States)

    McIntosh, Kent; Craft, Calli B.; MacKay, Leslie D.

    2013-01-01

    Despite an increasing need for culturally relevant curricula, what is considered culturally responsive and how it is assessed is under-researched. The present study examined the perceived cultural responsiveness and effectiveness of an early intervention program designed to teach early language skills and expose students to Indigenous culture, the…

  1. The relation between cultural values, euthanasia, and spiritual care in the Netherlands.

    Science.gov (United States)

    Leget, Carlo

    2017-04-28

    The aim of this paper is to gain some understanding of euthanasia as a Dutch cultural practice, focusing on value orientations that lie beneath the surface of what is made visible in the many national surveys done in the Netherlands. In order to reach this aim, I take 2 steps. In the first place, I give a short sketch of euthanasia as it is understood and practiced in the Netherlands. This is followed by a cultural analysis by the American‑Dutch historian James Kennedy who studied the euthanasia debate in the Netherlands from the 1960s until 1985. Having arrived at some cultural understanding of Dutch mentality, I dive deeper into the understanding of the Dutch value orientations by focusing on the dimension of spiritual care at the end of life. After having defined the concept of spirituality, I sketch the contemporary state of affairs in this area and report how spiritual care in the Netherlands is understood and practiced by discussing the consensus‑based Dutch guideline on spiritual care in palliative care, recent research on hope among palliative care patients in the Netherlands, and an often used Dutch tool for spiritual care: the Ars moriendi model. I end this contribution by sketching how I think that spiritual care at the end of life should be developed further in the Netherlands from a palliative care perspective.

  2. An empirical test of a self-care model of women's responses to battering.

    Science.gov (United States)

    Campbell, J C; Weber, N

    2000-01-01

    A model of women's responses to battering was constructed based on Orem's theory of self-care deficit and on empirical and clinical observations. The model proposed that the age, educational level, and cultural influences as basic conditioning factors would all be directly related to relational conflict, which would be negatively related to self-care agency (as a mediator) and indirectly related to both outcomes of health and well-being. Using simultaneous structural equation modeling with specification searching, a modified model was derived that eliminated the mediation path but supported direct effects of both abuse and self-care agency on health. The derived model was found to be only a borderline fit with the data, probably due to measurement problems, lack of inclusion of important variables, and small sample size (N = 117). However, there was support for several of the relationships deduced from and/or congruent with Orem's theory.

  3. Is older adult care mediated by caregivers' cultural stereotypes? The role of competence and warmth attribution

    Directory of Open Access Journals (Sweden)

    Fernández-Ballesteros R

    2016-05-01

    Full Text Available Rocío Fernández-Ballesteros,1 Antonio Bustillos,2 Marta Santacreu,1,3 Rocio Schettini,1 Pura Díaz-Veiga,4 Carmen Huici2 1Clinical and Health Psychology, Universidad Autónoma de Madrid (UAM, 2Social Psychology, Universidad Nacional de Educación a Distancia (UNED, 3Psychology Department, Universidad Europea de Madrid (UEM, 4Matia Instituto Gerontológico, Madrid, Spain Purpose: The purpose of this study is to examine, from the stereotype content model (SCM perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers.Methods: A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care approach and the other three providing standard geriatric care. In order to assess caregivers’ cultural stereotypical views, the SCM questionnaire was administered. To evaluate the role of caregivers’ cultural stereotypes in their professional performance as well as in older adult functioning, two observational scales from the Sistema de Evaluación de Residencias de Ancianos (assessment system for older adults residences-RS (staff functioning and residents’ functioning were applied.Results: Caregivers’ cultural views of older adults (compared to young people are characterized by low competence and high warmth, replicating the data obtained elsewhere from the SCM. Most importantly, the person-centered units predict better staff performance and better resident functioning than standard units. Moreover, cultural stereotyping of older adult competence moderates the effects of staff performance on resident functioning, in line with the findings of previous research.Conclusion: Our results underline the influence of caregivers’ cultural stereotypes on the type of care, as well as on their

  4. Changing health care culture: a prerequisite to improving patient safety

    Directory of Open Access Journals (Sweden)

    Azizi S

    2017-05-01

    Full Text Available Saeed Azizi, Faisal Siddiqui, Ithsham Iqbal Faculty of Medicine, St George’s Hospital Medical School, London, UKWe read the recent article by Chua et al1 with great interest. We found it thought-provoking to read how novel interventions, such as sharing errors, among the team can reduce the frequency of error recurrence in the future. We are hopeful that if such interventions were applied to other areas of health care, it would yield similar results. Having said this, we strongly believe that an important prerequisite of openness among health care workers is required for such interventions to work. View the original paper by Chua et al 

  5. Religious culture and health promotion: care, practice, object

    OpenAIRE

    Viola Timm

    2015-01-01

    At the margins of modern medical practice, pushing the very limits of science, and indefatigably rendering the precincts of public discourse, still functional remnants of Christian civilization continue to provide care for the hopeless, perform healing sacraments for the incurable, and curate objects of votive devotion for the suffering and needy. These public services go largely unaccounted for, though they secure an ordered world, structure perception, and serve as ontological anchors. Lost...

  6. Neuromyelitis optica IgG stimulates an immunological response in rat astrocyte cultures

    Institute of Scientific and Technical Information of China (English)

    Howe CL; Kaptzan T; Magaa SM; Ayers-Ringler JR; LaFrance-Corey RG; Lucchinetti CF

    2014-01-01

    Neuromyelitis optica (NMO) is a primary astrocyte disease associated with central nervous system inflammation, demyelination, and tissue injury. Brain lesions are frequently observed in regions enriched in expression of the aquaporin-4 (AQP4) water channel, an antigenic target of the NMO IgG serologic marker. Based on observations of disease reversibility and careful characterization of NMO lesion development, we propose that the NMO IgG may induce a dynamic immunological response in astrocytes. Using primary rat astrocyte-enriched cultures and treatment with NMO patient-derived serum or purified IgG, we observed a robust pattern of gene expression changes consistent with the induction of a reactive and inflammatory phenotype in astrocytes. The reactive astrocyte factor lipocalin-2 and a broad spectrum of chemokines, cytokines, and stress response factors were induced by either NMO patient serum or purified IgG. Treatment with IgG from healthy controls had no effect. The effect is disease-specific, as serum from patients with relapsing-remitting multiple sclerosis, Sj gren's, or systemic lupus erythematosus did not induce a response in the cultures. We hypothesize that binding of the NMO IgG to AQP4 induces a cellular response that results in transcriptional and translational events within the astrocyte that are consistent with a reactive and inflammatory phenotype. Strategies aimed at reducing the inflammatory response of astrocytes may short circuit an amplification loop associated with NMO lesion development.

  7. Dynamic adjustment of parental care in response to perceived paternity.

    Science.gov (United States)

    Neff, B D; Gross, M R

    2001-08-07

    Theories of parental care evolution predict that genetic relatedness will be an important variable in the amount of care a parent provides. However, current inferences of relatedness-based parental investment from studies in humans and birds remain challenged. No study has yet demonstrated parental care adjustment in a manner uncomplicated by life-history correlates or experimental design. We now present a unique test that controls for individual life histories and demonstrates paternity-related dynamic adjustments in parental care. Brood-rearing male bluegill sunfish (Lepomis macrochirus) that are cuckolded to a varying degree will either increase or decrease their parental investment in response to changing information on paternity during brood development. Specifically, as parental males detect paternity lost to cuckolders and, hence, a reduction in the value of their brood, they adaptively lower their level of parental care. Conversely, if they detect that their paternity is higher than previously assessed, they adaptively raise their level of parental care. This dynamic adjustment during brood rearing indicates the importance of genetic relatedness in parental investment decisions and provides needed empirical support for theoretical predictions.

  8. Culturally Competent Palliative and Hospice Care Training for Ethnically Diverse Staff in Long-Term Care Facilities.

    Science.gov (United States)

    Kataoka-Yahiro, Merle R; McFarlane, Sandra; Koijane, Jeannette; Li, Dongmei

    2016-03-29

    Between 2013 and 2030, older adults 65 years and older of racial/ethnic populations in the U.S. is projected to increase by 123% in comparison to the Whites (Non-Hispanics). To meet this demand, training of ethnically diverse health staff in long-term care facilities in palliative and hospice care is imperative. The purpose of this study was to evaluate a palliative and hospice care training of staff in two nursing homes in Hawaii - (a) to evaluate knowledge and confidence over three time periods, and (b) to compare staff and family caregiver satisfaction at end of program. The educational frameworks were based on cultural and communication theories. Fifty-two ethnically diverse staff, a majority being Asian (89%), participated in a 10-week module training and one 4 hour communication skills workshop. Staff evaluation included knowledge and confidence surveys, pre- and post-test knowledge tests, and FAMCARE-2 satisfaction instrument. There were nine Asian (89%) and Pacific Islander (11%) family caregivers who completed the FAMCARE-2 satisfaction instrument. The overall staff knowledge and confidence results were promising. The staff rated overall satisfaction of palliative care services lower than the family caregivers. Implications for future research, practice, and education with palliative and hospice care training of ethnically diverse nursing home staff is to include patient and family caregiver satisfaction of palliative and hospice care services, evaluation of effectiveness of cross-cultural communication theories in palliative and hospice care staff training, and support from administration for mentorship and development of these services in long term care facilities.

  9. Response to Marie Paz Morales' ``Influence of culture and language sensitive physics on science attitude achievement''

    Science.gov (United States)

    Cole, Mikel Walker

    2015-12-01

    This response to Marie Paz Morales' "Influence of culture and language sensitive physics on science attitude achievement" explores the ideas of culturally responsive pedagogy and critical literacy to examine some implications for culturally responsive science instruction implicit in the original manuscript.

  10. Response to Marie Paz Morales' "Influence of Culture and Language Sensitive Physics on Science Attitude Achievement"

    Science.gov (United States)

    Cole, Mikel Walker

    2015-01-01

    This response to Marie Paz Morales' "Influence of culture and language sensitive physics on science attitude achievement" explores the ideas of culturally responsive pedagogy and critical literacy to examine some implications for culturally responsive science instruction implicit in the original manuscript. [For "Influence of…

  11. Response to Marie Paz Morales' "Influence of Culture and Language Sensitive Physics on Science Attitude Achievement"

    Science.gov (United States)

    Cole, Mikel Walker

    2015-01-01

    This response to Marie Paz Morales' "Influence of culture and language sensitive physics on science attitude achievement" explores the ideas of culturally responsive pedagogy and critical literacy to examine some implications for culturally responsive science instruction implicit in the original manuscript. [For "Influence of…

  12. Point-of-Care Ultrasound and the Rapid Response System.

    Science.gov (United States)

    Lakoff, Daniel J; Barghash, Maya H; Lorin, Scott; Ungaro, Ryan; Nguyen, Vinh-Tung; Baumgardner, Jeffrey; Nelson, Bret P; Narula, Jagat

    2013-12-01

    Over the years, the use of ultrasound has moved solely from the domain of the radiologist to that of the intensivist and emergentologist for use in acute care settings. By virtue of its ease of use and rapid learning curve to proficiency, we are now seeing an increased desire by internists to learn the modality and apply it at the patient's bedside. The rapid response system represents a rational starting point for the introduction of point-of-care ultrasound to the inpatient ward setting. Copyright © 2013 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  13. Cultural Competence in Pediatrics: Health Care Provider Knowledge, Awareness, and Skills

    Directory of Open Access Journals (Sweden)

    Kirk Dabney

    2015-12-01

    Full Text Available The purpose of this study was to assess the effects of a cultural competence training (CCT program on pediatric health care providers’ self-reported ability to provide culturally competent care to a diverse pediatric patient population. This quantitative, nested ecologic level study design used a repeated measure in the form of pre-test and post-test data to assess percent change in providers’ cultural awareness, experience working or learning about different cultures, and preparedness and skills in working with different cultures before and after CCT. The study was conducted between 2011 and 2012 in a pediatric hospital and associated outpatient offices. The sample consisted of pediatric health care providers from various departments, mainly physicians and nurses (n = 69. Participants completed a pre-intervention cultural competence assessment and then were subjected to a cultural competence-training program, after which they completed the assessment a second time. The baseline and post-intervention data were collected in the form of Likert scales and transformed into a quintile or quartile scale as appropriate. Data were assessed using paired t-tests or Wilcoxon’s signed-rank tests. Providers indicated a 13% increase in knowledge (53.9% vs. 66.7%, t = 3.4, p = 0.001, 8.7% increase in awareness (46.7% vs. 55.4%, t = 3.0, p = 0.002, and 8% statistically marginal increase in skills (66.4% vs. 74.5%, z = 1.8, p = 0.06. Culturally competent training in a pediatric environment significantly enhances knowledge, awareness and to some extent skills in providing care to culturally diverse patient population.

  14. Ethical, Socioeconomic, and Cultural Considerations in Gynecologic Cancer Care in Developing Countries

    Directory of Open Access Journals (Sweden)

    Uzochukwu Uzoma Aniebue

    2014-01-01

    Full Text Available Gynaecologic cancers contribute significantly to the cancer burden in developing countries, resulting in higher mortality and morbidity rates among women in these nations. This situation is further compounded by the occurrence of wars, famine, poverty and natural disasters, and infectious diseases like hepatitis B and HIV/AIDS. In addition, merge resources and manpower lack in these countries further compound this very delicate situation. Often times, socioeconomic, cultural, and ethical factors such as truth-telling, choice of place of care, place of death, treatment choices, medication use, and terminal sedation can interfere in patient management. Availability and use of oral morphine for pain relief, spiritual care and availability of palliative care services, the individuals’ autonomy, and family and community participation in care, end of life issues, and preservation of fertility are also big issues that determine the course of care. This review discusses these pertinent factors, discusses how they affect cancer care in women, and proffers ideas for healthcare workers and policy makers on implementation of sustainable models for cancer care in developing countries. Addressing socioeconomic, cultural, and ethical issues affecting gynaecologic cancer care will aid in ensuring development of viable models of cancer care in resource-limited countries.

  15. Performance-based competencies for culturally responsive interprofessional collaborative practice.

    Science.gov (United States)

    Banfield, Valerie; Lackie, Kelly

    2009-11-01

    This paper will highlight how a literature review and stakeholder-expert feedback guided the creation of an interprofessional facilitator-collaborator competency tool, which was then used to design an interprofessional facilitator development program for the Partners for Interprofessional Cancer Education (PICE) Project. Cancer Care Nova Scotia (CCNS), one of the PICE Project partners, uses an Interprofessional Core Curriculum (ICC) to provide continuing education workshops to community-based practitioners, who as a portion of their practice, care for patients experiencing cancer. In order to deliver this curriculum, health professionals from a variety of disciplines required education that would enable them to become culturally sensitive interprofessional educators in promoting collaborative patient-centred practice. The Registered Nurses Professional Development Centre (RN-PDC), another PICE Project partner, has expertise in performance-based certification program design and utilizes a competency-based methodology in its education framework. This framework and methodology was used to develop the necessary interprofessional facilitator competencies that incorporate the knowledge, skills, and attitudes required for performance. Three main competency areas evolved, each with its own set of competencies, performance criteria and behavioural indicators.

  16. Ethnonursing: A Qualitative Research Method for Studying Culturally Competent Care across Disciplines

    Directory of Open Access Journals (Sweden)

    Marilyn R. McFarland PhD, RN, FNP-BC, CTN

    2012-07-01

    Full Text Available Nurse anthropologist, Madeleine Leininger, developed the culture care theory and ethnonursing research method to help researchers study transcultural human care phenomena and discover the knowledge nurses need to provide care in an increasingly multicultural world. The authors propose that the ethnonursing method can be useful for research that addresses providing care in other disciplines, including education, administration, physical, occupational, and speech therapy, social work, pharmacy, medicine, and other disciplines in which research findings have implications for human care and health. The authors discuss the culture care theory and describe the ethnonursing research method's enablers, data analysis phases, and qualitative evaluation criteria. The theory is presented as a guide for using research findings to design culturally competent and congruent care to promote well-being among diverse people, groups, communities, and institutions. Resources include a reference list of key source publications, a discussion of exemplar studies, and samples of a theory-based, open-ended interview guide and data coding system.

  17. A careful balance: multinational perspectives on culture, gender, and power in marriage and family therapy practice.

    Science.gov (United States)

    Keeling, Margaret L; Piercy, Fred P

    2007-10-01

    In this study, we examined how marriage and family therapists from various countries and diverse cultural backgrounds address the intersection of gender, power, and culture in therapy. Twenty participants from 15 countries responded to an Internet survey that included several hypothetical, clinical vignettes not associated with any one particular culture or nationality. Participants selected a vignette based on its similarity to clinical situations they face in practice within their cultural contexts, and provided information about their conceptualizations of gender, culture, and power, along with treatment recommendations. We analyzed data using analytic induction and constant comparison methods. Results indicate the careful balance with which the participants work to engage clients in therapy, respect cultural values and practices, and promote equitable gender relationships.

  18. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Science.gov (United States)

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-01-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation.

  19. Multi-Cultural Long Term Care Nurses’ Perceptions of Factors Influencing Patient Dignity at the End of Life

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S.; Stevens, Marguerite; Kraemer, Helena

    2012-01-01

    The goal of this mixed-methods study was to characterize the perceptions of multi-cultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban long-term care (LTC) facility. The participants were forty-five long-term care nurses and 26 terminally ill nursing home patients. Nurses completed an open-ended interview about their perceptions of the concept of dying with dignity and the data were analyzed using grounded theory methods. Main themes identified as promoting patient dignity at the EOL included treating them with respect, helping them prepare for their EOL, promoting shared decision making and providing high quality tenor of care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for end-of-life rituals but this was strikingly absent in the statements of US-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Both nurses and terminally ill patients completed the Dignity Card-sort Tool (DCT). A comparison of the LTC nurses cohort to the terminally ill patient responses on the DCT revealed that the nurses felt that patient dignity was eroded when her/his wishes were not carried out and when s/he is treated without respect. In contrast, dying LTC patients felt that poor medical care and loss of ability to choose care options to be the most important factors leading to erosion of dignity. PMID:23496266

  20. Importance of quality aspects of GP care among ethnic minorities: role of cultural attitudes, language and healthcare system of reference.

    Science.gov (United States)

    Lamkaddem, Majda; Spreeuwenberg, Peter M; Devillé, Walter L; Foets, Marleen M; Groenewegen, Peter P

    2012-02-01

    This study examines the mechanisms responsible for ethnic differences in perceived quality of care in The Netherlands. The specific role of cultural attitudes, language proficiency, and the health system in the country of origin was examined, taking socio-demographic characteristics into account. Interview data of 1339 respondents of Moroccan, Turkish, Surinamese and Antillean origin were combined with interview data of Dutch respondents (n = 405) and of Western immigrants (n = 102) in The Netherlands and of a random sample of Dutch privately or publicly insured persons (n = 9675). Data collection took place within the Second Dutch National Survey of General Practice (DNSGP-2, 2001). Items from the QUality Of care Through the patient's Eyes (QUOTE) questionnaire were used to measure expectations, as well as items from the QUOTE-Mi (adapted version for migrant groups). Items on normative orientations were used to measure cultural attitudes. In contrast to our hypothesis, respondents with more egalitarian/modern attitudes attached less importance to quality aspects related to access and quality. Tests on the role of the health system of reference were generally conclusive, showing that respondents accustomed to (parts of) another system have different expectations regarding several aspects of general practitioner healthcare quality, e.g. access to specialist care. Besides socio-demographic characteristics, culture influences patients' expectations regarding general practitioner care quality. However, the role of culture can be more clearly ascribed to the characteristics of the health system which is held as the reference than to the general attitudes on normative orientations.

  1. An approach to collaborative care and consultation: interviewing, cultural competence, and enhancing rapport and adherence.

    Science.gov (United States)

    Beck, B J; Gordon, Christopher

    2010-11-01

    Although changes in the US health care system promote a population-based approach, increases in population diversity emphasize the need for culturally competent, patient-centered, participatory care. Despite this perceived conflict, the global view has improved the recognition of mental health issues as a driver of overall health as well as health care spending. This recognition, along with the many forces that keep mental health care in the primary care sector, actually encourages the development of collaborative models that capitalize on the primary care provider's opportunity to leverage their rapport with the patient to improve access to, and comfort with, specialty mental health services. Engaging patients in their own path to recovery or well-being improves engagement in, and adherence to, the treatment plan and ultimately improves outcomes.

  2. Organizational culture affecting quality of care: guideline adherence in perioperative antibiotic use.

    Science.gov (United States)

    Ukawa, Naoto; Tanaka, Masayuki; Morishima, Toshitaka; Imanaka, Yuichi

    2015-02-01

    The objective of this work was to elucidate aspects of organizational culture associated with hospital performance in perioperative antibiotic prophylaxis using quantitative data in a multicenter and multidimensional study. Cross-sectional retrospective study using a survey data and administrative data. Eighty-three acute hospitals in Japan. A total of 4856 respondents in the organizational culture study, and 23 172 patients for the quality indicator analysis. Multilevel models of various cultural dimensions were used to analyze the association between hospital organizational culture and guideline adherence. The dependent variable was adherence or non-adherence to Japanese and CDC guidelines at the patient level and main independent variable was hospital groups categorized according to organizational culture score. Other control variables included hospital characteristics such as ownership, bed capacity, region and urbanization level of location. The multilevel analysis showed that hospitals with a high score in organizational culture were more likely to adhere to the Japanese and CDC guidelines when compared with lower scoring hospitals. In particular, the hospital group with high scores in the 'collaboration' and 'professional growth' dimensions had three times the odds for Japanese guideline adherence in comparison with low-scoring hospitals. Our study revealed that various aspects of organizational culture were associated with adherence to guidelines for perioperative antibiotic use. Hospital managers aiming to improve quality of care may benefit from improving hospital organizational culture. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  3. Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

    Science.gov (United States)

    Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

    2017-05-01

    To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p < .012) in young adulthood. Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. [Patients at the end of life in the intensive care unit: cultural aspects of accompaniment].

    Science.gov (United States)

    Grom, I-U; Vagts, D A; Kampa, U; Pfeiffer, G; Schreiber-Winzig, L; Wiese, C H R

    2013-06-01

    The accompaniment of people in the face of death offers insights into dimensions which are mostly not seen in ordinary life. These insights also exist in intensive care in German hospitals and are highly relevant in medical decision making. End-of-life decisions in particular often determine medical, cultural and spiritual aspects concerning medical treatment and therapeutic targets and if necessary new therapy targets. The following article especially illuminates cultural aspects and their characteristics in patients at the end of life in the intensive care unit.

  5. The Decent Care Movement: Subsidiarity, Pragmatic Solidarity, and Cross-Cultural Resonance.

    Science.gov (United States)

    Niforatos, Joshua D

    2016-02-01

    Decent Care is the World Health Organization and The Ford Foundation's joint effort to articulate a healthcare paradigm that makes a patient's voice equal to the voice of the healthcare provider. In this article, the six tenants of Decent Care are outlined with particular emphasis on subsidiarity. Liberation theology's preferential option for the poor maxim is presented and compared with other major world religions to demonstrate the cross-cultural focus of "decency." The power of this paradigm is in its emphasis and proclamation of human flourishing in a healthcare setting, generally speaking, and more specifically, human flourishing in the presence of affliction from chronic disease or dying cross-culturally.

  6. Homelessness as culture: How transcultural nursing theory can assist caring for the homeless.

    Science.gov (United States)

    Law, Kate; John, William

    2012-11-01

    The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups.

  7. Exploring the cultural aspects of compassion in nursing care: a comparative study of Greece and Cyprus.

    OpenAIRE

    Papadopoulos, Irena; Kouta, Christiana; Malliarou, Maria; Shea, Sue; Apostolara, Paraskevi; Vasiliou, Marios

    2016-01-01

    Introduction: It is important to consider the concept of compassionate care within a cultural context in terms of how it might be perceived and demonstrated in practice. People may vary in what constitutes suffering due to variations in their values, culture, needs and understanding. In this paper we report on the findings from data collected from Greek and Greek-Cypriot Nurses during a study which sought to explore similarities and differences between the two countries with regard to percept...

  8. Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

    Science.gov (United States)

    Ahn, Jung-Won

    2017-03-01

    This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved. Copyright © 2017. Published by Elsevier B.V.

  9. Pastoral care and counseling with the "un-homeless homeless": understanding cultures of homelessness.

    Science.gov (United States)

    Snodgrass, Jill

    2014-01-01

    This article presents a subset of findings from a larger study exploring the lived experiences of 16 former residents of a 90-day emergency family shelter program in Los Angeles County. Interpretative phenomenological analysis serves as a qualitative method for understanding the cultural uniqueness of the "un-homeless homeless." The findings offer implications for culturally competent pastoral care and counseling in the context of family homelessness and attend to both the process and content of caregiving.

  10. How price responsive is the demand for specialty care?

    Science.gov (United States)

    Maciejewski, Matthew L; Liu, Chuan-Fen; Kavee, Andrew L; Olsen, Maren K

    2012-08-01

    Outpatient visit co-payments have increased in recent years. We estimate the patient response to a price change for specialty care, based on a co-payment increase from $15 to $50 per visit for veterans with hypertension. A retrospective cohort of veterans required to pay co-payments was compared with veterans exempt from co-payments whose nonequivalence was reduced via propensity score matching. Specialty care expenditures in 2000-2003 were estimated via a two-part mixed model to account for the correlation of the use and level outcomes over time, and results from this correlated two-part model were compared with an uncorrelated two-part model and a correlated random intercept two-part mixed model. A $35 specialty visit co-payment increase had no impact on the likelihood of seeking specialty care but induced lower specialty expenditures over time among users who were required to pay co-payments. The log ratio of price responsiveness (semi-elasticity) for specialty care increased from -0.25 to -0.31 after the co-payment increase. Estimates were similar across the three models. A significant increase in specialty visit co-payments reduced specialty expenditures among patients obtaining medications at the Veterans Affairs medical centers. Longitudinal expenditure analysis may be improved using recent advances in two-part model methods. Published 2011. This article is a US Government work and is in the public domain in the USA.

  11. Individual and culture-level components of survey response styles: A multi-level analysis using cultural models of selfhood.

    Science.gov (United States)

    Smith, Peter B; Vignoles, Vivian L; Becker, Maja; Owe, Ellinor; Easterbrook, Matthew J; Brown, Rupert; Bourguignon, David; Garðarsdóttir, Ragna B; Kreuzbauer, Robert; Cendales Ayala, Boris; Yuki, Masaki; Zhang, Jianxin; Lv, Shaobo; Chobthamkit, Phatthanakit; Jaafar, Jas Laile; Fischer, Ronald; Milfont, Taciano L; Gavreliuc, Alin; Baguma, Peter; Bond, Michael Harris; Martin, Mariana; Gausel, Nicolay; Schwartz, Seth J; Des Rosiers, Sabrina E; Tatarko, Alexander; González, Roberto; Didier, Nicolas; Carrasco, Diego; Lay, Siugmin; Nizharadze, George; Torres, Ana; Camino, Leoncio; Abuhamdeh, Sami; Macapagal, Ma Elizabeth J; Koller, Silvia H; Herman, Ginette; Courtois, Marie; Fritsche, Immo; Espinosa, Agustín; Villamar, Juan A; Regalia, Camillo; Manzi, Claudia; Brambilla, Maria; Zinkeng, Martina; Jalal, Baland; Kusdil, Ersin; Amponsah, Benjamin; Çağlar, Selinay; Mekonnen, Kassahun Habtamu; Möller, Bettina; Zhang, Xiao; Schweiger Gallo, Inge; Prieto Gil, Paula; Lorente Clemares, Raquel; Campara, Gabriella; Aldhafri, Said; Fülöp, Márta; Pyszczynski, Tom; Kesebir, Pelin; Harb, Charles

    2016-12-01

    Variations in acquiescence and extremity pose substantial threats to the validity of cross-cultural research that relies on survey methods. Individual and cultural correlates of response styles when using 2 contrasting types of response mode were investigated, drawing on data from 55 cultural groups across 33 nations. Using 7 dimensions of self-other relatedness that have often been confounded within the broader distinction between independence and interdependence, our analysis yields more specific understandings of both individual- and culture-level variations in response style. When using a Likert-scale response format, acquiescence is strongest among individuals seeing themselves as similar to others, and where cultural models of selfhood favour harmony, similarity with others and receptiveness to influence. However, when using Schwartz's (2007) portrait-comparison response procedure, acquiescence is strongest among individuals seeing themselves as self-reliant but also connected to others, and where cultural models of selfhood favour self-reliance and self-consistency. Extreme responding varies less between the two types of response modes, and is most prevalent among individuals seeing themselves as self-reliant, and in cultures favouring self-reliance. As both types of response mode elicit distinctive styles of response, it remains important to estimate and control for style effects to ensure valid comparisons. © 2016 International Union of Psychological Science.

  12. Lack of Cultural Competency in International Aid Responses: The Ebola Outbreak in Liberia

    Science.gov (United States)

    Southall, Hannah Grace; DeYoung, Sarah E.; Harris, Curt Andrew

    2017-01-01

    A cornerstone of effective disaster management is that response should always begin and end at the local level (1). The response to the Ebola virus disease (EVD) outbreak in Liberia, West Africa, was a combination of independent efforts by many nations and organizations. Many of these independent efforts ignored or were not able to work with the local levels of emergency management in Liberia. This oversight occurred because of the Liberian’s mistrust of both their government and foreign aid groups, as well as the lack of cultural competency demonstrated by the aid groups. The health-care and emergency management infrastructure in Liberia appeared to be non-existent at the beginning of the EVD outbreak. However, there were resources available at the community level: the Liberians and their culture. Although these resources were rarely used, there were some instances in which communities were included in response efforts. It was in these instances that possible improvements to international disaster response protocol were found. PMID:28197401

  13. Improving health care quality through culturally competent physicians: leadership and organizational diversity training

    Directory of Open Access Journals (Sweden)

    Irwin B Horwitz

    2011-02-01

    Full Text Available Irwin B Horwitz1, Marilyn Sonilal2, Sujin K Horwitz31Cameron School of Business, University of St. Thomas, Houston, TX, USA; 2School of Public Health, University of Texas, Houston, TX, USAAbstract: The growing diversity of the population has resulted in substantial challenges for the US health care system. A substantial body of evidence has identified significant disparities in health care among culturally and ethnically diverse patients, irrespective of income, that negatively affects such factors as diagnostic precision, quality of care, adherence to healing protocols, and overall treatment outcomes. Diversity has also been shown to compromise the functionality of health care teams that are increasingly comprised of members with culturally different backgrounds, in which diversity produces misunderstanding and conflict. Many of the problems stem from a lack of cultural competence among both physicians and teams under their supervision. To reduce the numerous problems resulting from inadequate cultural competence among health care professionals, this article examines ways in which the issues of diversity can be effectively addressed in health care institutions. It is advocated that physicians adopt a proactive transformational leadership style to manage diversity because of its emphasis on understanding and aligning follower values which lie at the heart of diversity-related misunderstandings. It is also held that for leadership training among physicians to be fully effective, it should be integrated with organizational-wide diversity programs. By doing so, the complimentary effect could result in comprehensive change, resulting in substantial improvements in the quality of health care for all patients.Keywords: leadership, diversity, health care, disparities, medical education

  14. Viewpoint: Cultural competence and the African American experience with health care: The case for specific content in cross-cultural education.

    Science.gov (United States)

    Eiser, Arnold R; Ellis, Glenn

    2007-02-01

    Achieving cultural competence in the care of a patient who is a member of an ethnic or racial minority is a multifaceted project involving specific cultural knowledge as well as more general skills and attitude adjustments to advance cross-cultural communication in the clinical encounter. Using the important example of the African American patient, the authors examine relevant historical and cultural information as it relates to providing culturally competent health care. The authors identify key influences, including the legacy of slavery, Jim Crow discrimination, the Tuskegee syphilis study, religion's interaction with health care, the use of home remedies, distrust, racial concordance and discordance, and health literacy. The authors propose that the awareness of specific information pertaining to ethnicity and race enhances cross-cultural communication and ways to improve the cultural competence of physicians and other health care providers by providing a historical and social context for illness in another culture. Cultural education, modular in nature, can be geared to the specific populations served by groups of physicians and provider organizations. Educational methods should include both information about relevant social group history as well as some experiential component to emotively communicate particular cultural needs. The authors describe particular techniques that help bridge the cross-cultural clinical communication gaps that are created by patients' mistrust, lack of cultural understanding, differing paradigms for illness, and health illiteracy.

  15. Hemopoietic cell precursor responses to erythropoietin in plasma clot cultures

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, W.L.

    1979-01-01

    The time dependence of the response of mouse bone marrow cells to erythropoietin (Ep) in vitro was studied. Experiments include studies on the Ep response of marrow cells from normal, plethoric, or bled mice. Results with normal marrow reveal: (1) Not all erythroid precursors (CFU-E) are alike in their response to Ep. A significant number of the precursors develop to a mature erythroid colony after very short Ep exposures, but they account for only approx. 13% of the total colonies generated when Ep is active for 48 hrs. If Ep is active more than 6 hrs, a second population of erythroid colonies emerges at a nearly constant rate until the end of the culture. Full erythroid colony production requires prolonged exposure to erythropoietin. (2) The longer erythropoietin is actively present, the larger the number of erythroid colonies that reach 17 cells or more. Two distinct populations of immediate erythroid precursors are also present in marrow from plethoric mice. In these mice, total colony numbers are equal to or below those obtained from normal mice. However, the population of fast-responding CFU-E is consistently decreased to 10 to 20% of that found in normal marrow. The remaining colonies are formed from plethoric marrow at a rate equal to normal marrow. With increasing Ep exposures, the number of large colonies produced increases. From the marrow of bled mice, total erythroid colony production is equal to or above that of normal marrow. Two populations of colony-forming cells are again evident, with the fast-responding CFU-E being below normal levels. The lack of colonies from this group was compensated in bled mice by rapid colony production in the second population. A real increase in numbers of precursors present in this pool increased the rate of colony production in culture to twice that of normal marrow. The number of large colonies obtained from bled mice was again increased as the Ep exposure was lengthened. (ERB)

  16. The social responsibility commitment to the community and care environment

    Directory of Open Access Journals (Sweden)

    Martha Elena López Regalado

    2015-12-01

    Full Text Available The concept of csr has evolved in recent years, currently the main objective of the Company cannot lie only meet the monetary needs of the shareholders, but to seek the participation of all stakeholders in the company, with the different stakeholders that interact with the environment either customers, suppliers, employees and society at large, impacting the community with socially responsible actions. Because the concept has acquired new shades as social, economic and environmental responsibility among others, being on the great responsibility of the actions of companies to make social or common good acts to achieve their objectives without harming their economies community, the next job is presented focusing especially on two major indicators of social responsibility such as environmental care, and welfare of the community.

  17. Making Meaningful Improvements to Direct Care Worker Training Through Informed Policy: Understanding How Care Setting Structure and Culture Matter.

    Science.gov (United States)

    Kemeny, M Elizabeth; Mabry, J Beth

    2015-10-09

    Well-intentioned policy governing the training of direct care workers (DCWs) who serve older persons, in practice, may become merely a compliance issue for organizations rather than a meaningful way to improve quality of care. This study investigates the relationships between best practices in DCW training and the structure and culture of long term support service (LTSS) organizations. Using a mixed-methods approach to analyzing data from 328 licensed LTSS organizations in Pennsylvania, the findings suggest that public policy should address methods of training, not just content, and consider organizational variations in size, training evaluation practices, DCW integration, and DCW input into care planning. Effective training also incorporates support for organizations and supervisors as key aspects of DCWs' learning and working environment.

  18. In the right words: addressing language and culture in providing health care.

    Science.gov (United States)

    2003-08-01

    As part of its continuing mission to serve trustees, executives, and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of experts from philanthropy, research, health care practice, and policy on April 4, 2003, to discuss the roles of language and culture in providing effective health care. During this Issue Dialogue, In the Right Words: Addressing Language and Culture in Providing Health Care, health grantmakers and experts from policy and practice participated in an open exchange of ideas and perspectives on language access and heard from fellow grantmakers who are funding innovative programs in this area. Together they explored ways to effectively support comprehensive language services, including the use of interpreters and translation of written materials. This Issue Brief synthesizes key points from the day's discussion with a background paper previously prepared for Issue Dialogue participants. It focuses on the challenges and opportunities involved with ensuring language access for the growing number of people who require it. Sections include: recent immigration trends and demographic changes; the effect of language barriers on health outcomes and health care processes; laws and policies regarding the provision of language services to patients, including an overview of public financing mechanisms; strategies for improving language access, including enhancing access in delivery settings, promoting advocacy and policy change, improving interpreter training, and advancing research; and roles for foundations in supporting improved language access, including examples of current activities. The Issue Dialogue focused mainly on activities and programs that ensure linguistic access to health care for all patients. Although language and culture are clearly inseparable, a full exploration of the field of cultural competence and initiatives that promote its application to the health care setting are beyond the scope

  19. Clinical exchange: one model to achieve culturally sensitive care.

    Science.gov (United States)

    Scholes, J; Moore, D

    2000-03-01

    This paper reports on a clinical exchange programme that formed part of a pre-registration European nursing degree run by three collaborating institutions in England, Holland and Spain. The course included: common and shared learning including two summer schools; and the development of a second language before the students went on a three-month clinical placement in one of the other base institutions' clinical environments. The aim of the course was to enable students to become culturally sensitive carers. This was achieved by developing a programme based on transcultural nursing principles in theory and practice. Data were gathered by interview, focus groups, and questionnaires from 79 exchange students, fostering the strategies of illuminative evaluation. The paper examines: how the aims of the course were met; the factors that inhibited the attainment of certain goals; and how the acquisition of a second language influenced the students' learning about nursing. A model is presented to illustrate the process of transformative learning from the exchange experience.

  20. Deconstructing Death – Changing Cultures of Death, Dying, Bereavement and Care in the Nordic Countries

    DEFF Research Database (Denmark)

    Deconstructing Death is a book dealing with some of the most recent changes and transformations within the realms of death, dying, bereavement and care in contemporary Nordic countries. The book deals with some of the major as well as some of the less conspicuous changes in our cultural and social...... and ethics of end-of-life care, and the lonely death. Deconstructing Death contains contributions written by researchers and practitioners from Denmark, Sweden, Norway and Finland with professional and academic backgrounds within areas such as sociology, anthropology, religious studies and palliative care...

  1. Cultural influences upon advance care planning in a family-centric society.

    Science.gov (United States)

    Tay, Keson; Yu Lee, Rachel Jia; Sim, Shin Wei; Menon, Sumytra; Kanesvaran, Ravindran; Radha Krishna, Lalit Kumar

    2017-02-08

    Advanced care plans (ACPs) are designed to convey the wishes of patients with regards to their care in the event of incapacity. There are a number of prerequisites for creation of an effective ACP. First, the patient must be aware of their condition, their prognosis, the likely trajectory of the illness, and the potential treatment options available to them. Second, patient input into ACP must be free of any coercive factors. Third, the patient must be able to remain involved in adapting their ACP as their condition evolves. Continued use of familial determination and collusion within the local healthcare system, however, has raised concerns that the basic requirements for effective ACP cannot be met. To assess the credibility of these concerns, we employed a video vignette approach depicting a family of three adult children discussing whether or not to reveal a cancer diagnosis to their mother. Semistructured interviews with 72 oncology patients and 60 of their caregivers were conducted afterwards to explore the views of the participants on the different positions taken by the children. Collusion, family-centric decision making, adulteration of information provided to patients, and circumnavigation of patient involvement appear to be context-dependent. Patients and families alike believe that patients should be told of their conditions. However, the incidence of collusion and familial determination increases with determinations of a poor prognosis, a poor anticipated response to chemotherapy, and a poor premorbid health status. Financial considerations with respect to care determinations remain secondary considerations. Our data suggest that ACPs can be effectively constructed in family-centric societies so long as healthcare professionals continue to update and educate families on the patient's situation. Collusion and familial intervention in the decision-making process are part of efforts to protect the patient from distress and are neither solely dependent on

  2. Caring for a Bedouin Female Patient with Breast Cancer: An Application of Leininger’s Theory of Culture Care Diversity and Universality

    Directory of Open Access Journals (Sweden)

    Abdul Qadir J. Nashwan

    2013-07-01

    Full Text Available Leininger’s theory is to provide care measures that are in harmony with an individual or group’s cultural beliefs, practices, and values. In the 1960’s she coined the term culturally congruent care, which is the primary goal of Transcultural nursing practice. Recently, there is a noticeable increase in the usage of the advanced hospitals’ health services by the Bedouin; as their awareness developed in term of health issues, and this put the health care providers (especially nurses in a great chance to face this Bedouin’s culture in clinical areas. So we have to enrich our understanding of the Bedouin’s culture to deliver a culturally congruent and satisfying care. A personal experience of two oncology nurses in working with a female patient with breast cancer and her Bedouin family described, with application of Madeleine Leininger’s theory of culture care diversity and universality. Concluding that understanding, considering and valuing cultural differences when delivering nursing care are vital to ensure providing a culturally congruent nursing care as well as avoid conflicts.

  3. The Kawa model: the power of culturally responsive occupational therapy.

    Science.gov (United States)

    Iwama, Michael K; Thomson, Nicole A; Macdonald, Rona M

    2009-01-01

    The Kawa (Japanese for river) model, developed by Japanese and Canadian rehabilitation professionals, presents an important and novel alternative to contemporary 'Western' models of rehabilitation. Rather than focussing primarily on the individual client, the Kawa model focusses on 'contexts' that shape and influence the realities and challenges of peoples' dayto-day lives. The first substantial model of rehabilitation practice developed outside of the West illuminates the transactional quality of human-environment dynamics and the importance of inter-relations of self and others through the metaphor of a river's flow. The model's reflection of Eastern thought and views of nature presents a useful point of comparison to familiar rational and mechanical explanations of occupation and well-being. In this article, the rationale for an alternative model in rehabilitation is presented, followed by an explanation of the structure and concepts of the Kawa model. Implications for culturally responsive practice as well as the model's significance to the advancement of culturally safe rehabilitation worldwide are discussed.

  4. Nurses' perceptions of workplace culture in primary health care in Finland.

    Science.gov (United States)

    Hahtela, N; Paavilainen, E; McCormack, B; Helminen, M; Slater, P; Suominen, T

    2015-12-01

    This study aimed to describe nurses' perceptions of workplace culture, especially in regard to stress levels, job satisfaction and the practice environment in primary health care. Health care is facing many challenges related to its attractiveness as a place of employment and the maintenance of a sufficient workforce supply. Previous studies report increasing rates of nurse job dissatisfaction and intentions to leave their current positions both in Finland and also globally. Improving workplace culture is thus vital in meeting the challenges related to recruitment and retention. A cross-sectional descriptive design was used to describe nurses' perceptions of workplace culture. Data were collected by questionnaire from 22 units in nine primary healthcare organizations in Finland, and analysed using descriptive and inferential statistics. Most of the respondents indicated that they were not certain whether their workplace culture was either positive or negative. Profession, age and work shift characteristics had an effect on the respondents' perceptions of workplace culture. Younger licensed practical and registered nurses assessed their workplace culture more positively, whereas older registered nurses and those working rotating rosters viewed workplace culture more negatively. The findings suggest that both unit and demographic characteristics affect workplace culture. This survey highlights that a positive workplace culture is one of the key factors in retaining and recruiting nurses, and provides an essential evidence that may be considered by other healthcare organizations. Nurse managers and healthcare leaders need to address workload management and take into account the related variables that affect a unit's workplace culture. © 2015 International Council of Nurses.

  5. Learning from Japan: strengthening US emergency care and disaster response.

    Science.gov (United States)

    Parmar, Parveen; Arii, Maya; Kayden, Stephanie

    2013-12-01

    As Hurricane Katrina demonstrated in 2005, US health response systems for disasters-typically designed to handle only short-term mass-casualty events-are inadequately prepared for disasters that result in large-scale population displacements. Similarly, after the 2011 Great East Japan Earthquake, Japan found that many of its disaster shelters failed to meet international standards for long-term provision of basic needs and health care for the vulnerable populations that sought refuge in the shelters. Hospital disaster plans had not been tested and turned out to be inadequate, and emergency communication equipment did not function. We make policy recommendations that aim to improve US responses to mass-displacement disasters based on Japan's 2011 experience. First, response systems must provide for the extended care of large populations of chronically ill and vulnerable people. Second, policies should ensure that shelters meet or exceed international standards for the provision of food, water, sanitation, and privacy. Third, hospital disaster plans should include redundant communication systems and sufficient emergency provisions for both staff and patients. Finally, there must be routine drills for responses to mass-displacement disasters so that areas needing improvement can be uncovered before an emergency occurs.

  6. The Utility of Empathy for White Female Teachers' Culturally Responsive Interactions with Black Male Students

    Science.gov (United States)

    Warren, Chezare A.

    2013-01-01

    Teachers aiming to become culturally responsive must be concerned with negotiating professional interactions that produce favorable outcomes for the culturally diverse students under their charge. Very few studies offer empirical evidence of empathy's utility in the culturally responsive classroom, especially when the teacher is culturally…

  7. A Blueprint for Developing Culturally Proficient/Responsive School Administrators in Special Education

    Science.gov (United States)

    Bakken, Jeffrey P.; Smith, Beverly A.

    2011-01-01

    This article addresses the important topic of culturally proficient/responsive school administrators for culturally and linguistically diverse (CLD) students with learning disabilities (LD). Culturally proficient/responsive school administrators with knowledge and strong leadership skills in multicultural education are essential to impact school…

  8. Development of an Inventory for Health-Care Office Staff to Self-Assess Their Patient-Centered Cultural Sensitivity

    Directory of Open Access Journals (Sweden)

    Carolyn M. Tucker

    2016-02-01

    Full Text Available Background: Patient-centered culturally sensitive health care (PC-CSHC is a best practice approach for improving health-care delivery to culturally diverse populations and reducing health disparities. Despite patients’ report that cultural sensitivity by health-care office staff is an important aspect of PC-CSHC, the majority of available research on PC-CSHC focuses exclusively on health-care providers. This may be due in part to the paucity of instruments available to assess the cultural sensitivity of health-care office staff. The objective of the present study is to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF. This instrument is designed to enable health-care office staff to self-assess their level of agreement that they display behaviors and attitudes that culturally diverse patients have identified as office staff cultural sensitivity indicators. Methods: A sample of 510 health-care office staff were recruited at 67 health-care sites across the United States. These health-care office staff anonymously completed the T-CSHCOSI-SAF and a demographic data questionnaire. Results and Level of Evidence: Confirmatory factor analyses of the T-CSHCOSI-SAF revealed that this inventory has 2 factors with high internal consistency reliability (Cronbach’s αs= .916 and .912. Conclusion and Implications: The T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity. Such self-assessment data can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff and to help draw the attention of these staff to displaying patient-centered cultural sensitivity.

  9. Development of an Inventory for Health-Care Office Staff to Self-Assess Their Patient-Centered Cultural Sensitivity

    Directory of Open Access Journals (Sweden)

    Carolyn M. Tucker

    2016-02-01

    Full Text Available Background: Patient-centered culturally sensitive health care (PC-CSHC is a best practice approach for improving health-care delivery to culturally diverse populations and reducing health disparities. Despite patients’ report that cultural sensitivity by health-care office staff is an important aspect of PC-CSHC, the majority of available research on PC-CSHC focuses exclusively on health-care providers. This may be due in part to the paucity of instruments available to assess the cultural sensitivity of health-care office staff. The objective of the present study is to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF. This instrument is designed to enable health-care office staff to self-assess their level of agreement that they display behaviors and attitudes that culturally diverse patients have identified as office staff cultural sensitivity indicators. Methods: A sample of 510 health-care office staff were recruited at 67 health-care sites across the United States. These health-care office staff anonymously completed the T-CSHCOSI-SAF and a demographic data questionnaire. Results and Level of Evidence: Confirmatory factor analyses of the T-CSHCOSI-SAF revealed that this inventory has 2 factors with high internal consistency reliability (Cronbach’s αs= .916 and .912. Conclusion and Implications: The T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity. Such self-assessment data can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff and to help draw the attention of these staff to displaying patient-centered cultural sensitivity.

  10. Cross-cultural psychometric testing of the Care Dependency Scale with data

    NARCIS (Netherlands)

    Dijkstra, A; Coleman, M; Tomas, C; Valimaki, M; Dassen, T

    2003-01-01

    Background. The importance of the present study lies in addressing whether it is justified to compare the care dependency status of older patients from different settings and cultures using the same instrument. Aim. The aim of this international study was to compare the psychometric properties of th

  11. Patient Safety Culture and the Association with Safe Resident Care in Nursing Homes

    Science.gov (United States)

    Thomas, Kali S.; Hyer, Kathryn; Castle, Nicholas G.; Branch, Laurence G.; Andel, Ross; Weech-Maldonado, Robert

    2012-01-01

    Purpose of the study: Studies have shown that patient safety culture (PSC) is poorly developed in nursing homes (NHs), and, therefore, residents of NHs may be at risk of harm. Using Donabedian's Structure-Process-Outcome (SPO) model, we examined the relationships among top management's ratings of NH PSC, a process of care, and safety outcomes.…

  12. Cultural Competence, Systems of Care, and Students with Emotional and Behavioral Challenges

    Science.gov (United States)

    Meyer, Lakeisha D.; Anderson, Jeffrey A.; McQueen, Kand

    2013-01-01

    For youth with emotional and behavioral challenges, there is a trend of minority overrepresentation in restrictive settings. "System of care" refers to an approach that emphasizes cultural competence and providing services in the least restrictive setting. This study investigated the relationship between placement restrictiveness,…

  13. Building the Diversity Bridge Abroad: The Journey to Implement Cultural Competent Health Care in Lausanne, Switzerland

    Science.gov (United States)

    Casillas, Alejandra; Paroz, Sophie; Dory, Elody; Green, Alexander; Vu, Francis; Bodenmann, Patrick

    2016-01-01

    Introduction: Although the United States has been central in bringing cultural competency into the discussion of high-quality care, health systems all over the world are faced with the effects of global immigration and the widening disparities gap between socioeconomic classes. Lausanne University Hospital is one of five Swiss academic medical…

  14. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team

    Directory of Open Access Journals (Sweden)

    Andréia Tomazoni

    2014-10-01

    Full Text Available OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units.METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121.RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument.CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units.

  15. Wrongness, Responsibility, and Conscientious Refusals in Health Care.

    Science.gov (United States)

    Liberman, Alida

    2017-09-01

    In this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained in several important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health-care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort. © 2017 John Wiley & Sons Ltd.

  16. The role of values-based leadership in sustaining a culture of caring.

    Science.gov (United States)

    Faith, Karen E

    2013-01-01

    At the heart of healthcare are fundamental values like caring and compassion as well as the duty shared by healthcare organizations to address the care needs of those in their communities who are vulnerable, injured, or ill. A concern being raised by some political analysts in Canada is that fundamental values are being challenged by current economic and political influences that are reshaping the landscape of healthcare in this country. Influences from industry, technology, and business have significantly shifted healthcare from its moral foundations. A culture of caring is also challenged by the values and behaviours of individuals that negatively impact staff morale and inter-professional collaboration in many work settings. If a "culture of caring" is to survive the canons of cost containment, the impact of recurrent political wrangling, and other substantive influences, then healthcare must be guided by committed values-based leadership. Using case illustrations, this article attempts to explain the characteristics and role of values-based leaders in promoting those values that inspire a culture of caring.

  17. Toward Culturally Centered Integrative Care for Addressing Mental Health Disparities among Ethnic Minorities

    Science.gov (United States)

    Holden, Kisha; McGregor, Brian; Thandi, Poonam; Fresh, Edith; Sheats, Kameron; Belton, Allyson; Mattox, Gail; Satcher, David

    2014-01-01

    Despite decades of research, recognition and treatment of mental illness and its co-morbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden. The primary health care setting may be a promising venue for screening, assessment, and treatment of mental illnesses for ethnic minority populations. We propose a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, that includes provider and patient factors, to the system level, which include practice culture and system functionality issues. Our multi-disciplinary investigative team acknowledges the importance of providing culturally tailored integrative healthcare to holistically concentrate on physical, mental, emotional, and behavioral problems among ethnic minorities in a primary care setting. It is our intention that the proposed model will be useful for health practitioners, contribute to the reduction of mental health disparities, and promote better mental health and well-being for ethnic minority individuals, families, and communities. PMID:25383991

  18. The chasm of care: Where does the mental health nursing responsibility lie for the physical health care of people with severe mental illness?

    Science.gov (United States)

    Wynaden, Dianne; Heslop, Brett; Heslop, Karen; Barr, Lesley; Lim, Eric; Chee, Gin-Liang; Porter, James; Murdock, Jane

    2016-12-01

    The poor physical health of people with a severe mental illness is well documented and health professionals' attitudes, knowledge and skills are identified factors that impact on clients' access to care for their physical health needs. An evaluation was conducted to determine: (i) mental health nurses' attitudes and beliefs about providing physical health care; and, (ii) the effect that participant demographics may have on attitudes to providing physical health care. It was hypothesized that workplace culture would have the largest effect on attitudes. Nurses at three health services completed the "Mental health nurses' attitude towards the physical health care of people with severe and enduring mental illness survey" developed by Robson and Haddad (2012). The 28-item survey measured: nurses' attitudes, confidence, identified barriers to providing care and attitudes towards clients smoking cigarettes. The findings demonstrated that workplace culture did influence the level of physical health care provided to clients. However, at the individual level, nurses remain divided and uncertain where their responsibilities lie. Nursing leadership can have a significant impact on improving clients' physical health outcomes. Education is required to raise awareness of the need to reduce cigarette smoking in this client population.

  19. PA7 Developing a culture of medication safety in the palliative care home setting - supporting choices in place of care and death.

    Science.gov (United States)

    Short, Caroline; Scott, Anne

    2015-04-01

    It is common informal practice in Australia for carers to be trained to administer PRN subcutaneous medications, especially in the last few days of life. A safe, legal and ethical framework for practice was needed to support end of life decision-making. To develop a culture of safety in the palliative care home setting by applying a Health Promoting Palliative Care philosophy, Kellehear (1999), to enable choice in place of care and death. Team brainstorming and literature review - developed: Carer education programme to evaluate a carer's preparedness to administer subcutaneous medications. Guideline Evaluation and Communication strategy Support Focus Ease of access to equipment Piloted 2009 RESULTS: Pilot 93% participants achieved wish to die at home - consistent at approximately 90% medication errors reduced. Carer confidence increased to confident and most confident. Hospital admissions reduced - remains approximately 8-10% of all days on service spent in hospital. Staff safety and satisfaction increased with reduction in after-hours home visits - averages remain at one or two per year. After-hours phone calls did not increase in response to practice changes. Health promotion, enablement and promotion of autonomy and support rather than control and disablement are powerful determinants of carer's ability to cope when caring for the dying, and enduring bereavement. This project is now standard practice and has transformed community practice of palliative care empowering consumers and health professionals with such potential. However, in response to criticism of this practice the carer's perspective will be captured in a carer survey. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Patient care is a collective responsibility: perceptions of professional responsibility in surgery.

    Science.gov (United States)

    Park, Jason; Woodrow, Sarah I; Reznick, Richard K; Beales, Jennifer; MacRae, Helen M

    2007-07-01

    Changes in training are likely to affect the professionalization process, but such complex social phenomena are poorly studied by quantitative research methodologies. In contrast, qualitative research designs are more effective in exploring complex social processes. The objective of this study was to use a qualitative methodology to explore how professional responsibilities are perceived by surgical trainees and faculty in the current academic environment. Semi-structured individual interviews of 43 surgical residents and faculty (ranging from second year residents to senior faculty) were conducted at 2 academic institutions. The interviews consisted of open-ended questions, followed by discussion of 4 written, case-based scenarios on specific issues related to professional responsibilities. All interviews were audio-recorded and transcribed, and then analyzed for emergent themes by 3 researchers using a grounded theory approach. In discussing professional responsibilities, the motivations that shaped participants' responses reflected a balance between 4 major factors: (1) patient care, (2) education, (3) self, and (4) collegial relationships. Patient care was described as being at the center of professional responsibility, but it did not necessarily supersede other factors. Rather, patient care was described as a collective responsibility, operationalized through teamwork, communication, and trust. Traditional medical ethics have largely focused on professional responsibility from the standpoint of individual healthcare providers. Our findings suggest it is a much more complex construct characterized by competing responsibilities and an evolving perception of patient care as a collective responsibility. Explicit acknowledgment of this framework sets the stage for educational interventions to support residents' professional development and enhance cooperative behavior among participants.

  1. Lost in transformation? -Reviving ethics of care in hospital cultures of evidence-based healthcare

    DEFF Research Database (Denmark)

    Norlyk, Annelise; Haahr, Anita; Dreyer, Pia

    2017-01-01

    and values from evidence-based medicine are being lost in the transformation into the current evidence-based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today’s evidence practice...... as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. Key words: nursing practice, evidence-based practice, nursing theory, nursing theorists, ethics of care, hospital culture, patient......Drawing on our previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper is to analyse and discuss if and how it is possible to include patients...

  2. Communicating with culturally and linguistically diverse patients in an acute care setting: nurses' experiences.

    Science.gov (United States)

    Cioffi, R N Jane

    2003-03-01

    Communication with culturally and linguistically diverse (CLD) patients has been shown to be difficult. This study describes nurses' experiences of communicating with CLD patients in an acute care setting. A purposive sample of registered nurses and certified midwives (n=23) were interviewed. Main findings were: interpreters, bilingual health workers and combinations of different strategies were used to communicate with CLD patients; some nurses showed empathy, respect and a willingness to make an effort in the communication process with others showing an ethnocentric orientation. Main recommendations were: prioritising access to appropriate linguistic services, providing nurses with support from health care workers, e.g., bilingual health care workers who are able to provide more in-depth information, increasing nurses' understanding of legal issues within patient encounters, supporting nurses to translate their awareness of cultural diversity into acceptance of, appreciation for and commitment to CLD patients and their families.

  3. Culture at the centre of community based aged care in a remote Australian Indigenous setting: a case study of the development of Yuendumu Old People's Programme.

    Science.gov (United States)

    Smith, Kay; Grundy, John J; Nelson, Harry J

    2010-01-01

    Yuendumu is a Warlpiri Aboriginal community 300 km north west of Alice Springs in Central Australia. Since emerging from the welfare period in the early 1970s, a range of services have evolved with the aim of developing a comprehensive community based aged care service. In 2000 Mampu Maninja-kurlangu Jarlu Patu-ku Aboriginal Corporation (Yuendumu Old Peoples Programme; YOPP) commenced operation to manage the developing services. This case study aims to describe, from the analytic standpoint of community control and cultural comfort, the main features of the 'Family Model of Care', which underpins the operations of the service and YOPP management processes. Data were mostly generated from participant observation by the authors in the development and management of YOPP between 1993 and 2009. A literature review of Indigenous history and public health in Central Australia was also undertaken, which was supplemented by a review of Programme documentation, including evaluations, needs assessments and annual reports. The design and operations of YOPP are embodied in a documented 'Family Model of Care' which provides important lessons for the provision of aged care in a cross-cultural context. According to the concepts 'community control' and 'cultural comfort' outlined in this article, mainstream services can function in a complementary and supportive manner with professional services being accountable and responsive to a local management system that is governed by the structures and norms of community tradition. The notions of 'cultural comfort' and 'community control' as operating principles have enabled YOPP to continue under the management of local people, sustain core cultural strengths and values, and meet the needs for increased quality of care for the aged in Yuendumu. This model of care emphasizes and recognizes paradigms of mutual competence between traditional and mainstream human service culture, and offers important lessons for improvement to the quality of

  4. Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire.

    Science.gov (United States)

    Minvielle, Etienne; Dervaux, Benoît; Retbi, Aurélia; Aegerter, Philippe; Boumendil, Ariane; Jars-Guincestre, Marie Claude; Tenaillon, Alain; Guidet, Bertrand

    2005-06-01

    The objective of this study is to develop and validate a questionnaire designed to assess the culture, organization, and management of intensive care units. This is a prospective multicenter study. The study was conducted in 26 intensive care units located in Paris. All personnel were asked to complete the questionnaire. The questionnaire was developed in 2 steps: (1) development of a theoretical framework based on organizational theory and (2) testing of the reliability and validity of a comprehensive set of measures. The internal consistency of the items composing each scale was tested by using the Cronbach alpha. Convergent, and discriminant validity was assessed by factor analysis with varimax rotation. The overall completion rate was 74% with 1000 respondents (750 nurses, 26 head nurses, 168 physicians, and 56 medical secretaries). Starting with a 220-item questionnaire, we constructed a short version-conserving metrological characteristics with good reliability and validity. The short questionnaire, entitled Culture, Organization, and Management in Intensive Care, consists of 106 items distributed in 9 dimensions and 22 scales: culture (n = 3), coordination and adaptation to uncertainty (n = 3), communication (n = 3), problem solving and conflict management (n = 2), organizational learning and organizational change (n = 2), skills developed in a patient-caregiver relationship (n = 1), subjective unit performance (n = 3), burnout (n = 3), and job satisfaction and intention to quit (n = 2). All the scales showed good-to-high reliability, with Cronbach alpha scores higher than .7 (with the exception of coordination [.6]). Team satisfaction-oriented culture is positively correlated with good managerial practices and individual well-being. The Culture, Organization, and Management in Intensive Care questionnaire enables staff and managers to assess the organizational performance of their intensive care unit.

  5. Community transformation through culturally competent nursing leadership: application of theory of culture care diversity and universality and tri-dimensional leader effectiveness model.

    Science.gov (United States)

    Shapiro, Mina L; Miller, June; White, Kathleen

    2006-04-01

    Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger's culture care theory with the sunrise model and Hersey and Blanchard's tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.

  6. Relationship between organizational culture and commitment of employees in health care centers in west of Iran

    Science.gov (United States)

    Hamidi, Yadollah; Mohammadibakhsh, Roghayeh; Soltanian, Alireza; Behzadifar, Masoud

    2017-01-01

    Introduction Presence of committed personnel in each organization not only reduces their absenteeism, delays, and displacements but also leads to a dramatic increase in performance and efficiency of an organization, mental freshness of employees, better manifestation of noble objectives, and organizational mission as well as fulfillment of personal goals. Therefore, the purpose of this study was to determine the relationship between organizational culture and organizational commitment of employees in administrative units of health care centers in the cities of Hamedan Province based on the Denison model in 2015. Methods In this cross-sectional study, 177 employees in administrative units of health care centers in the cities of Hamedan Province were selected by a multistage stratified sampling method. The data collection instruments included the standardized Denison organizational culture survey and organizational commitment questionnaire by Meyer and Allen. Data were analyzed by IBM-SPSS version 21 using descriptive statistics and Pearson product-moment coefficient. Results Among the 12 indicators of organizational culture, the highest mean scores were assigned to empowerment (16.74), organizational learning (16.41), vision (16.4), and strategic direction (16.35); respectively. Furthermore, the indicators of capability development (14.2), core values (15.31), team orientation (15.45), and goals (15.46) received the lowest mean scores in this respect. Among the four dimensions of organizational culture, the highest mean score was related to “mission” in organizational culture and the lowest score was associated with “involvement.” Meyer and Allen’s organizational commitment model also had three components in which affective commitment in this study obtained the highest score (26.63) and continuance commitment received the lowest score (24.73). In this study, there was a significant correlation between all the components of organizational culture and

  7. The nexus of nursing leadership and a culture of safer patient care.

    Science.gov (United States)

    Murray, Melanie; Sundin, Deborah; Cope, Vicki

    2017-08-03

    To explore the connection between+6 nursing leadership and enhanced patient safety. Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation program and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture toward safer practices. The position of this paper is to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Safety is crucial in healthcare for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Identifying influential individuals on intensive care units: using cluster analysis to explore culture.

    Science.gov (United States)

    Fong, Allan; Clark, Lindsey; Cheng, Tianyi; Franklin, Ella; Fernandez, Nicole; Ratwani, Raj; Parker, Sarah Henrickson

    2017-07-01

    The objective of this paper is to identify attribute patterns of influential individuals in intensive care units using unsupervised cluster analysis. Despite the acknowledgement that culture of an organisation is critical to improving patient safety, specific methods to shift culture have not been explicitly identified. A social network analysis survey was conducted and an unsupervised cluster analysis was used. A total of 100 surveys were gathered. Unsupervised cluster analysis was used to group individuals with similar dimensions highlighting three general genres of influencers: well-rounded, knowledge and relational. Culture is created locally by individual influencers. Cluster analysis is an effective way to identify common characteristics among members of an intensive care unit team that are noted as highly influential by their peers. To change culture, identifying and then integrating the influencers in intervention development and dissemination may create more sustainable and effective culture change. Additional studies are ongoing to test the effectiveness of utilising these influencers to disseminate patient safety interventions. This study offers an approach that can be helpful in both identifying and understanding influential team members and may be an important aspect of developing methods to change organisational culture. © 2017 John Wiley & Sons Ltd.

  9. Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study

    NARCIS (Netherlands)

    Teunissen, E.; Gravenhorst, K.; Dowrick, C.; Weel-Baumgarten, E.M. van; Driessen Mareeuw, F.A. van den; Brun, T. de; Burns, N.; Lionis, C.; Mair, F.S.; O'Donnell, C.; O'Reilly-de Brun, M.; Papadakaki, M.; Saridaki, A.; Spiegel, W.; Weel, C. van; Muijsenbergh, M.E.T.C. van den; Macfarlane, A.

    2017-01-01

    BACKGROUND: Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this

  10. Does organisational culture influence prescribing in care homes for older people? A new direction for research.

    Science.gov (United States)

    Hughes, Carmel M; Lapane, Kate; Watson, Margaret C; Davies, Huw T O

    2007-01-01

    Prescribing in care homes for older people has been the focus of much research and debate because of inappropriate drug choice and poor monitoring practices. In the US, this has led to the implementation of punitive and adversarial regulation that has sought to improve the quality of prescribing in this healthcare setting. This approach is unique to the US and has not been replicated elsewhere. The literature has revealed that there are limitations as to how much can be achieved with regulation that is externally imposed (an 'external factor'). Other influences, which may be categorised as 'internal factors' operating within the care home (e.g. patient, physician and care-home characteristics), also affect prescribing. However, these internal and external factors do not appear to affect prescribing uniformly, and poor prescribing practices in care homes continue to be observed. One intangible factor that has received little attention in this area of healthcare is that of organisational culture. This factor has been linked to quality and performance within other health organisations. Consideration of organisational culture within care-home settings may help to understand what drives prescribing decisions in this particularly vulnerable patient group and thus provide new directions for future strategies to promote quality care.

  11. Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

    Science.gov (United States)

    Ulrey, K L; Amason, P

    2001-01-01

    Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication.

  12. Challenges to culturally sensitive care for elderly chinese patients: a first-generation Chinese-American perspective.

    Science.gov (United States)

    Chan, Karen C

    2013-01-01

    Physicians and medical institutions in the United States are placing increasing emphasis on providing culturally sensitive care for patients, such as implementing a Confucian family-based model of medical decision making when caring for elderly Chinese patients. In this article, I articulate various reasons why deferring to the family is not a guarantee of culturally sensitive care, particularly when family members are first-generation Chinese-Americans. Nonetheless, I offer several suggestions to help physicians, medical institutions, and family members to provide more culturally sensitive care for elderly Chinese patients.

  13. Workforce diversity and community-responsive health-care institutions.

    Science.gov (United States)

    Nivet, Marc A; Berlin, Anne

    2014-01-01

    While the levers for the social determinants of health reside largely outside institutional walls, this does not absolve health professional schools from exercising their influence to improve the communities in which they are located. Fulfilling this charge will require a departure from conventional thinking, particularly when it comes to educating future health professionals. We describe efforts within medical education to transform recruitment, admissions, and classroom environments to emphasize diversity and inclusion. The aim is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions.

  14. Guidelines for conducting rigorous health care psychosocial cross-cultural/language qualitative research.

    Science.gov (United States)

    Arriaza, Pablo; Nedjat-Haiem, Frances; Lee, Hee Yun; Martin, Shadi S

    2015-01-01

    The purpose of this article is to synthesize and chronicle the authors' experiences as four bilingual and bicultural researchers, each experienced in conducting cross-cultural/cross-language qualitative research. Through narrative descriptions of experiences with Latinos, Iranians, and Hmong refugees, the authors discuss their rewards, challenges, and methods of enhancing rigor, trustworthiness, and transparency when conducting cross-cultural/cross-language research. The authors discuss and explore how to effectively manage cross-cultural qualitative data, how to effectively use interpreters and translators, how to identify best methods of transcribing data, and the role of creating strong community relationships. The authors provide guidelines for health care professionals to consider when engaging in cross-cultural qualitative research.

  15. Clinical accuracy of point-of-care urine culture in general practice

    DEFF Research Database (Denmark)

    Holm, Anne; Cordoba, Gloria; Sørensen, Tina Møller

    2017-01-01

    in boric acid used for transportation for the reference standard. (4) Accuracy based on expert reading of photographs of POC urine cultures performed in general practice. Standard culture performed in the microbiological department was used as reference standard for all four measures. RESULTS: Twenty...... excluded was 0.82 (0.77-0.86) and agreement between expert readings of photographs and reference results was 0.81 (CI: 0.76-0.85). CONCLUSIONS: POC culture used in general practice has high SEN but low SPE. Low SPE could be due to both misinterpretation in general practice and an imperfect reference......OBJECTIVE: To assess the clinical accuracy (sensitivity (SEN), specificity (SPE), positive predictive value and negative predictive value) of two point-of-care (POC) urine culture tests for the identification of urinary tract infection (UTI) in general practice. DESIGN: Prospective diagnostic...

  16. 75 FR 76997 - Public Consultation on Personnel Reliability and Culture of Responsibility Issues

    Science.gov (United States)

    2010-12-10

    ... Responsibility Issues AGENCY: National Institutes of Health, HHS. ACTION: Notice of Public Consultation on Guidance for Enhancing Personnel Reliability and Strengthening the Culture of Responsibility at the Local... culture of responsibility at facilities that conduct research with dangerous pathogens. The discussion...

  17. The Culturally Responsive Teacher in Class-teaching

    Institute of Scientific and Technical Information of China (English)

    谢桂梅

    2008-01-01

    <正>Successfully teaching students from culturally and linguistically diverse backgrounds requires a new way of looking at teaching that is grounded in an understanding of the role of culture and language in learning.Teachers need to be familiar with constructivist views of learning,develop socio-cultural consciousnessuse instructional strategies.

  18. Safe patient care – safety culture and risk management in otorhinolaryngology

    Directory of Open Access Journals (Sweden)

    St. Pierre, Michael

    2013-12-01

    Full Text Available [english] Safety culture is positioned at the heart of an organization’s vulnerability to error because of its role in framing organizational awareness to risk and in providing and sustaining effective strategies of risk management. Safety related attitudes of leadership and management play a crucial role in the development of a mature safety culture (“top-down process”. A type marker for organizational culture and thus a predictor for an organization’s maturity in respect to safety is information flow and in particular an organization’s general way of coping with information that suggests anomaly. As all values and beliefs, relationships, learning, and other aspects of organizational safety culture are about sharing and processing information, safety culture has been termed “informed culture”. An informed culture is free of blame and open for information provided by incidents. “Incident reporting systems” are the backbone of a reporting culture, where good information flow is likely to support and encourage other kinds of cooperative behavior, such as problem solving, innovation, and inter-departmental bridging. Another facet of an informed culture is the free flow of information during perioperative patient care. The World Health Organization’s safe surgery checklist” is the most prevalent example of a standardized information exchange aimed at preventing patient harm due to information deficit. In routine tasks mandatory standard operating procedures have gained widespread acceptance in guaranteeing the highest possible process quality.Technical and non-technical skills of healthcare professionals are the decisive human resource for an efficient and safe delivery of patient care and the avoidance of errors. The systematic enhancement of staff qualification by providing training opportunities can be a major investment in patient safety. In recent years several otorhinolaryngology departments have started to incorporate

  19. EdU induces DNA damage response and cell death in mESC in culture.

    Science.gov (United States)

    Kohlmeier, Fanni; Maya-Mendoza, Apolinar; Jackson, Dean A

    2013-03-01

    Recently, a novel DNA replication precursor analogue called 5-ethynyl-2'-deoxyuridine (EdU) has been widely used to monitor DNA synthesis as an alternative to bromodeoxyuridine. Use of EdU benefits from simplicity and reproducibility and the simple chemical detection systems allows excellent preservation of nuclear structure. However, the alkyne moiety is highly reactive, raising the possibility that incorporation might compromise genome stability. To assess the extent of possible DNA damage, we have analysed the effect of EdU incorporation into DNA during short- and long-term cell culture using a variety of cell lines. We show that EdU incorporation has no measurable impact on the rate of elongation of replication forks during synthesis. However, using different cell lines we find that during long-term cell culture variable responses to EdU incorporation are seen, which range from delayed cell cycle progression to complete cell cycle arrest. The most profound phenotypes were seen in mouse embryonic stem cells, which following incorporation of EdU accumulated in the G2/M-phase of the cell cycle before undergoing apoptosis. In long-term cell culture, EdU incorporation also triggered a DNA damage response in all cell types analysed. Our study shows that while EdU is extremely useful to tag sites of on-going replication, for long-term studies (i.e. beyond the cell cycle in which labelling is performed), a careful analysis of cell cycle perturbations must be performed in order to ensure that any conclusions made after EdU treatment are not a direct consequence of EdU-dependent activation of cell stress responses.

  20. The cultural moral right to a basic minimum of accessible health care.

    Science.gov (United States)

    Menzel, Paul T

    2011-03-01

    (1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum.

  1. Nursing home organizational change: the "Culture Change" movement as viewed by long-term care specialists.

    Science.gov (United States)

    Miller, Susan C; Miller, Edward Alan; Jung, Hye-Young; Sterns, Samantha; Clark, Melissa; Mor, Vincent

    2010-08-01

    A decade-long grassroots movement aims to deinstitutionalize nursing home (NH) environments and individualize care. Coined "NH Culture Change" the movement is often described by its resident-centered/directed care focus. While empirical data of "culture change's" costs and benefits are limited, it is broadly viewed as beneficial and widely promoted. Still, debate abounds regarding barriers to its adoption. We used data from a Web-based survey of 1,147 long-term care specialists (including NH and other providers, consumers/advocates, state and federal government officials, university/academic, researchers/consultants, and others) to better understand factors associated with perceived barriers. Long-term care specialists view the number-one barrier to adoption differently depending on their employment, familiarity with culture change, and their underlying policy views. To promote adoption, research and broad-based educational efforts are needed to influence views and perceptions. Fundamental changes in the regulatory process together with targeted regulatory changes and payment incentives may also be needed.

  2. Cultural competence in mental health care: a review of model evaluations

    Directory of Open Access Journals (Sweden)

    McKenzie Kwame

    2007-01-01

    Full Text Available Abstract Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes.

  3. Assessing and Enhancing Health Care Providers’ Response to Domestic Violence

    Directory of Open Access Journals (Sweden)

    Tuija Leppäkoski

    2014-01-01

    Full Text Available This study aimed to examine possible changes from 2008 to 2012 in the skills of health care staff in identifying and intervening in domestic violence (DV. A longitudinal descriptive study design with volunteer samples (baseline; n=68, follow-up; n=100 was used to acquire information regarding the present state and needs of the staff in practices related to DV. The results of the baseline survey were used as a basis for planning two interventions: staff training and drafting practical guidelines. Information was collected by questionnaires from nurses, physicians, and social workers and supplemented by responses from the interviews. The data were analysed using both quantitative and qualitative methods. A chi-square test was used to test the statistical significance of the data sets. In addition, participants’ quotes are used to describe specific phenomena or issues. The comparison showed that overall a small positive change had taken place between the study periods. However, the participants were aware of their own shortcomings in identifying and intervening in DV. Changes happen slowly, and administrative support is needed to sustain such changes. Therefore, this paper offers recommendations to improve health care providers’ response to DV. Moreover, there is a great need for evaluating the training programme used.

  4. The impact of organisational culture on the delivery of person-centred care in services providing respite care and short breaks for people with dementia.

    Science.gov (United States)

    Kirkley, Catherine; Bamford, Claire; Poole, Marie; Arksey, Hilary; Hughes, Julian; Bond, John

    2011-07-01

    Ensuring the development and delivery of person-centred care in services providing respite care and short breaks for people with dementia and their carers has a number of challenges for health and social service providers. This article explores the role of organisational culture in barriers and facilitators to person-centred dementia care. As part of a mixed-methods study of respite care and short breaks for people with dementia and their carers, 49 telephone semi-structured interviews, two focus groups (N= 16) and five face-to-face in-depth interviews involving front-line staff and operational and strategic managers were completed in 2006-2007. Qualitative thematic analysis of transcripts identified five themes on aspects of organisational culture that are perceived to influence person-centred care: understandings of person-centred care, attitudes to service development, service priorities, valuing staff and solution-focused approaches. Views of person-centred care expressed by participants, although generally positive, highlight a range of understandings about person-centred care. Some organisations describe their service as being person-centred without the necessary cultural shift to make this a reality. Participants highlighted resource constraints and the knowledge, attitudes and personal qualities of staff as a barrier to implementing person-centred care. Leadership style, the way that managers' support and value staff and the management of risk were considered important influences. Person-centred dementia care is strongly advocated by professional opinion leaders and is prescribed in policy documents. This analysis suggests that person-centred dementia care is not strongly embedded in the organisational cultures of all local providers of respite-care and short-break services. Provider organisations should be encouraged further to develop a shared culture at all levels of the organisation to ensure person-centred dementia care.

  5. [Home care in a culturally sensitive environment: perspectives of caregivers of Haitian elderly patients and relatives].

    Science.gov (United States)

    Ducharme, Francine; Paquet, Mario; Vissandjée, Bilkis; Carpentier, Normand; Lévesque, Louise; Trudeau, Denise

    2008-01-01

    In Canada, the care provided by families occurs in an increasingly multiethnic context. Against this backdrop, the present qualitative study aims to explore the needs/expectations and solutions not only of (female) natural caregivers of an elderly relative hailing from Haiti (presented in terms of tracking cases) but also of remunerated home care providers - all with a view to developing a culturally sensitive service offering. As such, this study works from a conceptual framework centring on the negotiation of a common area of agreement between the stakeholders involved (i.e., natural caregivers and home care providers). To this end, focus groups and individual interviews were conducted among 15 caregivers and 37 home care providers. The three recurrent themes emerging from the data analysis concern, in context, the needs/expectations and solutions surrounding the experience of service use, barriers to use, and the relationships between natural caregivers and home care providers. The statements of both groups evidenced a consistency of views and have thus provided a basis for developing some recommendations acceptable to all stakeholders from the perspective of making culturally-based adjustments to the service offering.

  6. Culture-independent analysis of bacterial diversity in a child-care facility

    Directory of Open Access Journals (Sweden)

    Tin Sara

    2007-04-01

    Full Text Available Abstract Background Child-care facilities appear to provide daily opportunities for exposure and transmission of bacteria and viruses. However, almost nothing is known about the diversity of microbial contamination in daycare facilities or its public health implications. Recent culture-independent molecular studies of bacterial diversity in indoor environments have revealed an astonishing diversity of microorganisms, including opportunistic pathogens and many uncultured bacteria. In this study, we used culture and culture-independent methods to determine the viability and diversity of bacteria in a child-care center over a six-month period. Results We sampled surface contamination on toys and furniture using sterile cotton swabs in four daycare classrooms. Bacteria were isolated on nutrient and blood agar plates, and 16S rRNA gene sequences were obtained from unique (one of a kind colony morphologies for species identification. We also extracted DNA directly from nine representative swab samples taken over the course of the study from both toy and furniture surfaces, and used "universal" 16S rRNA gene bacterial primers to create PCR-based clone libraries. The rRNA gene clones were sequenced, and the sequences were compared with related sequences in GenBank and subjected to phylogenetic analyses to determine their evolutionary relationships. Culturing methods identified viable bacteria on all toys and furniture surfaces sampled in the study. Bacillus spp. were the most commonly cultured bacteria, followed by Staphylococcus spp., and Microbacterium spp. Culture-independent methods based on 16S rRNA gene sequencing, on the other hand, revealed an entirely new dimension of microbial diversity, including an estimated 190 bacterial species from 15 bacterial divisions. Sequence comparisons and phylogenetic analyses determined that the clone libraries were dominated by a diverse set of sequences related to Pseudomonas spp., as well as uncultured

  7. Development of scales to assess patients' perception of physicians' cultural competence in health care interactions.

    Science.gov (United States)

    Ahmed, Rukhsana; Bates, Benjamin R

    2012-07-01

    This study describes the development of scales to measure patients' perception of physicians' cultural competence in health care interactions and thus contributes to promoting awareness of physician-patient intercultural interaction processes. Surveys were administrated to a total of 682 participants. Exploratory factor analyses were employed to assess emergent scales and subscales to develop reliable instruments. The first two phases were devoted to formative research and pilot study. The third phase was devoted to scale development, which resulted in a five-factor solution to measure patient perception of physicians' cultural competence for patient satisfaction.

  8. Quality of health care: the responsibility of health care professionals in delivering high quality services.

    Science.gov (United States)

    Giangrande, A

    1998-11-01

    According to a recent definition, quality of care consists of the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge; a definition that introduces both requirements of outcomes and the appropriateness of the process used. Clearly many different figures are interested in quality assessment initiatives in the health care field and these include patients, administrators and doctors each having different perspective. Doctors obviously pay greater attention to technical quality and results, giving greater emphasis to the health of the individual patient, tending to give priority to technical excellence and interaction between patient and doctor. Although the perspective of health care professionals is widely acknowledged to be important and useful, other perspectives on quality have been emphasised in recent years. The most important of these is the recognition that care must be responsive to the preferences and values of the consumers of health care services. In complete harmony with one's own professional commitment, the attention to the perspectives of patients must give physician the chance to identify methods of measuring and verifying quality which take account of the expectations of the many groups with an interest in improving the functioning of the health system. A global approach in the health field is needed the more specialization advances. The quality of medicine lies in its capacity to integrate what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator.

  9. Advance care planning, culture and religion: an environmental scan of Australian-based online resources.

    Science.gov (United States)

    Pereira-Salgado, Amanda; Mader, Patrick; Boyd, Leanne M

    2017-04-20

    Objectives Culture and religion are important in advance care planning (ACP), yet it is not well understood how this is represented in ACP online resources. The aim of the present study was to identify the availability of Australian-based ACP websites and online informational booklets containing cultural and religious information.Methods An environmental scanning framework was used with a Google search conducted from 30 June 2015 to 5 July 2015. Eligible Australian-based ACP websites and online informational booklets were reviewed by two analysts (APS & PM) for information pertaining to at least one culture or religion. Common characteristics were agreed upon and tabulated with narrative description.Results Seven Australian-based ACP websites were identified with varying degrees of cultural and religious information. Seven Australian-based ACP informational booklets were identified addressing culture or religion, namely of Aboriginal and Torres Strait Islander (n=5), Sikh (n=1) and Italian (n=1) communities. Twenty-one other online resources with cultural and religious information were identified, developed within the context of health and palliative care.Conclusions There is no comprehensive Australian-based ACP website or informational booklet supporting ACP across several cultural and religious contexts. Considering Australia's multicultural and multifaith population, such a resource may be beneficial in increasing awareness and uptake of ACP.What is known about the topic? Health professionals and consumers frequently use the Internet to find information. Non-regulation has resulted in the proliferation of ACP online resources (i.e. ACP websites and online informational booklets). Although this has contributed to raising awareness of ACP, the availability of Australian-based ACP online resources with cultural and religious information is not well known.What does this paper add? This paper is the first to use an environmental scanning methodology to identify

  10. Leadership-organizational culture relationship in nursing units of acute care hospitals.

    Science.gov (United States)

    Casida, Jesus; Pinto-Zipp, Genevieve

    2008-01-01

    The phenomena of leadership and organizational culture (OC) has been defined as the driving forces in the success or failure of an organization. Today, nurse managers must demonstrate leadership behaviors or styles that are appropriate for the constantly changing, complex, and turbulent health care delivery system. In this study, researchers explored the relationship between nurse managers' leadership styles and OC of nursing units within an acute care hospital that had achieved excellent organizational performance as demonstrated by a consistent increase in patient satisfaction ratings. The data from this study support that transformational and transactional contingent reward leaderships as nurse manager leadership styles that are associated with nursing unit OC that have the ability to balance the dynamics of flexibility and stability within their nursing units and are essential for maintaining organizational effectiveness. It is essential for first-line nursing leaders to acquire knowledge and skills on organizational cultural competence.

  11. [Primary health care reform and implications for the organizational culture of Health Center Groups in Portugal].

    Science.gov (United States)

    Leone, Claudia; Dussault, Gilles; Lapão, Luís Velez

    2014-01-01

    The health sector's increasing complexity poses major challenges for administrators. There is considerable consensus on workforce quality as a key determinant of success for any health reform. This study aimed to explore the changes introduced by an action-training intervention in the organizational culture of the 73 executive directors of Health Center Groups (ACES) in Portugal during the primary health care reform. The study covers two periods, before and after the one-year ACES training, during which the data were collected and analyzed. The Competing Values Framework allowed observing that after the ACES action-training intervention, the perceptions of the executive directors regarding their organizational culture were more aligned with the practices and values defended by the primary health care reform. The study highlights the need to continue monitoring results over different time periods to elaborate further conclusions.

  12. Cultural differences in interpersonal responses to depressives' nonverbal behaviour.

    Science.gov (United States)

    Vanger, P; Summerfield, A B; Rosen, B K; Watson, J P

    1991-01-01

    The Social Impression and Interpersonal Attraction of British depressed patients was rated by British and German subjects on the basis of the patients' video-recorded nonverbal behaviour. Depressives were rated negatively by all subjects. Males in both cultural groups agreed in their ratings of depressives but German females expressed a more negative attitude than British females. This is attributed to cultural differences in sex-appropriate interactive behaviour. The importance of studying the expression of depression and its meaning within a particular cultural context is indicated and the role of cultural differences in interactive behaviour is discussed with respect to intercultural assessment and treatment of depression.

  13. Maternity care services and culture: a systematic global mapping of interventions.

    Directory of Open Access Journals (Sweden)

    Ernestina Coast

    Full Text Available BACKGROUND: A vast body of global research shows that cultural factors affect the use of skilled maternity care services in diverse contexts. While interventions have sought to address this issue, the literature on these efforts has not been synthesised. This paper presents a systematic mapping of interventions that have been implemented to address cultural factors that affect women's use of skilled maternity care. It identifies and develops a map of the literature; describes the range of interventions, types of literature and study designs; and identifies knowledge gaps. METHODS AND FINDINGS: Searches conducted systematically in ten electronic databases and two websites for literature published between 01/01/1990 and 28/02/2013 were combined with expert-recommended references. Potentially eligible literature included journal articles and grey literature published in English, French or Spanish. Items were screened against inclusion and exclusion criteria, yielding 96 items in the final map. Data extracted from the full text documents are presented in tables and a narrative synthesis. The results show that a diverse range of interventions has been implemented in 35 countries to address cultural factors that affect the use of skilled maternity care. Items are classified as follows: (1 service delivery models; (2 service provider interventions; (3 health education interventions; (4 participatory approaches; and (5 mental health interventions. CONCLUSIONS: The map provides a rich source of information on interventions attempted in diverse settings that might have relevance elsewhere. A range of literature was identified, from narrative descriptions of interventions to studies using randomised controlled trials to evaluate impact. Only 23 items describe studies that aim to measure intervention impact through the use of experimental or observational-analytic designs. Based on the findings, we identify avenues for further research in order to better

  14. Assessment of Patient Safety Culture in Primary Health Care Settings in Kuwait

    OpenAIRE

    Maha Mohamed Ghobashi; Hanan Abdel Ghani El-ragehy; Hanan Mosleh Ibrahim; Fatma Abdullah Al-Doseri

    2014-01-01

    Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue.Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of resp...

  15. Construct comparisons of IT adoption theories across cultures and innovativeness of health care professionals.

    Science.gov (United States)

    Park, Jae Sung; Kim, Hye-Sook; Park, Young-Taek; Speedie, Stuart M

    2008-11-06

    This investigation verified the study model derived from TAM and tested path significance across moderating variables such as cultures, personal innovativeness in IT (PIIT), and two different health care professionals. The findings demonstrated that the theory can apply to other settings and to different work professionals as well as across PIIT. There were different aspects on path significance, which have managerial implications on how an organization can successfully use their IT resources without resistance.

  16. Culture-independent analysis of bacterial diversity in a child-care facility

    OpenAIRE

    Tin Sara; Lee Lesley; Kelley Scott T

    2007-01-01

    Abstract Background Child-care facilities appear to provide daily opportunities for exposure and transmission of bacteria and viruses. However, almost nothing is known about the diversity of microbial contamination in daycare facilities or its public health implications. Recent culture-independent molecular studies of bacterial diversity in indoor environments have revealed an astonishing diversity of microorganisms, including opportunistic pathogens and many uncultured bacteria. In this stud...

  17. A Mirror of Voices: A Collaborative Learning Community of Culturally Responsive Digital Storytelling

    Science.gov (United States)

    Harris, Kim Diann

    2013-01-01

    This action research study acknowledged the possibilities of culturally responsive pedagogy by examining digital storytelling via online workshops that were facilitated for a group of educators and educational leaders. The presence of cultural biases and cultural discontinuities in Pre-K-12 education has the propensity to contribute to the…

  18. Three Curriculum and Organisational Responses to Cultural Pluralism in New Zealand Schooling.

    Science.gov (United States)

    Corson, David

    1990-01-01

    Examines three educational responses to cultural diversity operating in New Zealand schools: incorporation of Maori culture programs in mainstream curriculums, organizational modification to accommodate Maori students, and the development of Maori culture and language immersion programs in primary schools. Application of similar programs to…

  19. Culturally Responsive Differentiated Instruction: Narrowing Gaps between Best Pedagogical Practices Benefiting All Learners

    Science.gov (United States)

    Santamaria, Lorri J.

    2009-01-01

    Background/Context: Because of its special education association, differentiated instruction (DI) is a topic of concern for many educators working with culturally and linguistically diverse (CLD) learners, whereby bilingual, multicultural, and culturally responsive teaching (CRT) is considered more appropriate for responding to cultural and…

  20. The cultural beliefs of Jordanian women during childbearing: implications for nursing care.

    Science.gov (United States)

    Bawadi, H A; Al-Hamdan, Z

    2017-06-01

    To determine the cultural and religious beliefs and practices about childbirth among Jordanian women and to indicate how these beliefs and practices can be integrated into the maternity care of Muslim women in general, especially those immigrating to Western countries. The physiology of childbirth is similar for all women worldwide, but the surroundings in which it takes place makes it a unique experience for each woman. Every society has cultural practices and beliefs related to childbirth, and what is considered to be a vital practice in one culture may be seen as insignificant in another. A qualitative research design with an interpretative phenomenological approach was used to conduct semi-structured, audiotaped interviews with nine Jordanian mothers. Five main themes identified: childbearing is a blessing of Allah, a time for special maternal care, a time for maternal self-renewal, a time for maternal spiritual purification and a time to prepare for the sacrifices of motherhood. The findings reflected the sensitivity of the grace of God in all the interviews, illustrating the permeating influence of religious beliefs on traditional Jordanian childbirth practices. In planning policies, health services globally should acknowledge the diverse need of migrant women during childbirth, in order to gain women's trust in maternity services. To offer sensitive care, nurses need to address mothers' cultural and spiritual needs and meet these needs respectfully. To improve the childbearing experience, maternity staff should consider these themes to help build trust with mothers based on an appreciation of their spiritual and cultural beliefs. © 2016 International Council of Nurses.

  1. Samoan Philosophy of Nursing: a basis for culturally proficient care and policy.

    Science.gov (United States)

    Enoka, I S; Petrini, M A; Turale, S

    2014-09-01

    To explore nurses' perspectives about the Samoan Philosophy of Nursing, and determine its feasibility for nursing care of Samoans internationally. This philosophy is the conceptual cultural framework for nursing law, practice, education and research in Samoa, and was developed by Samoan nurses who recognized the need for guidance to deliver quality, culturally competent and proficient health care. A mixed method study, employing a questionnaire and ethnographic methods. The Samoan Philosophy of Nursing Questionnaire sought demographic data and aspects about the philosophy from 95 registered nurse clinicians, administrators and educators throughout Samoa during 2012. Descriptive statistics were used for data analysis. Additionally, 19 focus groups (5-6 participants each) and 19 in-depth interviews were held to further explore these aspects, as well as participant observations. Descriptive statistics were used to analyse quantitative data, and Spradley's ethnographic method was adopted for analysing the qualitative data. Of 95 questionnaires analysed, 70% of participants reported using the philosophy all the time, and 30% most of the time. They placed a high satisfaction rate, value and importance on this philosophy. From the ethnography, six major themes emerged: valuable framework of learning; conceptual framework for holistic assessment; benchmark for regulating and monitoring practice improving interaction and culturally proficient practice; potential use for Samoans overseas; and maintaining quality health and the dignity of people. This first-time study evaluated the Samoan Philosophy of Nursing and adds to nursing knowledge. Findings confirmed its usefulness as a culturally based conceptual framework to facilitate, regulate and monitor education, research and practice for sustainable health outcomes in Samoa, and for Samoans living abroad. It is important that Samoans living abroad receive culturally proficient care, but this requires the support of

  2. Shifting the balance of power? Culture change and identity in an English health-care setting.

    Science.gov (United States)

    McDonald, Ruth

    2005-01-01

    A recurring theme in Government policy documents has been the need to change the culture of the NHS in order to deliver a service "fit for the twenty-first century". However, very little is said about what constitutes "culture" or how this culture change is to be brought about. This paper seeks to focus on an initiative aimed ostensibly at "empowering" staff in an English Primary Care Trust as a means of changing organisational culture. It presents findings from an ethnographic study which suggests that this attempt at "culture change" is aimed at manipulating the behaviour and values of individual employees and may be interpreted as a process of changing employee identity. Employees reacted in different ways to the empowerment initiative, with some resisting attempts to shape their identity and others actively engaging in projects to bring their unruly self into line with the ideal self to which they were encouraged to aspire. The challenges presented by the need to respond to conflicting Government policies created tensions between individuals and conflicts of allegiance and identity within individual members of staff. Alternative forms of self-hood did not merely replace existing identities, but interacted with them, often uncomfortably. The irony is that, whilst Government seeks to promote culture change, the frustrations created by its top-down target-driven regime acted to mitigate the transformational and reconstitutive effects of a discourse of empowerment aimed at achieving this change.

  3. An examination of acquiescent response styles in cross-cultural research

    NARCIS (Netherlands)

    R. Fischer; J.R.J. Fontaine; F.J.R. van de Vijver; D.A. van Hemert

    2006-01-01

    Response styles constitute a formidable challenge for cross-cultural research. In this article, three different response styles are discussed (acquiescence, extremity scoring, and social desirability). Acquiescence responding (ARS) is then integrated into a larger classical test theoretical framewor

  4. Ethical and cultural striving: Lived experiences of minority nurses in dementia care.

    Science.gov (United States)

    Egede-Nissen, Veslemøy; Sellevold, Gerd Sylvi; Jakobsen, Rita; Sørlie, Venke

    2017-09-01

    Nursing workforce in Western European health institutions has become more diverse because of immigration and recruitment from Asian, African, and East-European countries. Minority healthcare providers may experience communication problems in interaction with patients and coworkers, and they are likely to experience conflict or uncertainty when confronted with different cultural traditions and values. Persons with dementia are a vulnerable group, and the consequences of their illness challenge the ability to understand and express oneself verbally. The large number of minority healthcare providers in nursing homes underlines the importance to obtain better knowledge about this group's experiences with the care challenges in dementia care units. Can you tell about any challenges in the experiences in the encounter with persons suffering from dementia? Participants and research context: Five minority healthcare providers in a nursing home, in a dementia unit. All guidelines for research ethic were followed. Ethical consideration: The participants were informed that participation was voluntary, and they were guarantied anonymity. We used a qualitative method, conducting individual interviews, using a narrative approach. In the analysis, we applied a phenomenological-hermeneutical method, developed for researching life experiences. One theme and four subthemes: striving to understand the quality of care for persons with dementia. The subthemes: sensitivity to understand the patients' verbal and nonverbal expressions. To understand gratefulness, understand the patient as an adult and autonomous person, and understand the patient as a patient in a nursing home. Challenges comprise both ethical and cultural striving to understand persons with dementia. To care for persons with dementia in an unfamiliar context may be understood as a striving for acting ethically, when at the same time striving to adapt and acculturate to new cultural norms, in order to practice good

  5. School Nurse Cultural Competence Needs Assessment: Results and Response.

    Science.gov (United States)

    Matza, Maria; Maughan, Erin; Barrows, Beth M

    2015-11-01

    NASN conducted a needs assessment to learn about the cultural competence skills needed by school nurses. The purpose of this article is to describe the results of the needs assessment and describe actions taken to address cultural competency needs for the U.S. school nurse workforce.

  6. Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care

    NARCIS (Netherlands)

    Parker, D.; Wensing, M.; Esmail, A.; Valderas, J.M.

    2015-01-01

    BACKGROUND: There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. OBJECTIVE: To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance

  7. Culturable bacteria in Himalayan ice in response to atmospheric circulation

    Directory of Open Access Journals (Sweden)

    S. Zhang

    2006-06-01

    Full Text Available Only recently has specific attention been given to culturable bacteria in Tibetan glaciers, but their relation to atmospheric circulation is less understood yet. Here we investigate the seasonal variation of culturable bacteria preserved in a Himalayan ice core. High concentration of culturable bacteria in glacial ice deposited during the pre-monsoon season is attributed to the transportation of continental dust stirred up by the frequent dust storms in Northwest China during spring. This is also confirmed by the spatial distribution of culturable bacteria in Tibetan glaciers. Culturable bacteria deposited during monsoon season are more diverse than other seasons because they derive from both marine air masses and local or regional continental sources. We suggest that microorganisms in Himalayan ice can be used to reconstruct atmospheric circulation.

  8. Cross-cultural pragmatics: compliments and compliment responses in English and Chinese

    Institute of Scientific and Technical Information of China (English)

    张苏

    2012-01-01

    Language and culture are distinctly interdependent;one reflects the other.In cross-cultural communications,it is critical for language users to use and understand the language appropriately in a certain socio-cultural context.This paper aims to compare the similarities and differences of compliments and compliment responses in English and Chinese from the cross-cultural pragmatic perspective.The implications for teaching are also discussed so as to bridge the gap caused by cultural differences and minimize the occurrence of potential cross-cultural pragmatic failures.

  9. Considering Culturally Responsive Teaching, Children, and Place in the Music Room

    Science.gov (United States)

    Wiens, Kimberly Friesen

    2015-01-01

    In this article, the author explores how culturally responsive teaching and the concept of children and place relate in the music room. The article begins with a brief explanation of both culturally responsive teaching and children and place. Through the use of anecdotes and ideas to consider, this article provides elementary music teachers with…

  10. Considering Culturally Responsive Teaching, Children, and Place in the Music Room

    Science.gov (United States)

    Wiens, Kimberly Friesen

    2015-01-01

    In this article, the author explores how culturally responsive teaching and the concept of children and place relate in the music room. The article begins with a brief explanation of both culturally responsive teaching and children and place. Through the use of anecdotes and ideas to consider, this article provides elementary music teachers with…

  11. Using Culturally Competent Responsive Services to Improve Student Achievement and Behavior

    Science.gov (United States)

    Schellenberg, Rita; Grothaus, Tim

    2011-01-01

    This article illustrates standards blending, the integration of core academic and school counseling standards, as a culturally alert responsive services strategy to assist in closing the achievement gap while also enhancing employability skills and culturally salient career competencies. The responsive services intervention described in this…

  12. Ethnic and Urban Intersections in the Classroom: Latino Students, Hybrid Identities, and Culturally Responsive Pedagogy

    Science.gov (United States)

    Irizarry, Jason G.

    2007-01-01

    Drawing from data collected through classroom observations and in-depth interviews, this article describes and analyzes practices identified as culturally responsive by Latinos students in an urban, multiethnic/racial context. The findings suggest that culturally responsive pedagogy must be more broadly conceptualized to address the cultural…

  13. Using Culturally Competent Responsive Services to Improve Student Achievement and Behavior

    Science.gov (United States)

    Schellenberg, Rita; Grothaus, Tim

    2011-01-01

    This article illustrates standards blending, the integration of core academic and school counseling standards, as a culturally alert responsive services strategy to assist in closing the achievement gap while also enhancing employability skills and culturally salient career competencies. The responsive services intervention described in this…

  14. "Because That's Who I Am": Extending Theories of Culturally Responsive Pedagogy to Consider Religious Identity, Belief, and Practice

    Science.gov (United States)

    Dallavis, Christian

    2011-01-01

    In this conceptual article the author explores the intersection of culturally responsive pedagogy and religious school contexts. He extends theories of culturally responsive pedagogy to consider how religion, a dimension of student culture that has largely been overlooked in the literature surrounding culturally responsive pedagogy, can inflect…

  15. "Because That's Who I Am": Extending Theories of Culturally Responsive Pedagogy to Consider Religious Identity, Belief, and Practice

    Science.gov (United States)

    Dallavis, Christian

    2011-01-01

    In this conceptual article the author explores the intersection of culturally responsive pedagogy and religious school contexts. He extends theories of culturally responsive pedagogy to consider how religion, a dimension of student culture that has largely been overlooked in the literature surrounding culturally responsive pedagogy, can inflect…

  16. Patient safety culture in a Dutch pediatric surgical intensive care unit: an evaluation using the Safety Attitudes Questionnaire.

    Science.gov (United States)

    Poley, Marten J; van der Starre, Cynthia; van den Bos, Ada; van Dijk, Monique; Tibboel, Dick

    2011-11-01

    Nowadays, the belief is widespread that a safety culture is crucial to achieving patient safety, yet there has been virtually no analysis of the safety culture in pediatric hospital settings so far. Our aim was to measure the safety climate in our unit, compare it with benchmarking data, and identify potential deficiencies. Prospective longitudinal survey study at two points in time. Pediatric surgical intensive care unit at a Dutch university hospital. All unit personnel. To measure the safety climate, the Safety Attitudes Questionnaire was administered to physicians, nurses, nursing assistants, pharmacists, technicians, and ward clerks in both May 2006 and May 2007. This questionnaire assesses caregiver attitudes through use of the six following scales: teamwork climate, job satisfaction, perceptions of management, safety climate, working conditions, and stress recognition. Earlier research showed that the Safety Attitudes Questionnaire has good psychometric properties and produced benchmarking data that can be used to evaluate strengths and weaknesses in a given clinical unit against peers. The response rates for the Safety Attitudes Questionnaire were 85% (May 2006) and 74% (May 2007). There were mixed findings regarding the difference between physicians and nurses: on three scales (i.e., teamwork climate, safety climate, and stress recognition), physicians scored better than nurses at both points in time. On another two scales (i.e., perceptions of management and working conditions), nurses consistently had higher mean scale scores. Probably due to the small number of physicians, only some of these differences between physicians and nurses reached the level of statistical significance. Compared to benchmarking data, scores on perceptions of management were higher than expected (p culture in our unit was good when compared to benchmark data, there is still room for improvement. This requires us to continue working on interventions intended to improve the safety

  17. Co-sleeping as a window into Swedish culture: considerations of gender and health care.

    Science.gov (United States)

    Welles-Nystrom, Barbara

    2005-12-01

    The purpose of this study is to examine the Swedish practice of co-sleeping and relate it to the cultural discourse on the gendered family and health. The Swedish study, part of the International Study of Parents, Children and Schools, focuses on some Western parents' ideas about health, child development, child-rearing goals and parental practices. It also addressed specific questions regarding parents' theories about the nature, gender and frequency of co-sleeping in Swedish families. Quantitative and qualitative data were collected with five cohorts of parents and their 60 children who ranged in age from 6 months to 8 years. The sample was balanced for sex and birth order. Parents completed batteries of standardized questionnaires and they were interviewed about their beliefs and practices related to child rearing and child development. A questionnaire about co-sleeping was sent post hoc to the families. The results showed that Swedish children often co-sleep with both their parents until school age, when more boys than girls cease the practice. This is an important finding, because much of the literature suggests that this practice exists primarily for infants in non-Western cultures who co-sleep with their mothers. Co-sleeping in Sweden is perceived as a normal family activity, which differed from the other societies studied. Thus, the study of practice has important methodological implications. When a family practice is studied, carefully documented and understood in its many dimensions, it provides a window into the culture in which the practice is embedded and may explain how gender relates to the practice. For health-care professionals who encounter families from diverse cultural backgrounds, this methodological approach illustrates how parenting practices relate to health-care issues.

  18. Culturally diverse health care students' experiences with teaching strategies in Finland: a national survey.

    Science.gov (United States)

    Pitkajarvi, Marianne; Eriksson, Elina; Pitkala, Kaisu

    2013-06-01

    All over the world, current health care students come from a variety of cultural, linguistic and educational backgrounds. Their expectations and learning needs vary, yet little is known about how our current education system meets their needs. The purpose of this study was to explore culturally diverse health care students' experiences of teaching strategies in polytechnic faculties of health care in Finland. Specifically, we aimed to compare how international students and Finnish students experience the same curriculum. A cross sectional survey. Ten polytechnic faculties of health care in Finland offering English-Language-Taught Degree Programmess (ELTDPs). 283 students studying nursing, public health nursing, or physiotherapy in English. Of these, 166 were international students and 112 were Finnish students. The data were collected using a questionnaire designed specifically for this study. The survey included items grouped into seven dimensions: 1. concreteness of theoretical instruction, 2. encouragement of student activity, 3. use of skills labs, 4. variation among teaching strategies, 5. assessment, 6. interaction in the English-Language-Taught Degree Programmes, and 7. approach to diversity in the English-Language-Taught Degree Programmes. The most positive experiences for all students were with the approach to cultural diversity and the concreteness of theoretical instruction, whereas the most negative experiences were with assessment. International students' experiences were more positive than Finnish students' in the following dimensions: encouragement of student activity (p=0.005), variation among teaching strategies (p<0.001), and assessment (p<0.001). Compared to the Finnish students, more than double the number of international students were dissatisfied with their lives (p<0.001). The implications for education include the strengthening teachers' leadership role in small group activities, providing individual and detailed feedback, and ensuring

  19. CHIP: Facilitating Interprofessional and Culturally Competent Patient Care Through Experiential Learning in China.

    Science.gov (United States)

    Mu, Keli; Peck, Kirk; Jensen, Lou; Bracciano, Al; Carrico, Cathy; Feldhacker, Diana

    2016-12-01

    Health care professionals have advocated for educating culturally competent practitioners. Immersion in international experiences has an impact on student cultural competency and interprofessional development. The China Honors Interprofessional Program (CHIP) at a university in the Midwest is designed to increase students' cultural competency and interprofessional development. From 2009 to 2013, a total of 25 professional students including twelve occupational therapy students, ten physical therapy students and three nursing students were enrolled in the programme. Using a one group pre and posttest research design, this study evaluated the impact of CHIP on the participating students. Both quantitative and qualitative data were collected in the study. Findings of the study revealed that CHIP has impact on students' cultural competency and professional development including gaining appreciation and understanding of the contributions of other healthcare professionals and knowledge and skills in team work. The findings of the study suggested that international immersion experience such as CHIP is an important way to increase students' cultural competency and interprofessional knowledge and skills. Limitations of the study included the small sample in the study, indirect outcome measures and the possible celling effect of the instruments of the study. Future research studies should include a larger and more representative sample, direct outcome measures such as behaviour observation and more rigorous design such as prospective experimental comparison group design. Future research should also examine the long-term effects of international experience on the professional development of occupational therapy students. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. The Ethical Turn in Commodity Culture: Consumption, Care and the Other

    Directory of Open Access Journals (Sweden)

    Tania Lewis

    2011-06-01

    Full Text Available In a small courtyard at the University of Melbourne, there is an unprepossessing, somewhat makeshift looking outdoor café called KereKere. The coffee on offer is organic, Fair Trade, Rainforest alliance-branded and sustainable: a list of options we’ve increasingly come to expect even in corporate café chains such as Starbucks. But at this café, customers are also asked to decide how the profits from that sale are distributed every time they buy a coffee. As customers are handed their order, they are also presented with playing cards that allow them to choose from a list of causes where the café’s profits will go. The café thus operates in the spirit of ‘kerekere’, a Fijian custom in which a relative or neighbour can request something that is needed and it must be willingly given with no expectation of repayment. The café’s young ethically minded owner sees this process as fostering ‘a culture that promotes community wellbeing’. At this café, the traditional economic exchange associated with the purchase of a cup of coffee has been subtly moved into other territories through the introduction of questions of gift giving, and of responsibility, care and even love (as we see here, the café’s logo is a coffee cup with a series of hearts rising from it into the exchange ritual. Such attempts by social justice-oriented businesses to reconfigure the privatized moment of spending as a communal act, thus positioning consumer choice as a site of responsibility, are increasingly commonplace in today’s marketplace. No longer purely associated with fringe politics or hippie lifestyles, terms such as ‘ethical’ and ‘responsible’ shopping and ‘conscience consumption’, are increasingly entering into the everyday language as well as the shopping experiences and practices of so-called ‘ordinary’ consumers.

  1. Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

    Science.gov (United States)

    Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; O'Keeffe, Daniel F

    2015-01-01

    Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have roles in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now.

  2. Culture and long-term care: the bath as social service in Japan.

    Science.gov (United States)

    Traphagan, John W

    2004-01-01

    A central feature of Japan's approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difflcult task of bathing a frail or disabled elder--a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States.

  3. Join the Revolution: How Montessori for Aging and Dementia can Change Long-Term Care Culture.

    Science.gov (United States)

    Bourgeois, Michelle S; Brush, Jennifer; Elliot, Gail; Kelly, Anne

    2015-08-01

    Efforts to improve the quality of life of persons with dementia in long-term care through the implementation of various approaches to person-centered care have been underway for the past two decades. Studies have yielded conflicting reports evaluating the evidence for these approaches. The purpose of this article is to outline the findings of several systematic reviews of this literature, highlighting the areas of improvement needs, and to describe a new person-centered care model, DementiAbility Methods: The Montessori Way. This model focuses on the abilities, needs, interests, and strengths of the person and creating worthwhile and meaningful roles, routines, and activities for the person within a supportive physical environment. This is accomplished through gaining the commitment of the facility's leaders, training staff, and monitoring program implementation. The potential for a culture change in long-term care environments is dependent on the development and rigorous evaluation of person-centered care approaches. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Cultural aspects in family care for children with malnutrition/ Aspectos culturais no cuidado familiar a crianca com desnutricao

    National Research Council Canada - National Science Library

    Frota, Mirna Albuquerque; Martins, Mariana Cavalcante; de Albuquerque, Conceicao de Maria

    2009-01-01

    This study aimed to identify the cultural factor that interferes with the care of undernourished children and to propose actions of Popular Health Education in the assistance of undernourished children...

  5. [Self-responsibility as a component of quality-oriented care-reflections on further development of nursing care insurance].

    Science.gov (United States)

    Gohde, J

    2005-08-01

    Further development of nursing care insurance must consider both ethical aspects and scarcity of resources. An economy that serves human life has two principal targets: safeguarding the basis of existence and extension of the fulfillment of life. From an ethical perspective welfare and personal responsibility have to be equilibrated by promoting individuality and self-responsibility and maintaining relatives' willingness to become a caregiver. Discussing the role of prevention and rehabilitation in nursing care it is argued that the legally committed primacy of prevention and rehabilitation over care has still not been put into practise due to unresolved problems at the interface of health insurance and nursing care insurance as well as at the interface of inpatient and outpatient providers. Moreover, it seems necessary to strengthen prevention and rehabilitation in the context of care. A comprehensive understanding of individual demands for help, support, and care requires a revision of the common definition of need for care in terms of activities of daily living which neglects particularly psycho-social needs. Case management is a suitable approach to provide adequate and coordinated support as a prerequisite for quality of life in people in need for care. Overcoming compartmentalization of inpatient and outpatient sectors and crosslinking of services are described as essential challenges for future provision of nursing care insurance. Intensification of counseling and advice for patients and relatives, extension and diversification of local providers, upgrading of ambulant services, daily care and short-term care, diversification of nursing homes and other housing arrangements, further development of hospices and palliative care, and acceptance of institutions for the elderly as indispensable components of the future care system are discussed as specific tasks in the further development of nursing care insurance.

  6. Beneficial Coercion in Psychiatric Care: Insights from African Ethico-Cultural System.

    Science.gov (United States)

    Ewuoso, Cornelius Olukunle

    2016-12-19

    There is a 'catch 22' situation about applying coercion in psychiatric care. Autonomous choices undeniably are rights of patients. However, emphasizing rights for a mentally-ill patient could jeopardize the chances of the patient receiving care or endanger the public. Conversely, the beneficial effects of coercion are difficult to predict. Thus, applying coercion in psychiatric care requires delicate balancing of individual-rights, individual well-being and public safety, which has not been achieved by current frameworks. Two current frameworks may be distinguished: the civil liberty approach and the Stone model. Both frameworks are restrictive, and not respectful of human dignity. In a civil liberty approach, individuals who are severely mentally-ill but not dangerous would be denied care because they do not meet the dangerousness threshold or because the use of coercion will not lead to rebirthing of autonomy. This is unsatisfactory. Albeit involuntary interventions such as talk therapies, peer-support etc., may not always lead to rebirthing of autonomy or free patients from mental illness; they can however help to maintain the dignity of each mentally ill patient. In place of these frameworks, this study proposes a new ethical framework for applying coercion in psychiatric care that is respectful of human dignity. Specifically, it draws on insights from the African ethico-cultural system by using the Yoruba concept Omo-olu-iwabi to develop this new framework. This way, the study shows that only a more respectful approach for applying coercion in psychiatric care can lead to the careful balancing of the competing interests of individual's rights, individual's well-being and public safety. © 2016 John Wiley & Sons Ltd.

  7. Development and testing of the 'Culture of Care Barometer' (CoCB) in healthcare organisations: a mixed methods study.

    Science.gov (United States)

    Rafferty, Anne Marie; Philippou, Julia; Fitzpatrick, Joanne M; Pike, Geoff; Ball, Jane

    2017-08-18

    Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. An exploratory mixed methods study designed to develop and test the validity of a tool to measure 'culture of care' through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

  8. The ethical leadership challenge: creating a culture of patient- and family-centered care in the hospital setting.

    Science.gov (United States)

    Piper, Llewellyn E

    2011-01-01

    The growing number of medical errors and resulting preventable deaths in hospitals presents an ethical dilemma that must be addressed by health care leaders and managers. These medical errors and deaths raise questions about safety and quality issues resulting in rising public mistrust and patient dissatisfaction. Many of these medical errors and deaths could have been avoided by including the patient and family in the care. The ethical challenge for leadership is creating a culture of patient- and family-centered care as a means to improve quality, safety, patient satisfaction, and public trust. This article addresses ways to improve safety, quality, patient satisfaction, and cost and thereby reduce medical errors and deaths by implementing a patient- and family-centered care culture. The first critical step for improvement is for hospital leaders and managers to answer the ethical call to create a culture centered on patient- and family-centered care in the hospital setting.

  9. Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care.

    Science.gov (United States)

    Hahtela, Nina; Paavilainen, Eija; McCormack, Brendan; Slater, Paul; Helminen, Mika; Suominen, Tarja

    2015-10-01

    To explore the influence of workplace culture on sickness absences, overtime work and occupational injuries in municipal primary health care. The need to improve nursing sensitive outcomes has been highlighted. Therefore, an adequate understanding of the influence of workplace culture on nursing-sensitive nurse outcomes is essential for nurse managers to meet the requirements of improving nursing outcomes. A cross-sectional survey design was used to incorporating the data from 21 inpatient acute care units of nine organisations at the Finnish municipal primary health care system from 2011 to 2012. Findings emphasise in particular the importance of the practice environment as being an interpretative factor for nurses' absences owing to sickness, overtime work and occupational injuries. To ensure favourable nursing sensitive outcomes it is essential that there is a shared interest in the unit to invest in the creation of a supportive practice environment. Outcome improvements require a special focus on issues related to nursing management, adequate staffing and resources and intention to leave. © 2014 John Wiley & Sons Ltd.

  10. The Polyacetylenes Falcarinol and Falcarindiol Affect Stress Responses in Myotube Cultures in a Biphasic Manner

    OpenAIRE

    Young, Jette F; Christensen, Lars P.; Theil, Peter K.; Oksbjerg, Niels

    2008-01-01

    The effects of the bioactive polyacetylenes, falcarinol and falcarindiol, present in carrots, celery, celeriac and other umbelliferous vegetables, on the stress responses in primary myotube cultures, were studied. Biphasic responses on cellular stress responses in myotube cultures were investigated by exposing them to various concentrations of falcarinol and falcarindiol for 24 h before testing effects of 100 μM H2O2 on the intracellular formation of reactive oxygen species (ROS), transcripti...

  11. Responsiveness of culture-based segmentation of organizational buyers

    Directory of Open Access Journals (Sweden)

    Veronika Jadczaková

    2013-01-01

    Full Text Available Much published work over the four decades has acknowledged market segmentation in business-to-business settings yet primarily focusing on observable segmentation bases such as firmographics or geographics. However, such bases were proved to have a weak predictive validity with respect to industrial buying behavior. Therefore, this paper attempts to add a debate to this topic by introducing new (unobservable segmentation base incorporating several facets of business culture, denoted as psychographics. The justification for this approach is that the business culture captures the collective mindset of an organization and thus enables marketers to target the organization as a whole. Given the hypothesis that culture has a merit for micro-segmentation a sample of 278 manufacturing firms was first subjected to principal component analysis and Varimax to reveal underlying cultural traits. In next step, cluster analysis was performed on retained factors to construct business profiles. Finally, non-parametric one-way analysis of variance confirmed discriminative power between profiles based on psychographics in terms of industrial buying behavior. Owing to this, business culture may assist marketers when targeting more effectively than some traditional approaches.

  12. Oviposition Attractancy of Bacterial Culture Filtrates: response of Culex quinquefasciatus

    Directory of Open Access Journals (Sweden)

    S Poonam

    2002-04-01

    Full Text Available Oviposition attractants could be used for monitoring as well as controlling mosquitoes by attracting them to lay eggs at chosen sites. In the present study, culture filtrates of seven bacterial species were tested for their attractancy against gravid females of Culex quinquefasciatus. When their oviposition active indices (OAI were studied, the culture filtrates of Bacillus cereus and Pseudomonas fluorescens exhibited oviposition attractancy (OAI = >0.3 at 100 ppm and the OAI were respectively 0.70 and 0.47. Culture filtrates of B. thuringiensis var. israelensis (wild type, B. t. var. israelensis (mutant and B. sphaericus showed attractancy at 2000 ppm with OAI of respectively 0.71, 0.59 and 0.68. However, the OAI of B. megaterium as well as Azospirillum brasilense was 0.13 (at 2000 ppm, which was less than 0.3 required to be considered them as attractants. When the oviposition attractancy of the bacterial culture filtrates were compared with that of a known oviposition attractant, p-cresol (at 10 ppm, the culture filtrates of B. t. var. israelensis (wild type and B. cereus were found to be more active than p-cresol, respectively with 64.2 and 54.3% oviposition.

  13. Development and evaluation of a teaching and learning approach in cross-cultural care and antidiscrimination in university nursing students.

    Science.gov (United States)

    Allen, Jacqui; Brown, Lucinda; Duff, Carmel; Nesbitt, Pat; Hepner, Anne

    2013-12-01

    Cross-cultural care and antidiscrimination are vital to ethical effective health systems. Nurses require quality educational preparation in cross-cultural care and antidiscrimination. Limited evidence-based research is available to guide teachers. To develop, implement and evaluate an evidence-based teaching and learning approach in cross-cultural care and antidiscrimination for undergraduate nursing students. A quantitative design using pre- and post-survey measures was used to evaluate the teaching and learning approach. The Bachelor of Nursing program in an Australian university. Academics and second year undergraduate nursing students. A literature review and consultation with academics informed the development of the teaching and learning approach. Thirty-three students completed a survey at pre-measures and following participation in the teaching and learning approach at post-measures about their confidence to practice cross-cultural nursing (Transcultural Self-efficacy Tool) and about their discriminatory attitudes (Quick Discrimination Index). The literature review found that educational approaches that solely focus on culture might not be sufficient in addressing discrimination and racism. During consultation, academics emphasised the importance of situating cross-cultural nursing and antidiscrimination as social determinants of health. Therefore, cross-cultural nursing was contextualised within primary health care and emphasised care for culturally diverse communities. Survey findings supported the effectiveness of this strategy in promoting students' confidence regarding knowledge about cross-cultural nursing. There was no reported change in discriminatory attitudes. The teaching and learning approach was modified to include stronger experiential learning and role playing. Nursing education should emphasise cross-cultural nursing and antidiscrimination. The study describes an evaluated teaching and learning approach and demonstrates how evaluation

  14. Tissue Culture Responses from Different Explants of Rice

    Institute of Scientific and Technical Information of China (English)

    WANG Xiu-hong; SHI Xiang-yuan; WU Xian-jun

    2005-01-01

    Different culture explants, including anther, young panicle, young embryo, and mature embryo, from 19 rice varieties were used for callus induction and green plantlet differentiation. The culture efficiency differed significantly among the four types of explants, and varied from genotype to genotype. Callus induction frequency presented significantly positive correlation each between anther and young panicle, anther and mature embryo, and young panicle and young embryo. Green plantlet differentiation showed no relationship between different types of explants. In addition, no relationship was found between callus induction frequency and green plantlet differentiation frequency.

  15. Safety Culture in Neonatal Intensive Care Units in the Gaza Strip, Palestine: A Need for Policy Change.

    Science.gov (United States)

    Abu-El-Noor, Nasser Ibrahim; Hamdan, Motasem Abduallah; Abu-El-Noor, Mysoon Khalil; Radwan, Abdal-Karim Said; Alshaer, Ahmed Ali

    Assessment of the prevailing safety culture within the Gazan health care system can be used to identify problem areas. Specifically, the need for improvements, raising awareness about patient safety, the identification and evaluation of existing safety programs and interventions for improving the safety culture. This study aims to assess the safety culture in the neonatal intensive care units (NICUs) in Gaza Strip hospitals and to assess the safety culture in regards to caregivers' characteristics. In a cross-sectional study using a census sample, we surveyed all nurses and physicians working in at all the NICUs in the Gaza Strip, Palestine. The Safety Attitudes Questionnaire (SAQ) which includes six scales was used to assess participants' attitudes towards safety culture. The overall score for SAQ was 63.9. Domains' scores ranged between 55.5 (perception of management) and 71.8 (stress recognition). The scores reported by our participants fell below the 75 out of a possible score of 100, which was considered as a cut-off point for a positive score. Moreover, our results revealed substantial variation in safety culture domain scores among participating NICUs. These results should be an indicator to our health care policy makers to modify current or adopt new health care policies to improve safety culture. It should also be a call to design customized programs for improving the safety culture in NICUs in the Gaza Strip. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Early Child Care Teachers' Socialization Goals and Preferred Behavioral Strategies: A Cross-Cultural Comparison

    Science.gov (United States)

    Gernhardt, Ariane; Lamm, Bettina; Keller, Heidi; Döge, Paula

    2014-01-01

    This study investigated early child care teachers' culturally shaped socialization goals and preferred behavioral strategies. The participants were 183 female teachers and trainees, 93 from Osnabrück, Germany, representing an urban Western context, which can be characterized by a primary cultural orientation toward psychological autonomy and…

  17. African-Americans' perceptions of health care provider cultural competence that promote HIV medical self-care and antiretroviral medication adherence.

    Science.gov (United States)

    Gaston, Gina B

    2013-01-01

    Most studies of cultural competence in healthcare examine healthcare providers' definitions of cultural competence practices. This study is unique in that it examines the relationship between African-American patients' perceptions of the cultural competence of their HIV healthcare providers and the adherence of these patients to medical self-care and antiretroviral therapy (ART). This cross-sectional, exploratory, descriptive study was conducted at the Ruth Rothstein CORE Center in Chicago, Illinois. The sample consisted of 202 HIV-positive African-Americans who completed surveys during clinic visits. Multiple measures were used, including the Patient Assessments of Cultural Competency survey instrument developed by the Department of Health and Human Services Agency for Healthcare Research and Quality. Medical self-care was measured using the advice and instructions scale and the self-care symptom management for people living with HIV/AIDS categorical scale. ART adherence was measured using the Adherence Behaviors Self-Report and Adherence Self-Report scales. The data revealed many significant correlations between variables. The more patients believed that providers should integrate culture in HIV treatment; the better their reported health (F1,138=0.151, P=0.05) and the more they followed their provider's advice and instructions (medical self-care; F1,138=0.029, P=0.05). Participants who trusted their providers engaged in more medical self-care (F1,138=0.280, P=0.01). More shared treatment decisions were reported among participants who had higher levels of education (F1,127=0.337, P=0.05). Findings of this study indicate the need for increased attention to the role of cultural competence in HIV/AIDS care. Understanding patient perceptions of provider cultural competence has the potential to improve HIV treatment adherence and health outcomes.

  18. Learning to live with a child with diabetes--problems related to immigration and cross-cultural diabetes care

    DEFF Research Database (Denmark)

    Povlsen, Lene; Ringsberg, Karin C

    2009-01-01

    perceived learning to live with a child with diabetes. This was done in order to identify potential problems related to immigration and cross-cultural care which should be considered in the provision of diabetes care to immigrant families. Data were collected by semi-structured interviews with Arabic...

  19. Lessons to Exchange: A Comparison of Long-Term Care Between Two Cultures: Uganda and Singapore.

    Science.gov (United States)

    Tam, Wai Jia; Yap, Philip

    2015-12-01

    Today, both the developed and developing world are facing fast-aging populations. Projections show that by 2050, 80% of the world's older persons will live in low and middle-income countries. As developed countries look to institutionalization as one of the means to cope with the challenges of long-term care of seniors, the developing world, with a different cultural, socioeconomic, and environmental context, may yet offer insights that instruct and inspire. By analyzing and comparing the approaches, context, and progress of Singapore and Uganda in coping with frail and dependent seniors, this article provides lessons about what the developing and developed world can offer each other, and in turn, teach us about long-term care of seniors.

  20. Cultural differences in survey responding: Issues and insights in the study of response biases.

    Science.gov (United States)

    Kemmelmeier, Markus

    2016-12-01

    This paper introduces the special section "Cultural differences in questionnaire responding" and discusses central topics in the research on response biases in cross-cultural survey research. Based on current conceptions of acquiescent, extreme, and socially desirable responding, the author considers current data on the correlated nature of response biases and the conditions under which different response styles they emerge. Based on evidence relating different response styles to the cultural dimension of individualism-collectivism, the paper explores how research presented as part of this special section might help resolves some tensions in this literature. The paper concludes by arguing that response styles should not be treated merely as measurement error, but as cultural behaviors in themselves.

  1. Achieving excellence in private intensive care units: The effect of transformational leadership and organisational culture on organisational change outcomes

    Directory of Open Access Journals (Sweden)

    Portia J. Jordan

    2015-03-01

    Full Text Available Orientation: Organisational change outcomes in private intensive care units are linked to higher patient satisfaction, improved quality of patient care, family support, cost-effective care practices and an increased level of excellence. Transformational leadership and fostering a positive organisational culture can contribute to these change outcomes.Research purpose: The study determined whether transformational leadership and a supportive organisational culture were evident in six private intensive care units in the Eastern Cape, South Africa. A conceptual framework to investigate the relationship between transformational leadership, organisational culture, and organisational change outcomes, was proposed and tested.Motivation for the study: The prevalence of transformational leadership, a positive organisational culture and their effect on organisational change outcomes in private healthcare industries require further research in order to generate appropriate recommendations.Research design, approach and method: A positivistic, quantitative design was used. A survey was conducted using a questionnaire which, in previous studies, produced scores with Cronbach’s alpha coefficients greater than 0.80, to collect data from a sample of 130 professional nurses in private intensive care units.Main findings: Transformational leadership and a positive organisational culture were evident in the private intensive care units sampled. A strong, positive correlation exists between transformational leadership, organisational culture, and organisational change outcomes. This correlation provides sufficient evidence to accept the postulated research hypotheses. Innovation and intellectual stimulation were identified as the factors in need of improvement.Practical or managerial implications: The findings of the study may be used by managers in intensive care units to promote organisational change outcomes, linked to transformational leadership and a positive

  2. Shades of truth: cultural and psychological factors affecting communication in pediatric palliative care.

    Science.gov (United States)

    Hatano, Yutaka; Yamada, Miwa; Fukui, Kenji

    2011-02-01

    Communication with children who have life-threatening illnesses is a major challenge. Communication practices are greatly influenced by factors such as the child's age, the parents' wishes, and the cultural norms. This article presents the case of a 12-year-old Japanese boy with advanced hepatoblastoma. The patient also was diagnosed with Asperger's syndrome, which impairs interpersonal communication. The case is discussed from the perspective of clinical ethics, especially with regard to truth telling. The health care team faced an ethical dilemma because of the complications involved. Physicians treating children with cancer should be aware of these issues to be able to effectively communicate with their patients.

  3. Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care.

    Science.gov (United States)

    Lopez-Class, Maria; Perret-Gentil, Monique; Kreling, Barbara; Caicedo, Larisa; Mandelblatt, Jeanne; Graves, Kristi D

    2011-12-01

    Breast cancer is the most common cancer among Latinas. This study examined social, cultural, and health care system factors that impact the quality of life and survivorship experiences of Latina immigrant breast cancer survivors. We interviewed Latina breast cancer survivors (n = 19) and, based on the interview findings, conducted two focus groups (n = 9). Research staff translated transcripts from Spanish into English. Two trained raters reviewed the content and identified themes. Thematic content analysis was used to categorize and organize data. Participants were largely monolingual in Spanish, predominantly from Central and South America and most (68%) had lived in the U.S. for ten or more years. All women were diagnosed and treated in the U.S. and were an average of 3.1 years from diagnosis. Women's survivorship experiences appeared to be shaped by cultural beliefs and experiences as immigrants such as secrecy/shame about a breast cancer diagnosis, feelings of isolation, importance of family support (familism), challenges with developing social relationships in the U.S. (less personalismo), and, for some, their partner's difficulty with showing emotional support (machismo). Navigating the U.S. medical system and language barriers were additional challenges in the participants' health care interactions. Latina breast cancer survivors adhere to certain cultural values and face unique issues as immigrants, potentially influencing overall quality of life and doctor-patient communication. Efforts to improve Latina immigrant breast cancer survivors' quality of life could include increased assessment of psychosocial functioning and referral to social support services, culturally sensitive navigation programs, and consistent use of appropriately trained interpreters.

  4. Quality of Life among Immigrant Latina Breast Cancer Survivors: Realities of Culture and Enhancing Cancer Care

    Science.gov (United States)

    Lopez-Class, Maria; Perret-Gentil, Monique; Kreling, Barbara; Caicedo, Larisa; Mandelblatt, Jeanne; Graves, Kristi D.

    2012-01-01

    Objectives Breast cancer is the most common cancer among Latinas. This study examined social, cultural, and health care system factors that impact quality of life and survivorship experiences of Latina immigrant breast cancer survivors. Design We interviewed Latina breast cancer survivors (n=19) and, based on the interview findings, conducted two focus groups (n=9). Research staff translated transcripts from Spanish into English. Two trained raters reviewed the content and identified themes. Thematic content analysis was used to categorize and organize data. Results Participants were largely mono-lingual in Spanish, predominantly from Central and South America and most (68%) had lived in the U.S. for 10 or more years. All women were diagnosed and treated in the U.S. and were an average of 3.1 years from diagnosis. Women’s survivorship experiences appeared to be shaped by cultural beliefs and experiences as immigrants such as secrecy/shame about a breast cancer diagnosis, feelings of isolation, importance of family support (familism), challenges with developing social relationships in the U.S. (less personalismo), and, for some, their partner’s difficulty with showing emotional support (machismo). Navigating the U.S. medical system and language barriers were additional challenges in participants’ health care interactions. Conclusion Latina breast cancer survivors adhere to certain cultural values and face unique issues as immigrants, potentially influencing overall quality of life and doctor-patient communication. Efforts to improve Latina immigrant breast cancer survivors’ quality of life could include increased assessment of psychosocial functioning and referral to social support services, culturally-sensitive navigation programs and consistent use of appropriately trained interpreters. PMID:21706194

  5. Culturally Responsive L2 Education: An Awareness-Raising Proposal

    Science.gov (United States)

    Porto, Melina

    2010-01-01

    The increasing prevalence of multilingual, multiethnic, and multicultural classrooms in varied educational contexts worldwide points to the importance of cultural factors in language education and education in general. In the EFL/ESL classroom of this century, ELT is seen as including much more than purely linguistic aspects as it focuses also on…

  6. Development of a Culturally Responsive Nutrition Promotion Course for Latinos

    Science.gov (United States)

    Frank, Gail C.; Beaudoin, Jessica; Rascon, Mayra; Garcia-Vega, Melawhy; Rios-Ellis, Britt

    2013-01-01

    The health of Hispanics is greatly influenced by level of education, socioeconomic status, and access to healthcare (United States Department of Health and Human Services [DHHS], 2011). To address this issue and to reduce health disparities among all ethnic groups, community based interventions with culturally appropriate and linguistically…

  7. Socio-Cultural Norms for Corporate Social Responsibility

    DEFF Research Database (Denmark)

    Kampf, Constance Elizabeth

    Abstract – This paper considers the cultural resources for corporate action tied into stakeholder models, criticizes current stakeholder models, and develops a perspective based in ethics and the political model of the stakeholder. The purpose of this analysis is to lay out models which recognize...

  8. Socio-Cultural Norms for Corporate Social Responsibility

    DEFF Research Database (Denmark)

    Kampf, Constance Elizabeth

    Abstract – This paper considers the cultural resources for corporate action tied into stakeholder models, criticizes current stakeholder models, and develops a perspective based in ethics and the political model of the stakeholder. The purpose of this analysis is to lay out models which recognize...

  9. Development of a Culturally Responsive Nutrition Promotion Course for Latinos

    Science.gov (United States)

    Frank, Gail C.; Beaudoin, Jessica; Rascon, Mayra; Garcia-Vega, Melawhy; Rios-Ellis, Britt

    2013-01-01

    The health of Hispanics is greatly influenced by level of education, socioeconomic status, and access to healthcare (United States Department of Health and Human Services [DHHS], 2011). To address this issue and to reduce health disparities among all ethnic groups, community based interventions with culturally appropriate and linguistically…

  10. Making Culturally Responsive Mathematics Teaching Explicit: A Lesson Analysis Tool

    Science.gov (United States)

    Aguirre, Julia M.; Zavala, Maria del Rosario

    2013-01-01

    In the United States, there is a need for pedagogical tools that help teachers develop essential pedagogical content knowledge and practices to meet the mathematical education needs of a growing culturally and linguistically diverse student population. In this article, we introduce an innovative lesson analysis tool that focuses on integrating…

  11. Making Culturally Responsive Mathematics Teaching Explicit: A Lesson Analysis Tool

    Science.gov (United States)

    Aguirre, Julia M.; Zavala, Maria del Rosario

    2013-01-01

    In the United States, there is a need for pedagogical tools that help teachers develop essential pedagogical content knowledge and practices to meet the mathematical education needs of a growing culturally and linguistically diverse student population. In this article, we introduce an innovative lesson analysis tool that focuses on integrating…

  12. Collaborative Voices Exploring Culturally and Socially Responsive Literacies

    Science.gov (United States)

    Medina, Carmen L.; del Rocio Costa, Maria

    2010-01-01

    This piece shares preservice teachers and instructors reflections on their perceptions of a course on Spanish language arts methods in Puerto Rico. The course was redesigned to focus on interrelated curricular and pedagogical aspects such as literacies as situated social practice, funds of knowledge, popular culture and critical literacy. In…

  13. Challenges of mediated communication, disclosure and patient autonomy in cross-cultural cancer care.

    Science.gov (United States)

    Kai, J; Beavan, J; Faull, C

    2011-09-27

    Evidence concerning the influence of ethnic diversity on clinical encounters in cancer care is sparse. We explored health providers' experiences in this context. Focus groups were conducted with a purposeful sample of 106 health professionals of differing disciplines, in 18 UK primary and secondary care settings. Qualitative data were analysed using constant comparison and processes for validation. Communication and the quality of information exchanged with patients about cancer and their treatment was commonly frustrated within interpreter-mediated consultations, particularly those involving a family member. Relatives' approach to ownership of information and decision making could hinder assessment, informed consent and discussion of care with patients. This magnified the complexity of disclosing information sensitively and appropriately at the end of life. Professionals' concern to be patient-centred, and regard for patient choice and autonomy, were tested in these circumstances. Health professionals require better preparation to work effectively not only with trained interpreters, but also with the common reality of patients' families interpreting for patients, to improve quality of cancer care. Greater understanding of cultural and individual variations in concepts of disclosure, patient autonomy and patient-centredness is needed. The extent to which these concepts may be ethnocentric and lack universality deserves wider consideration.

  14. Standardization and Whiteness: One and the Same? A Response to "There Is No Culturally Responsive Teaching Spoken Here"

    Science.gov (United States)

    Weilbacher, Gary

    2012-01-01

    The article "There Is No Culturally Responsive Teaching Spoken Here: A Critical Race Perspective" by Cleveland Hayes and Brenda C. Juarez suggests that the current focus on meeting standards incorporates limited thoughtful discussions related to complex notions of diversity. Our response suggests a strong link between standardization and White…

  15. Leadership style and culturally competent care: Nurse leaders' views of their practice in the multicultural care settings of the United Arab Emirates.

    Science.gov (United States)

    El Amouri, Souher; O'Neill, Shirley

    2014-06-20

    Abstract It is well recognised that nurse leader managers play an important role in facilitating the quality and nature of hospital care, the improvement of work performance and work satisfaction. In the United Arab Emirates (UAE) they face the additional challenge of working within a context of significant linguistic and cultural diversity where leadership in the provision of culturally competent care is a major requirement. With this goal at the fore, a sample of 153 nurse-leader-managers, including matrons, nursing directors, supervisors, nurses-in-charge and in-service education staff from four private and six government hospitals completed the Multifactor Leadership Questionnaire (Bass & Avolio, 2004). The survey also explored participants' perceptions of the characteristics of good leaders and what they needed to do in their particular work place to enhance culturally competent care. The results showed nurseleader-managers used both transformational and transactional leadership attributes but in different combinations across the two hospital types.

  16. Identification of cultural determinants of antibiotic use cited in primary care in Europe: a mixed research synthesis study of integrated design "Culture is all around us".

    Science.gov (United States)

    Touboul-Lundgren, Pia; Jensen, Siri; Drai, Johann; Lindbæk, Morten

    2015-09-17

    Inappropriate antibiotic prescribing, particularly for respiratory tract infections (RTI) in ambulatory care, has become a worldwide public health threat due to resulting antibiotic resistance. In spite of various interventions and campaigns, wide variations in antibiotic use persist between European countries. Cultural determinants are often referred to as a potential cause, but are rarely defined. To our knowledge, so far no systematic literature review has focused on cultural determinants of antibiotic use. The aim of this study was to identify cultural determinants, on a country-specific level in ambulatory care in Europe, and to describe the influence of culture on antibiotic use, using a framework of cultural dimensions. A computer-based systematic literature review was conducted by two research teams, in France and in Norway. Eligible publications included studies exploring antibiotic use in primary care in at least two European countries based on primary study results, featuring a description of cultural determinants, and published between 1997 and 2015. Quality assessment was conducted independently by two researchers, one in each team, using appropriate checklists according to study design. Each included paper was characterized according to method, countries involved, sampling and main results, and cultural determinants mentioned in each selected paper were extracted, described and categorized. Finally, the influence of Hofstede's cultural dimensions associated with antibiotic consumption within a primary care setting was described. Among 24 eligible papers, 11 were rejected according to exclusion criteria. Overall, 13 papers meeting the quality assessment criteria were included, of which 11 used quantitative methods and two qualitative or mixed methods. The study participants were patients (nine studies) and general practitioners (two studies). This literature review identified various cultural determinants either patient-related (illness perception

  17. The Cultural Meaning of Cardiac Illness and Self-Care Among Lebanese Patients With Coronary Artery Disease.

    Science.gov (United States)

    Dumit, Nuhad Yazbik; Magilvy, Joan Kathy; Afifi, Rima

    2016-07-01

    Cardiac disease is the leading cause of death in Lebanon, accounting for 22% to 26% of total deaths in the country. A thorough understanding of perceptions of cardiac illness and related self-care management is critical to the development of secondary prevention programs that are specific to the Lebanese culture. To explore the cultural perceptions of cardiac illness and the associated meaning of self-care among Lebanese patients. Using a qualitative descriptive method, semistructured interviews were conducted with a purposive sample of 15 Lebanese cardiac patients recruited from a medical center in Beirut, Lebanon. The qualitative descriptive analysis yielded one overarching and two other themes describing perceptions of cardiac illness and self-care within the Lebanese cultural context. The overarching cultural theme was, "Lebanese cardiac patients were unfamiliar with the term concept and meaning of self-care." Lebanese cardiac patients thanked God and accepted their fate (Theme I). The participants considered their cardiac incident a life or death warning (Theme II). Health care providers need to consider patients' cultural perception of illness while planning and evaluating cardiac self-care programs. © The Author(s) 2015.

  18. Assessing the responsiveness of chronic disease care - is the World Health Organization's concept of health system responsiveness applicable?

    Science.gov (United States)

    Röttger, Julia; Blümel, Miriam; Fuchs, Sabine; Busse, Reinhard

    2014-07-01

    The concept of health system responsiveness is an important dimension of health system performance assessment. Further efforts have been made in recent years to improve the analysis of responsiveness measurements, yet few studies have applied the responsiveness concept to the evaluation of specific health care delivery structures. The objective of this study was to test the World Health Organization's (WHO's) responsiveness concept for an application in the evaluation of chronic disease care. In September and October 2012 we conducted four focus groups of chronically ill people (n = 38) in Germany, in which participants discussed their experiences and expectations regarding health care. The data was analyzed deductively (on the basis of the WHO responsiveness concept) and inductively using directed content analysis. Ten themes related to health system responsiveness and one theme (finances) not directly related to health system responsiveness, but of high importance to the focus group participants, could be identified. Eight of the ten responsiveness themes are consistent with the WHO concept. Additionally, two new themes were identified: trust (consultation and treatment are not led by any motive other than the patients' wellbeing) and coordination (treatment involving different providers is coordinated and different actors communicate with each other). These findings indicate the suitability of the WHO responsiveness concept for the evaluation of chronic disease care. However, some amendments, in particular an extension of the concept to include the two domains trust and coordination, are necessary for a thorough assessment of the responsiveness of chronic disease care.

  19. Temperature and photoperiod responses of soybean embryos cultured in vitro

    Science.gov (United States)

    Raper, C. D. Jr; Patterson, R. P.; Raper CD, J. r. (Principal Investigator)

    1986-01-01

    Temperature and photoperiod each have direct effects on growth rate of excised embryos of soybean (Glycine max (L.) Merrill). To determine if the effects of photoperiod are altered by temperature, embryos of 'Ransom II' were cultured in vitro at 18, 24, and 30 degrees C under photoperiod durations of 12 and 18 h at an irradiance of 9 W m-2 (700 to 850 nm) and a photosynthetic photon flux density of 58 micromoles m-2 s-1 (400 to 700 nm). Accumulation rates of fresh and dry weight were greater under 18-h than 12-h photoperiods over the entire range of temperature. Water content of the culture embryos was not affected by photoperiod but was greater at 18 and 30 than 24 degrees C. The accumulation rate of dry weight increased from 18 to 26 but declined at 30 degrees C.

  20. Empowerment and responsibility of the culture of peace through education

    Directory of Open Access Journals (Sweden)

    Mariela Inés Sánchez Cardona

    2012-01-01

    Full Text Available This article seeks to highlight the possibilities of empowering the culture of peace in the society in general, so it is necessary a joint work of different actors and social institutions. In this perspective each individual must transcend commitment to the peace of the personal to the social, also the State specifically in the case of Colombia must be monitored for compliance with the legislation in story to the compulsory education for educational institutions peace through public policies. Similarly, we emphasize that when they achieve consistently develop the principles and methodologies of education for peace, in institutions both family, school and University, this facilitates the strengthening of the culture for peace in the country.

  1. Empowerment and responsibility of the culture of peace through education

    OpenAIRE

    Mariela Inés Sánchez Cardona

    2012-01-01

    This article seeks to highlight the possibilities of empowering the culture of peace in the society in general, so it is necessary a joint work of different actors and social institutions. In this perspective each individual must transcend commitment to the peace of the personal to the social, also the State specifically in the case of Colombia must be monitored for compliance with the legislation in story to the compulsory education for educational institutions peace through public policies....

  2. Communication in cancer care: Psycho social, interactional, and cultural issues. A general overview and the example of India

    Directory of Open Access Journals (Sweden)

    SANTOSH K CHATURVEDI

    2014-11-01

    Full Text Available Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication in India include beliefs about health and illness, societal values, integration of spiritual care, family roles, and expectations concerning disclosure of cancer information, and rituals around death and dying. The rapidly emerging area of e-health significantly impacts cancer communication and support globally. In view of current globalization, understanding these multidimensional psychosocial, and cultural factors that shape communication are essential for providing comprehensive, appropriate and sensitive cancer care.

  3. Communication in cancer care: psycho-social, interactional, and cultural issues. A general overview and the example of India.

    Science.gov (United States)

    Chaturvedi, Santosh K; Strohschein, Fay J; Saraf, Gayatri; Loiselle, Carmen G

    2014-01-01

    Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication in India include beliefs about health and illness, societal values, integration of spiritual care, family roles, and expectations concerning disclosure of cancer information, and rituals around death and dying. The rapidly emerging area of e-health significantly impacts cancer communication and support globally. In view of current globalization, understanding these multidimensional psychosocial, and cultural factors that shape communication are essential for providing comprehensive, appropriate, and sensitive cancer care.

  4. Dose responses for Colletotrichum lindemuthianum elicitor-mediated enzyme induction in French bean cell suspension cultures.

    Science.gov (United States)

    Dixon, R A; Dey, P M; Murphy, D L; Whitehead, I M

    1981-03-01

    The induction of L-phenylalanine ammonialyase (PAL, EC 4.3.1.5) and flavanone synthase in French bean cell suspension cultures in response to heat-released elicitor from cell walls of the phytopathogenic fungus Colletotrichum lindemuthianum is highly dependent upon elicitor concentration. The elicitor dose-response curve for PAL induction shows two maxima at around 17.5 and 50 μg elicitor carbohydrate per ml culture, whereas the flavanone synthase response shows one maximum at around 100 μg ml(-1). The PAL response is independent of the elicitor concentration present during the lag phase of enzyme induction; if the initial elicitor concentration is increased after 2 h by addition of extra elicitor, or decreased by dilution of the cultures, the dose response curves obtained reflect the concentration of elicitor present at the time of harvest. PAL induction is not prevented by addition of methyl sugar derivatives to the cultures; α-methyl-D-glucoside, itself a weak elicitor of PAL activity, elicits a multiphasic PAL response when increasing concentrations are added in the presence of Colletotrichum elicitor. Eight fractions with different monosaccharide compositions, obtained from the crude elicitor by gel-filtration, each elicit different dose-responses for PAL induction; the response to unfractionated elicitor is not the sum of the response to the isolated fractions. There is no correlation between the ability of the fractions to induce PAL in the cultures and their ability to act as elicitors of isoflavonoid phytoalexin accumulation in bean hypocotyls.

  5. Exploring dental students' perceptions of cultural competence and social responsibility.

    Science.gov (United States)

    Rubin, Richard W; Rustveld, Luis O; Weyant, Robert J; Close, John M

    2008-10-01

    The improvement of basic cultural competency skills and the creation of a greater community-minded spirit among dental students are important parts of dental education. The purpose of our study was to assess changes in dental students' attitudes and beliefs about community service and changes in cultural competencies after participation in a two-year program of non-dental community service (Student Community Outreach Program and Education, SCOPE). During 2003-07, two identical twenty-eight-item surveys were administered to SCOPE participants/completers. In the first, students reported on their attitudes after program completion. In the second, students reported retrospectively on their attitudes prior to starting the program. One hundred twenty-six post- and pre-intervention surveys were matched and assessed for changes in student attitudes after program participation. Based on factor analysis, four distinct scales were identified: 1) community service, 2) cultural competence, 3) communication, and 4) treatment perspective. Over time, statistically significant changes (pstudent attitudes and beliefs were found for scales 1 (p=.017), 2 (p=.001), and 3 (borderline significance, p=.057). Scale 4 showed no significant difference (p=.108). These scales indicate main focus areas to help guide future dentists in acquiring relevant sociocultural competencies and enabling community-minded attitudes. Overall, this study provides support for the addition of a non-dental community service-learning program into the preclinical curriculum.

  6. Culturally Responsive Teaching: Awareness and Professional Growth through a School-University Collaboration

    Science.gov (United States)

    McCormick, Theresa M.; Eick, Charles J.; Womack, Janet S.

    2013-01-01

    Preparing in-service and pre-service teachers to effectively work with culturally diverse students is an ongoing challenge for schools and universities alike. This article reports on a University-Professional Development School (PDS) initiative designed to enhance an awareness of culturally responsive pedagogy. This article describes a yearlong…

  7. Social Justice and Cultural Responsiveness: Innovative Teaching Strategies for Group Work

    Science.gov (United States)

    Ibrahim, Farah A.

    2010-01-01

    This article presents a teaching strategy for group work that enhances the social justice consciousness of course participants by increasing their knowledge of their own cultural identity, worldview, acculturation, privilege, and oppression to improve their cultural responsiveness and understanding of social justice issues. The focus is on group…

  8. The Relationship between Organizational Culture and the Implementation of Response to Intervention in One Elementary School

    Science.gov (United States)

    Methner, Lynn M.

    2013-01-01

    This study investigated the relationship between organizational culture and the implementation of Response to Intervention in one elementary school. It examined issues corresponding to change within a system, with particular attention to those relating to school culture. An ethnographic approach was used to gather data, including the collection of…

  9. Literature and Lives: A Response-Based, Cultural Studies Approach to Teaching English.

    Science.gov (United States)

    Carey-Webb, Allen

    Telling stories from secondary and college English classrooms, this book explores the new possibilities for teaching and learning generated by bringing together reader-response and cultural-studies approaches. The book connects William Shakespeare, Charles Dickens, Mark Twain, and other canonical figures to multicultural writers, popular culture,…

  10. Infusing Culturally Responsive Instruction to Improve Mathematics Performance of Latino Students with Specific Learning Disabilities

    Science.gov (United States)

    Shumate, Lorraine; Campbell-Whatley, Gloria D.; Lo, Ya-yu

    2012-01-01

    Culturally responsive instruction has the advantage of helping diverse students make academic gains. The purpose of this study was to investigate the effects of culturally infused mathematics lessons on the academic achievement of five middle school Latino students with specific learning disabilities in a resource classroom. We used an ABACACA…

  11. The Cultural Responsiveness of Teacher Candidates Towards Roma Pupils in Serbia and Slovenia--Case Studies

    Science.gov (United States)

    Pecek, Mojca; Macura-Milovanovic, Suncica; Vujisic-Živkovic, Nataša

    2014-01-01

    In many countries, there is a growing need for teacher awareness and sensitivity to cultural differences, what is often called culturally responsive teaching. This is why teacher education institutions are making significant efforts to require student teachers to enrol in courses that focus on understanding, tolerance and acceptance of differences…

  12. Culturally Responsive Teaching: The Harlem Renaissance in an Urban English Class

    Science.gov (United States)

    Stairs, Andrea J.

    2007-01-01

    Andrea J. Stairs advocates culturally responsive teaching, a practice that explicitly highlights "issues of race, ethnicity, and culture as central to teaching, learning, and schooling," and emphasizes the necessity of interrogating the themes of race, power, and privilege in the urban classroom. Stairs observes two student teachers as they…

  13. Native American Indian Adolescents: Response to a Culturally Tailored, School-Based Substance Abuse Intervention

    Science.gov (United States)

    Patchell, Beverly A.

    2011-01-01

    Native American Indian adolescent substance abuse has been a longstanding health concern. There are few culturally tailored interventions for mild to moderate substance users. The purpose of this study was to measure the response of Native American Indian adolescents from the Plains tribal groups to a school-based culturally tailored substance…

  14. The Cultural Responsiveness of Teacher Candidates Towards Roma Pupils in Serbia and Slovenia--Case Studies

    Science.gov (United States)

    Pecek, Mojca; Macura-Milovanovic, Suncica; Vujisic-Živkovic, Nataša

    2014-01-01

    In many countries, there is a growing need for teacher awareness and sensitivity to cultural differences, what is often called culturally responsive teaching. This is why teacher education institutions are making significant efforts to require student teachers to enrol in courses that focus on understanding, tolerance and acceptance of differences…

  15. Impact of telemedicine in hospital culture and its consequences on quality of care and safety.

    Science.gov (United States)

    Steinman, Milton; Morbeck, Renata Albaladejo; Pires, Philippe Vieira; Abreu Filho, Carlos Alberto Cordeiro; Andrade, Ana Helena Vicente; Terra, Jose Claudio Cyrineu; Teixeira Junior, José Carlos; Kanamura, Alberto Hideki

    2015-01-01

    To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.

  16. Workforce ethnic diversity and culturally competent health care: the case of Arab physicians in Israel.

    Science.gov (United States)

    Popper-Giveon, Ariela; Liberman, Ido; Keshet, Yael

    2014-01-01

    In recent years, a growing body of literature has been calling for ethnic diversity in health systems, especially in multicultural contexts. Ethnic diversity within the health care workforce is considered to play an important role in reducing health disparities among different ethnic groups. The present study explores the topic using quantitative data on participation of Arab employees in the Israeli health system and qualitative data collected through semi-structured interviews with Arab physicians working in the predominantly Jewish Israeli health system. We show that despite the underrepresentation of Arabs in the Israeli health system, Arab physicians who hold positions in Israeli hospitals do not perceive themselves as representatives of the Arab sector; moreover, they consider themselves as having broken through the 'glass ceiling' and reject stereotyping as Arab 'niche doctors.' We conclude that minority physicians may prefer to promote culturally competent health care through integration and advocacy of interaction with the different cultures represented in the population, rather than serving as representatives of their own ethnic minority population. These findings may concern various medical contexts in which issues of ethnic underrepresentation in the health system are relevant, as well as sociological contexts, especially those regarding minority populations and professions.

  17. Secondary English Learners: Strengthening Their Literacy Skills through Culturally Responsive Teaching

    Science.gov (United States)

    Ramirez, Pablo C.; Jimenez-Silva, Margarita

    2014-01-01

    In high school English classrooms where English language learners may be at risk of academic failure, Culturally Responsive Teaching can help educators build an inclusive community in which all students can improve their literacy skills.

  18. Secondary English Learners: Strengthening Their Literacy Skills through Culturally Responsive Teaching

    Science.gov (United States)

    Ramirez, Pablo C.; Jimenez-Silva, Margarita

    2014-01-01

    In high school English classrooms where English language learners may be at risk of academic failure, Culturally Responsive Teaching can help educators build an inclusive community in which all students can improve their literacy skills.

  19. The response rate in postal epidemiological studies in the context of national cultural behaviour

    DEFF Research Database (Denmark)

    Angelova, Radostina A.; Naydenov, Kiril; Hägerhed-Engman, Linda

    2012-01-01

    The purpose of this study was to analyse the effect of national cultural differences on the response rate, obtained in questionnaire based epidemiological studies on allergy and asthma, performed in Sweden (DBH) and Bulgaria (ALLHOME). The two studies used one and the same methodology...... of people in Sweden and Bulgaria. It was found that national culture could strongly influence the response behaviour of people in epidemiological studies and Hofstede’s indexes can be useful tool when designing and performing epidemiological studies, and in particular – questionnaire surveys......., but the obtained response rate was different: 78.8% in DBH and 34.5% in ALLHOME. The differences in the obtained response rate and the reasons for these differences were analyzed on the basis of the Hofstede’s cultural dimensions’ indexes, which clearly show the distinction in the national cultural behaviour...

  20. Clients' initiatives and caregivers' responses in the organizational dynamics of care delivery.

    Science.gov (United States)

    Kajamaa, Anu; Hilli, Angelique

    2014-01-01

    Our aim with this article is to develop a typology for the analysis of client-caregiver encounters in health care. We first observed client-caregiver interactions in the homes of home care clients and during the care processes of surgical patients. We then conducted a data-driven analysis to identify the clients' initiatives and the degree of engagement in the responses they received. The clients shaped their care by commenting on, questioning, ensuring, and enriching their care. The responses from the caregivers consisted of neutral acceptance, disregard, and shared expansive development of the clients' initiatives. The typology developed from these will be a tool to widen our understanding of the complex interactions in care delivery and of the different conceptualizations of care that actors hold. In future studies this typology will help in the analysis of the organizational dynamics of health care delivery.

  1. Cross-Cultural Homestays: An Analysis of College Students' Responses After Living in an Unfamiliar Culture

    Science.gov (United States)

    Baty, Roger M.; Dold, Eugene

    1977-01-01

    Discusses a study designed to investigate the effects of a cross-cultural homestay program on students' attitudes and health. Available from: International Journal of Intercultural Relations, Transaction Periodicals Consortium, Rutgers-The State University, New Brunswick, New Jersey 08903. (MH)

  2. Creating Culturally Responsive Environments: Ethnic Minority Teachers' Constructs of Cultural Diversity in Hong Kong Secondary Schools

    Science.gov (United States)

    Hue, Ming-tak; Kennedy, Kerry John

    2014-01-01

    One of the challenges facing Hong Kong schools is the growing cultural diversity of the student population that is a result of the growing number of ethnic minority students in the schools. This study uses semi-structured interviews with 12 American, Canadian, Indian, Nepalese and Pakistani teachers working in three secondary schools in the public…

  3. Creating Culturally Responsive Environments: Ethnic Minority Teachers' Constructs of Cultural Diversity in Hong Kong Secondary Schools

    Science.gov (United States)

    Hue, Ming-tak; Kennedy, Kerry John

    2014-01-01

    One of the challenges facing Hong Kong schools is the growing cultural diversity of the student population that is a result of the growing number of ethnic minority students in the schools. This study uses semi-structured interviews with 12 American, Canadian, Indian, Nepalese and Pakistani teachers working in three secondary schools in the public…

  4. Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help-Seeking Among East Asian Immigrants to North America.

    Science.gov (United States)

    Na, Sumin; Ryder, Andrew G; Kirmayer, Laurence J

    2016-09-01

    Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro-Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help-seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help-seeking and use of services. This paper reviews the literature on help-seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified.

  5. Instrumentality in health care: a response to Adam Oliver.

    Science.gov (United States)

    Tanenbaum, Sandra J

    2015-07-01

    In his paper, 'Incentivizing improvements in health care delivery', Adam Oliver discusses recent efforts to manage the performance of health care workers in the United States and United Kingdom. Overall, the results of performance management seem to be mixed, but Oliver's discussion hints at a more fundamental question about this approach, specifically: what are the limits of a focused instrumentality in a context as rich, fluid and collaborative as the delivery of health care? Might performance management schemes actually frustrate the efforts of conscientious health care workers? Indicators make few allowances for the heterogeneity of treatment effects or patient values or preferences. Health care workers may also face pressure to appear to satisfy indicators that are actually impossible to satisfy.

  6. Microbiological burden in air culture at various units of a tertiary care government hospital in Nepal

    Directory of Open Access Journals (Sweden)

    Binaya Sapkota

    2016-01-01

    Full Text Available Background The environmental matrices (water, air, and surfaces play a vital role as reservoirs of Legionella spp. and Pseudomonas aeruginosa (Pseudomonas spp.. Hence, hospital environment control procedures are effective measures for reducing nosocomial infections. Aims This study was carried out to explore the profiles of microorganisms in air culture at various wards/units of a tertiary care hospital in Nepal. Methods A descriptive cross-sectional study was carried out at various wards/units of a tertiary care hospital in Nepal between January and September 2015 to explore the microbiological burden in inanimate objects. Each week one ward or unit was selected for the study. Bed, tap, the entire room, trolley, computer, phone, rack handles, table, chair, door, stethoscope, oxygen mask, gown, cupboard handles, and wash basins were selected for air culture testing. Ten different wards/units and 77 locations/pieces of equipment were selected for air culture by employing a simple random sampling technique. Information about the organisms was entered into the Statistical Package for the Social Sciences (SPSS Version 22 (IBM: Armonk, NY and descriptive analyses were carried out. Results Staphylococcus aureus (S. aureus, Micrococcus, coagulase negative staphylococcus (CONS, Bacillus, Pseudomonas aeruginosa, yeast, and Acinetobacter were the most commonly detected organisms. In the postoperative ward, S. aureus was the most frequently detected microorganism. Micrococcus was detected in four out of 10 locations. In the x-ray unit, S. aureus was detected in three out of four locations. Conclusion S. aureus, Micrococcus, CONS, Bacillus, Pseudomonas, yeast, and Acinetobacter were the most common organisms detected.

  7. Language and Culture in Health Literacy for People Living with HIV: Perspectives of Health Care Providers and Professional Care Team Members.

    Science.gov (United States)

    Mogobe, Keitshokile Dintle; Shaibu, Sheila; Matshediso, Ellah; Sabone, Motshedisi; Ntsayagae, Esther; Nicholas, Patrice K; Portillo, Carmen J; Corless, Inge B; Rose, Carol Dawson; Johnson, Mallory O; Webel, Allison; Cuca, Yvette; Rivero-Méndez, Marta; Solís Báez, Solymar S; Nokes, Kathleen; Reyes, Darcel; Kemppainen, Jeanne; Reid, Paula; Sanzero Eller, Lucille; Lindgren, Teri; Holzemer, William L; Wantland, Dean

    2016-01-01

    Low health literacy has been linked to inadequate engagement in care and may serve as a contributor to poor health outcomes among people living with HIV and AIDS. The purpose of this paper was to examine the perspectives of health care providers and professional care team members regarding health literacy in HIV disease. A secondary data analysis was conducted from a qualitative study aimed at understanding factors that help an HIV positive person to manage their HIV disease. Data were collected from sites in Botswana, the US, and Puerto Rico. In the parent study, data were collected through focus group discussions with 135 people living with HIV, 32 HIV health care providers (HCPs), and 39 HIV professional care team members (PCTMs). SPSS was used to analyze quantitative data while ATLAS.ti was used to analyze qualitative data. The findings from analyses of the perspectives of HCPs/PCTMs suggested that linguistic and cultural factors were important themes in the exchange of HIV information between health care providers and PLHIV. These themes included ineffective communication, health seeking behavior, cultural facilitators, and complementary and alternative/traditional healing methods. Thus, this study suggests that language and culture have a major role in health literacy for PLHIV.

  8. Language and Culture in Health Literacy for People Living with HIV: Perspectives of Health Care Providers and Professional Care Team Members

    Directory of Open Access Journals (Sweden)

    Keitshokile Dintle Mogobe

    2016-01-01

    Full Text Available Low health literacy has been linked to inadequate engagement in care and may serve as a contributor to poor health outcomes among people living with HIV and AIDS. The purpose of this paper was to examine the perspectives of health care providers and professional care team members regarding health literacy in HIV disease. A secondary data analysis was conducted from a qualitative study aimed at understanding factors that help an HIV positive person to manage their HIV disease. Data were collected from sites in Botswana, the US, and Puerto Rico. In the parent study, data were collected through focus group discussions with 135 people living with HIV, 32 HIV health care providers (HCPs, and 39 HIV professional care team members (PCTMs. SPSS was used to analyze quantitative data while ATLAS.ti was used to analyze qualitative data. The findings from analyses of the perspectives of HCPs/PCTMs suggested that linguistic and cultural factors were important themes in the exchange of HIV information between health care providers and PLHIV. These themes included ineffective communication, health seeking behavior, cultural facilitators, and complementary and alternative/traditional healing methods. Thus, this study suggests that language and culture have a major role in health literacy for PLHIV.

  9. Neonatal care practices in a tribal community of Odisha, India: a cultural perspective.

    Science.gov (United States)

    Pati, Sanghamitra; Chauhan, Abhimanyu S; Panda, Madhusmita; Swain, Subhashish; Hussain, Mohammad A

    2014-06-01

    Neonatal care practices have been shown to vary across tribal communities. This cross-sectional study was conducted in tribal block in Nabarangpur district of Odisha, India, to measure perinatal and antenatal practices by qualitative inquiries of 55 mothers who had babies aged traditional birth attendants. Reasons for home deliveries were cited as easy availability of traditional birth attendants and family preferences. Application of indigenously made substances on umbilical stump and skin of the baby, bathing baby immediately after birth, late initiation of breast-feeding and 'Budu practices' were common. Cultural issues, decision of family members and traditional beliefs still play a crucial role in shaping neonatal care practice in tribal communities. Awareness on child care, ethnographic understanding of health-seeking behavior of tribal community and mobilization of community by health workers can be useful in improving health status of mothers and newborn babies in tribal population. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. The cardiac patients' perceptions of their responsibilities in adherence to care: a qualitative interview study.

    Science.gov (United States)

    Kangasniemi, Mari; Hirjaba, Marina; Kohonen, Katja; Vellone, Ercole; Moilanen, Tanja; Pietilä, Anna-Maija

    2017-09-01

    To describe cardiac patients' perceptions of their responsibilities in adherence to care. The responsibilities of cardiac patients' adherence to care is a topical issue because of the increasing prevalence of noncommunicable diseases in Western countries, including cardiovascular disease (CVD). Responsibilities for cardiac patients' care have been studied, but little is described about patients' perspectives in this study. A qualitative, hermeneutic inquiry. We used face-to-face individual semistructured interviews with 21 cardiac patients (76% male) aged 58-86 in an urban area of Finland in winter 2013. The data were analysed hermeneutically with inductive content analysis. Based on our results, patients with cardiac disease understood that autonomy provided a basis for their responsibility in adherence to care. It included being able to make independent decisions, in collaboration with health professionals, or even to entrust that responsibility to healthcare professionals. Responsibilities were understood to be an expression of adherence, perceived to benefit the patient and included the duty to adopt a healthy lifestyle and care for their own medical condition. The main factors that influenced patients' responsibilities around adherence to care were their individual resources and motivation, relationships with healthcare professionals and the resources of the healthcare system. Autonomy is an inherent part of cardiac patients' adherence to care, but there has been little focus on their responsibilities in the literature. More attention needs to be paid to the healthcare providers' abilities to support patients' duties and responsibilities in clinical practice and to future research. © 2016 John Wiley & Sons Ltd.

  11. Arthritis pain and disability: response to collaborative depression care.

    Science.gov (United States)

    Lin, Elizabeth H B; Tang, Lingqi; Katon, Wayne; Hegel, Mark T; Sullivan, Mark D; Unützer, Jürgen

    2006-01-01

    Collaborative care for depression decreases arthritis pain and disability among older adults, above and beyond mood improvement. This study investigates whether depression management is effective for improving arthritis outcomes across a range of pain severity and activity interference. A multi-site randomized-controlled trial (Improving Mood, Providing Access to Collaborative Treatment - IMPACT) identified 1001 participants with both depression and arthritis (mostly osteoarthritis). Depression care managers provided 12 months of systematic depression care [antidepressant pharmacotherapy, and/or problem-solving treatment (PST)] for intervention participants in primary care settings. Control patients received care as usual. Baseline and 12-month interviews assessed arthritis pain severity and activity interference as well as depression, analgesic use, overall functional impairment and coexisting medical conditions. Baseline pain severity showed significant interactions with the intervention on 12-month pain severity (t=2.28, df=68, P=.03) and disability outcomes (t=2.03, df=177, P=.04). Interaction effects of the intervention with baseline activity interference on 12-month pain severity showed a similar trend, but were not statistically significant (t=1.87, df=944, P=.06). Systematic depression management was more effective than usual care in decreasing pain severity among arthritis patients with lower initial pain severity, but did not have greater benefits than usual care on pain among patients with higher initial pain severity.

  12. The significance of 'facilitator as a change agent'--organisational learning culture in aged care home settings.

    Science.gov (United States)

    Grealish, Laurie; Henderson, Amanda; Quero, Fritz; Phillips, Roslyn; Surawski, May

    2015-04-01

    To explore the impact of an educational programme focused on social behaviours and relationships on organisational learning culture in the residential aged care context. The number of aged care homes will continue to rise as the frail older elderly live longer, requiring more formal care and support. As with other small- to medium-sized health services, aged care homes are faced with the challenge of continuous development of the workforce and depend upon registered nurses to lead staff development. A mixed-method evaluation research design was used to determine the impact of an educational programme focused on social aspects of learning on organisational learning culture. One hundred and fifty-nine (pre) and 143 (post) participants from three aged care homes completed the Clinical Learning Organisational Culture survey, and three participant-researcher registered nurse clinical educators provided regular journal entries for review. While each site received the same educational programme over a six-month period, the change in organisational learning culture at each site was notably different. Two aged care homes had significant improvements in affiliation, one in accomplishment and one in recognition. The educators' journals differed in the types of learning observed and interventions undertaken, with Eucalyptus focused on organisational change, Grevillea focused on group (student) change and the Wattle focused on individual or situational change. Clinical educator activities appear to have a significant effect on organisational learning culture, with a focus on the organisational level having the greatest positive effect on learning culture and on individual or situational level having a limited effect. Clinical educator facilitation that is focused on organisational rather than individual interests may offer a key to improving organisational learning culture. © 2014 John Wiley & Sons Ltd.

  13. Survey Response Styles, Acculturation, and Culture Among a Sample of Mexican American Adults.

    Science.gov (United States)

    Davis, Rachel E; Resnicow, Ken; Couper, Mick P

    2011-10-01

    A number of studies have investigated use of extreme (ERS) and acquiescent (ARS) response styles across cultural groups. However, due to within-group heterogeneity, it is important to also examine use of response styles, acculturation, and endorsement of cultural variables at the individual level. This study explores relationships between acculturation, six Mexican cultural factors, ERS, and ARS among a sample of 288 Mexican American telephone survey respondents. Three aspects of acculturation were assessed: Spanish use, the importance of preserving Mexican culture, and interaction with Mexican Americans versus Anglos. These variables were hypothesized to positively associate with ERS and ARS. Participants with higher Spanish use did utilize more ERS and ARS; however, value for preserving Mexican culture and interaction with Mexican Americans were not associated with response style use. In analyses of cultural factors, endorsement of familismo and simpatia were related to more frequent ERS and ARS, machismo was associated with lower ERS among men, and la mujer was related to higher ERS among women. Caballerismo was marginally associated with utilization of ERS among men. No association was found between la mujer abnegada and ERS among women. Relationships between male gender roles and ARS were nonsignificant. Relationships between female gender roles and ARS were mixed but trended in the positive direction. Overall, these findings suggest that Mexican American respondents vary in their use of response styles by acculturation and cultural factors. This usage may be specifically influenced by participants' valuing of and engagement with constructs directly associated with social behavior.

  14. [Nursing professionals and health care assistants' perception of patient safety culture in the operating room].

    Science.gov (United States)

    Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto

    2015-01-01

    To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  15. Cultural conflict: the impact of western feminism(s) on nurses caring for women of non-English speaking background.

    Science.gov (United States)

    Blackford, Jeanine; Street, Annette

    2002-09-01

    Much research has been conducted for understanding the health needs of people of different cultural backgrounds and the problems they experience in seeking health care. In Australia, despite such research, it is argued that there remains an exclusionary health care culture that continues to affect equity and access for people of non-English speaking background. There was a need for research in which health professionals examined their own Anglo-Australian culture and its impact on other ethnic communities. Such concerns provided the impetus for a feminist praxis study to engage nurses in understanding and improving care for migrant women. This study was conducted with 26 nurses in a paediatric hospital in Melbourne, Australia. Five collaborative research groups were formed, each consisting of four to six nurses who were co-researchers. Together, the nurses and researchers explored the health care experiences of migrant women, using a variety of quantitative and qualitative data collection strategies. This paper explores a major finding of the study, which was the impact of liberal feminist approaches on the practices of Australian nurses who cared for women of different ethnicity and race. The study found that the efforts of liberal feminist nurses to "treat all people the same" meant that women from different cultural backgrounds did not always receive equity in care. Through the feminist praxis process the nurses were able to explore contradictions in their practice and focus on equity in care to meet the specific gendered and racially constructed needs of women of different cultural backgrounds. A number of strategies were adopted that included regular use of female health interpreters and provision of privacy for migrant women when caring for their children.

  16. [Genetic regulation of T-lymphocyte responsiveness to PHA is independent of culture conditions (author's transl)].

    Science.gov (United States)

    Stiffel, C; Liacopoulos-Briot, M; Decreusefond, C; Lambert, F

    1979-01-01

    A maximal interline separation has been obtained after 10 consecutive generations of selective breeding for the character "quantitative in vitro response of lymph node lymphocytes to the mitogenic effect of phytohaemagglutinin". At the selection limit the difference between high and low responder lines was about 20-fold. A similar interline separation has been demonstrated for the T-mitogen effect of concanavalin A. The identical response to PPD (purified protein derivative of tuberculin), a B mitogen, proved that the genetic selection has only modified the potentialities of T lymphocytes. During the selective breeding, responsiveness to PHA stimulation has been always measured under identical culture conditions. To demonstrate that the interline difference in responsiveness was due essentially to genetic factors independent of environmental effects, a systematic study of various culture conditions has been undertaken. The optimal stimulation was found after two days of culture for high line cells and after three days for low line cells. The difference between maximal responses was only slightly lower than that obtained after a two-day culture as used for the selection test. Increase in cell concentrations produced higher thymidine incorporation. In the two lines, a linear correlation was established between the cell concentration and the response produced. The maximal response given by the highest number of low line lymphocytes was equivalent to that given by a number, 11-fold smaller, of high line cells. Within certain limits, changes in the amount of tritiated thymidine added to the culture did not affect the interline separation. With a thymidine of high specific activity, a sub-evaluation of uptake by high line cells decreased the interline difference. Results in mixed culture of lymph node cells from high and low lines indicated that the low response was not due to the release of inhibiting factors or to the presence of suppressive cells in low responder mice

  17. Protocorm development of Epidendrum fulgens (Orchidaceae in response to different saline formulations and culture conditions

    Directory of Open Access Journals (Sweden)

    Joana Gerent Voges

    2014-08-01

    Full Text Available The asymbiotic technique of orchid seeds germination is an important method of mass production of seedlings. Studies on the best culture conditions for each species are important to obtain seedlings in less time and at lower costs. Current analysis evaluates different consistencies of culture medium, saline formulations and culture conditions on the germination rate and further development of protocorms of Epidendrum fulgens. After 45 days in culture the protocorms were classified into three categories of development. The liquid saline formulation of Murashige and Skoog (1962 (MS provided the highest germination rate (83.5%, and the Knudson formulation (1946 the lowest (10.9%. The different consistencies or conditions or culture conditions did not affect the germination rate percentage, except the Knudson medium, which resulted in the highest rate in response to the gelled consistency. Protocorms cultured in liquid MS medium with or without agitation showed the fastest development.

  18. Enhancing Self-Awareness: A Practical Strategy to Train Culturally Responsive Social Work Students

    Directory of Open Access Journals (Sweden)

    Nalini J. Negi

    2010-10-01

    Full Text Available A primary goal of social justice educators is to engage students in a process of self-discovery, with the goal of helping them recognize their own biases, develop empathy, and become better prepared for culturally responsive practice. While social work educators are mandated with the important task of training future social workers in culturally responsive practice with diverse populations, practical strategies on how to do so are scant. This article introduces a teaching exercise, the Ethnic Roots Assignment, which has been shown qualitatively to aid students in developing self-awareness, a key component of culturally competent social work practice. Practical suggestions for classroom utilization, common challenges, and past student responses to participating in the exercise are provided. The dissemination of such a teaching exercise can increase the field’s resources for addressing the important goal of cultural competence training.

  19. Professional carers' knowledge and response to depression among their aged-care clients: the care recipients' perspective.

    Science.gov (United States)

    Mellor, David; Davison, Tanya; McCabe, Marita; George, Kuruvilla

    2008-05-01

    Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

  20. The effect of non-response on estimates of health care utilisation

    DEFF Research Database (Denmark)

    Gundgaard, Jens; Ekholm, Orla; Hansen, Ebba Holme;

    2008-01-01

    living in Funen County. Data were linked with register information on health care utilisation in hospitals and primary care. Health care utilisation was estimated for respondents and non-respondents, and the difference was explained by a decomposition method of bias components. RESULTS: The surveys......-contact, and other reasons were less frequent. Respondents used 3-6% less health care than non-respondents at the aggregate level, but the opposite was true for some specific types of health care. Non-response due to illness was the main contributor to non-response bias. CONCLUSIONS: Different types of non......BACKGROUND: Non-response in health surveys may lead to bias in estimates of health care utilisation. The magnitude, direction and composition of the bias are usually not well known. When data from health surveys are merged with data from registers at the individual level, analyses can reveal non...

  1. Research progress on Leininger cross cultural care%Leininger跨文化护理的研究进展

    Institute of Scientific and Technical Information of China (English)

    范家莉; 孔悦; 殷婷婷; 程玉红

    2015-01-01

    对 Leininger跨文化护理在我国的护理教育和临床实践的研究和应用进行综述,着重阐述在临床护理中的应用情况,并对其发展提出展望,以期为跨文化护理本土化研究提供参考。%It reviewed the research and application of nursing education and clinical practice of Leininger cross cultural care in China.It focused on expounding the application status of Leininger cross cultural care,and looked forward to its development,in order to provide reference for the localization of study of cross cultural care.

  2. Advancing research in transitional care: challenges of culture, language and health literacy in Asian American and native Hawaiian elders.

    Science.gov (United States)

    Nishita, Christy; Browne, Colette

    2013-02-01

    Recent federal policy supports an individual's preference for home and community-based long-term care, even among nursing home residents. Optimizing transitions from the nursing home to home is a complex undertaking that requires addressing the interrelationships between health literacy and cultural-linguistic factors in the nation's increasingly diverse older adult population. We look at four Asian American and Pacific Islander elder populations to illustrate that differing health profiles and cultural-linguistic values can affect the type of care and support needed and preferred. A research gap exists that links these factors together for optimal transitional care. The paper presents a conceptual framework and proposes a six-point research agenda that includes family assessments of health literacy abilities, exploring the relationship between culture, health, and decision-making, and the development/adaptation of transition planning tools.

  3. Cultural Mapping as a Social Practice: A Response to "Mapping the Cultural Boundaries in Schools and Communities: Redefining Spaces Through Organizing"

    Science.gov (United States)

    Vadeboncoeur, Jennifer A.; Hanif-Shahban, Shenaz A.

    2015-01-01

    Inspired by Gerald Wood and Elizabeth Lemley's (2015) article entitled "Mapping the Cultural Boundaries in Schools and Communities: Redefining Spaces Through Organizing," this response inquires further into cultural mapping as a social practice. From our perspective, cultural mapping has potential to contribute to place making, as well…

  4. Reflection on pastoral care in Africa: Towards discerning emerging pragmatic pastoral ministerial responses

    Directory of Open Access Journals (Sweden)

    Vhumani Magezi

    2016-03-01

    Full Text Available Pastoral care takes different forms in responding to people’s needs in their context. Accordingly, over the centuries it has evolved in response to emerging needs. Historical developments in pastoral care are well-documented. However, pastoral care in Africa has a short and unsystematically documented history. Scholarly discussions on pastoral care concerning the continent tend to be considered under African theological frameworks. Notwithstanding the already existing weaknesses in African theological discussion, pastoral care in Africa has remained fragmented with diverse and seemingly knee-jerk approaches in guiding individuals who provide pastoral care. In view of this, this article firstly aims to provide a broad overview and initiate a discussion on the current challenges in pastoral care in Africa. Secondly, it aims to reveal some gaps worth pursuing by scholars in the discipline. Thirdly, it sheds some light on approaches employed by pastoral practitioners in pastoral ministry practice. In doing so, this article opens the lid on some perspectives adopted in ministry work on the frontlines, that is, providing pastoral care to people in their communities – particularly church communities. This article first outlines the problem to be addressed followed by an overview of pastoral care in Africa. It then proceeds to address potential research opportunities within the discipline. Finally, it highlights some emerging approaches in providing pastoral care in the communities. This article does not focus on one particular pastoral care issue, but gives an overview of the situation relative to pastoral care in Africa and the emerging responses.

  5. The Culture of Corporate Social Responsibility (CSR) in the Academic Framework: Some Literary Implications

    Science.gov (United States)

    Mehta, Sandhya Rao

    2011-01-01

    Corporate Social Responsibility (CSR) is swiftly emerging as an integral part of corporate culture and discourse. Associated with notions of responsibility, accountability and community involvement, it remains privileged with concerns that increasingly define the new millennium. Less developed, however, is the relevance of CSR ideas to academic…

  6. Stories that Matter: Native American Fifth Graders' Responses to Culturally Authentic Text

    Science.gov (United States)

    Hoffman, Angeline P.

    2010-01-01

    The purpose of this study is to examine textual features in Native American children's literature and Native children's responses to these textual features. Culturally authentic children's literature was used to gain insights into children's perspectives as they engaged in responses within literature circles. This study utilized qualitative…

  7. Cross-cultural Differences in Compliment Response between China and US

    Institute of Scientific and Technical Information of China (English)

    李志远

    2015-01-01

    Compliment response is one of the most commonly used speech acts in social communication.This thesis,through the comparative studies on compliment response between China and America,aims at helping English learners have a profound understanding on compliments in cross-cultural communication.

  8. A new in vitro model to study cellular responses after thermomechanical damage in monolayer cultures.

    Directory of Open Access Journals (Sweden)

    Alice Hettler

    Full Text Available Although electrosurgical instruments are widely used in surgery to cut tissue layers or to achieve hemostasis by coagulation (electrocautery, only little information is available concerning the inflammatory or immune response towards the debris generated. Given the elevated local temperatures required for successful electrocautery, the remaining debris is likely to contain a plethora of compounds entirely novel to the intracorporal setting. A very common in vitro method to study cell migration after mechanical damage is the scratch assay, however, there is no established model for thermomechanical damage to characterise cellular reactions. In this study, we established a new in vitro model to investigate exposure to high temperature in a carefully controlled cell culture system. Heatable thermostat-controlled aluminium stamps were developed to induce local damage in primary human umbilical vein endothelial cells (HUVEC. The thermomechanical damage invoked is reproducibly locally confined, therefore allowing studies, under the same experimental conditions, of cells affected to various degrees as well as of unaffected cells. We show that the unaffected cells surrounding the thermomechanical damage zone are able to migrate into the damaged area, resulting in a complete closure of the 'wound' within 48 h. Initial studies have shown that there are significant morphological and biological differences in endothelial cells after thermomechanical damage compared to the mechanical damage inflicted by using the unheated stamp as a control. Accordingly, after thermomechanical damage, cell death as well as cell protection programs were activated. Mononuclear cells adhered in the area adjacent to thermomechanical damage, but not to the zone of mechanical damage. Therefore, our model can help to understand the differences in wound healing during the early phase of regeneration after thermomechanical vs. mechanical damage. Furthermore, this model lends itself

  9. Providing Culturally Competent Care for LGBTQ Youth in School-Based Health Centers: A Needs Assessment to Guide Quality of Care Improvements.

    Science.gov (United States)

    Garbers, Samantha; Heck, Craig J; Gold, Melanie A; Santelli, John S; Bersamin, Melina

    2017-01-01

    School-based health centers (SBHCs) can take specific steps to provide culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, potentially impacting well-being. A needs assessment survey was conducted among a convenience sample of SBHC administrators and medical directors to assess climates and actions supportive of LGBTQ quality medical care. Half (53%) of the SBHCs surveyed ( N = 66) reviewed print materials for negative LGBTQ stereotypes, and 27.3% conducted exhaustive materials review. Regional differences were detected: 46.2% of Southern SBHCs conducted any materials review compared to 91.3% in the West and all in the East and Midwest (χ(2), p LGBTQ youth. On intake forms, 85.4% included preferred names, but only 23.5% included preferred pronoun. There are significant gaps in the extent to which SBHCs provide culturally competent care. These findings can guide future training and advocacy.

  10. Effects of cell type and culture media on Interleukin-6 secretion in response to environmental particles.

    Science.gov (United States)

    Veranth, John M; Cutler, N Shane; Kaser, Erin G; Reilly, Christopher A; Yost, Garold S

    2008-03-01

    Cultured lung cells provide an alternative to animal exposures for comparing the effects of different types of air pollution particles. Studies of particulate matter in vitro have reported proinflammatory cytokine signaling in response to many types of environmental particles, but there have been few studies comparing identical treatments in multiple cell types or identical cells with alternative cell culture protocols. We compared soil-derived, diesel, coal fly ash, titanium dioxide, and kaolin particles along with soluble vanadium and lipopolysaccharide, applied to airway-derived cells grown in submerged culture. Cell types included A549, BEAS-2B, RAW 264.7, and primary macrophages. The cell culture models (specific combinations of cell types and culture conditions) were reproducibly different in the cytokine signaling responses to the suite of treatments. Further, Interleukin-6 (IL-6) response to the treatments changed when the same cells, BEAS-2B, were grown in KGM versus LHC-9 media or in media containing bovine serum. The effect of changing media composition was reversible over multiple changes of media type. Other variables tested included culture well size and degree of confluence. The observation that sensitivity of a cell type to environmental agonists can be manipulated by modifying culture conditions suggests a novel approach for studying biochemical mechanisms of particle toxicity.

  11. Effects of cell type and culture media on Interleukin-6 secretion in response to environmental particles

    Energy Technology Data Exchange (ETDEWEB)

    Veranth, J.M.; Cutler, N.S.; Kaser, E.G.; Reilly, C.A.; Yost, G.S. [University of Utah, Salt Lake City, UT (United States)

    2008-03-15

    Cultured lung cells provide an alternative to animal exposures for comparing the effects of different types of air pollution particles. Studies of particulate matter in vitro have reported proinflammatory cytokine signaling in response to many types of environmental particles, but there have been few studies comparing identical treatments in multiple cell types or identical cells with alternative cell culture protocols. We compared soil-derived, diesel, coal fly ash, titanium dioxide, and kaolin particles along with soluble vanadium and lipopolysaccharide, applied to airway-derived cells grown in submerged culture. Cell types included A549, BEAS-2B, RAW 264.7, and primary macrophages. The cell culture models (specific combinations of cell types and culture conditions) were reproducibly different in the cytokine signaling responses to the suite of treatments. Further, Interleukin-6 (IL-6) response to the treatments changed when the same cells, BEAS-2B, were grown in KGM versus LHC-9 media or in media containing bovine serum. The effect of changing media composition was reversible over multiple changes of media type. Other variables tested included culture well size and degree of confluence. The observation that sensitivity of a cell type to environmental agonists can be manipulated by modifying culture conditions suggests a novel approach for studying biochemical mechanisms of particle toxicity.

  12. Irradiation Response of Adipose-derived Stem Cells under Three-dimensional Culture Condition

    Institute of Scientific and Technical Information of China (English)

    DU Ya Rong; PAN Dong; CHEN Ya Xiong; XUE Gang; REN Zhen Xin; LI Xiao Man; ZHANG Shi Chuan; HU Bu Rong

    2015-01-01

    Objective Adipose tissue distributes widely in human body. The irradiation response of the adipose cells in vivo remains to be investigated. In this study we investigated irradiation response of adipose-derived stem cells (ASCs) under three-dimensional culture condition. Methods ASCs were isolated and cultured in low attachment dishes to form three-dimensional (3D) spheres in vitro. The neuronal differentiation potential and stem-liked characteristics was monitored by using immunofluoresence staining and flow cytometry in monolayer and 3D culture. To investigate the irradiation sensitivity of 3D sphere culture, the fraction of colony survival and micronucleus were detected in monolayer and 3D culture. Soft agar assays were performed for measuring malignant transformation for the irradiated monolayer and 3D culture. Results The 3D cultured ASCs had higher differentiation potential and an higher stem-like cell percentage. The 3D cultures were more radioresistant after either high linear energy transfer (LET) carbon ion beam or low LET X-ray irradiation compared with the monolayer cell. The ASCs’ potential of cellular transformation was lower after irradiation by soft agar assay. Conclusion These findings suggest that adipose tissue cell are relatively genomic stable and resistant to genotoxic stress.

  13. Translation of interviews from a source language to a target language: examining issues in cross-cultural health care research.

    Science.gov (United States)

    Al-Amer, Rasmieh; Ramjan, Lucie; Glew, Paul; Darwish, Maram; Salamonson, Yenna

    2015-05-01

    To illuminate translation practice in cross-language interview in health care research and its impact on the construction of the data. Globalisation and changing patterns of migration have created changes to the world's demography; this has presented challenges for overarching social domains, specifically, in the health sector. Providing ethno-cultural health services is a timely and central facet in an ever-increasingly diverse world. Nursing and other health sectors employ cross-language research to provide knowledge and understanding of the needs of minority groups, which underpins cultural-sensitive care services. However, when cultural and linguistic differences exist, they pose unique complexities for cross-cultural health care research; particularly in qualitative research where narrative data are central for communication as most participants prefer to tell their story in their native language. Consequently, translation is often unavoidable in order to make a respondent's narrative vivid and comprehensible, yet, there is no consensus about how researchers should address this vital issue. An integrative literature review. PubMed and CINAHL databases were searched for relevant studies published before January 2014, and hand searched reference lists of studies were selected. This review of cross-language health care studies highlighted three major themes, which identify factors often reported to affect the translation and production of data in cross-language research: (1) translation style; (2) translators; and (3) trustworthiness of the data. A plan detailing the translation process and analysis of health care data must be determined from the study outset to ensure credibility is maintained. A transparent and systematic approach in reporting the translation process not only enhances the integrity of the findings but also provides overall rigour and auditability. It is important that minority groups have a voice in health care research which, if accurately

  14. Assessing undergraduate nursing students' knowledge, attitudes, and cultural competence in caring for lesbian, gay, bisexual, and transgender patients.

    Science.gov (United States)

    Strong, Kristy L; Folse, Victoria N

    2015-01-01

    Lesbian, gay, bisexual, and transgender (LGBT) patients experience barriers to health care that include fear of discrimination, as well as insensitivity and lack of knowledge about LGBT-specific health needs among providers. This study examined the effectiveness of an educational intervention designed to improve knowledge and attitudes of baccalaureate nursing students regarding LGBT patient care. Education focused on key terminology, health disparities, medical needs of transgender patients, and culturally sensitive communication skills for competent LGBT patient care. Knowledge level and attitudes were evaluated before and after the intervention using a survey based on a modified Attitudes Toward Lesbians and Gay Men Scale and two assessment tools developed for this study. A statistically significant increase in positive attitudes and knowledge level was found immediately after the intervention. Findings from this study support the inclusion of education related to LGBT patient health care in undergraduate nursing curricula to promote cultural competence and sensitivity.

  15. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.

    OpenAIRE

    Betancourt, Joseph R.; Green, Alexander R.; Carrillo, J. Emilio; Ananeh-Firempong, Owusu

    2003-01-01

    OBJECTIVES: Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care. METHODS: The authors conducted a literature...

  16. Some Aspects of Culturally Competent Communication in Health Care in the Republic of Macedonia

    Science.gov (United States)

    Pollozhani, Aziz; Kosevska, Elena; Petkovski, Kostadin; Memeti, Shaban; Limani, Blerim; Kasapinov, Blasko

    2013-01-01

    Aim: To examine the existing situation, barriers and consequences of the intercultural communication in health institutions and to offer training models for strengthening and improving communication skills of health professionals in the Republic of Macedonia. Methods: A cross-sectional survey was conducted to assess the relationship between patients and health professionals. A total of 813 health professionals (302 physicians and 511 other medical staff) from different healthcare institutions, and 1016 patients participated in cross-sectional survey performed in autumn 2010. Results: The research has showed that each third examined patient thought that his/her physician or the other medical personnel had no understanding for his/her emotions and gave no answer to all of his/her questions. From the other side, 60% of the physicians declare that they have a good communication with patients speaking other language than their mother tongue. Only 60% of physicians said that they know good the culture of their patient and 52% of the other medical staff said that they adjusted the treatment to the patient culture (religion, attitudes, language, life style). Conclusion: There are some gaps in current provision of health care practice in an aspect of effective interactions and communication skills of health professionals to meet patient needs in a multicultural and multilingual setting. A training model is proposed for strengthening communication skills of health professionals. PMID:24511268

  17. Consumers’ responses to CSR in a cross-cultural setting

    Directory of Open Access Journals (Sweden)

    Hakan Karaosman

    2015-12-01

    Full Text Available The paper aims to clarify the relationship between corporate social responsibility (CSR and consumer behaviour in an international setting. Consumers’ responses to CSR activities and the impact on the purchase decision are limited discourses. CSR-based studies in the fashion and apparel industry are also scarce. Therefore, this study attempts to enlighten the subject of how consumers from different countries respond to CSR adopted in the fashion and apparel industry. This study is based on an exploratory qualitative research for which focus group interviews, including six group discussions with Spanish and Turkish consumers, have been used. The fundamental dimension for sampling was consumers’ interest and knowledge of CSR-related issues. The data were examined by constant comparison analysis. The paper provides empirical insights that suggest that these consumers, regardless of their country of origin, perceive CSR actions as part of companies’ marketing strategies, while overall consumer awareness to CSR is low. Moreover, the criteria, which determine the purchase decision is to be governed by self-interest. A difference between participants from both countries has been found with regard to their demand for more regulation towards CSR. An identified research need in international marketing discipline, is fulfilled in this study.

  18. Competencia Cultural: Una forma humanizada de ofrecer Cuidados de Enfermería Cultural competence: a humane form of offering Nursing Care

    Directory of Open Access Journals (Sweden)

    Teresa Ximena Ibarra Mendoza

    2006-03-01

    Full Text Available La actual dinámica social, hace que el cuidado de Enfermería se convierta en un desafío permanente, pues debe considerar los valores, creencias y prácticas de individuos que tiene bajo su cuidado, así como manifestar el respeto por la diferencia cuando ofrece dicho cuidado. El presente trabajo muestra las dimensiones que el profesional de Enfermería debería considerar al ofrecer cuidado, dada la incidencia en la diversidad cultural de los grupos humanos bajo la perspectiva de la competencia cultural. En el desarrollo del trabajo se define la diversidad cultural como elemento de valoración en Enfermería y los constructos que el modelo incluye para adquirir la competencia cultural. Es a partir del desarrollo de estos puntos cuando se puede llegar a entender el papel del profesional de enfermería bajo la dimensión transcultural, siempre teniendo como referencia que para propiciar Cuidados de Enfermería de calidad, el profesional debe tener conocimiento, sensibilidad y disposición para colaborar en ello. La aceptación y respeto por las diferencias culturales, la sensibilidad para entender cómo esas diferencias influyen en las relaciones con las personas, y la habilidad para ofrecer estrategias que mejoren los encuentros culturales, son requisitos indispensables para que el cuidado transcultural en enfermería se pueda consolidar.The current social dynamics require that the Nursing treatment becomes a permanent challenge, as it has to consider the values, beliefs and practices of the individuals that are under its care, as much as it has to manifest respect for the differences when the attention is being offered. The present paper is intended to expose the dimensions that the Nursing Professional should consider when offering treatment, given the incidence in the cultural diversity of the human groups under the perspective of the cultural competence. In the development of this work, cultural diversity is defined as a valuation element

  19. Cultures for mental health care of young people: an Australian blueprint for reform.

    Science.gov (United States)

    McGorry, Patrick D; Goldstone, Sherilyn D; Parker, Alexandra G; Rickwood, Debra J; Hickie, Ian B

    2014-12-01

    Mental ill health is now the most important health issue facing young people worldwide. It is the leading cause of disability in people aged 10-24 years, contributing 45% of the overall burden of disease in this age group. Despite their manifest need, young people have the lowest rates of access to mental health care, largely as a result of poor awareness and help-seeking, structural and cultural flaws within the existing care systems, and the failure of society to recognise the importance of this issue and invest in youth mental health. We outline the case for a specific youth mental health stream and describe the innovative service reforms in youth mental health in Australia, using them as an example of the processes that can guide the development and implementation of such a service stream. Early intervention with focus on the developmental period of greatest need and capacity to benefit, emerging adulthood, has the potential to greatly improve the mental health, wellbeing, productivity, and fulfilment of young people, and our wider society.

  20. Organizational culture, team climate and diabetes care in small office-based practices

    NARCIS (Netherlands)

    Bosch, M.; Dijkstra, R.F.; Wensing, M.J.P.; Weijden, T.T. van der; Grol, R.P.T.M.

    2008-01-01

    BACKGROUND: Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary team