WorldWideScience

Sample records for culturally responsive caring

  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. 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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. Culture, Gender and Health Care Stigma: Practitioners’ Response to Facial Masking Experienced by People with Parkinson’s Disease

    Science.gov (United States)

    Tickle-Degnen, Linda; Zebrowitz, Leslie A.; Ma, Hui-ing

    2011-01-01

    Facial masking in Parkinson’s disease is the reduction of automatic and controlled expressive movement of facial musculature, creating an appearance of apathy, social disengagement or compromised cognitive status. Research in western cultures demonstrates that practitioners form negatively biased impressions associated with patient masking. Socio-cultural norms about facial expressivity vary according to culture and gender, yet little research has studied the effect of these factors on practitioners’ responses toward patients who vary in facial expressivity. This study evaluated the effect of masking, culture and gender on practitioners’ impressions of patient psychological attributes. Practitioners (N=284) in the United States and Taiwan judged 12 Caucasian American and 12 Asian Taiwanese women and men patients in video clips from interviews. Half of each patient group had a moderate degree of facial masking and the other half had near-normal expressivity. Practitioners in both countries judged patients with higher masking to be more depressed and less sociable, less socially supportive, and less cognitively competent than patients with lower masking. Practitioners were more biased by masking when judging the sociability of the American patients, and American practitioners’ judgments of patient sociability were more negatively biased in response to masking than were those of Taiwanese practitioners. Practitioners were more biased by masking when judging the cognitive competence and social supportiveness of the Taiwanese patients, and Taiwanese practitioners’ judgments of patient cognitive competence were more negatively biased in response to masking than were those of American practitioners. The negative response to higher masking was stronger in practitioner judgments of women than men patients, particularly American patients. The findings suggest local cultural values as well as ethnic and gender stereotypes operate on practitioners’ use of facial

  5. Culture, gender and health care stigma: Practitioners' response to facial masking experienced by people with Parkinson's disease.

    Science.gov (United States)

    Tickle-Degnen, Linda; Zebrowitz, Leslie A; Ma, Hui-ing

    2011-07-01

    Facial masking in Parkinson's disease is the reduction of automatic and controlled expressive movement of facial musculature, creating an appearance of apathy, social disengagement or compromised cognitive status. Research in western cultures demonstrates that practitioners form negatively biased impressions associated with patient masking. Socio-cultural norms about facial expressivity vary according to culture and gender, yet little research has studied the effect of these factors on practitioners' responses toward patients who vary in facial expressivity. This study evaluated the effect of masking, culture and gender on practitioners' impressions of patient psychological attributes. Practitioners (N = 284) in the United States and Taiwan judged 12 Caucasian American and 12 Asian Taiwanese women and men patients in video clips from interviews. Half of each patient group had a moderate degree of facial masking and the other half had near-normal expressivity. Practitioners in both countries judged patients with higher masking to be more depressed and less sociable, less socially supportive, and less cognitively competent than patients with lower masking. Practitioners were more biased by masking when judging the sociability of the American patients, and American practitioners' judgments of patient sociability were more negatively biased in response to masking than were those of Taiwanese practitioners. Practitioners were more biased by masking when judging the cognitive competence and social supportiveness of the Taiwanese patients, and Taiwanese practitioners' judgments of patient cognitive competence were more negatively biased in response to masking than were those of American practitioners. The negative response to higher masking was stronger in practitioner judgments of women than men patients, particularly American patients. The findings suggest local cultural values as well as ethnic and gender stereotypes operate on practitioners' use of facial

  6. Cultural aspects of communication in cancer care.

    Science.gov (United States)

    Surbone, A

    2006-01-01

    Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase, and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care leads to improved therapeutic outcome and it may decrease disparities in medical care. Cultural competence in medicine is a complex multilayered accomplishment, requiring knowledge, skills and attitudes whose acquisition is needed for effective cross-cultural negotiation in the clinical setting. Effective cultural competence is based on knowledge of the notion of culture; on awareness of possible biases and prejudices related to stereotyping, racism, classism, sexism; on nurturing appreciation for differences in health care values; and on fostering the attitudes of humility, empathy, curiosity, respect, sensitivity and awareness. Cultural competence in healthcare relates to individual professionals, but also to organizations and systems. A culturally competent healthcare system must consider in their separateness and yet in there reciprocal influences social, racial and cultural factors. By providing a framework of reference to interpret the external world and relate to it, culture affects patients' perceptions of disease, disability and suffering; degrees and expressions of concern about them; their responses to treatments and their relationship to individual physicians and to the healthcare system. Culture also influences the interpretation of ethical norms and principles, and especially of individual autonomy, which can be perceived either as synonymous with freedom or with isolation depending on the cultural context. This, in turn, determines the variability of truth-telling attitudes and practices worldwide as well as the different roles of family in the information and decision-making process of

  7. Connecting care competencies and culture during disasters

    Science.gov (United States)

    Chhabra, Vivek

    2009-01-01

    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 PMID:19561968

  8. [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.

  9. Cross-cultural barriers to health care.

    Science.gov (United States)

    Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju

    2015-01-01

    Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. To overcome difficulties in culturally dissimilar interactions and eventually remove cross-cultural barriers to health care, a culturally sensitive physician considers his or her own identity, values, and beliefs; recognizes the similarities and differences among cultures; understands what those similarities and differences mean; and is able to bridge the differences to accomplish clear and effective communication.

  10. Cultural and spiritual considerations in palliative care.

    Science.gov (United States)

    Long, Carol O

    2011-10-01

    Culture is a fundamental part of one's being. Spirituality is integrated with culture and both play a significant role in a person's journey through life. Yet, culture and spirituality are often misunderstood and may not seem to be important in healthcare settings. For adults with cancer and their families, this cannot be ignored. This paper reviews The Purnell Model of Cultural Competence as a framework for considering culture and spirituality in healthcare and discusses the importance of acknowledging and incorporating practices that support culture and spirituality in healthcare settings. Examples of how to include cultural and spiritual care in palliative and end-of-life care in healthcare settings are provided.

  11. Culture brokerage as a form of caring

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

  13. Islamic Cultures: Health Care Beliefs and Practices.

    Science.gov (United States)

    Kemp, Charles

    1996-01-01

    Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

  14. 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.

  15. Culturally Responsive Leadership for Community Empowerment

    Science.gov (United States)

    Johnson, Lauri

    2014-01-01

    Culturally responsive leadership, derived from the concept of culturally responsive pedagogy, incorporates those leadership philosophies, practices, and policies that create inclusive schooling environments for students and families from ethnically and culturally diverse backgrounds. In this essay I extend the tenets of culturally responsive…

  16. Cultures for performance in health care

    National Research Council Canada - National Science Library

    Mannion, Russell; Davies, Huw T.O; Marshall, Martin N

    2005-01-01

    ... in performance are intrinsically linked to cultural changes within health care settings. Using theories from a wide range of disciplines including economics, management and organization studies, policy studies and the health sciences, this book sets out definitions of cultures and performance, in particular the specific characteristics that help...

  17. Cultural Safety and the Duty of Care.

    Science.gov (United States)

    Fulcher, Leon C.

    2002-01-01

    Examines the notion of cultural safety in relation to the duty of care mandate assigned to child welfare workers when the state intervenes in family life, focusing on the vulnerabilities of rural and indigenous youth in New Zealand to cultural racism. Asserts that child welfare professionals have a professional obligation to enhance their cultural…

  18. Instrument care: everyone's responsibility

    Directory of Open Access Journals (Sweden)

    Renée du Toit

    2011-12-01

    Full Text Available Everyone working in an ophthalmic operating theatre must be competent in the care, handling, storage, and maintenance of instruments. This will help to improve surgical outcomes, maintain an economic and affordable service for patients, and provide a safe environment for the wellbeing of patients and staff.Including instrument care in theatre courses and in-service training is one way of ensuring staff competence.

  19. The Culture Care theory and the Old Order Amish.

    Science.gov (United States)

    Wenger, A F

    1991-11-01

    This chapter discussed knowledge about culture care and culture context in relation to Old Order Amish culture. Leininger's theory of Cultural Care Diversity and Universality and Hall's concept of high-context culture were used to study culture care of the Old Order Amish. This study provided new findings about the culture, especially as related to culture care and high context. These findings also are important to guide nurses and other health care professionals in providing culture-specific care to the Old Order Amish. Leininger's Cultural Care theory has provided a comprehensive theoretical framework to explicate embedded care constructs and patterns of daily living within this culture. Hall's concepts helped to value and discover the importance of high context within the Old Order Amish culture and its relation to the phenomenon of care.

  20. Successful chronic disease care for Aboriginal Australians requires cultural competence.

    Science.gov (United States)

    Liaw, Siaw Teng; Lau, Phyllis; Pyett, Priscilla; Furler, John; Burchill, Marlene; Rowley, Kevin; Kelaher, Margaret

    2011-06-01

    To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice. A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes. In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed. Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'. Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  1. Culturally Responsive Leadership in School Libraries

    Science.gov (United States)

    Summers, Laura L.

    2010-01-01

    Students need culturally responsive teacher-librarians who focus on 21st century skills for all students. Basic principles for culturally responsive leadership in school libraries are articulated by multicultural educators who know that social equity is more important than ever, as the number of diverse and underserved students increase each year.…

  2. Culturally Responsive Pedagogy for Teachers of Color

    Science.gov (United States)

    Gist, Conra D.

    2017-01-01

    This study utilizes the conceptual framework of culturally responsive pedagogy and theoretical suppositions about the culturally responsive teacher educator to examine the learning experiences of teacher candidates of color. Findings from the case study of a teacher educator's and teacher candidates' of color teaching and learning experiences in a…

  3. Cultural factors in preventive care: Latinos.

    Science.gov (United States)

    Diaz, Victor Alejandro

    2002-09-01

    For many, the term "Hispanic" places undue emphasis on the European influence of Spanish colonialism and may even have negative connotations for some. "Latino" is a more encompassing term that gives recognition to the influences of the indigenous and African cultures on modern day Latin Americans. Nevertheless, recognition of typical Latino attitudes and beliefs may assist health care providers. Poverty, unemployment, and low level of education usually account for adverse health in this population. Anti-immigrant sentiment and discrimination in health care and education add adversity to the immigrant's experience. Lack of health insurance and access to quality health care typically plague the adult immigrant. For many, the nearest emergency department is their only source of medical care.

  4. Network Culture, Performance & Corporate Responsibility

    OpenAIRE

    Silvio M. Brondoni

    2003-01-01

    The growth and sustainability of free market economies highlights the need to define rules more suited to the current condition of market globalisation and also encourages firms to adopt more transparent and accountable corporate responsibility (and corporate social responsibility, namely the relationship between the company, environment and social setting). From a managerial perspective, corporate responsibility is linked to ensure the lasting pursuit of the company mission, seeking increasi...

  5. A framework for cultural competence in health care organizations.

    Science.gov (United States)

    Castillo, Richard J; Guo, Kristina L

    2011-01-01

    Increased racial and ethnic diversity in the United States brings challenges and opportunities for health care organizations to provide culturally competent services that effectively meet the needs of diverse populations. The need to provide more culturally competent care is essential to reducing and eliminating health disparities among minorities. By removing barriers to cultural competence and placing a stronger emphasis on culture in health care, health care organizations will be better able to address the unique health care needs of minorities. Organizations should assess cultural differences, gain greater cultural knowledge, and provide cultural competence training to deliver high-quality services. This article develops a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.

  6. Promoting Culturally Responsive Standards-Based Teaching

    Science.gov (United States)

    Saifer, Steffen; Barton, Rhonda

    2007-01-01

    Culturally responsive standards-based (CRSB) teaching can help bring diverse school communities together and make learning meaningful. Unlike multicultural education--which is an important way to incorporate the world's cultural and ethnic diversity into lessons--CRSB teaching draws on the experiences, understanding, views, concepts, and ways of…

  7. 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…

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

    Science.gov (United States)

    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.

  9. Culturally competent care for members of sexual minorities.

    Science.gov (United States)

    Gonser, P A

    2000-01-01

    Culture has historically been interpreted as the beliefs, mores, and lifeways of groups of people primarily related to race and ethnicity. However, individuals who self identify as being lesbian, gay, bisexual and/or transgendered experience ethnocentrism when seeking care from medical and health professionals. Using the principles and concepts of Lenninger's theory of Culture Care Diversity and Universality, members of sexual minorities can assist their health care providers to provide culturally sensitive and ethical care.

  10. 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…

  11. Use of the Culture Care Theory and ethnonursing method to discover how nursing faculty teach culture care.

    Science.gov (United States)

    Mixer, Sandra J

    2008-04-01

    As the world becomes increasingly multicultural, transcultural nursing education is critical to ensuring a culturally competent workforce. This paper presents a comprehensive review of literature and results of an ethnonursing pilot study using the Culture Care Theory (CCT) to discover how nursing faculty teach culture care. The literature revealed that despite 50 years of transcultural nursing knowledge development through theory, research and practice, there remains a lack of formal, integrated culture education in nursing. The importance of faculty providing generic and professional care to nursing students and using an organising framework to teach culture care was discovered. Additionally, care was essential for faculty health and well-being to enable faculty to teach culture care. This unique use of the theory and method demonstrates its usefulness in discovering and describing the complex nature of teaching culture care. Larger scale studies are predicted to further substantiate the CCT, building the discipline of nursing.

  12. 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

  13. End of life care - the importance of culture and ethnicity.

    Science.gov (United States)

    Clark, Katherine; Phillips, Jane

    2010-04-01

    Australia is a culturally and ethnically diverse country. Within such diversity there will be differing beliefs systems about death and dying. This may be a challenging prospect for health professionals. This article discusses how cultural diversity may impact care and provides some strategies for the general practitioner when considering the provision of end of life care. This article does not attempt to provide GPs with a prescriptive approach to multicultural care, as this would run the risk of stereotyping individuals. Rather, it discusses the barriers to end of life care among different cultural and ethnic groups, and suggests ways in which to improve understanding of different cultural needs in end of life care.

  14. Practising Political Care Ethics: Can Responsive Evaluation Foster Democratic Care?

    NARCIS (Netherlands)

    Visse, M.A.; Abma, T.; Widdershoven, G.

    2015-01-01

    This paper examines if and how responsive evaluation as a deliberative approach can serve as a guide for a politically oriented care ethics. A political care ethics puts the assignment of responsibilities and the inclusion of multiple perspectives of people at the centre of care. It honours the

  15. Integration of Latino/a cultural values into palliative health care: a culture centered model.

    Science.gov (United States)

    Adames, Hector Y; Chavez-Dueñas, Nayeli Y; Fuentes, Milton A; Salas, Silvia P; Perez-Chavez, Jessica G

    2014-04-01

    Culture helps us grapple with, understand, and navigate the dying process. Although often overlooked, cultural values play a critical and influential role in palliative care. The purpose of the present study was two-fold: one, to review whether Latino/a cultural values have been integrated into the palliative care literature for Latinos/as; two, identify publications that provide recommendations on how palliative care providers can integrate Latino/a cultural values into the end-of-life care. A comprehensive systematic review on the area of Latino/a cultural values in palliative care was conducted via an electronic literature search of publications between 1930-2013. Five articles were identified for reviewing, discussing, or mentioning Latino/a cultural values and palliative care. Only one article specifically addressed Latino/a cultural values in palliative care. The four remaining articles discuss or mention cultural values; however, the cultural values were not the main focus of each article's thesis. The results of the current study highlight the lack of literature specifically addressing the importance of integrating Latino/a cultural values into the delivery of palliative care. As a result, this article introduces the Culture-Centered Palliative Care Model (CCPC). The article defines five key traditional Latino/a cultural values (i.e., familismo, personalismo, respeto, confianza, and dignidad), discusses the influence of each value on palliative health care, and ends with practical recommendations for service providers. Special attention is given to the stages of acculturation and ethnic identity.

  16. Organizational culture during the accident response process

    International Nuclear Information System (INIS)

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

    1992-01-01

    A large volume of literature hypothesizes a direct relationship between organizational culture and organizational effectiveness. Culture data have been collected by the authors and others at nuclear power plants (NPPs) and other organizations that demand high reliability. In this paper, the literature and data are used to explore a critical dimension of the accident response process in an NPP: the transition from an anticipatory strategy to an ad hoc strategy. In particular, the effect of organizational culture on the implementation of each of these strategies is examined

  17. Response Strategies and Response Styles in Cross-Cultural Surveys

    NARCIS (Netherlands)

    Morren, M.H.; Gelissen, J.P.T.M.; Vermunt, J.K.

    2012-01-01

    This article addresses the following research questions: Do respondents participating in cross-cultural surveys differ in their response style when responding to attitude statements? If so, are characteristics of the response process associated with their ethnicity and generation of immigration? To

  18. The CARE model of social accountability: promoting cultural change.

    Science.gov (United States)

    Meili, Ryan; Ganem-Cuenca, Alejandra; Leung, Jannie Wing-sea; Zaleschuk, Donna

    2011-09-01

    On the 10th anniversary of Health Canada and the Association of Faculties of Medicine of Canada's publication in 2001 of Social Accountability: A Vision for Canadian Medical Schools, the authors review the progress at one Canadian medical school, the College of Medicine at the University of Saskatchewan, in developing a culture of social accountability. They review the changes that have made the medical school more socially accountable and the steps taken to make those changes possible. In response to calls for socially accountable medical schools, the College of Medicine created a Social Accountability Committee to oversee the integration of these principles into the college. The committee developed the CARE model (Clinical activity, Advocacy, Research, Education and training) as a guiding tool for social accountability initiatives toward priority health concerns and as a means of evaluation. Diverse faculty and student committees have emerged as a result and have had far-reaching impacts on the college and communities: from changes in curricula and admissions to community programming and international educational experiences. Although a systematic assessment of the CARE model is needed, early evidence shows that the most significant effects can be found in the cultural shift in the college, most notably among students. The CARE model may serve as an important example for other educational institutions in the development of health practitioners and research that is responsive to the needs of their communities.

  19. 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.

  20. Culturally divergent responses to mortality salience.

    Science.gov (United States)

    Ma-Kellams, Christine; Blascovich, Jim

    2011-08-01

    Two experiments compared the effects of death thoughts, or mortality salience, on European and Asian Americans. Research on terror management theory has demonstrated that in Western cultural groups, individuals typically employ self-protective strategies in the face of death-related thoughts. Given fundamental East-West differences in self-construal (i.e., the independent vs. interdependent self), we predicted that members of Eastern cultural groups would affirm other people, rather than defend and affirm the self, after encountering conditions of mortality salience. We primed European Americans and Asian Americans with either a death or a control prime and examined the effect of this manipulation on attitudes about a person who violates cultural norms (Study 1) and on attributions about the plight of an innocent victim (Study 2). Mortality salience promoted culturally divergent responses, leading European Americans to defend the self and Asian Americans to defend other people.

  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. A survey of cultural competence of critical care nurses in KwaZuluNatal

    Directory of Open Access Journals (Sweden)

    Jennifer de Beer

    2014-11-01

    Full Text Available Background. Nurses are primary caregivers and have a key role in providing care in a culturally diverse healthcare system, such as in South Africa (SA. Nurses need cultural competence in the management of patients within this cultural context. A healthcare system staffed by a culturally competent workforce can provide high-quality care to diverse population groups, contributing to the elimination of health disparities.Objective. To describe the self-rated levels of cultural competence of nurses working in critical care settings in a selected public hospital in SA.Methods. A quantitative descriptive survey was conducted with nurses from eight critical care units in a selected public hospital in KwaZulu-Natal, using the Inventory to Access the Process of Cultural Competency - Revised (IAPCC-R cultural competence questionnaire. Results. The overall cultural competence score for the respondents was 70.2 (standard deviation 7.2 out of a possible 100, with 77 (74% of the respondents scoring in the awareness range, 26 (25% in the competent range, and only 1 in the proficient range. Nurses from non-English-speaking backgrounds scored significantly higher in cultural competence than English-speaking nurses.Conclusion. In addressing the many faces of cultural diversity, healthcare professionals must realise that these faces share a common vision: to obtain quality healthcare services that are culturally responsive and culturally relevant to the specific cultural group.

  3. Working with culture: culturally appropriate mental health care for Asian Americans.

    Science.gov (United States)

    Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

    2011-11-01

    The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

  4. The Dispositions for Culturally Responsive Pedagogy Scale

    Science.gov (United States)

    Whitaker, Manya C.; Valtierra, Kristina Marie

    2018-01-01

    Purpose: The purpose of this study is to develop and validate the dispositions for culturally responsive pedagogy scale (DCRPS). Design/methodology/approach: Scale development consisted of a six-step process including item development, expert review, exploratory factor analysis, factor interpretation, confirmatory factor analysis and convergent…

  5. Arts and cultural activity: A vital part of the health and care system.

    Science.gov (United States)

    Cann, Paul L

    2017-06-01

    This article discusses how the arts and cultural activities are a vital part of a health and care system and have potential to fulfil the theme of active ageing. The changing nature of care provision in response to demographic change, fiscal pressure and increasingly consumerist attitudes on the part of care users, is considered. Selected examples of how participation in arts and cultural activities increases not only well-being but also health outcomes are then outlined. The article highlights the potential of 'cultural commissioning' and within that 'arts on prescription' - public funding of arts-related activities for people with care needs - and advocates investment in arts and cultural activities to better meet the demands of health, social care and aged care. Concluding remarks are made, and a way forward is suggested. © 2017 AJA Inc.

  6. 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.

  7. 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.

  8. Creating a successful culturally sensitive home care program.

    Science.gov (United States)

    Blanter, R; Page, P M

    1995-12-01

    Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

  9. Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making.

    Science.gov (United States)

    Cain, Cindy L; Surbone, Antonella; Elk, Ronit; Kagawa-Singer, Marjorie

    2018-05-01

    Palliative care is gaining acceptance across the world. However, even when palliative care resources exist, both the delivery and distribution of services too often are neither equitably nor acceptably provided to diverse population groups. The goal of this study was to illustrate tensions in the delivery of palliative care for diverse patient populations to help clinicians to improve care for all. We begin by defining and differentiating culture, race, and ethnicity, so that these terms-often used interchangeably-are not conflated and are more effectively used in caring for diverse populations. We then present examples from an integrative literature review of recent research on culture and palliative care to illustrate both how and why varied responses to pain and suffering occur in different patterns, focusing on four areas of palliative care: the formation of care preferences, communication patterns, different meanings of suffering, and decision-making processes about care. For each area, we provide international and multiethnic examples of variations that emphasize the need for personalization of care and the avoidance of stereotyping beliefs and practices without considering individual circumstances and life histories. We conclude with recommendations for improving palliative care research and practice with cultural perspectives, emphasizing the need to work in partnerships with patients, their family members, and communities to identify and negotiate culturally meaningful care, promote quality of life, and ensure the highest quality palliative care for all, both domestically and internationally. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Integrating Cultural Humility into Health Care Professional Education and Training

    Science.gov (United States)

    Chang, E-shien; Simon, Melissa; Dong, XinQi

    2012-01-01

    As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article…

  11. 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.

  12. 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. Copyright © 2014 by the National Comprehensive Cancer Network.

  13. 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...

  14. Chapter 7. Creating and Sustaining a Culture of Group Care

    Science.gov (United States)

    Ainsworth, Frank; Fulcher, Leon C.

    2006-01-01

    Group care centers are established to provide a range of living, learning, treatment, and supervisory opportunities for children and young people who, for a variety of reasons, need alternative, supplementary, or substitute care. It is important, therefore, that group care centres establish an organizational climate, ethos, or culture of caring…

  15. Exploring the development of a cultural care framework for European caring science.

    Science.gov (United States)

    Albarran, John; Rosser, Elizabeth; Bach, Shirley; Uhrenfeldt, Lisbeth; Lundberg, Pranee; Law, Kate

    2011-01-01

    The aim of this paper is to discuss the development of a cultural care framework that seeks to inform and embrace the philosophical ideals of caring science. Following a review of the literature that identified a lack of evidence of an explicit relationship between caring science and cultural care, a number of well-established transcultural care frameworks were reviewed. Our purpose was to select one that would resonate with underpinning philosophical values of caring science and that drew on criteria generated by the European Academy of Caring Science members. A modified framework based on the work of Giger and Davidhizar was developed as it embraced many of the values such as humanism that are core to caring science practice. The proposed caring science framework integrates determinants of cultural lifeworld-led care and seeks to provide clear directions for humanizing the care of individuals. The framework is offered to open up debate and act as a platform for further academic enquiry.

  16. The association between culture, climate and quality of care in primary health care teams.

    Science.gov (United States)

    Hann, Mark; Bower, Peter; Campbell, Stephen; Marshall, Martin; Reeves, David

    2007-09-01

    Culture and climate represent shared beliefs and values that may influence quality of care in health care teams, and which could be manipulated for quality improvement. However, there is a lack of agreement on the theoretical and empirical relationships between climate and culture, and their relative power as predictors of quality of care. This study sought to examine the association between self-report measures of climate and culture in primary care teams and comprehensive measures of quality of care. The data were derived from a cross-sectional survey of 492 professionals in 42 general practices in England. Self-report measures of culture (the Competing Values Framework) and climate (the Team Climate Inventory) were used, together with validated measures of quality of care from medical records and self-report. The majority of practices could be characterized as 'clan' culture type. Practices with a dominant clan culture scored higher on climate for participation and teamwork. There were no associations between culture and quality of care, and only limited evidence of associations between climate and quality. The current analysis would not support the hypothesis that culture and climate are important predictors of quality of care in primary care. Although larger studies are required to provide a definitive test, the results may suggest the need for a more complex model of the associations between culture, climate and outcomes, and further research may be required into the interaction between culture and climate with other determinants of behaviour such as internal and external incentives.

  17. 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.

  18. 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.

  19. Culture care meanings, beliefs, and practices in Rural Dominican Republic.

    Science.gov (United States)

    Schumacher, Gretchen

    2010-04-01

    This ethnonursing study explored the meanings, beliefs, and practices of care for rural Dominicans in the Dominican Republic. Leininger's culture care diversity and universality theory, ethnonursing, and four-phase analysis method guided the study. Interviews were conducted with 19 general and 10 key informants. Analysis of interviews revealed three main themes: (a) family presence is essential for meaningful care experiences and care practices, (b) respect and attention are central to the meaning of care and care practices, and (c) rural Dominicans value and use both generic (folk) and professional care practices. Implications and recommendations for nursing practice, education, and research are described.

  20. Innovative culture in long-term care settings: the influence of organizational characteristics.

    Science.gov (United States)

    Nieboer, Anna P; Strating, Mathilde M H

    2012-01-01

    Innovative cultures have been reported to enhance the creation and implementation of new ideas and working methods in organizations. Although there is considerable research on the impact of organizational context on the innovativeness of organizations, the same is not the case for research on the organizational characteristics responsible for an innovative culture in (long-term) care settings. The aim of this study was to identify organizational characteristics that explain innovative culture in the (long-term) care sector. A large cross-sectional study in Dutch long-term care-nursing homes and/or elderly homes, care organizations for the handicapped, and long-term mental health care organizations-was conducted. A total of 432 managers and care professionals in 37 organizations participated. The Group Innovation Inventory was used to measure innovative culture in long-term care organizations. Structural characteristics of the organization were centralization and formalization, environmental dynamism and competitiveness, internal and external exchange of information, leadership style, commitment to quality improvement, and the organization's innovative strategy. The determinants of an innovative culture were estimated with a two-level random-intercepts and fixed-slopes model. Multilevel regression models were used to account for the organizational clustering of individuals within the 37 care organizations. Environmental dynamism, job codification, formal external exchange of information, transformational leadership, commitment to quality, and an exploratory and exploitative innovation strategy were all significantly correlated with an innovative culture in the multivariate multilevel analysis; the other characteristics were not. The explained organizational- and individual-level variance was 52.5% and 49.2%, respectively. The results point to substantial differences in innovative cultures between and within care organizations that can, in part, be explained by

  1. Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen.

    Science.gov (United States)

    Webair, Hana H; Al-Assani, Salwa S; Al-Haddad, Reema H; Al-Shaeeb, Wafa H; Bin Selm, Manal A; Alyamani, Abdulla S

    2015-10-13

    Patient safety culture in primary care is the first step to achieve high quality health care. This study aims to provide a baseline assessment of patient safety culture in primary care settings in Al-Mukala, Yemen as a first published study from a least developed country. A survey was conducted in primary healthcare centres and units in Al-Mukala District, Yemen. A comprehensive sample from the available 16 centres was included. An Arabic version of the Medical Office Survey on Patient Safety Culture was distributed to all health workers (110). Participants were physicians, nurses and administrative staff. The response rate from the participating centres was 71 %. (N = 78). The percent positive responses of the items is equal to the percentage of participants who answered positively. Composite scores were calculated by averaging the percent positive response on the items within a dimension. Positive safety culture was defined as 60 % or more positive responses on items or dimensions. Patient safety culture was perceived to be generally positive with the exception of the dimensions of 'Communication openness', 'Work pressure and pace' and 'Patient care tracking/follow-up', as the percent positive response of these dimensions were 58, 57, and 52 % respectively. Overall, positive rating on quality and patient safety were low (49 and 46 % respectively). Although patient safety culture in Al-Mukala primary care setting is generally positive, patient safety and quality rating were fairly low. Implementation of a safety and quality management system in Al-Mukala primary care setting are paramount. Further research is needed to confirm the applicability of the Medical Office Survey on Patient Safety Culture (MOSPSC) for Al-Mukala primary care.

  2. Corporate moral responsibility in health care.

    Science.gov (United States)

    Wilmot, S

    2000-01-01

    The question of corporate moral responsibility--of whether it makes sense to hold an organisation corporately morally responsible for its actions, rather than holding responsible the individuals who contributed to that action--has been debated over a number of years in the business ethics literature. However, it has had little attention in the world of health care ethics. Health care in the United Kingdom (UK) is becoming an increasingly corporate responsibility, so the issue is increasingly relevant in the health care context, and it is worth considering whether the specific nature of health care raises special questions around corporate moral responsibility. For instance, corporate responsibility has usually been considered in the context of private corporations, and the organisations of health care in the UK are mainly state bodies. However, there is enough similarity in relevant respects between state organisations and private corporations, for the question of corporate responsibility to be equally applicable. Also, health care is characterised by professions with their own systems of ethical regulation. However, this feature does not seriously diminish the importance of the corporate responsibility issue, and the importance of the latter is enhanced by recent developments. But there is one major area of difference. Health care, as an activity with an intrinsically moral goal, differs importantly from commercial activities that are essentially amoral, in that it narrows the range of opportunities for corporate wrongdoing, and also makes such organisations more difficult to punish.

  3. 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

  4. 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.

  5. 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.

  6. Organizational culture during the accident response process

    International Nuclear Information System (INIS)

    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

  7. Cultural barriers to health care for southeast Asian refugees.

    OpenAIRE

    Uba, L

    1992-01-01

    Many Southeast Asians now living in the United States experience severe health problems, attributable to physical trauma and inadequate health care in Asia, and low socioeconomic status in this country. Evidence indicates that despite their health problems, Southeast Asian refugees underuse the American health care system. Cultural reasons for this underuse are examined. Southeast Asian cultural attitudes toward suffering, such as beliefs that suffering is inevitable or that one's life span i...

  8. Cultural competency: providing quality care to diverse populations.

    Science.gov (United States)

    Betancourt, Joseph R

    2006-12-01

    The goal of this paper is to define cultural competence and present a practical framework to address crosscultural challenges that emerge in the clinical encounter, with a particular focus on the issue of nonadherence. English-language literature, both primary and reports from various agencies, and the author's personal experiences in clinical practice. Relevant literature on patient-centered care and cultural competence. There is a growing literature that delineates the impact of sociocultural factors, race, ethnicity, and limited-English proficiency on health and clinical care. The field of cultural competence focuses on addressing these issues. Health care providers need a practical set of tools and skills that will enable them to provide quality care to patients during a brief encounter, whatever differences in background that may exist. Cultural competence has evolved from the gathering of information and making of assumptions about patients on the basis of their sociocultural background to the development of skills to implement the principles of patient-centered care. This patient-based approach to cross-cultural care consists of first, assessing core cross-cultural issues; second, exploring the meaning of the illness to the patient; third, determining the social context in which the patient lives; and fourth, engaging in negotiation with the patient to encourage adherence. Addressing adherence is a particularly challenging issue, the determinants of which are multifactorial, and the ESFT (explanatory/social/fears/treatment) model--derived from the patient-based approach--is a tool that identifies barriers to adherence and provides strategies to address them. It obviously is impossible to learn everything about every culture and that should not be expected. Instead, we should learn about the communities we care for. More important, we should have a framework that allows us to provide appropriate care for any patient--one that deals with issues of adherence

  9. 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.

  10. 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.

  11. Care and cultural context of Lebanese Muslim immigrants: using Leininger's theory.

    Science.gov (United States)

    Luna, L

    1994-01-01

    The purpose of this ethnonursing study was to describe and analyze the meanings and experiences of care for Lebanese Muslims as influenced by cultural context in selected natural and community settings. Leininger's theory of Cultural Care Diversity and Universality served as the conceptualizing frame-work for the study. Research questions focused on discovering the meanings and experiences of care as influenced by world view, social structure, and cultural context in the hospital, clinic, and home. Ethno-nursing research methods were used with key and general informants in an urban US community. The majority of informants were new immigrants living less than 10 years in the US. Universal themes of care that were similar in the three contexts reflected care as a religious obligation in Islam, care as equal but different gender role responsibilities, and care as individual and collective meanings of honor. This article also presents findings related to gender role responsibilities. Nursing decisions and actions using Leininger's three modes were identified to achieve culturally congruent nursing care.

  12. Cultural Responsiveness and Routines: When Center and Home Don't Match

    Science.gov (United States)

    Gonzalez-Mena, Janet

    2010-01-01

    This article discusses cultural responsiveness and routines of child care centers that do not match what families are accustomed to at home. It can be difficult to discuss cultural differences in some routine caregiving activities because of the standards, rules, regulations, best practices, and health concerns that those trained in early…

  13. Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings.

    Science.gov (United States)

    McFarland, Marilyn M; Eipperle, Marilyn K

    2008-04-01

    Leininger's Theory of Culture Care Diversity and Universality is presented as a foundational basis for the educational preparation, primary care contextual practice, and outcomes-focused research endeavours of advanced practice nursing. Discussion emphasises the value of care and caring as the essence of advanced practice nursing through the use of three modes of care, use of the Sunrise and other enablers, and the ethnonursing method. Education, research, practice, and key concepts of the theory are connected as essential components toward the provision of culturally congruent care to meet the healthcare needs of diverse individuals, families, groups, and communities by family nurse practitioners.

  14. Generalist palliative care in hospital: cultural and organisational interactions

    DEFF Research Database (Denmark)

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

    2016-01-01

    : a quantitative study, in which three independent datasets were triangulated to study the organisation and evaluation of generalist palliative care, and a qualitative, ethnographic study exploring the culture of generalist palliative nursing care in medical departments. SETTING/PARTICIPANTS: A Danish regional...

  15. 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.

    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

  16. Exploring the concept of "caring cultures": A critical examination of the conceptual, methodological and validity issues with the "caring cultures" construct.

    Science.gov (United States)

    Gillin, Nicola; Taylor, Ruth; Walker, Susan

    2017-12-01

    To critically examine the conceptual, methodological and validity issues with the "caring cultures" construct. Post the Francis Report, "caring cultures" and alternative terminology such as "culture/s of care/caring/compassionate care" have gained prominence in the literature, especially within a UK policy context. However, in order to understand the value these "caring cultures" hold in terms of clinical practice, the concept itself first needs to be understood. A discussion and critical examination of the concept of "caring cultures" and associated terminology. Grey literature, database, library and reference list searches were conducted. It is implied that "caring cultures" influence patient care. However, evidence which verifies this assertion is limited. In this article, the concept of "caring cultures" is deconstructed and its validity explored. An alternative to "caring cultures" is proposed in terms of research, whereby the concept of culture is instead explored in detail, on a microsystem level, using appropriate methodology. The concept of "caring cultures", although attractive in terms of its apparent simplicity, is not considered the most useful nor appropriate phrases in terms of advancing research. Instead, research which examines the established concept of "culture" in relation to outcomes such as patient care, doing so with an appropriate methodology, is viewed as a more suitable alternative. Clarifying concepts and terminology relating to "caring cultures" is essential for research to progress and the impact of culture on clinical practice to be better understood. © 2017 John Wiley & Sons Ltd.

  17. 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.

  18. 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.

  19. Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences.

    Science.gov (United States)

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

    2017-03-01

    Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters. © 2016 Nordic College of Caring Science.

  20. Mixed messages: residents' experiences learning cross-cultural care.

    Science.gov (United States)

    Park, Elyse R; Betancourt, Joseph R; Kim, Minah K; Maina, Angela W; Blumenthal, David; Weissman, Joel S

    2005-09-01

    An Institute of Medicine report issued in 2002 cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' training and capabilities to provide quality care to diverse populations. This article explores a select group of residents' perceptions of their preparedness to deliver quality care to diverse populations. Seven focus groups and ten individual interviews were conducted with 68 residents in locations nationwide. Qualitative analysis of focus-group and individual interview transcripts was performed to assess residents' perceptions of (1) preparedness to deliver care to diverse patients; (2) educational climate; and (3) training experiences. Most residents in this study noted the importance of cross-cultural care yet reported little formal training in this area. Residents wanted more formal training yet expressed concern that culture-specific training could lead to stereotyping. Most residents had developed ad hoc, informal skills to care for diverse patients. Although residents perceived institutional endorsement, they sensed it was a low priority due to lack of time and resources. Residents in this study reported receiving mixed messages about cross-cultural care. They were told it is important, yet they received little formal training and did not have time to treat diverse patients in a culturally sensitive manner. As a result, many developed coping behaviors rather than skills based on formally taught best practices. Training environments need to increase training to enhance residents' preparedness to deliver high-quality cross-cultural care if the medical profession is to achieve the goals set by the Institute of Medicine.

  1. Culturally Responsive Pedagogy: Reflections on Mentoring by Educational Leadership Candidates

    Science.gov (United States)

    Genao, Soribel

    2016-01-01

    Authentic field experience is an important component in educational leadership programs. This article revisits the literature examining the cultural gap that exists in public education, while taking a closer look at what it means to be a culturally responsive leader and teacher. The need to integrate culturally responsive practices to connect and…

  2. 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.

  3. Culture care of Iranian immigrants in New South Wales, Australia: sharing transcultural nursing knowledge.

    Science.gov (United States)

    Omeri, A

    1997-01-01

    Discovery and analysis of care meanings, expressions, and practices of Iranian Immigrants in New South Wales, Australia was the focus of this ethnonursing qualitative research. The purpose of the study was to systematically discover, describe and analyse the values, beliefs, and practices of Iranian immigrants in New South Wales, Australia. The aim of the investigation was to discover transcultural nursing knowledge to guide nurses and health professionals to provide culturally congruent nursing and health care to Iranians. Leininger's theory of Culture Care Diversity and Universality (Leininger, 1991) was used as the conceptual framework for the study. It was predicted that care meanings and expressions of Iranian immigrants would be influenced by their worldview, social structure features, language, and cultural values rooted in their long ethnohistorical past and reflected in their lifeways in Australia. Using the ethnonursing qualitative research method, key and general informants were purposefully selected among Iranian immigrants residing in New South Wales. Three care themes supported by a number of universal and some diverse patterns were identified for Iranian immigrants. The three themes were: (1) Care meant family and kinship ties (hambastegie) as expressed in daily lifeways and interactions with family, friends, and community; (2) Care as expressed in carrying out traditional urban gender roles (role-zan-o-mard) (Azadie zan) as well as in fulfilling emerging new role responsibilities related to equality for female Iranian immigrants; and (3) Care as preservation of Iranian identity (inhamoni, hamonandi) as expressed in traditional cultural events and health care practices. Leininger's (1991) three modes of actions and decisions were used to develop appropriate and culturally meaningful nursing care actions and decisions which were in harmony with the cultural beliefs of Iranian immigrants.

  4. Culture as anchor or culture as impediment? The plight of child care ...

    African Journals Online (AJOL)

    The authors document the nature of the conflict, highlighting how the care workers adopted 'mothering roles' based on African cultural parenting practices, resulting in the need to perform culturally prescribed rituals, and how this brought about challenges within the workplace. The need for integrating traditional methods of ...

  5. Developing a culturally appropriate mental health care service for Samoa.

    Science.gov (United States)

    Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse

    2013-06-01

    Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  6. 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.

  7. PERCEPTIONS OF CULTURE CARE IN HUMANITARIAN WORK BY THE STUDENTS OF MASTERS' DEGREE IN GLOBAL HEALTH CARE

    OpenAIRE

    Kering, Naomy

    2016-01-01

    As the world is increasingly becoming multicultural, the need for cultural competence education to students of health care is essential to ensure a culturally competent workforce. The main purpose of this study is to determine the students’ perceptions of culture care and its importance in their work contexts. The main aim is to identify how students’ worldview, cultural and socio-cultural factors influence the way of care to people of diverse cultures. Qualitative method was used in this stu...

  8. 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.

  9. Pushing boundaries-culture-sensitive care in oncology and palliative care: a qualitative study.

    Science.gov (United States)

    Schrank, Beate; Rumpold, Tamara; Amering, Michaela; Masel, Eva Katharina; Watzke, Herbert; Schur, Sophie

    2017-06-01

    In increasingly globalized societies, patient-centered cancer care requires culture-sensitive approaches in order to ensure patients well-being. While migrant patients' needs are frequently reported in the literature, staff members' perception of work with migrant patients, associated challenges, or individual work approaches are largely unknown. This study addresses this research gap through qualitative exploration of experiences of multicultural health care professionals in supportive oncology and palliative care, working with patients from different cultural backgrounds. This study aims to understand staff experience of the impact of culture on cancer care. This study was conducted at the Medical University of Vienna, including staff from different settings of oncology and palliative care, in different professional positions, and with a range of individual migration backgrounds. Semistructured interviews were conducted with 21 staff members working with patients from different cultural backgrounds. Interviews explored views on the impact of culture on care were audio-taped, transcribed, and analyzed using a rigorous method of thematic analysis, enhanced with grounded theory techniques. Interviews revealed 4 key topics: culture-specific differences, assumed reasons for differences, consequences of multicultural care, and tools for culture-sensitive care. Strategies to better deal with migrant patients and their families were suggested to improve work satisfaction amongst staff. This study identifies relevant staff challenges in work with migrant patients. Concrete suggestions for improvement include measures on an organizational level, team level, and personal tools. The suggested measures are applicable to improve work satisfaction and culture-sensitive care not only in cancer care but also in other areas of medicine. Copyright © 2016 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Hemberg, Jessica Anne Viveka; Vilander, Susann

    2017-12-01

    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.

  11. [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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    in medical departments. Methods: An ethnographic study, using Spradley's 12-step method, with observational field studies and interviews with nurses from three medical departments in a Danish regional hospital. Findings: Three cultural themes emerged from the analysis, focusing on the setting, the practice...... 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...

  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. Building evaluative culture in community services: Caring for evidence.

    Science.gov (United States)

    Mayne, John

    2017-05-25

    An organization with a strong evaluative culture engages in self-reflection, evidence-based learning and experimentation. It sees evidence as essential for managing well, but building such a culture is challenging. Community service organizations seek to provide effective services for their clients. To build an evaluative culture, they need to acquire basic monitoring and evaluation capabilities, be provided with opportunities for using these capabilities and be adequately motivated to care about evidence as a means to improve services to their clients. Leadership along with a phased in approach are key in bringing about these behaviour changes. Copyright © 2017. Published by Elsevier Ltd.

  15. 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.

  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. 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.

  18. 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 cross-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, particularly among physicians.

  19. Towards culturally competent paediatric oncology care. A qualitative study from the perspective of care providers.

    Science.gov (United States)

    Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N

    2017-11-01

    In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Murray, Melanie; Sundin, Deborah; Cope, Vicki

    2018-03-01

    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 programme 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 towards safer practices. The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Safety is crucial in health care 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. Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes. © 2017 John Wiley & Sons Ltd.

  1. Culturally Responsive: Art Education in a Global Era

    Science.gov (United States)

    Lai, Alice

    2012-01-01

    Facing the era of globalization, culturally responsive art teachers must recognize that students' home culture, including local artistic expression, is inevitably influenced by global forces. They should strive to engage with students systems and issues of globalization and its impact on their community culture and art. In this article, the author…

  2. 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…

  3. Culture and maternity care in Kazakhstan: what new mothers expected.

    Science.gov (United States)

    Craig, Brett J; Kabylbekova, Zhanar

    2015-01-01

    Maternity care in the developing nation of Kazakhstan has been characterized as low in quality, with mothers having low levels of health knowledge. Some nongovernmental organizations have been offering childbirth preparation courses to address the lack of knowledge and encourage participation and decision making among expecting mothers. The participants of this study, however, report that information is more for preparation than for decision making, and that the relational aspects of their care, namely, emotional support and trust, are most important. This emphasis reflects the cultural and historical influences that need to be considered when adopting foreign models of care and health education.

  4. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Epilogue: The study of care in cross cultural, interdisciplinary ...

    African Journals Online (AJOL)

    No abstract available for this article... Keywords: care in cross culture, interdisciplinary perspective. Research Review Supplement 16 (2004: 95-101). AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

  6. 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.…

  7. Safe patient care - safety culture and risk management in otorhinolaryngology.

    Science.gov (United States)

    St Pierre, Michael

    2013-12-13

    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 stimulation based team trainings into their

  8. [Safe patient care: safety culture and risk management in otorhinolaryngology].

    Science.gov (United States)

    St Pierre, M

    2013-04-01

    Safety culture is positioned at the heart of an organisation'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 organizations 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 Organisation'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 simulation based team trainings into their curriculum

  9. 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.

  10. Shared responsibility for children in care

    DEFF Research Database (Denmark)

    Schwartz, Ida

    2014-01-01

    as other kids. These differences are often explained by pointing at individual or family inheritance. This paper takes the perspective that social exclusion is multi-dimensional, and the cross-professional structuring of children´s everyday life plays an important role. Processes of social exclusion...... 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......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...

  11. 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.

  12. 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.

  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)

    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 cross-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 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, particularly among physicians. PMID:24479405

  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. 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…

  16. 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

  17. 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.

  18. 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

  19. Understanding Muslim patients: cross-cultural dental hygiene care.

    Science.gov (United States)

    Sirois, M L; Darby, M; Tolle, S

    2013-05-01

    Healthcare providers who understand the basic pillars of Islamic beliefs and common religious practices can apply these concepts, anticipate the needs of the Muslim patient and family, and attract Muslim patients to the practice. Cross cultural knowledge can motivate dental hygienists to adopt culturally acceptable behaviors, strengthen patient-provider relationships and optimize therapeutic outcomes. Trends in Muslim population growth, Islamic history and beliefs, modesty practices, healthcare beliefs, contraception, childbearing, childrearing, pilgrimage, dietary practices, dental care considerations and communication are explained. This paper reviews traditional Muslim beliefs and practices regarding lifestyle, customs, healthcare and religion as derived from the literature and study abroad experiences. Recommendations are offered on how to blend western healthcare with Islamic practices when making introductions, appointments, eye contact, and selecting a practitioner. The significance of fasting and how dental hygiene care can invalidate the fast are also discussed. The ultimate goal is for practitioners to be culturally competent in providing care to Muslim patients, while keeping in mind that beliefs and practices can vary widely within a culture. © 2012 John Wiley & Sons A/S.

  20. Organizational culture in cardiovascular care in Chinese hospitals: a descriptive cross-sectional study.

    Science.gov (United States)

    Yin, Emily S; Downing, Nicholas S; Li, Xi; Singer, Sara J; Curry, Leslie A; Li, Jing; Krumholz, Harlan M; Jiang, Lixin

    2015-12-21

    Organizational learning, the process by which a group changes its behavior in response to newly acquired knowledge, is critical to outstanding organizational performance. In hospitals, strong organizational learning culture is linked with improved health outcomes for patients. This study characterizes the organizational learning culture of hospitals in China from the perspective of a cardiology service. Using a modified Abbreviated Learning Organization Survey (27 questions), we characterized organizational learning culture in a nationally representative sample of 162 Chinese hospitals, selecting 2 individuals involved with cardiovascular care at each hospital. Responses were analyzed at the hospital level by calculating the average of the two responses to each question. Responses were categorized as positive if they were 5+ on a 7-point scale or 4+ on a 5-point scale. Univariate and multiple regression analyses were used to assess the relationship between selected hospital characteristics and perceptions of organizational learning culture. Of the 324 participants invited to take the survey, 316 responded (98 % response rate). Perceptions of organizational learning culture varied among items, among domains, and both among and within hospitals. Overall, the median proportion of positive responses was 82 % (interquartile range = 59 % to 93 %). "Training," "Performance Monitoring," and "Leadership that Reinforces Learning" were characterized as the most favorable domains, while "Time for Reflection" was the least favorable. Multiple regression analyses showed that region was the only factor significantly correlated with overall positive response rate. This nationally representative survey demonstrated variation in hospital organizational learning culture among hospitals in China. The variation was not substantially explained by hospital characteristics. Organizational learning culture domains with lower positive response rates reveal important areas for

  1. Organizational culture influences health care workers' influenza immunization behavior.

    Science.gov (United States)

    Isaacson, Nicole; Roemheld-Hamm, Beatrix; Crosson, Jesse C; Dicicco-Bloom, Barbara; Winston, Carla A

    2009-03-01

    Low rates of influenza immunization among health care workers (HCWs) pose a potential health risk to patients in primary care practices. Despite previous educational efforts and programs to reduce financial barriers, HCW influenza immunization rates remain low. Variation in practice-level organizational culture may affect immunization rates. To explore this relationship, we examined organizational cultures and HCWs' influenza immunization behaviors in three family medicine practices. We used a multi-method comparative case study. A field researcher used participant observation, in-depth interviews, and key informant interviews to collect data in each practice in November-December 2003. A diverse team used grounded theory to analyze text data. Organizational culture varied among practices and differing HCW immunization rates were observed. The most structured and business-like practice achieved immunization of all HCWs, while the other two practices exhibited greater variation in HCW immunization rates. Physicians in the practices characterized as chaotic/disorganized or divided were immunized at higher rates than other members of the practices. In these practices, organizational culture was associated with varying rates of influenza immunization for HCWs, especially among nonphysicians. Addressing elements of organizational culture such as beliefs regarding influenza immunization and office policies may facilitate the immunization of all staff members.

  2. 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

    2016-10-07

    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. Copyright © 2016 by the American Society of Nephrology.

  3. Effectiveness of cross-cultural education for medical residents caring for burmese refugees.

    Science.gov (United States)

    McHenry, Megan Song; Nutakki, Kavitha; Swigonski, Nancy L

    2016-01-01

    Limited resources are available to educate health professionals on cultural considerations and specific healthcare needs of Burmese refugees. The objective of this study was to determine the effectiveness of a module focused on cross-cultural considerations when caring for Burmese refugees. A brief educational module using anonymously tracked pre- and post-intervention, self-administered surveys was developed and studied. The surveys measured pediatric and family medicine residents' knowledge, attitudes, and comfort in caring for Burmese refugees. Paired t-tests for continuous variables and Fisher's exact tests for categorical variables were used to test pre- and post-intervention differences. We included open-ended questions for residents to describe their experiences with the Burmese population. The survey was available to 173 residents. Forty-four pre- and post-intervention surveys were completed (response rate of 25%). Resident comfort in caring for Burmese increased significantly after the module (P = 0.04). Resident knowledge of population-specific cultural information increased regarding ethnic groups (P = 0.004), appropriate laboratory use (P = 0.04), and history gathering (P = 0.001). Areas of improved resident attitudes included comprehension of information from families (P = 0.03) and length of time required with interpreter (P = 0.01). Thematic evaluation of qualitative data highlighted four themes: access to interpreter and resources, verbal communication, nonverbal communication, and relationship building with cultural considerations. A brief intervention for residents has the potential to improve knowledge, attitudes, and comfort in caring for Burmese patients. Interventions focused on cultural considerations in medical care may improve cultural competency when caring for vulnerable patient populations.

  4. Cultural responses to climate change during the late Holocene.

    Science.gov (United States)

    deMenocal, P B

    2001-04-27

    Modern complex societies exhibit marked resilience to interannual-to- decadal droughts, but cultural responses to multidecadal-to-multicentury droughts can only be addressed by integrating detailed archaeological and paleoclimatic records. Four case studies drawn from New and Old World civilizations document societal responses to prolonged drought, including population dislocations, urban abandonment, and state collapse. Further study of past cultural adaptations to persistent climate change may provide valuable perspective on possible responses of modern societies to future climate change.

  5. Transcultural nursing: providing culturally congruent care to the Hausa of Northwest Africa.

    Science.gov (United States)

    Chmielarczyk, V

    1991-01-01

    Research around the world is now beginning to validate the theory of Cultural Care as an important means to provide culturally congruent care to clients, families, and groups of diverse cultures. Knowledge of Leininger's Theory of Cultural Care Diversity and Universality can provide meaningful care to clients who have different traditional and current beliefs and values. The Leininger Sunrise Model can serve as a valuable guide to discover care meanings and practices related to the theory, and to provide practical and meaningful culture specific care decisions and actions by nurses. The three major modes of action, namely, cultural care maintenance or preservation, accommodation or negotiation, and repatterning or restructuring, are important differential means to provide culturally congruent care to clients within their own cultural setting. This article considers the application of such care for the Hausa of Northwest Africa.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Responsible care - the challenge of communication

    International Nuclear Information System (INIS)

    Hunter, D.; Mullin, R.

    1992-01-01

    When the chemical industry embarked on the Responsible Care initiative, no one had any illusions that it would not be a long haul. Economic circumstances are hardly helping, as the industry follows up on its efforts to get ahead of the regulatory curve and make the investments needed to improve its environmental performance, in line with the collective commitments it has made. At the same time, recently available data show that while there has been progress in implementation of the program in the US there has been no visible progress in turning around attitudes toward the chemical industry. The program is spreading ever wider across the worldwide chemical industry - recent recruits include Poland, Venezuela, and Turkey - but everyone knows that endorsement is just the start of the work. OxyChem CEOJ J. Roger Hirl, next in line to be chairman of CMA, says the industry's next moves will be crucial. The background is hard: The chemical industry is still in a prolonged period of financial stress, the Clinton Administration may not be as easy to deal with in the areas touched by Responsible Care, and many critics of the program expect enthusiasm over investment in clean technology to evaporate. We've got to keep up the progress, says Hirl. Now is the time Responsible Care has really got to work

  7. Teachers' Texts in Culturally Responsive Teaching

    Science.gov (United States)

    Kesler, Ted

    2011-01-01

    In this paper, the author shares three teaching stories that demonstrate the social, cultural, political, and historical factors of all texts in specific interpretive communities. The author shows how the texts that comprised his curriculum constructed particular subject positions that inevitably included some students but marginalized and…

  8. Culturally Responsive Marketing of Coach and Pepsi

    OpenAIRE

    Edwin Quinn; Renika Quinn

    2015-01-01

    This study will focus on the cultural aspects of China and how the brands Coach and Pepsi will target Chinese consumers. Information will be provided on the society, economical facets, marketing analysis and positive and normative perspectives of the study. China, like with many other countries has developed certain marketing techniques as a way of gaining the interest of their consumers.

  9. Practicing Culturally Responsive Pedagogy in Physical Education

    Science.gov (United States)

    Young, Shawna; Sternod, Brandon M.

    2011-01-01

    As a result of continuous global immigration to the United States, several microcultures coexist within the country. Today's classroom should provide an interface where individuals from different cultural backgrounds have the potential for sharing a rich place of learning--a place where the teacher embraces and celebrates individual differences,…

  10. Olympism, physical education and culturally responsive pedagogies ...

    African Journals Online (AJOL)

    The ubiquitous forces of the globalisation of sport and other social constructs, such as economic and political, create cultural necessities for physical education (PE) to connect and celebrate diversity, yet at the same time, commit to contextualised educative and social purposes. The commitment is the need for an inclusive ...

  11. Culturally Responsive Contexts: Establishing Relationships for Inclusion

    Science.gov (United States)

    Berryman, Mere; Ford, Therese; Nevin, Ann; SooHoo, Suzanne

    2015-01-01

    As our education systems become more culturally, ethnically and linguistically diverse, rather than benefiting and learning from each other, we still expect all students to be represented within the same curriculum, pedagogy and testing regimen or we form separate enclaves resulting in marginalizaton. When diverse students have physical and/or…

  12. 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.

  13. Responsibility, fairness and rationing in health care.

    Science.gov (United States)

    Cappelen, Alexander W; Norheim, Ole Frithjof

    2006-05-01

    People make different choices about how to live their life and these choices have a significant effect on their health, the risks they face and their need for treatment in the future. The objective of this article is, drawing on normative political theory, to sketch an argument that assigns a limited but significant role to individual responsibility in the design of the health-care system. In developing our argument, we proceed in five steps. First, we review the literature on criteria for priority setting. Second, we explore the most prominent contemporary tradition in normative theory, liberal egalitarian ethics, with the aim to clarify the role of responsibility for choice. In particular, we discuss where liberal egalitarian theories would draw the 'cut' between the responsibility of the state (which is extensive) and the responsibility of the individuals (which is limited but significant). In the third step, we identify a priority setting dilemma where the commonly advocated criteria would assign equal priority. Finally, we develop a simple model in order to examine the implications of introducing a well-defined notion of responsibility for choice in a priority-setting dilemma of this kind. Liberal egalitarianism holds individuals responsible for choices that affect their health, given that (i) the illness is completely or partly a result of individual behaviour and choice; (ii) the illness is not life-threatening; (iii) the illness does not limit the use of political rights or the exercise of fundamental capabilities; and (iv) the cost of treatment is low relative to the income of the patients. The paper shows how this type of considerations can be used to determine an optimal level of co-payments for diseases even when individual choices cannot be observed directly. It is possible to assign a limited but significant role to individual responsibility in the rationing of health-care resources. The liberal egalitarian argument captures a concern that is not

  14. [The representation of care in the cultural image of nursing].

    Science.gov (United States)

    Vieira, M J

    1999-12-01

    We analyzed Sergipan nurses' life stories, related to the cultural image of Nursing perceived in their professional choice, in order to assist students in this professional identification. Subjects were divided into four chronological groups, from retired nurses to those who had been graduated for 5 years, all of whom chose Nursing as their preferred career. We used the Social Representation approach in the cultural systems to analyze the life stories. Findings were analyzed through categories and themes, and it was presented by graphics and tables. Care was identified as a permanent cultural trace and it was verbalized using words from charity, religion to scientific Nursing and professionalism, to describe scientific knowledge and humanism, with temporal configuration.

  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. 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...

  17. Diallel analysis of anther culture response in wheat ( Triticum ...

    African Journals Online (AJOL)

    The four wheat (Triticum aestivum L.) genotypes differing in their ability to produce embryogenic callus from anther culture were reciprocally crossed and inheritance of anther culture response [callus induction frequency (CIF, %), embryogenic callus induction frequency (ECIF, %), regeneration capacity of callus (RCC, %) ...

  18. Addressing Cultural Responsiveness in Consultation: An Empirical Demonstration

    Science.gov (United States)

    McKenney, Elizabeth L. W.; Mann, Kacee A.; Brown, Danice L.; Jewell, Jeremy D.

    2017-01-01

    This study explored whether and to what extent consultation practices specifically focused on culturally responsive instruction provided additive benefit, after establishing strong classroom management. Three teachers leading culturally diverse classrooms participated in two phases of consultation. The first was a traditional, classroom-management…

  19. Implementing culture change in long-term dementia care settings.

    Science.gov (United States)

    McGreevy, Jessica

    2016-01-06

    The approach to nursing in long-term care settings for people living with dementia continues to evolve from a traditional, task-oriented culture to one that is person-centred. Such change can be difficult to manage and may encounter considerable opposition; having an understanding of change management and leadership styles may help to make this transition easier. This article discusses the differences between task-oriented and person-centred care, theories of management, motivation and leadership styles, and focuses on those that are most appropriate for this type of change. An improved understanding of these theories will enable nurses to support others in the delivery of person-centred care.

  20. 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

  1. Statistical optimization of cultural conditions by response surface ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-08-04

    Aug 4, 2009 ... Full Length Research Paper. Statistical optimization of cultural conditions by response surface methodology for phenol degradation by a novel ... Phenol is a hydrocarbon compound that is highly toxic, ... Microorganism.

  2. Cultural crossings of care: An appeal to the medical humanities.

    Science.gov (United States)

    Kristeva, Julia; Moro, Marie Rose; Ødemark, John; Engebretsen, Eivind

    2018-03-01

    Modern medicine is confronted with cultural crossings in various forms. In facing these challenges, it is not enough to simply increase our insight into the cultural dimensions of health and well-being. We must, more radically, question the conventional distinction between the 'objectivity of science' and the 'subjectivity of culture'. This obligation creates an urgent call for the medical humanities but also for a fundamental rethinking of their grounding assumptions.Julia Kristeva (JK) has problematised the biomedical concept of health through her reading of the anthropogony of Cura (Care), who according to the Roman myth created man out of a piece of clay. JK uses this fable as an allegory for the cultural distinction between health construed as a 'definitive state', which belongs to biological life ( bios ), and healing as a durative 'process with twists and turns in time' that characterises human living ( zoe ). A consequence of this demarcation is that biomedicine is in constant need of 'repairing' and bridging the gap between bios and zoe, nature and culture. Even in radical versions, the medical humanities are mostly reduced to such an instrument of repairment, seeing them as what we refer to as a soft, 'subjective' and cultural supplement to a stable body of 'objective', biomedical and scientific knowledge. In this article, we present a prolegomenon to a more radical programme for the medical humanities, which calls the conventional distinctions between the humanities and the natural sciences into question, acknowledges the pathological and healing powers of culture, and sees the body as a complex biocultural fact. A key element in such a project is the rethinking of the concept of 'evidence' in healthcare. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The Assessment of Athletic Training Students' Knowledge and Behavior to Provide Culturally Competent Care

    Science.gov (United States)

    Nynas, Suzette Marie

    2015-01-01

    Context: Culturally competent knowledge and skills are critical for all healthcare professionals to possess in order to provide the most appropriate health care for their patients and clients. Objective: To investigate athletic training students' knowledge of culture and cultural differences, to assess the practice of culturally competent care,…

  4. Guiding the Process of Culturally Competent Care With Hispanic Patients: A Grounded Theory Study.

    Science.gov (United States)

    Sobel, Linda L; Metzler Sawin, Erika

    2016-05-01

    To explore nursing care actions that lead to culturally competent care for Hispanic patients. Nurses report apprehension when delivering nursing care because of language barriers and a lack of Hispanic cultural understanding. Research is needed to inform culturally aware nursing practice actions for Hispanic patients. The study used a qualitative, grounded theory design to address the questions: (a) What cultural knowledge should nurses have when caring for Hispanic patients and families and (b) What nursing actions should nurses take to provide culturally competent care? Hispanic lay health promoters and Hispanic community members were interviewed to make recommendations for care. A model was identified that informs culturally competent nursing care. "Connectedness," the central phenomenon, describes nursing actions and contains subthemes explaining influences on nursing care. "Up to You" and "At the Mercy of the System" are descriptive themes influencing connectedness. Connectedness is central to culturally well-informed nurse-patient interactions. © The Author(s) 2014.

  5. Conceptualising 'materialities of care': making visible mundane material culture in health and social care contexts.

    Science.gov (United States)

    Buse, Christina; Martin, Daryl; Nettleton, Sarah

    2018-02-01

    'Materialities of care' is outlined as a heuristic device for making visible the mundane and often unnoticed aspects of material culture within health and social care contexts, and exploring interrelations between materials and care in practice. Three analytic strands inherent to the concept are delineated: spatialities of care, temporalities of care and practices of care. These interconnecting themes span the articles in this special issue. The articles explore material practice across a range of clinical and non-clinical spaces, including hospitals, hospices, care homes, museums, domestic spaces, and community spaces such as shops and tenement stairwells. The collection addresses fleeting moments of care, as well as choreographed routines that order bodies and materials. Throughout there is a focus on practice, and relations between materials and care as ongoing, emergent and processual. We conclude by reflecting on methodological approaches for examining 'materialities of care', and offer some thoughts as to how this analytic approach might be applied to future research within the sociology of health and illness. © 2018 Foundation for the Sociology of Health & Illness.

  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. © 2015 John Wiley & Sons Ltd.

  7. 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.

  8. 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.

  9. What is the key to culturally competent care: Reducing bias or cultural tailoring?

    Science.gov (United States)

    Cuevas, Adolfo G; O'Brien, Kerth; Saha, Somnath

    2017-04-01

    To gain a better understanding as to whether disparities in patient-provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently. African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10. Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients' needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to racially/ethnically contextualise their care, and most Latina/Latino patients preferred language/culturally concordant clinicians. Health care disparities might be reduced through a patient-centred approach to cultural competency training, general knowledge of the cultural context of clinicians' patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff.

  10. 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. PMID:14728220

  11. [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.

  12. Cultures differ in the ability to enhance affective neural responses.

    Science.gov (United States)

    Varnum, Michael E W; Hampton, Ryan S

    2017-10-01

    The present study (N = 55) used an event-related potential paradigm to investigate whether cultures differ in the ability to upregulate affective responses. Using stimuli selected from the International Affective Picture System, we found that European-Americans (N = 29) enhanced central-parietal late positive potential (LPP) (400-800 ms post-stimulus) responses to affective stimuli when instructed to do so, whereas East Asians (N = 26) did not. We observed cultural differences in the ability to enhance central-parietal LPP responses for both positively and negativelyvalenced stimuli, and the ability to enhance these two types of responses was positively correlated for Americans but negatively for East Asians. These results are consistent with the notion that cultural variations in norms and values regarding affective expression and experiences shape how the brain regulates emotions.

  13. 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.

  14. Management Culture as Part of Organizational Culture in the Context of Corporate Social Responsibility Implementation

    Directory of Open Access Journals (Sweden)

    Jolita Vveinhardt

    2017-10-01

    Full Text Available The article is theoretically based on management culture as part of the formal organizational culture, separately reviewing some of its elements. Expert evaluation organization, process and results of the instrument shaped by the authors and meant for qualitative research are briefly presented. The structure of the instrument is detailed by presenting its component parts and explanations. The research was carried out by interviewing the top managers of two big manufacturing company groups consisting of six enterprises. The article presents passages of an interview with the top managers of the six companies, revealing management culture as part of the formal organizational culture expression aiming to implement corporate social responsibility. It should be emphasized that the companies of both groups are preparing to become socially responsible and this results in the timeliness and importance of the research. Structured interviewing method was applied for the research, and the substantive content of the interview included strategy, organizational structure, rules and regulations, technologies, processes, information systems, control and incentive issues. The results of the research show that in both groups of the manufacturing companies management culture and corporate social responsibility, analysing them in terms of formal organizational culture, are perceived in very narrow aspects and their development is not part of the organizations’ strategic goals. The results of the study suggest that the ideas of corporate social responsibility cannot be implemented in a consistent way unless they are integrated into the formal part of organisational culture which plays an instrumental role.

  15. Using Culturally Responsive Stories in Mathematics: Responses from the Target Audience

    Science.gov (United States)

    Corp, Amy

    2017-01-01

    This study examined how Black students responded to the utilization of culturally responsive stories in their mathematics class. All students in the two classes participated in mathematics lessons that began with an African American story (culturally responsive to this population), followed by mathematical discussion and concluded with solving…

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

    Directory of Open Access Journals (Sweden)

    Robert Mash

    2016-08-01

    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.

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

    Science.gov (United States)

    Durant, Anne Foss; 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. PMID:26828076

  18. 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.

  19. 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.

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

    OpenAIRE

    Dumitru ZAIȚ; Angelica-Nicoleta ONEA; Ruxandra CIULU; Maria TĂTĂRUȘANU

    2013-01-01

    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 ...

  1. 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, health care 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 1st January 2006 to 31st 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 person

  2. The relationship between organizational culture and family satisfaction in critical care.

    Science.gov (United States)

    Dodek, Peter M; Wong, Hubert; Heyland, Daren K; Cook, Deborah J; Rocker, Graeme M; Kutsogiannis, Demetrios J; Dale, Craig; Fowler, Robert; Robinson, Sandra; Ayas, Najib T

    2012-05-01

    Family satisfaction with critical care is influenced by a variety of factors. We investigated the relationship between measures of organizational and safety culture, and family satisfaction in critical care. We further explored differences in this relationship depending on intensive care unit survival status and length of intensive care unit stay of the patient. Cross-sectional surveys. Twenty-three tertiary and community intensive care units within three provinces in Canada. One thousand two-hundred eighty-five respondents from 2374 intensive care unit clinical staff, and 880 respondents from 1381 family members of intensive care unit patients. None. Intensive care unit staff completed the Organization and Management of Intensive Care Units survey and the Hospital Survey on Patient Safety Culture. Family members completed the Family Satisfaction in the Intensive Care Unit 24, a validated survey of family satisfaction. A priori, we analyzed adjusted relationships between each domain score from the culture surveys and either satisfaction with care or satisfaction with decision-making for each of four subgroups of family members according to patient descriptors: intensive care unit survivors who had length of intensive care unit stay 14 days, and intensive care unit nonsurvivors who had length of stay relationships between most domains of organizational and safety culture, and satisfaction with care or decision-making for family members of intensive care unit nonsurvivors who spent at least 14 days in the intensive care unit. For the other three groups, there were only a few weak relationships between domains of organizational and safety culture and family satisfaction. Our findings suggest that the effect of organizational culture on care delivery is most easily detectable by family members of the most seriously ill patients who interact frequently with intensive care unit staff, who are intensive care unit nonsurvivors, and who spend a longer time in the intensive

  3. A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

    OpenAIRE

    Chun, Maria BJ; Jackson, David S; Lin, Susan Y; Park, Elyse R

    2010-01-01

    The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruc...

  4. The evolution of cognitive mechanisms in response to cultural innovations.

    Science.gov (United States)

    Lotem, Arnon; Halpern, Joseph Y; Edelman, Shimon; Kolodny, Oren

    2017-07-24

    When humans and other animals make cultural innovations, they also change their environment, thereby imposing new selective pressures that can modify their biological traits. For example, there is evidence that dairy farming by humans favored alleles for adult lactose tolerance. Similarly, the invention of cooking possibly affected the evolution of jaw and tooth morphology. However, when it comes to cognitive traits and learning mechanisms, it is much more difficult to determine whether and how their evolution was affected by culture or by their use in cultural transmission. Here we argue that, excluding very recent cultural innovations, the assumption that culture shaped the evolution of cognition is both more parsimonious and more productive than assuming the opposite. In considering how culture shapes cognition, we suggest that a process-level model of cognitive evolution is necessary and offer such a model. The model employs relatively simple coevolving mechanisms of learning and data acquisition that jointly construct a complex network of a type previously shown to be capable of supporting a range of cognitive abilities. The evolution of cognition, and thus the effect of culture on cognitive evolution, is captured through small modifications of these coevolving learning and data-acquisition mechanisms, whose coordinated action is critical for building an effective network. We use the model to show how these mechanisms are likely to evolve in response to cultural phenomena, such as language and tool-making, which are associated with major changes in data patterns and with new computational and statistical challenges.

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

    African Journals Online (AJOL)

    A survey of cultural competence of critical care nurses in ... Nurses are primary caregivers and have a key role in providing care in a culturally ... relating to culture, gender or sexual orientation. ... concerning the population they work with, and although a ... lead to conflict, increased levels of anxiety, and stress among nurses,.

  6. Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

    Science.gov (United States)

    Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

    2007-01-01

    Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

  7. Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

    Science.gov (United States)

    Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

    2007-08-01

    Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

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

    OpenAIRE

    Bosch, Marije; Dijkstra, Rob; Wensing, Michel; van der Weijden, Trudy; Grol, Richard

    2008-01-01

    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 d...

  9. The Exploration of Culturally Sensitive Nursing Care in Pediatric Setting: a Qualitative Study

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2017-02-01

    Full Text Available Background: One of the essential aspects of the provision of care is cultural issues. Cultural sensitivity is the key for cultural care. The aim of this study was to explore culturally sensitive care in pediatric nursing care in Iran.Materials and Methods: This study was a conventional content analysis. Participants were consisted of 25 nurses and 9 parents selected through purposive sampling from three pediatric referral centers in Tabriz and Tehran, Iran. Data was collected using semi-structured interviews and field notes and were concurrently analyzed by using Graneheim and Lundman (2004 method. Data was transcribed verbatim, words, sentences, and phrases were considered meaning units, abstracted, labeled and compared for developing categories.Results: Culturally sensitive care of a sick child was consisted of three themes: ‘cultural exposure’, ‘intercultural communication’ and ‘the reconciliation of cultural conflict in families/care’. During the ‘cultural exposure’ nurses were informed of the cultural manifestations, strived to identify and understand patients/families with cultural diversities and respect their cultural beliefs. The nurse used the native language in ‘intercultural communication’ or a combination of verbal and nonverbal communication methods to reach a common understanding. Finally, a nurse in the conflict between the culture of child/family and care took actions for making decisions to develop a compliance between care and the family culture and amended parents’ harmful desires through negotiation and appropriate care.Conclusion: Understanding the concept of culturally sensitive care, can help with resolving the problems of cultural exchanges in Pediatric wards. Providing cultural facilities and interpreters to communicate with patients/family increase their satisfaction.

  10. The impact of cross-cultural interactions on medical students' preparedness to care for diverse patients.

    Science.gov (United States)

    Niu, Nina N; Syed, Zeba A; Krupat, Edward; Crutcher, Betty N; Pelletier, Stephen R; Shields, Helen M

    2012-11-01

    Medical students who graduate from schools with diverse student populations are more likely to rate themselves as prepared to care for diverse patients compared with students who graduate from more homogenous schools. This study aimed to identify the types of cross-cultural interactions associated with students' self-rated preparedness. In 2010, the authors developed and administered a Web-based survey that queried Harvard Medical School students about their voluntary interethnic interactions (studying, socializing), participation in diversity-related extracurricular activities, and self-rated preparedness to care for diverse patients. The authors separated students' responses regarding interethnic interactions and participation in diversity-related extracurricular activities into high and low participation, then determined the association between these responses and those to questions about students' self-rated preparedness to care for diverse patients. They used ANOVA and Z tests of proportion to analyze their data. Of 724 eligible students, 460 completed the survey (64%). Seventy-five percent (324/433) believed they were prepared to care for patients from backgrounds different from their own. Students who spent >75% of their study time with students from different backgrounds or who participated in a greater number of diversity-related extracurricular activities were more likely to rate themselves as prepared to care for diverse patients overall and to perform seven other skills. Voluntary cross-cultural interactions, both studying and socializing, are associated with higher self-rated preparedness to care for patients from diverse backgrounds. Medical schools should continue to support multicultural pursuits to prepare students to become physicians sensitive to the needs of diverse patients.

  11. Patient Safety Culture in Intensive Care Units from the Perspective of Nurses: A Cross-Sectional Study.

    Science.gov (United States)

    Farzi, Sedigheh; Moladoost, Azam; Bahrami, Masoud; Farzi, Saba; Etminani, Reza

    2017-01-01

    One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a two-part questionnaire that included demographic and hospital survey on Patient Safety Culture (HSOPSC) questionnaire. Data analysis was done using descriptive statistics (mean and standard deviation). Among the 12 dimensions of safety culture, the nurses assigned the highest score to "team work within units" (97.3%) and "Organizational learning-continuous improvement" (84%). They assigned the least score to "handoffs and transitions"(21.1%), "non-punitive response to errors" (24.7%), "Staffing" (35.6%), "Communication openness" (47.5%), and "Teamwork across units" (49.4%). The patient safety culture dimensions have low levels that require adequate attention and essential measures of health care centers including facilitating teamwork, providing adequate staff, and developing a checklist of handoffs and transitions. Furthermore, to increase reporting error and to promote a patient safety culture in intensive care units, some strategies should be adopted including a system-based approach to deal with the error.

  12. 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

  13. 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. © 2013 by the American College of Medical Quality.

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

    NARCIS (Netherlands)

    Lamkaddem, M.; Spreeuwenberg, P.M.; Devillé, W.L.; Foets, M.M.; Groenewegen, P.P.

    2012-01-01

    Aims: 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

  15. Patient involvement in mental health care: culture, communication and caution.

    Science.gov (United States)

    Tse, Samson; Tang, Jessica; Kan, Alice

    2015-02-01

    Patient or service user involvement in mental health services (MHS) is a hallmark of the recovery approach. In this viewpoint article, we review Tambuyzer et al. paper 'Patient involvement in mental health care: One size does not fit all' in order to express our opinion of their work. We also suggest specific actions that may enhance the implementation of patient involvement in MHS. We make three main points about Tambuyzer et al. model. First, the cultural dimension of patient involvement seems underemphasized in the model. Second, the model might be improved if the increasing role of communications technology in patient involvement is taken into consideration. Third, it is important to acknowledge that the process of patient involvement is not linear, and participation is not a homogeneous experience. We suggest that the model be expanded and that further work be carried out on the implementation of patient involvement in MHS. © 2012 John Wiley & Sons Ltd.

  16. Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

    Directory of Open Access Journals (Sweden)

    Adel F. Almutairi

    Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

  17. Preparing teachers for ambitious and culturally responsive science teaching

    Science.gov (United States)

    Seiler, Gale

    2013-03-01

    Communities, schools and classrooms across North America are becoming more ethnically, racially, and linguistically diverse, particularly in urban areas. Against this backdrop, underrepresentation of certain groups in science continues. Much attention has been devoted to multicultural education and the preparation of teachers for student diversity. In science education, much research has focused on classrooms as cultural spaces and the need for teachers to value and build upon students' everyday science knowledge and ways of sense-making. However it remains unclear how best to prepare science teachers for this kind of culturally responsive teaching. In attempting to envision how to prepare science teachers with cross-cultural competency, we can draw from a parallel line of research on preparing teachers for ambitious science instruction. In ambitious science instruction, students solve authentic problems and generate evidence and models to develop explanations of scientific phenomenon, an approach that necessitates great attention to students' thinking and sense-making, thus making it applicable to cultural relevance aims. In addition, this line of research on teacher preparation has developed specific tools and engages teachers in cycles of reflection and rehearsal as they develop instructional skills. While not addressing cross-cultural teaching specifically, this research provides insights into specific ways through which to prepare teachers for culturally responsive practices. In my presentation, I will report on efforts to join these two areas of research, that is, to combine ideas about multicultural science teacher preparation with what has been learned about how to develop ambitious science instruction. This research suggests a new model for urban science teacher preparation--one that focuses on developing specific teaching practices that elicit and build on student thinking, and doing so through cycles of individual and collective planning, rehearsal

  18. 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…

  19. 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

  20. 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…

  1. Culturally Responsive Teaching. Second Edition. Multicultural Education Series

    Science.gov (United States)

    Gay, Geneva

    2010-01-01

    The achievement of students of color continues to be disproportionately low at all levels of education. More than ever, Geneva Gay's foundational book on culturally responsive teaching is essential reading in addressing the needs of today's diverse student population. Combining insights from multicultural education theory and research with…

  2. 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…

  3. A Systemic Approach to Culturally Responsive Assessment Practices and Evaluation

    Science.gov (United States)

    Slee, June

    2010-01-01

    In an earlier paper, Slee and Keenan demonstrated that it was possible for tertiary education institutions to design culturally responsive assessment procedures that complied with standardised assessment policy. The authors' paper described "Growing Our Own," an initiative between Charles Darwin University and Northern Territory Catholic…

  4. 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…

  5. 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…

  6. 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

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

    OpenAIRE

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

    2013-01-01

    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 speci...

  8. 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.

  9. Culture, demographics, and critical care issues: an overview.

    Science.gov (United States)

    Núñez, Germán R

    2003-10-01

    The population dynamic and the immigration trends in the United States continue to challenge health care professionals who each day must serve an increasingly diverse population. Today's physicians must not only have a solid background in medical sciences but they must also have knowledge of how culture, race, and ethnicity impact how patients view and accept traditional Western practices. Whether doctors and patients are close in the "context spectrum" will often determine their ability to communicate beyond the spoken language. According to a report of the American Medical Association, by the year 2000, out of a total 812,770 physicians, only 2.5% were Black, 3.5% Hispanic, and 8.9% Asian. Only a fraction of a percent was American Native/Alaskan Native. Therefore, the majority of the physicians are Caucasian, and it could be assumed that they would likely be accustomed to high-context communication styles. The gross of the demographic changes and population increases in the United States during the past 10 years can be attributed to immigration from regions of the world where low-context communication styles are prevalent. Such differences between physicians and patients can create difficult, tense situations in an already charged atmosphere as can be that of a critical care unit.

  10. 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. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Towards culturally competent health care: language use of bilingual staff.

    Science.gov (United States)

    Johnson, M; Noble, C; Matthews, C; Aguilar, N

    1998-01-01

    The presence of diverse language skills within health staff provides opportunities to better meet the needs of a multicultural population. A cross-sectional survey of all staff within the South Western Sydney Area Health Service was undertaken to compare language skills with population needs and examine the context of language use. Thirty-one per cent of staff (n = 964) were bilingual or multilingual, with the predominant languages spoken being Tagalog (Filipino), Cantonese, Hindi, Spanish, Vietnamese and Italian. Thirty-seven per cent of bilingual staff used their language skills at least weekly, predominantly in situations of simple conversation and giving directions. Bilingual staff are a valuable resource for the organisation and the presence of a similar overall proportion of bilingual and bicultural staff may engender tolerance and adaptability in providing care to a diverse population. However, supply does not directly match community demand. This mismatch will continue unless recruitment is focused towards identified language groups. The high proportion of staff who rarely used their language skills (37%) may be due to lack of opportunity or limited need, and suggests that further research needs to examine service models that locate bilingual workers close to client need. This study takes a crucial first step towards realising equitable and culturally appropriate care utilising the principles of productive diversity.

  12. Perceptions of safety culture vary across the intensive care units of a single institution.

    Science.gov (United States)

    Huang, David T; Clermont, Gilles; Sexton, J Bryan; Karlo, Crystal A; Miller, Rachel G; Weissfeld, Lisa A; Rowan, Kathy M; Angus, Derek C

    2007-01-01

    To determine whether safety culture factors varied across the intensive care units (ICUs) of a single hospital, between nurses and physicians, and to explore ICU nursing directors' perceptions of their personnel's attitudes. Cross-sectional surveys using the Safety Attitudes Questionnaire-ICU version, a validated, aviation industry-based safety culture survey instrument. It assesses culture across six factors: teamwork climate, perceptions of management, safety climate, stress recognition, job satisfaction, and work environment. Four ICUs in one tertiary care hospital. All ICU personnel. We conducted the survey from January 1 to April 1, 2003, and achieved a 70.2% response rate (318 of 453). We calculated safety culture factor mean and percent-positive scores (percentage of respondents with a mean score of > or =75 on a 0-100 scale for which 100 is best) for each ICU. We compared mean ICU scores by ANOVA and percent-positive scores by chi-square. Mean and percent-positive scores by job category were modeled using a generalized estimating equations approach and compared using Wald statistics. We asked ICU nursing directors to estimate their personnel's mean scores and generated ratios of their estimates to the actual scores.Overall, factor scores were low to moderate across all factors (range across ICUs: 43.4-74.9 mean scores, 8.6-69.4 percent positive). Mean and percent-positive scores differed significantly (p safety culture variation exists across ICUs of a single hospital. ICU nursing directors tend to overestimate their personnel's attitudes, particularly for teamwork. Culture assessments based on institutional level analysis or director opinion may be flawed.

  13. Radiation adaptive response for the growth of cultured glial cells

    International Nuclear Information System (INIS)

    Suzuki, S.; Miura, Y.; Kano, M.; Toda, T.; Urano, S.

    2003-01-01

    Full text: To examine the molecular mechanism of radiation adaptive response (RAR) for the growth of cultured glial cells and to investigate the influence of aging on the response, glial cells were cultured from young and aged rats (1 month and 24 months old). RAR for the growth of glial cells conditioned with a low dose of X-rays and subsequently exposed to a high dose of X-rays was examined for cell number and BrdU incorporation. Involvement of the subcellular signaling pathway factors in RAR was investigated using their inhibitors, activators and mutated glial cells. RAR was observed in cells cultured from young rats, but was not in cells from aged rats. The inhibitors of protein kinase C (PKC) and DNA-dependent protein kinase (DNA-PK) or phosphatidylinositol 3-kinase (PI3K) suppressed RAR. The activators of PKC instead of low dose irradiation also caused RAR. Moreover, glial cells cultured from severe combined immunodeficiency (scid) mice (CB-17 scid) and ataxia-telangiectasia (AT) cells from AT patients showed no RAR. These results indicated that PKC, ATM, DNAPK and/or PI3K were involved in RAR for growth and BrdU incorporation of cultured glial cells and RAR decreased with aging. Proteomics data of glial cells exposed to severe stress of H 2 O 2 or X-rays also will be presented in the conference since little or no difference has not been observed with slight stress yet

  14. 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.

  15. Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance.

    Science.gov (United States)

    Dupuis, Sherry; McAiney, Carrie A; Fortune, Darla; Ploeg, Jenny; Witt, Lorna de

    2016-01-01

    Longstanding concerns about quality care provision, specifically in the area of long-term care, have prompted calls for changing the culture of care to reflect more client-driven and relationship-centred models. Despite an increase in culture change initiatives in both Canada and the United States, there is insufficient information about the theories and approaches that guide culture change. The purpose of this paper is to describe a culture change initiative currently underway in Canada, the Partnerships in Dementia Care Alliance, and the theoretical foundations informing our work. More specifically, we describe how the theoretical and philosophical underpinnings of the Alzheimer Disease and Related Dementias framework, the authentic partnership approach, participatory action research and Appreciative Inquiry have been integrated to guide a culture change process that encourages working collaboratively, thinking and doing differently and re-imagining new possibilities for changing the culture of dementia care. © The Author(s) 2014.

  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. Copyright © 2013. Published by Elsevier Ltd.

  18. 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.

  19. 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.

  20. 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.

  1. Use of culture care theory with Anglo- and African American elders in a long-term care setting.

    Science.gov (United States)

    McFarland, M R

    1997-01-01

    The purpose of this study was to discover the care expressions, practices, and patterns of elderly Anglo- and African American elders. The domain of inquiry was the cultural care of elderly residents within the environmental context of a long-term care institution. The ethnonursing qualitative research method was used to conduct the study which was conceptualized within Leininger's theory of culture care diversity and universality. Four major themes were discovered: (a) Residents expressed and lived generic care to maintain their preadmission lifeways; (b) The nursing staff provided aspects of professional care to support satisfying lifeways for residents; (c) Institutional care patterns and expressions were viewed as a continuing life experience but with major differences between the apartment section and nursing home units; and (d) An institutional culture of the retirement home was discovered which reflected unique lifeways and shared care and health expressions and practices. These themes substantiated the culture care theory and revealed new modes of care for the elderly in an institutional setting.

  2. 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.

  3. Exploring undergraduate midwifery students' readiness to deliver culturally secure care for pregnant and birthing Aboriginal women.

    Science.gov (United States)

    Thackrah, Rosalie D; Thompson, Sandra C; Durey, Angela

    2015-04-16

    Culturally secure health care settings enhance accessibility by Aboriginal Australians and improve their satisfaction with service delivery. A culturally secure health service recognises and responds to the legitimate cultural rights of the recipients of care. Focus is upon the health care system as well as the practice and behaviours of the individuals within it. In an attempt to produce culturally secure practitioners, the inclusion of Aboriginal content in health professional programs at Australian universities is now widespread. Studies of medical students have identified the positive impact of this content on knowledge and attitudes towards Aboriginal people but relatively little is known about the responses of students in other health professional education programs. This study explored undergraduate midwifery students' knowledge and attitudes towards Aboriginal people, and the impact of Aboriginal content in their program. The study surveyed 44 students who were in their first, second and third years of a direct entry, undergraduate midwifery program at a Western Australian (WA) university. The first year students were surveyed before and after completion of a compulsory Aboriginal health unit. Second and third year students who had already completed the unit were surveyed at the end of their academic year. Pre- and post-unit responses revealed a positive shift in first year students' knowledge and attitudes towards Aboriginal people and evidence that teaching in the unit was largely responsible for this shift. A comparison of post-unit responses with those from students in subsequent years of their program revealed a significant decline in knowledge about Aboriginal issues, attitudes towards Aboriginal people and the influence of the unit on their views. Despite this, all students indicated a strong interest in more clinical exposure to Aboriginal settings. The inclusion of a unit on Aboriginal health in an undergraduate midwifery program has been shown to

  4. 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.

  5. 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

  6. Culture and End of Life Care: A Scoping Exercise in Seven European Countries

    NARCIS (Netherlands)

    Gysels, M.; Evans, N.C.; Menaca, A.; Andrew, E.; Toscani, F.; Finetti, S.; Pasman, H.R.W.; 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

  7. 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...

  8. Cultural Responsive Teaching Readiness Scale Validity and Reliability Study

    Directory of Open Access Journals (Sweden)

    Kasım KARATAŞ

    2017-12-01

    Full Text Available The aim of this research is to develop a measurement instrument that will determine the cultural responsive teaching readiness level of teacher candidates. The study group consisted of a total of 231 candidate teachers, of which 83 were males and 148 were females, who were attending their final year of class teacher education programs at various Turkish universities during the 2016-2017 education year. In the first phase, a 33-item draft form was presented to experts to be reviewed. Based on the feedback received, revisions were made and the final scale was applied to a group of 231 candidate teachers. In the analysis of the data obtained as the result of the application, Exploratory Factor Analysis (EFA was performed. The EFA produced 21 items within a two-factor structure as, “Personal Readiness” and “Professional Readiness.” It was observed that the sub-factors were components of the “cultural responsive teaching readiness” dimension, and that the goodness of fit measures obtained as a result of the First and Second Level Confirmatory Factor Analyzes (CFA were high. In addition, reliability coefficients were found to be high as a result of reliability measurements. With the help of these findings, this study concludes that the Cultural Responsive Teaching Readiness scale is both valid and reliable.

  9. 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.

  10. Cultural and ethnic differences in content validation responses.

    Science.gov (United States)

    Evans, Bronwynne C

    2004-04-01

    Eight instruments to evaluate grant interventions aimed at increasing recruitment and retention of Hispanic/Latino and American Indian nurses were developed for a Nursing Workforce Diversity Grant. This article compares expert reviewer responses during content validation of these instruments with (a) current literature and (b) seven filmed intervals of Hispanic/Latino and American Indian nurses speaking about their educational experiences. White reviewers responded differently to certain items than did Hispanic/Latino and American Indian reviewers (or reviewers closely affiliated with such persons). Responses of Hispanic/Latino and American Indian experts were aligned with one another but not aligned with the responses of White experts, who also agreed with one another, prompting literature and film comparisons with their responses. Faculty development may be needed to help teachers uncover their assumptions about students of color, acquire knowledge about cultural perspectives, recognize institutional racism, and attain the skills necessary to develop and implement a curriculum of inclusion.

  11. 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.    

  12. 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.

  13. Care dependency of hospitalized children: testing the Care Dependency Scale for Paediatrics in a cross-cultural comparison.

    Science.gov (United States)

    Tork, Hanan; Dassen, Theo; Lohrmann, Christa

    2009-02-01

    This paper is a report of a study to examine the psychometric properties of the Care Dependency Scale for Paediatrics in Germany and Egypt and to compare the care dependency of school-age children in both countries. Cross-cultural differences in care dependency of older adults have been documented in the literature, but little is known about the differences and similarities with regard to children's care dependency in different cultures. A convenience sample of 258 school-aged children from Germany and Egypt participated in the study in 2005. The reliability of the Care Dependency Scale for Paediatrics was assessed in terms of internal consistency and interrater reliability. Factor analysis (principal component analysis) was employed to verify the construct validity. A Visual Analogue Scale was used to investigate the criterion-related validity. Good internal consistency was detected both for the Arabic and German versions. Factor analysis revealed one factor for both versions. A Pearson's correlation between the Care Dependency Scale for Paediatrics and Visual Analogue Scale was statistically significant for both versions indicating criterion-related validity. Statistically significant differences between the participants were detected regarding the mean sum score on the Care Dependency Scale for Paediatrics. The Care Dependency Scale for Paediatrics is a reliable and valid tool for assessing the care dependency of children and is recommended for assessing the care dependency of children from different ethnic origins. Differences in care dependency between German and Egyptian children were detected, which might be due to cultural differences.

  14. Prenatal care of African American women in selected USA urban and rural cultural contexts.

    Science.gov (United States)

    Morgan, M

    1996-01-01

    The purpose of this ethnonursing research was to systematically discover, describe, and analyze the beliefs, practices, and values of African American women related to prenatal care. The domain of inquiry was prenatal care of African American women within their familiar cultural contexts. The study was conceptualized within Leininger's Theory of Culture Care Diversity and Universality which enabled the researcher to study professional and generic care as influenced by the worldview, social structural factors, cultural values and beliefs, ethnohistory, and environmental context. The goal of the study was to discover knowledge that could be used by health professionals to provide culturally congruent prenatal care that would increase the health and well being of the people. The rationale for the study was based on studies that showed the lack of prenatal care in the African American cultural group leads to low birth weights and high infant mortality rates. Four major themes that focused on the domain of inquiry were identified: 1) Cultural care meant protection, presence, and sharing; 2) social structural factors that greatly influenced the health and well being were spirituality, kinship, and economics; 3) professional prenatal care was seen by the women as necessary and essential but there was distrust of noncaring professionals, and barriers to such care; and 4) folk health beliefs, practices, and indigenous health care providers were widely used by women in the African American community.

  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. the problem of cultural stereotyping in the pastoral care of a suicidal

    African Journals Online (AJOL)

    By global culture we mean the fusion of cultures as a result of immigration and ... individualism in the European context: “the importance of self-expression and the .... interdependence and growth. .... exchange of cultures and religious/spiritual experience in pastoral care. .... Medical students in this study were to explore.

  17. Everyday Routines: A Window into the Cultural Organization of Family Child Care

    Science.gov (United States)

    Tonyan, Holli A.

    2015-01-01

    Eco(logical)-cultural Theory suggests that a daily routine results from individuals adapting cultural ideas to the constraints of a local context or ecology. Using Ecocultural Theory, this research examined family child care providers' descriptions of daily activities and overall approach to understand cultural models. The results highlighted a…

  18. Developments in neonatal care and nursing responses.

    Science.gov (United States)

    Healy, Patricia; Fallon, Anne

    This article reviews the origins and evolution of neonatology and considers the role of the neonatal nurse within this specialty. Neonatal nurses are a vital part of the neonatal team that provides care for sick babies. The nursing care required by sick babies and their families on a neonatal unit can be variable and complex. The past century has seen significant changes in the role of the neonatal nurse. This has come about through dramatic technological developments on neonatal units, an increased understanding of neonatal physiology and pathology, changes in the education of neonatal nurses, and active and ongoing clinical research within the specialty. The resulting significant advances in neonatal care, including that provided by neonatal nurses, have made a crucial and steadfast contribution to marked improvements in neonatal outcomes.

  19. Organisational culture in residential aged care facilities: a cross-sectional observational study.

    Science.gov (United States)

    Etherton-Beer, Christopher; Venturato, Lorraine; Horner, Barbara

    2013-01-01

    Organisational culture is increasingly recognised as important for provision of high-quality long-term care. We undertook this study to measure organisational culture in residential aged care facilities in two Australian states. Cross-sectional observational study in 21 residential aged care facilities in Western Australia (n = 14) and Queensland (n = 7), Australia. Staff and next-of-kin of residents participated. Measurement comprised surveys of facility staff and residents' next-of-kin, and structured observation of indicators of care quality. Staff tended to rate organisational culture positively. Some qualitative feedback from staff emphasised negative perceptions of communication, leadership and teamwork. Staffing levels were perceived as a dominant challenge, threatening care quality. Direct observation revealed variability within and between facilities but suggested that most facilities (n = 12) were in the typical range, or were quality facilities (n = 8). There was scope to strengthen organisational culture in participating aged care facilities.

  20. A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

    Science.gov (United States)

    Jackson, David S; Lin, Susan Y; Park, Elyse R

    2010-01-01

    The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and/or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility — more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. PMID:21225585

  1. Validation of a patient-centered culturally sensitive health care office staff inventory.

    Science.gov (United States)

    Tucker, Carolyn M; Wall, Whitney; Marsiske, Michael; Nghiem, Khanh; Roncoroni, Julia

    2015-09-01

    Research suggests that patient-perceived culturally sensitive health care encompasses multiple components of the health care delivery system including the cultural sensitivity of front desk office staff. Despite this, research on culturally sensitive health care focuses almost exclusively on provider behaviors, attitudes, and knowledge. This is due in part to the paucity of instruments available to assess the cultural sensitivity of front desk office staff. Thus, the objective of the present study is to determine the psychometric properties of the pilot Tucker-Culturally Sensitive Health Care Office Staff Inventory-Patient Form (T-CSHCOSI-PF), which is an instrument designed to enable patients to evaluate the patient-defined cultural sensitivity of their front desk office staff. A sample of 1648 adult patients was recruited by staff at 67 health care sites across the United States. These patients anonymously completed the T-CSHCOSI-PF, a demographic data questionnaire, and a patient satisfaction questionnaire. Findings Confirmatory factor analyses of the TCSHCOSI-PF revealed that this inventory has two factors with high internal consistency reliability and validity (Cronbach's αs=0.97 and 0.95). It is concluded that the T-CSHCOSI-PF is a psychometrically strong and useful inventory for assessing the cultural sensitivity of front desk office staff. This inventory can be used to support culturally sensitive health care research, evaluate the job performance of front desk office staff, and aid in the development of trainings designed to improve the cultural sensitivity of these office staff.

  2. Understanding organizational and cultural premises for quality of care in nursing homes: an ethnographic study

    OpenAIRE

    Nakrem, Sigrid

    2015-01-01

    Background Internationally, there are concerns about the quality of care in nursing homes. The concept of ?corporate culture? as an internal variable could be seen as the means to improve quality of care and quality of life for the residents. The aim of this article was to describe the nursing home culture from the staff?s perspective and to include how the residents describe quality of care. Methods An ethnographic design was employed. A purposive sample of four municipal public nursing home...

  3. 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…

  4. Measuring health care workers' perceptions of what constitutes a compassionate organisation culture and working environment: Findings from a quantitative feasibility survey.

    Science.gov (United States)

    McSherry, Robert; Pearce, Paddy

    2018-03-01

    Health care organisation cultures and working environments are highly complex, dynamic and constantly evolving settings. They significantly influence both the delivery and outcomes of care. Phase 1 quantitative findings are presented from a larger three phase feasibility study designed to develop and test a Cultural Health Check toolkit to support health care workers, patients and organisations in the provision of safe, compassionate and dignified care. A mixed methods approach was applied. The Cultural Health Check Healthcare Workers Questionnaire was distributed across two National Health Service Hospitals in England, UK. Both hospitals allocated two wards comprising of older people and surgical specialities. The newly devised Cultural Health Check Staff Rating Scale Version 1 questionnaire was distributed to 223 health care workers. Ninety eight responses were returned giving a response rate of 44%. The Cultural Health Check Staff Rating Scale Version 1 has a significant Cronbach alpha of .775; this reliability scaling is reflected in all 16 items in the scale. Exploratory factor analysis identified two significant factors "Professional Practice and Support" and "Workforce and Service Delivery." These factors according to health care workers significantly impact on the organisation culture and quality of care delivered by staff. The Cultural Health Check Staff Rating Scale Version 1 questionnaire is a newly validated measurement tool that could be used and applied to gauge health care workers perceptions of an organisations level of compassion. Historically we have focused on identifying how caring and compassionate nurses, doctors and related allied health professionals are. This turns the attention on employers of nurses and other related organisations. The questionnaire can be used to gauge the level of compassion with a health care organisation culture and working environment. Nurse managers and leaders should focus attention regarding how these two factors

  5. The health care system: factoring in the ethnicity, cultural and health care needs of women and children of color.

    Science.gov (United States)

    Griffin, F N

    1994-01-01

    The author reviews the literature on factors which influence the health of African Americans. The concept of poverty as a health problem is discussed as well as the feminization of poverty. The author implores health care workers, to begin to implement the concepts of ethnicity and culture when giving care to clients of color.

  6. 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.

  7. 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.

  8. 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…

  9. Generalist palliative care in hospital - Cultural and organisational interactions. Results of a mixed-methods study.

    Science.gov (United States)

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

    2016-06-01

    It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-oriented treatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactions that occur is sparse. To investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, if possible, to suggest workable solutions for the provision of generalist palliative care. A convergent parallel mixed-methods design was chosen using two independent studies: a quantitative study, in which three independent datasets were triangulated to study the organisation and evaluation of generalist palliative care, and a qualitative, ethnographic study exploring the culture of generalist palliative nursing care in medical departments. A Danish regional hospital with 29 department managements and one hospital management. Two overall themes emerged: (1) 'generalist palliative care as a priority at the hospital', suggesting contrasting issues regarding prioritisation of palliative care at different organisational levels, and (2) 'knowledge and use of generalist palliative care clinical guideline', suggesting that the guideline had not reached all levels of the organisation. Contrasting issues in the hospital's provision of generalist palliative care at different organisational levels seem to hamper the interactions between organisation and culture - interactions that appear to be necessary for the provision of integrated palliative care in the hospital. The implementation of palliative care is also hindered by the main focus being on disease-oriented treatment, which is reflected at all the organisational levels. © The Author(s) 2015.

  10. Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.

    Science.gov (United States)

    Milberg, Anna; Torres, Sandra; Ågård, Pernilla

    2016-01-01

    The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care. Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety of challenges

  11. Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study

    Science.gov (United States)

    Torres, Sandra; Ågård, Pernilla

    2016-01-01

    Objective The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals’ understandings of cross-cultural interaction during end-of-life care. Methods Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. Results The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, ‘unusual’ emotional and pain expressions, the expectation that these patients’ families would be ‘different’ and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting “the unknown”. In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. Conclusions The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as

  12. Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.

    Directory of Open Access Journals (Sweden)

    Anna Milberg

    Full Text Available The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care.Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis.The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients.The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety

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

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    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

  14. Truth Telling as an Element of Culturally Competent Care at End of Life.

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    Rising, Margaret L

    2017-01-01

    Nondisclosure of terminal prognosis in the context of intercultural interactions can cause moral distress among health care providers guided exclusively by informed consent. However, cultural humility can show that revealing and withholding prognostic information are two equally valid paths to the goal of protecting the patient from harm. Assumptions and history giving rise to the preference for truth telling in the United States(US) are examined. Principles of biomedical ethics are described within the context of US, Chinese, and Latin American cultures. The process of cultural competence in the delivery of health care services is explained and introduces the concept of cultural humility. By focusing more on biases and assumptions brought forth from the dominant culture, health care providers may experience less moral distress and convey increased caring in the context of intercultural interactions and nondisclosure of prognosis of a terminal illness. © The Author(s) 2015.

  15. Influence of culture and community perceptions on birth and perinatal care of immigrant women: doulas' perspective.

    Science.gov (United States)

    Kang, Hye-Kyung

    2014-01-01

    A qualitative study examined the perceptions of doulas practicing in Washington State regarding the influence of cultural and community beliefs on immigrant women's birth and perinatal care, as well as their own cultural beliefs and values that may affect their ability to work interculturally. The findings suggest that doulas can greatly aid immigrant mothers in gaining access to effective care by acting as advocates, cultural brokers, and emotional and social support. Also, doulas share a consistent set of professional values, including empowerment, informed choice, cultural relativism, and scientific/evidence-based practice, but do not always recognize these values as culturally based. More emphasis on cultural self-awareness in doula training, expanding community doula programs, and more integration of doula services in health-care settings are recommended.

  16. Influence of Culture and Community Perceptions on Birth and Perinatal Care of Immigrant Women: Doulas’ Perspective

    Science.gov (United States)

    Kang, Hye-Kyung

    2014-01-01

    A qualitative study examined the perceptions of doulas practicing in Washington State regarding the influence of cultural and community beliefs on immigrant women’s birth and perinatal care, as well as their own cultural beliefs and values that may affect their ability to work interculturally. The findings suggest that doulas can greatly aid immigrant mothers in gaining access to effective care by acting as advocates, cultural brokers, and emotional and social support. Also, doulas share a consistent set of professional values, including empowerment, informed choice, cultural relativism, and scientific/evidence-based practice, but do not always recognize these values as culturally based. More emphasis on cultural self-awareness in doula training, expanding community doula programs, and more integration of doula services in health-care settings are recommended. PMID:24453465

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

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    Bosch, Marije; Dijkstra, Rob; Wensing, Michel; van der Weijden, Trudy; Grol, Richard

    2008-08-21

    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. 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. A strong group culture was negatively associated to the quality of diabetes care provided to patients (beta = -0.04; p = 0.04), whereas a more 'balanced culture' was positively associated to diabetes care quality (beta = 5.97; p = 0.03). No associations were found between organizational culture, team climate and clinical patient outcomes. 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 that aspects of redesigning care such as teamwork and culture

  18. 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

  19. Child Care Teachers' Response to Children's Emotional Expression

    Science.gov (United States)

    Ahn, Hey Jun; Stifter, Cynthia

    2006-01-01

    This observational study examined practices through which child care teachers socialize children's emotion. A specific aim was to describe strategies of teacher intervention in response to emotion displayed by children in child care centers, and to answer the question of differential interactions based on children's age and gender. The results of…

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

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    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. 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.

  2. Patient safety culture in care homes for older people: a scoping review

    Directory of Open Access Journals (Sweden)

    Emily Gartshore

    2017-11-01

    Full Text Available Abstract Background In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. Methods A scoping review was undertaken to describe the availability of evidence related to care homes’ patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Results Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. Conclusions Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.

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

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

    2016-12-01

    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. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  4. Patient Safety Culture in Slovenian out-of-hours Primary Care Clinics.

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    Klemenc-Ketiš, Zalika; Deilkås, Ellen Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

    2017-10-01

    Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire - an ambulatory version (SAQAV) to measure the climate of safety. Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score ± standard deviation of the SAQ was 56.6±16.0 points, of Perceptions of Management 53.6±19.6 points, of Job Satisfaction 48.5±18.3 points, of Safety Climate 59.1±22.1 points, of Teamwork Climate 72.7±16.6, and of Communication 51.5±23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-AV. The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.

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

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    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.

  6. 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…

  7. Dental students' beliefs about culture in patient care: self-reported knowledge and importance.

    Science.gov (United States)

    Wagner, Julie A; Redford-Badwal, Deborah

    2008-05-01

    In order to decrease the well-documented disparities in oral health and oral health care, the next generation of dentists must be prepared to serve a diverse patient population. This article describes dental students' self-reported knowledge of culture and importance of using culturally sensitive dental practices. Three consecutive graduating classes (n=111) were surveyed anonymously in their sophomore years. Students indicated their self-rated knowledge of oral health and oral health care for their own culture and the cultures of patients they are likely to see in dental practice. Students also rated their perceived importance of culturally sensitive dental practice. Overall, students reported low knowledge of the cultures of the patients they will see in practice. Few students could identify any cultural group that they knew well. However, students as a group indicated that using culturally sensitive practices in dentistry is important. Students who could identify at least one cultural group they knew well perceived cultural sensitivity in dental practice as more important than students who could not. These results suggest that students need cross-cultural training and believe that such training is important. The results also suggest that a specific curriculum that increases knowledge of other cultures may have the potential to ultimately increase the use of culturally sensitive practices.

  8. Patient safety culture in intensive care units from the perspective of nurses: A cross-sectional study

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    Sedigheh Farzi

    2017-01-01

    Full Text Available Background: One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. Materials and Methods: This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a two-part questionnaire that included demographic and hospital survey on Patient Safety Culture (HSOPSC questionnaire. Data analysis was done using descriptive statistics (mean and standard deviation. Results: Among the 12 dimensions of safety culture, the nurses assigned the highest score to “team work within units” (97.3% and “Organizational learning-continuous improvement” (84%. They assigned the least score to “handoffs and transitions”(21.1%, “non-punitive response to errors” (24.7%, “Staffing” (35.6%, “Communication openness” (47.5%, and “Teamwork across units” (49.4%. Conclusions: The patient safety culture dimensions have low levels that require adequate attention and essential measures of health care centers including facilitating teamwork, providing adequate staff, and developing a checklist of handoffs and transitions. Furthermore, to increase reporting error and to promote a patient safety culture in intensive care units, some strategies should be adopted including a system-based approach to deal with the error.

  9. 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.

  10. Cultural care of Thai immigrants in Uppsala: a study of transcultural nursing in Sweden.

    Science.gov (United States)

    Lundberg, P C

    2000-10-01

    The purpose of this study was to discover and describe the meanings and expressions of cultural care of a group of Thai immigrants in Sweden. Participants included 15 key informants and 24 general informants living in and around the town of Uppsala. The conceptual framework was provided by Leininger's theory of cultural care diversity and universality. Use was made of the ethnonursing method and the Sunrise Model in the search for multiple and related dimensions that influenced the generic and professional care practices of the Thai immigrants. Four major themes were formulated. Thus, care (a) means family and kinship relationships as expressed in daily life, (b) is expressed in traditional gender roles, (c) means religious beliefs as expressed in the Buddhist worship, and (d) means support of traditional health care practices. These themes support the cultural care theory and also confirm the Sunrise Model.

  11. Organizational and safety culture in Canadian intensive care units: relationship to size of intensive care unit and physician management model.

    Science.gov (United States)

    Dodek, Peter M; Wong, Hubert; Jaswal, Danny; Heyland, Daren K; Cook, Deborah J; Rocker, Graeme M; Kutsogiannis, Demetrios J; Dale, Craig; Fowler, Robert; Ayas, Najib T

    2012-02-01

    The objectives of this study are to describe organizational and safety culture in Canadian intensive care units (ICUs), to correlate culture with the number of beds and physician management model in each ICU, and to correlate organizational culture and safety culture. In this cross-sectional study, surveys of organizational and safety culture were administered to 2374 clinical staff in 23 Canadian tertiary care and community ICUs. For the 1285 completed surveys, scores were calculated for each of 34 domains. Average domain scores for each ICU were correlated with number of ICU beds and with intensivist vs nonintensivist management model. Domain scores for organizational culture were correlated with domain scores for safety culture. Culture domain scores were generally favorable in all ICUs. There were moderately strong positive correlations between number of ICU beds and perceived effectiveness at recruiting/retaining physicians (r = 0.58; P organizational and safety culture. Differences in perceptions between staff in larger and smaller ICUs highlight the importance of teamwork across units in larger ICUs. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. 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.

  13. 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

    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 the improvement of Eo

  14. 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

  15. Dental care as a vital service response for disaster victims.

    Science.gov (United States)

    Mosca, Nicholas G; Finn, Emanuel; Joskow, Renée

    2007-05-01

    Hurricane Katrina's impact on the infrastructure of public health and the health care system in the affected areas was unprecedented in the United States. Many dental offices were flood-bound in New Orleans and over 60% of dental practices were partially or completely damaged in affected counties in Mississippi. Most needs assessments conducted during the initial recovery operations did not include questions about access to oral health care. However, the extent of the destruction of the health care infrastructure demonstrated the need for significant state and federal support to make dental treatment accessible to survivors and evacuees. The Katrina response is one of the few times that state and federal government agencies responded to provide dental services to victims as part of disaster response and recovery. The purpose of this paper is to share our experiences in Mississippi and the District of Columbia providing urgent dental care to disaster victims as part of a crisis response.

  16. 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

    2017-03-01

    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. © 2016 John Wiley & Sons Australia, Ltd.

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

    Science.gov (United States)

    Howe, Charles L; Kaptzan, Tatiana; Magaña, Setty M; Ayers-Ringler, Jennifer R; LaFrance-Corey, Reghann G; Lucchinetti, Claudia F

    2014-05-01

    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, Sjögren'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. Copyright © 2014 Wiley Periodicals, Inc.

  18. Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

    Science.gov (United States)

    Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

    2010-10-01

    The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  19. 42 CFR 476.78 - Responsibilities of health care facilities.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions... 42 Public Health 4 2010-10-01 2010-10-01 false Responsibilities of health care facilities. 476.78...

  20. Patient Safety Culture Survey in Pediatric Complex Care Settings: A Factor Analysis.

    Science.gov (United States)

    Hessels, Amanda J; Murray, Meghan; Cohen, Bevin; Larson, Elaine L

    2017-04-19

    Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012. Items were screened by principal axis factoring, and the original structure was tested using confirmatory factor analysis. Exploratory factor analysis was conducted to identify the best model fit for the pLTC data, and factor reliability was assessed by Cronbach alpha. The extracted, rotated factor solution suggested items in 4 (staffing, nonpunitive response to mistakes, communication openness, and organizational learning) of the original 12 dimensions may not be a good fit for this population. Nevertheless, in the pLTC setting, both the original and the modified factor solutions demonstrated similar reliabilities to the published consistencies of the survey when tested in adult nursing homes and the items factored nearly identically as theorized. This study demonstrates that the Nursing Home Survey on Patient Safety Culture with minimal modification may be an appropriate instrument to measure PSC in pLTC settings. Additional psychometric testing is recommended to further validate the use of this instrument in this setting, including examining the relationship to safety outcomes. Increased use will yield data for benchmarking purposes across these specialized settings to inform frontline workers and organizational leaders of areas of strength and opportunity for improvement.

  1. 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 organizational communication interventions might protect HIV health-care providers from burnout.

  2. Diversity and cultural competence training in health care organizations: hallmarks of success.

    Science.gov (United States)

    Curtis, Ellen Foster; Dreachslin, Janice L; Sinioris, Marie

    2007-01-01

    The authors reviewed recent literature on diversity training interventions and identified effective practices for health care organizations. Self-reported satisfaction was especially likely to be found as a result of training, whereas attitude change measured by standardized instruments was mixed. Although those responsible for diversity training in the workplace agree that behavioral change is key, awareness building and associated attitude change remain the focus of most diversity training in the workplace. Consequently, the authors recommend a systems approach to diversity training interventions wherein training is a key component of a health care organization's strategic approach to organizational performance, and diversity training is linked to the organizations' strategic goals for improved quality of care. The systems approach requires these steps: determine diversity and cultural competence goals in the context of strategy, measure current performance against needs, design training to address the gap, implement the training, assess training effectiveness, and strive for continuous improvement. Higher level evaluations measuring whether employees have transferred learning from training to their jobs are paramount to the systems approach to diversity training interventions. Measuring other positive changes in a "return on investment" format can be used to convince stakeholders of training's value.

  3. 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.

  4. 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)

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

    Science.gov (United States)

    ... Azen, S.P. (1995). Ethnicity and attitudes toward patient autonomy. JAMA, 274, 820-5 . Phipps, E., True, G., & ... briefly about end-of-life options and neglect culture or values (Tulsky, Fischer, Rose, & Arnold, 1998). Speaking ...

  6. Dutch translation and cross-cultural validation of the Adult Social Care Outcomes Toolkit (ASCOT).

    Science.gov (United States)

    van Leeuwen, Karen M; Bosmans, Judith E; Jansen, Aaltje Pd; Rand, Stacey E; Towers, Ann-Marie; Smith, Nick; Razik, Kamilla; Trukeschitz, Birgit; van Tulder, Maurits W; van der Horst, Henriette E; Ostelo, Raymond W

    2015-05-13

    The Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation. The ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study. The pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website ( http://www.pssru.ac.uk/ascot ). This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation.

  7. 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…

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

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.G.W.; Zee, J. van der; Groenewegen, P.P.

    2013-01-01

    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,

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

    NARCIS (Netherlands)

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

    2013-01-01

    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,

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

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.G.W.; Zee, J. van der; Groenewegen, P.P.

    2013-01-01

    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

  11. Negotiated risk and resident autonomy: Frontline care staff perspectives on culture change in long term care in Nova Scotia, Canada.

    Science.gov (United States)

    Roberts, Emily

    2016-08-12

    Regulating risk, freedom of action, and autonomy in decision making are problems shared by both caregivers and residents in long term care settings, and may become the subject of tension and constant negotiation. This study focuses on long term care staff and management perceptions of day to day life in a care community which has gone through a culture change transition, where small residentially scaled households replace large instutional models of care. In each household, the setting is considered to be home for the 8-12 residents, creating a major shift of roles for the caregivers; they are, in essence, coming into a home rather than institutional environment as a place of work. This potentially changes the dynamics of both patterns of work for caregivers and patterns of daily living for residents. Participant observations and care staff interviews. Several key themes emrged which include: teamwork; the culture of care; regulating risk; the physical environment and care staff empowerment. An unexpected outcome was the consensus among care staff that it is they who feel at home while working in the care households, leading to empowerment in their work roles and a deeper understanding of the importance of their role in the lives of the residents.

  12. 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.

  13. 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.

  14. Canadian residents' perceptions of cross-cultural care training in graduate medical school.

    Science.gov (United States)

    Singh, Barinder; Banwell, Emma; Groll, Dianne

    2017-12-01

    The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine.

  15. Ethics of cancer palliative care in Sri Lanka. A cross- cultural perspective.

    Directory of Open Access Journals (Sweden)

    Dayasiri MBKC

    2010-12-01

    Full Text Available The diagnosis of cancer is associated with an unexpected breakdown of the physical, psychological and social well being. In addition to cancer related physical outcomes, cross-cultural issues are known to hasten patients’ clinical deterioration and can impact upon orientation as a healthy human being in society. As members of a developing nation in the second world, to provide patient oriented quality care while maintaining high standards of ethical practice, health care workers in Sri Lanka have to be culturally competent. In Sri Lanka, the cross-cultural ethical issues related to patients with a diagnosis of cancer include, awareness of one’s own cultural identity, gaining knowledge of different cultural issues, verbal and non verbal communication skills, respect for patients’ autonomy, involvement of the family and the relatives, addressing moral and spiritual backgrounds, development of effective communication skills and provision of social support. Therefore in the management of cancer patients in Sri Lanka, cultural issues should be given a high priority to maintain ethical standards and quality in palliative care. Culturally competent Health care workers safeguard the rights of patients, as well as providing optimal medical and surgical care.

  16. Canadian residents’ perceptions of cross-cultural care training in graduate medical school

    Science.gov (United States)

    Singh, Barinder; Banwell, Emma; Groll, Dianne

    2017-01-01

    Background The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. Methods The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Results Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. Conclusion While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine. PMID:29354194

  17. Changes in patient safety culture after restructuring of intensive care units: Two cross-sectional studies.

    Science.gov (United States)

    Vifladt, Anne; Simonsen, Bjoerg O; Lydersen, Stian; Farup, Per G

    2016-02-01

    Compare changes in registered nurses' perception of the patient safety culture in restructured and not restructured intensive care units during a four-year period. Two cross-sectional surveys were performed, in 2008/2009 (time 1) and 2012/2013 (time 2). During a period of 0-3 years after time 1, three of six hospitals merged their general and medical intensive care units (restructured). The other hospitals maintained their structure of the intensive care units (not restructured). Intensive care units in hospitals at one Norwegian hospital trust. The safety culture was measured with Hospital Survey on Patient Safety Culture. At times 1 and 2, 217/302 (72%) and 145/289 (50%) registered nurses participated. Restructuring was negatively associated with change in the safety culture, in particular, the dimensions of the safety culture within the unit level. The dimensions most vulnerable for restructuring were manager expectations and actions promoting safety, teamwork within hospital units and staffing. In this study, the restructuring of intensive care units was associated with a negative impact on the safety culture. When restructuring, the management should be particularly aware of changes in the safety culture dimensions manager expectations and actions promoting safety, teamwork within hospital units and staffing. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Please Ask Gently: Using Culturally Targeted Communication Strategies to Initiate End-of-Life Care Discussions With Older Chinese Americans.

    Science.gov (United States)

    Chi, Han-Lin; Cataldo, Janine; Ho, Evelyn Y; Rehm, Roberta S

    2018-01-01

    Health-care providers (HCPs) find facilitating end-of-life (EOL) care discussions challenging, especially with patients whose ethnicities differ from their own. Currently, there is little guidance on how to initiate and facilitate such discussions with older Chinese Americans (≥55 years) and their families. To explore communication strategies for HCPs to initiate EOL care discussions with older Chinese Americans in the San Francisco Bay Area. This qualitative (focused) ethnographic study included field observations and individual semistructured interviews with 14 community-dwelling older Chinese Americans who lived independently at home, 9 adult children, and 7 HCPs. Responses were analyzed using open coding, memos, and comparison across participants. The study participants emphasized the importance of assessing readiness for early EOL care discussions. All recommended using indirect communication approaches to determine older Chinese Americans' readiness. Indirect communication can be culturally targeted and applied at both system-wide (ie, health-care system) and individual (ie, HCP) levels. To institutionalize the practice, health-care facilities should implement EOL care discussion inquiries as part of routine during check-in or intake questionnaires. In individual practice, using depersonalized communication strategies to initiate the discussion was recommended to determine older Chinese Americans' readiness. Assessing readiness should be an essential and necessary action for early EOL care discussions. Culturally targeted assessment of older Chinese Americans includes using indirect communication approaches to initiate an EOL care discussion to determine their readiness. In addition to health-care system integration, providers should implement and evaluate proposed EOL discussion initiation prompts with their older Chinese American patients.

  19. 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

    2018-01-01

    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.

  20. The socio-cultural significance of the diagnostic label "neurasthenia" in Japan's mental health care system.

    Science.gov (United States)

    Munakata, T

    1989-06-01

    This paper is an attempt to explore the socio-cultural significance of deliberately disguising schizophrenia as neurasthenia, neurosis or malfunction of autonomic nervous system. To understand its significance, the socio-cultural background of Japanese attitudes toward mental illness and Japan's mental health care system is also examined from a non-Western standpoint.

  1. Asian and Pacific Islander Cultural Values: Considerations for Health Care Decision Making.

    Science.gov (United States)

    McLaughlin, Linda A.; Braun, Kathryn L.

    1998-01-01

    Some history on health-care decision making is reviewed. The current "individualist" model in the United States is contrasted with "collectivist" models of Asian and Pacific Islander cultures. Decision making styles are discussed in relationship to Western medicine. Six groups' cultural norms are presented. Conflicts with U.S.…

  2. 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 a…

  3. The Cultural Turn in Sociology: Can It Help Us Resolve an Age-Old Problem in Understanding Decision Making for Health Care?

    Science.gov (United States)

    Pescosolido, Bernice A; Olafsdottir, Sigrun

    2010-12-01

    Culture has long affected individuals' response to problems. A classic puzzle in the sociology of health and illness is discrepancy between theory and research regarding cultural beliefs and knowledge of medical care service use. "Utilization research," examining individuals' responses to the onset of health problems, has not consistently affected culture on the uptake of formal treatment. First, while ethnographic research often describes how culture shapes illness behaviors, survey-based studies rarely find significant beliefs or predispositions once "need" is controlled. Second, in quantitative studies, individuals report supportive treatment beliefs or predispositions to use services but low utilization levels, reinforcing claims about lack of utility of cultural ideologies in health-care decision making. We ask whether innovations in the sociology of culture and cognition provide theoretical scaffolding to conceptualize and measure culture in health service utilization. Rather than estimating effect of cultural beliefs on health-care decisionmaking, we question the measurement of cultural beliefs in understanding service use. Examining data from the General Social Survey, we focus on how approaches to culture might explain the paradox of high cultural predispositions and low actual use. Children with mental health problems provide a comparison between suggestions and endorsements. Suggestions, sources of care offered by individuals in response to a case description without any other social cues, align with new cultural approaches, and are measured by responses to open-ended questions about what should be done for the child described (with clinical criteria for ADHD, major depression, asthma, or "daily troubles"). Endorsements, requiring less cognitive work and cultural resistance, align with traditional conceptualizations of culture, and are measured by closed-ended questions that ask respondents to agree or disagree with seeking help from different treatment

  4. 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.

  5. 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.

  6. The response of human glioblastoma in culture to radiation

    International Nuclear Information System (INIS)

    Masuda, Koji; Aramaki, Ryoji; Takagi, Tosuke

    1980-01-01

    Cells from two human glioblastoma multiforme and one mouse glioma were grown in tissue cultures and their X-ray survival curve parameters were determined under oxygenated and hypoxic conditions. These were compared with the survival parameters for mouse fibroblasts (L5) and established cell lines from human carcinoma coli (HeLa S3) irradiated under identical conditions. There was no significant difference in response among the cell lines used. Repair of potentially lethal damage for human glioblastoma and HeLa S3 was assessed by the increase in survival which occurred as the cells were held in density inhibited stationary phase. The magnitude of repair of potentially lethal damage (slope modifying factors) for the glioblastoma and HeLa were 1.9 and 1.1, respectively. (author)

  7. Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

    Science.gov (United States)

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

    2017-08-31

    The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

  8. The role of culture in primary health care

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... thrombolytic therapy may be beneficial although the risks of haemorrhage from areas of infarct may be substantial. The haemodynamic .... variety of ideas about health and physical care, and they also have a multitude of diet ...

  9. 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

  10. 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.…

  11. LGBT Cultural Competence and Interventions to Help Oncology Nurses and Other Health Care Providers.

    Science.gov (United States)

    Radix, Asa; Maingi, Shail

    2018-02-01

    To define and give an overview of the importance of lesbian, gay, bisexual, and transgender (LGBT) cultural competency and offer some initial steps on how to improve the quality of care provided by oncology nurses and other health care professionals. A review of the existing literature on cultural competency. LGBT patients experience cancer and several other diseases at higher rates than the rest of the population. The reasons for these health care disparities are complex and include minority stress, fear of discrimination, lower rates of insurance, and lack of access to quality, culturally competent care. Addressing the health care disparities experienced by LGBT individuals and families requires attention to the actual needs, language, and support networks used by patients in these communities. Training on how to provide quality care in a welcoming and non-judgmental way is available and can improve health equity. Health care professionals and institutions that acquire cultural competency training can improve the overall health of LGBT patients who currently experience significant health care disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Holistic models for end of life care: establishing the place of culture

    NARCIS (Netherlands)

    Selman, L.; Speck, P.; Barfield, R.C.; Gysels, M.; Higginson, I.J.; Harding, R.

    2014-01-01

    Introduction This article presents a holistic model for clinical palliative care and research which expands and improves previous models by fully recognizing the place of culture in illness. Methods Literature review and philosophical enquiry. Results Holistic models of patient care are essential to

  13. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. 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…

  15. Culture care theory: a major contribution to advance transcultural nursing knowledge and practices.

    Science.gov (United States)

    Leininger, Madeleine

    2002-07-01

    This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contributing theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consultation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.

  16. Cross-cultural communication and use of the family meeting in palliative care.

    Science.gov (United States)

    Sharma, Rashmi K; Dy, Sydney M

    2011-09-01

    Terminally-ill patients and their families often report poor communication and limited understanding of the patient's diagnosis, prognosis, and treatment plan; these deficits can be exacerbated by cross-cultural issues. Although family meetings are frequently recommended to facilitate provider-family communication, a more structured, evidence-based approach to their use may improve outcomes. Drawing on research and guidelines from critical care, palliative care, and cross-cultural communication, we propose a framework for conducting family meetings with consideration for cross-cultural issues.

  17. Racial/ethnic disparities and culturally competent health care among youth and young men.

    Science.gov (United States)

    Vo, Dzung X; Park, M Jane

    2008-06-01

    Racial/ethnic disparities in health and health care are receiving increasing national attention from the fields of public health and medicine. Efforts to reduce disparities should adopt a life-span approach and recognize the role of gender. During adolescence, young people make increasingly independent decisions about health-related behavior and health care, while developing gender identity. Little is known about how cultural context shapes gender identity and gender identity's influence on health-related behavior and health care utilization. The authors review disparities in health status and health care among adolescents, especially young men, by reviewing health care access, clinical services, and issues related to culture, identity, and acculturation. Significant differences in health status by gender exist in adolescence, with young men faring worse on many health markers. This article discusses gaps in research and offers recommendations for improving health care quality and strengthening the research base on gender and disparities during adolescence.

  18. Cultural competence springs up in the desert: the story of the center for cultural competence in health care at Weill Cornell Medical College in Qatar.

    Science.gov (United States)

    Elnashar, Maha; Abdelrahim, Huda; Fetters, Michael D

    2012-06-01

    The authors describe the factors that led Weill Cornell Medical College in Qatar (WCMC-Q) to establish the Center for Cultural Competence in Health Care from the ground up, and they explore challenges and successes in implementing cultural competence training.Qatar's capital, Doha, is an extremely high-density multicultural setting. When WCMC-Q's first class of medical students began their clinical clerkships at the affiliated teaching hospital Hamad Medical Corporation in 2006, the complicated nature of training in a multicultural and multilingual setting became apparent immediately. In response, initiatives to improve students' cultural competence were undertaken. Initiatives included launching a medical interpretation program in 2007; surveying the patients' spoken languages, examining the effect of an orientation program on interpretation requests, and surveying faculty using the Tool for Assessing Cultural Competence Training in 2008; implementing cultural competence training for students and securing research funding in 2009; and expanding awareness to the Qatar community in 2010. These types of initiatives, which are generally highly valued in U.S. and Canadian settings, are also apropos in the Arabian Gulf region.The authors report on their initial efforts, which can serve as a resource for other programs in the Arabian Gulf region.

  19. 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.

  20. 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. Copyright © 2011. Published by Elsevier Inc.

  1. 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.

  2. 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.

  3. 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.

  4. [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.

  5. 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. © 2012 American Society of Law, Medicine & Ethics, Inc.

  6. A comparison of surgery and family medicine residents' perceptions of cross-cultural care training.

    Science.gov (United States)

    Chun, Maria B J; Jackson, David S; Lin, Susan Y; Park, Elyse R

    2010-12-01

    The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and÷or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility - more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. Hawaii Medical Journal Copyright 2010.

  7. 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.

  8. Personal characteristics associated with resident physicians' self perceptions of preparedness to deliver cross-cultural care.

    Science.gov (United States)

    Lopez, Lenny; Vranceanu, Ana-Maria; Cohen, Amy P; Betancourt, Joseph; Weissman, Joel S

    2008-12-01

    Recent reports from the Institute of Medicine emphasize patient-centered care and cross-cultural training as a means of improving the quality of medical care and eliminating racial and ethnic disparities. To determine whether, controlling for training received in medical school or during residency, resident physician socio-cultural characteristics influence self-perceived preparedness and skill in delivering cross-cultural care. National survey of resident physicians. A probability sample of residents in seven specialties in their final year of training at US academic health centers. Nine resident characteristics were analyzed. Differences in preparedness and skill were assessed using the chi(2) statistic and multivariate logistic regression. Fifty-eight percent (2047/3500) of residents responded. The most important factor associated with improved perceived skill level in performing selected tasks or services believed to be useful in treating culturally diverse patients was having received cross-cultural skills training during residency (OR range 1.71-4.22). Compared with white residents, African American physicians felt more prepared to deal with patients with distrust in the US healthcare system (OR 1.63) and with racial or ethnic minorities (OR 1.61), Latinos reported feeling more prepared to deal with new immigrants (OR 1.88) and Asians reported feeling more prepared to deal with patients with health beliefs at odds with Western medicine (1.43). Cross-cultural care skills training is associated with increased self-perceived preparedness to care for diverse patient populations providing support for the importance of such training in graduate medical education. In addition, selected resident characteristics are associated with being more or less prepared for different aspects of cross-cultural care. This underscores the need to both include medical residents from diverse backgrounds in all training programs and tailor such programs to individual resident needs in

  9. Is psychotropic medication use related to organisational and treatment culture in residential care.

    Science.gov (United States)

    Peri, Kathryn; Kerse, Ngaire; Moyes, Simon; Scahill, Shane; Chen, Charlotte; Hong, Jae Beom; Hughes, Carmel M

    2015-01-01

    The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture

  10. Communication and Culture in the Surgical Intensive Care Unit: Boundary Production and the Improvement of Patient Care.

    Science.gov (United States)

    Conn, Lesley Gotlib; Haas, Barbara; Cuthbertson, Brian H; Amaral, Andre C; Coburn, Natalie; Nathens, Avery B

    2016-06-01

    This ethnography explores communication around critically ill surgical patients in three surgical intensive care units (ICUs) in Canada. A boundary framework is used to articulate how surgeons', intensivists', and nurses' communication practices shape and are shaped by their respective disciplinary perspectives and experiences. Through 50 hours of observations and 43 interviews, these health care providers are found to engage in seven communication behaviors that either mitigate or magnify three contested symbolic boundaries: expertise, patient ownership, and decisional authority. Where these boundaries are successfully mitigated, experiences of collaborative, high-quality patient care are produced; by contrast, boundary magnification produces conflict and perceptions of unsafe patient care. Findings reveal that high quality and safe patient care are produced through complex social and cultural interactions among surgeons, intensivists, and nurses that are also expressions of knowledge and power. This enhances our understanding of why current quality improvement efforts targeting communication may be ineffective. © The Author(s) 2015.

  11. Intra-Cultural Variation in Child Care Practices in Japan

    Science.gov (United States)

    Toyama, Noriko

    2016-01-01

    This study, comprising three sub-studies, aims to examine how child-rearing practices vary according to different social circumstances in Japan. By comparing teacher-child interaction at mealtimes in day care centres both on an isolated small island located in Okinawa prefecture, Tarama, and in a large industrialised city, Tokyo, the following was…

  12. Proposing an Empirically Justified Reference Threshold for Blood Culture Sampling Rates in Intensive Care Units

    Science.gov (United States)

    Castell, Stefanie; Schwab, Frank; Geffers, Christine; Bongartz, Hannah; Brunkhorst, Frank M.; Gastmeier, Petra; Mikolajczyk, Rafael T.

    2014-01-01

    Early and appropriate blood culture sampling is recommended as a standard of care for patients with suspected bloodstream infections (BSI) but is rarely taken into account when quality indicators for BSI are evaluated. To date, sampling of about 100 to 200 blood culture sets per 1,000 patient-days is recommended as the target range for blood culture rates. However, the empirical basis of this recommendation is not clear. The aim of the current study was to analyze the association between blood culture rates and observed BSI rates and to derive a reference threshold for blood culture rates in intensive care units (ICUs). This study is based on data from 223 ICUs taking part in the German hospital infection surveillance system. We applied locally weighted regression and segmented Poisson regression to assess the association between blood culture rates and BSI rates. Below 80 to 90 blood culture sets per 1,000 patient-days, observed BSI rates increased with increasing blood culture rates, while there was no further increase above this threshold. Segmented Poisson regression located the threshold at 87 (95% confidence interval, 54 to 120) blood culture sets per 1,000 patient-days. Only one-third of the investigated ICUs displayed blood culture rates above this threshold. We provided empirical justification for a blood culture target threshold in ICUs. In the majority of the studied ICUs, blood culture sampling rates were below this threshold. This suggests that a substantial fraction of BSI cases might remain undetected; reporting observed BSI rates as a quality indicator without sufficiently high blood culture rates might be misleading. PMID:25520442

  13. Culture and biomedical care in Africa: the influence of culture on biomedical care in a traditional African society, Nigeria, West Africa.

    Science.gov (United States)

    Chukwuneke, F N; Ezeonu, C T; Onyire, B N; Ezeonu, P O

    2012-01-01

    Biomedical Care in Africa and the influence of culture on the health-seeking behaviour of Africans can not be underestimated; many African cultures have different understanding of the causes of disease which more often affect our public health system, policy, planning and implementations. The traditional African healer unlike a doctor trained in western biomedicine, looks for the cause of the patient's ailments as misfortune in relationship between the patient and the social, natural and spiritual environments. The complexity of African society with different cultural and religious practices also reflects on the people's attitude and understanding of their health matters. This paper is an overview of the cultural influence on biomedical care in a traditional African society, Nigeria, West Africa. A research on the patients' health seeking behaviour and Primary Health Care service organization in 10 health centres in the five eastern states of the Federal Republic of Nigeria was carried out using a multistage cross-sectional study. A semi-structured questionnaire was administered to the health care providers and patients while an in-depth semi- structured interview was also conducted. We observed there is underutilization of health care services at the primary level because most people do not accept the model of health care system provided for them. Most people believe diseases are caused by supernatural beings, the handiwork of neighbours or vengeance from an offended god as a result of transgressions committed in the past by an individual or parents. This group of people therefore prefers seeking traditional medicine to seeking orthodox medicine and often ends up in the hands of witch doctors who claim to have cure to almost all the diseases. Biomedical care in Africa is influence by culture because of different understanding of what ailment is and also due to limited knowledge of health matters, poverty and ignorance. There is a need therefore to focus on health

  14. Culturally Responsive Positive Behavior Supports: Considerations for Practice

    Science.gov (United States)

    Banks, Tachelle; Obiakor, Festus E.

    2015-01-01

    Classrooms are not culturally neutral terrains, but rather are constructed around sets of norms, values, and expected behaviors that are culturally bound. Low tolerance levels and expectations are an indication of the incongruence between the education strategies utilized by teachers and the cultural and linguistic differences of students that are…

  15. [Refusal of personal hygiene care and nursing responsibility].

    Science.gov (United States)

    Peyé, Anne

    2013-03-01

    Situations of patients refusing personal hygiene care are frequent. Sources of difficulties and questioning for caregivers, they can lead to maltreatment. In order to avoid this pitfall, it is essential to support the teams in their approach around representations of caregiving and nursing responsibility.

  16. The Responsive Leadership Intervention: Improving leadership and individualized care in long-term care.

    Science.gov (United States)

    Caspar, Sienna; Le, Anne; McGilton, Katherine S

    The Responsive Leadership Intervention (RLI) is a multi-faceted intervention. We evaluated the influence of the RLI on i) responsive leadership practices by team leaders; ii) health care aides' (HCAs) self-determination; iii) HCAs' perceived ability to provide individualized care. A quasi-experimental repeated measures non-equivalent control group design was used to assess participant outcomes in four long-term care facilities (two control, two intervention) across four time periods. Change from baseline to 1-month post-intervention was greater in the intervention group than control group for Individualized Care (IC) (p = 0.001), but not for Self Determination (p = 0.26). Perceived levels of responsive leadership was greater following the intervention among participants with baseline measures that were less than the median (p = 0.007), but not if greater. At 3-months post-intervention, the intervention group retained 32% of the difference from control in IC, and 49% of the difference from control in responsive leadership; at 6-months post-intervention, 35% and 28%, respectively. The RLI is a feasible method for improving responsive leadership practices and individualized care. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The Development of a Model of Culturally Responsive Science and Mathematics Teaching

    Science.gov (United States)

    Hernandez, Cecilia M.; Morales, Amanda R.; Shroyer, M. Gail

    2013-01-01

    This qualitative theoretical study was conducted in response to the current need for an inclusive and comprehensive model to guide the preparation and assessment of teacher candidates for culturally responsive teaching. The process of developing a model of culturally responsive teaching involved three steps: a comprehensive review of the…

  18. A culture of education: Enhancing school performance of youth living in residential group care in Ontario.

    Science.gov (United States)

    Gharabaghi, Kiaras

    2011-01-01

    This article presents a synthesis of what is known about the educational experiences of youth living in residential group care based on a literature review that highlights both the experiences of the youth themselves and the operational context of residential group care in Ontario as it pertains to educational performance. The author argues that there is little emphasis on education within the residential group care sector in Ontario that could translate into more productive educational experiences for youth. The article then provides a framework for developing a culture of education for residential group care that can be acted upon expeditiously. Enhancing the educational performance of young people living in group care will require a cultural approach that provides for daily and pervasive education supports and encouragement, and aims to enhance the lived experience of young people pursuant to their education.

  19. 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.

  20. Structural and Socio-cultural Barriers to Prenatal Care in a US Marshallese Community.

    Science.gov (United States)

    Ayers, Britni L; Purvis, Rachel S; Bing, Williamina Ioanna; Rubon-Chutaro, Jellesen; Hawley, Nicola L; Delafield, Rebecca; Adams, Ingrid K; McElfish, Pearl Anna

    2018-02-22

    Objectives Pacific Islanders are disproportionately burdened by poorer perinatal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care. The aim of this study is to examine Marshallese mothers' beliefs, perceptions, and experiences of prenatal care and to identify potential barriers. Methods Three focus groups were conducted with Marshallese mothers, who were 18 years or older, and living in Arkansas. Focus groups focused on mothers' beliefs, perceptions, and experiences of prenatal care. A thematic qualitative analysis was conducted to identify salient themes within the data. Results The results demonstrated that negotiating health insurance, transportation, and language barriers were all major structural barriers that constrain prenatal care. The social-cultural barriers that emerged included a lack of understanding of the importance of seeking early and consistent prenatal care, as well as how to navigate the healthcare process. The more complicated challenges that emerged were the feelings of shame and embarrassment due to the perception of their age or being unmarried during pregnancy not being acceptable in American culture. Furthermore, the participants described perceived discrimination from prenatal care providers. Lastly, the participants described fear as a barrier to seeking out prenatal care. Conclusions for Practice This study identified both structural and socio-cultural barriers that can be incorporated into suggestions for policy makers to aid in alleviating maternal health disparities among Pacific Islander women. Further research is needed to address the Marshallese mothers' perceived discrimination from maternal health care providers.

  1. Patients' evaluation of quality of care in general practice: what are the cultural and linguistic barriers?

    Science.gov (United States)

    Harmsen, J A M; Bernsen, R M D; Bruijnzeels, M A; Meeuwesen, L

    2008-07-01

    Increased migration implies increased contacts for physicians with patients from diverse cultural backgrounds who have different expectations about healthcare. How satisfied are immigrant patients, and how do they perceive the quality of care? This study investigated which patient characteristics (such as cultural views and language proficiency) are related to patients' satisfaction and perceived quality of care. Patients (n=663) from 38 general practices in Rotterdam (The Netherlands) were interviewed. General satisfaction with the general practitioner (GP) was measured by a report mark. Perceived quality of care was measured using the 'Quote-mi' scale (quality of care through the patient's eyes-for migrants), which contains an ethnic-specific subscale and a communication process subscale. Using multilevel regression techniques, the relation between patient characteristics (ethnicity, age, education, Dutch language proficiency, cultural views) and satisfaction and perceived quality of care was analysed. In general, patients seemed fairly satisfied. Non-Western patients perceived less quality of care and were less satisfied than Dutch-born patients. The older the patients and the more modern cultural views they had, the more satisfied they were about the GP in general, as well as about the communication process. However, non-Western patients holding more modern views were the most critical regarding the ethnic-specific quality items. The poorer patients' Dutch language proficiency, the more negative they were about the communication process. It is concluded that next to communication aspects, especially when the patient's proficiency in Dutch is poor, physician awareness about the patient's cultural views is very important during the consultation. This holds especially true when the immigrant patient seems to be more or less acculturated. Medical students and physicians should be trained to become aware of the relevance of patients' different cultural backgrounds

  2. Patient autonomy in home care: Nurses' relational practices of responsibility.

    Science.gov (United States)

    Jacobs, Gaby

    2018-01-01

    Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course ('learning circle') for home care nurses, including participant observations and focus groups. The theoretical notion of 'relational agency' and the moral concept of 'practices of responsibility' were used to conduct a narrative analysis on the nurses' stories about autonomy. Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients' strengths and collaboration with patients and informal caregivers. On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

  3. 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...

  4. Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States.

    Science.gov (United States)

    Missmer, Stacey A; Seifer, David B; Jain, Tarun

    2011-05-01

    To identify cultural differences in access to infertility care. Cross-sectional, self-administered survey. University hospital-based fertility center. Thirteen hundred fifty consecutive women who were seen for infertility care. None. Details about demographic characteristics, health care access, and treatment opinions based on patient race or ethnicity. The median age of participants was 35 years; 41% were white, 28% African American, 18% Hispanic, and 7% Asian. Compared with white women, African American and Hispanic women had been attempting to conceive for 1.5 years longer. They also found it more difficult to get an appointment, to take time off from work, and to pay for treatment. Forty-nine percent of respondents were concerned about the stigma of infertility, 46% about conceiving multiples, and 40% about financial costs. Disappointing one's spouse was of greater concern to African-American women, whereas avoiding the stigmatization of infertility was of greatest concern to Asian-American women. While the demand for infertility treatment increases in the United States, attention to cultural barriers to care and cultural meanings attributed to infertility should be addressed. Enhanced cultural competencies of the health care system need to be employed if equal access is to be realized as equal utilization for women of color seeking infertility care. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Measuring safety culture in Dutch primary care: psychometric characteristics of the SCOPE-PC questionnaire.

    Science.gov (United States)

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

    2013-09-17

    Patient safety has been a priority in primary healthcare in the last years. The prevailing culture is seen as an important condition for patient safety in practice and several tools to measure patient safety culture have therefore been developed. Although Dutch primary care consists of different professions, such as general practice, dental care, dietetics, physiotherapy and midwifery, a safety culture questionnaire was only available for general practices. The purpose of this study was to modify and validate this existing questionnaire to a generic questionnaire for all professions in Dutch primary care. A validated Dutch questionnaire for general practices was modified to make it usable for all Dutch primary care professions. Subsequently, this questionnaire was administered to a random sample of 2400 practices from eleven primary care professions. The instrument's factor structure, reliability and validity were examined using confirmatory and explorative factor analyses. 921 questionnaires were returned. Of these, 615 were eligible for factor analysis. The resulting SCOPE-PC questionnaire consisted of seven dimensions: 'open communication and learning from errors', 'handover and teamwork', 'adequate procedures and working conditions', 'patient safety management', 'support and fellowship', 'intention to report events' and 'organisational learning' with a total of 41 items. All dimensions had good reliability with Cronbach's alphas ranging from 0.70-0.90, and the questionnaire had a good construct validity. The SCOPE-PC questionnaire has sound psychometric characteristics for use by the different professions in Dutch primary care to gain insight in their safety culture.

  6. Aging, Genetic Variations, and Ethnopharmacology: Building Cultural Competence Through Awareness of Drug Responses in Ethnic Minority Elders.

    Science.gov (United States)

    Woods, Diana Lynn; Mentes, Janet C; Cadogan, Mary; Phillips, Linda R

    2017-01-01

    Unique drug responses that may result in adverse events are among the ethnocultural differences described by the Agency for Healthcare Research and Quality. These differences, often attributed to a lack of adherence on the part of the older adult, may be linked to genetic variations that influence drug responses in different ethnic groups. The paucity of research coupled with a lack of knowledge among health care providers compound the problem, contributing to further disparities, especially in this era of personalized medicine and pharmacogenomics. This article examines how age-related changes and genetic differences influence variations in drug responses among older adults in unique ethnocultural groups. The article starts with an overview of age-related changes and ethnopharmacology, moves to describing genetic differences that affect drug responses, with a focus on medications commonly prescribed for older adults, and ends with application of these issues to culturally congruent health care. © The Author(s) 2015.

  7. Exploring traditional end-of-life beliefs, values, expectations, and practices among Chinese women living in England: Informing culturally safe care.

    Science.gov (United States)

    Fang, Mei Lan; Malcoe, Lorraine Halinka; Sixsmith, Judith; Wong, Louise Yuen Ming; Callender, Matthew

    2015-10-01

    This study explores the end-of-life (EoL) beliefs, values, practices, and expectations of a select group of harder-to-reach Chinese women living in England. A cultural safety approach was undertaken to interpret 11 in-depth, semistructured interviews. Interviews were conducted in Mandarin and Cantonese. Transcripts were translated and back-translated by two researchers. Findings were analyzed using the technical analytical principles of grounded theory. The key themes generated from our analysis include: acculturation; differential beliefs and norms in providing care: family versus health services; language and communication; Eastern versus Western spiritual practices and beliefs; and dying, death, and the hereafter. End-of-life discussions can be part of an arduous, painful, and uncomfortable process, particularly for migrants living on the margins of society in a new cultural setting. For some Chinese people living in the United Kingdom, end-of-life care requires attention to acculturation, particularly Western versus Eastern beliefs on religion, spirituality, burial practices, and provision of care, and the availability of culturally specific care, all of which encompass issues related to gender. Stories of a purposive sample of Chinese women were viewed through a cultural safety lens to gain a deeper understanding of how social and cultural norms and expectations, in addition to the pressures of acculturation, impact gendered roles and responsibilities. The analysis revealed variations between/within Eastern and Western culture that resulted in pronounced, and oftentimes gendered, differences in EoL care expectations.

  8. Emotions in primary care: Are there cultural differences in the expression of cues and concerns?

    Science.gov (United States)

    Schouten, Barbara C; Schinkel, Sanne

    2015-11-01

    This study compared native-Dutch and Turkish-Dutch patients' expressions of emotional cues/concerns and GPs' responses to these cues/concerns. Relations between patient's cues/concerns and GPs' perceptions of the patient's health complaint were examined too. 82 audiotaped encounters with native-Dutch and 38 with Turkish-Dutch GP patients were coded using the VR-CoDES and VR-CoDES-P. Patients filled out a survey before each consultation to assess their cultural identification, Dutch language proficiency and health-related variables. GPs filled out a survey after each consultation to assess their perceptions of the patient's health complaint. Turkish-Dutch patients expressed more cues than native-Dutch patients, which was explained by higher worries about their health and worse perceived general health. GPs responded more often with space-providing responses to Turkish-Dutch patients compared to native-Dutch patients. Turkish-Dutch patients' cue expression strongly influenced GPs' perceptions about the presence of psychosocial problems. Migrant patient-related factors influence the amount of emotional cue expression in primary care. GPs perceive these cues as indicating the presence of psychosocial problems and provide space for patients to elaborate on their emotional distress. GPs should be trained in using more affective communication techniques to enhance elicitation of the underlying reasons for migrant patients' enhanced emotional cue expression. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Canadian physicians' responses to cross border health care.

    Science.gov (United States)

    Runnels, Vivien; Labonté, Ronald; Packer, Corinne; Chaudhry, Sabrina; Adams, Owen; Blackmer, Jeff

    2014-04-03

    The idea for this survey emanated from desk research and two meetings for researchers that discussed medical tourism and out-of-country health care, which were convened by some of the authors of this article (VR, CP and RL). A Cross Border Health Care Survey was drafted by a number of the authors and administered to Canadian physicians via the Canadian Medical Association's e-panel. The purpose of the survey was to gain an understanding of physicians' experiences with and views of their patients acquiring health care out of country, either as medical tourists (paying out-of-pocket for their care) or out-of-country care patients funded by provincial/territorial public health insurance plans. Quantitative and qualitative results of the survey were analyzed. 631 physicians responded to the survey. Diagnostic procedures were the top-ranked procedure for patients either as out-of-country care recipients or medical tourists. Respondents reported that the main reason why patients sought care abroad was because waiting times in Canada were too long. Some respondents were frustrated with a lack of information about out-of-country procedures upon their patients' return to Canada. The majority of physician respondents agreed that it was their responsibility to provide follow-up care to medical travellers on return to Canada, although a substantial minority disagreed that they had such a responsibility. Cross-border health care, whether government-sanctioned (out-of-country-care) or patient-initiated (medical tourism), is increasing in Canada. Such flows are thought likely to increase with aging populations. Government-sanctioned outbound flows are less problematic than patient-initiated flows but are constrained by low approval rates, which may increase patient initiation. Lack of information and post-return complications pose the greatest concern to Canadian physicians. Further research on both types of flows (government-sanctioned and patient-initiated), and how they affect

  10. Canadian physicians’ responses to cross border health care

    Science.gov (United States)

    2014-01-01

    Background The idea for this survey emanated from desk research and two meetings for researchers that discussed medical tourism and out-of-country health care, which were convened by some of the authors of this article (VR, CP and RL). Methods A Cross Border Health Care Survey was drafted by a number of the authors and administered to Canadian physicians via the Canadian Medical Association’s e-panel. The purpose of the survey was to gain an understanding of physicians’ experiences with and views of their patients acquiring health care out of country, either as medical tourists (paying out-of-pocket for their care) or out-of-country care patients funded by provincial/territorial public health insurance plans. Quantitative and qualitative results of the survey were analyzed. Results 631 physicians responded to the survey. Diagnostic procedures were the top-ranked procedure for patients either as out-of-country care recipients or medical tourists. Respondents reported that the main reason why patients sought care abroad was because waiting times in Canada were too long. Some respondents were frustrated with a lack of information about out-of-country procedures upon their patients’ return to Canada. The majority of physician respondents agreed that it was their responsibility to provide follow-up care to medical travellers on return to Canada, although a substantial minority disagreed that they had such a responsibility. Conclusions Cross-border health care, whether government-sanctioned (out-of-country-care) or patient-initiated (medical tourism), is increasing in Canada. Such flows are thought likely to increase with aging populations. Government-sanctioned outbound flows are less problematic than patient-initiated flows but are constrained by low approval rates, which may increase patient initiation. Lack of information and post-return complications pose the greatest concern to Canadian physicians. Further research on both types of flows (government

  11. 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.

  12. 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.

  13. Partnerships With Aviation: Promoting a Culture of Safety in Health Care.

    Science.gov (United States)

    Skinner, Lori; Tripp, Terrance R; Scouler, David; Pechacek, Judith M

    2015-01-01

    According to the Institute of Medicine (IOM, 1999, p. 1), "Medical errors can be defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim." The current health care culture is disjointed, as evidenced by a lack of consistent reporting standards for all providers; provider licensing pays little attention to errors, and there are no financial incentives to improve safety (IOM, 1999). Many errors in health care are preventable. "Near misses" and adverse events that do occur can offer insight on how to improve practice and prevent future events. The aim of this article is to better understand underreporting of errors in health care, to present a model of change that increases voluntary error reporting, and to discuss the role nurse executives play in creating a culture of safety. This article explores how high reliability organizations such as aviation improve safety through enhanced error reporting, culture change, and teamwork.

  14. How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation.

    Science.gov (United States)

    Bokhour, Barbara G; Fix, Gemmae M; Mueller, Nora M; Barker, Anna M; Lavela, Sherri L; Hill, Jennifer N; Solomon, Jeffrey L; Lukas, Carol VanDeusen

    2018-03-07

    Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care. We conducted qualitative semi-structured interviews with 108 employees (22 senior leaders, 42 middle managers, 37 front-line providers and 7 staff). Transcripts of audio recordings were analyzed using a priori codes based on the Consolidated Framework for Implementation Research. We used constant comparison analysis to synthesize codes into meaningful domains. Sites described actions taken to foster patient-centered care in seven domains: 1) leadership; 2) patient and family engagement; 3) staff engagement; 4) focus on innovations; 5) alignment of staff roles and priorities; 6) organizational structures and processes; 7) environment of care. Within each domain, we identified multi-faceted strategies for implementing change. These included efforts by all levels of organizational leaders who modeled patient-centered care in their interactions and fostered willingness to try novel approaches to care amongst staff. Alignment and integration of patient centered care within the organization, particularly surrounding roles, priorities and bureaucratic rules, remained major challenges. Transforming healthcare systems to focus on patient-centered care and better serve the "whole" patient is a complex endeavor. Efforts to transform healthcare culture require robust, multi-pronged efforts at all levels of the organization; leadership is only the beginning. Challenges remain for incorporating patient-centered approaches in the

  15. Culture care meanings and experiences of postpartum depression among Jordanian Australian women: a transcultural study.

    Science.gov (United States)

    Nahas, V; Amasheh, N

    1999-01-01

    This study discovers, describes, and explains the personal experiences, perceptions, and care meanings of Jordanian women who have suffered postpartum depression. Most postpartum cases often are misdiagnosed as exclusively psychological and untreated by health care professionals without consideration to the cultural meanings of this problem. Understanding the experiences of these women is important, as their expressions often are contextually and culturally influenced. Using Leininger's Theory of Culture Care Diversity and Universality, a purposive sample of 22 Jordanian women diagnosed with postpartum depression, living in Sydney, were interviewed. The ethnonursing research method and data analysis procedures were used. Results revealed that Jordanian mothers experienced severe loss of control over emotions of loneliness, hopelessness, and feelings of being a bad mother. Three major themes focusing on the care meanings and experiences of Jordanian women are discussed: (a) Care means strong family support and kinship during the postpartum period, (b) care is carrying out and fulfilling traditional gender roles as mother and wife, and (c) care is preservation of Jordanian childbearing customs as expressed in the celebration of the birth of the baby.

  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. 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

    Science.gov (United States)

    Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M

    2015-01-01

    ABSTRACT 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 that should be assessed when investigating the relationship between safety culture and performance in primary care. Methods: Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. Results: The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Conclusion: Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care. PMID:26339832

  18. Cultural competence and perceptions of community health workers' effectiveness for reducing health care disparities.

    Science.gov (United States)

    Mobula, Linda M; Okoye, Mekam T; Boulware, L Ebony; Carson, Kathryn A; Marsteller, Jill A; Cooper, Lisa A

    2015-01-01

    Community health worker (CHW) interventions improve health outcomes of patients from underserved communities, but health professionals' perceptions of their effectiveness may impede integration of CHWs into health care delivery systems. Whether health professionals' attitudes and skills, such as those related to cultural competence, influence perceptions of CHWs, is unknown. A questionnaire was administered to providers and clinical staff from 6 primary care practices in Maryland from April to December 2011. We quantified the associations of self-reported cultural competence and preparedness with attitudes toward the effectiveness of CHWs using logistic regression adjusting for respondent age, race, gender, provider/staff status, and years at the practice. We contacted 200 providers and staff, and 119 (60%) participated. Those reporting more cultural motivation had higher odds of perceiving CHWs as helpful for reducing health care disparities (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 3.48-28.80). Those reporting more frequent culturally competent behaviors also had higher odds of believing CHWs would help reduce health disparities (OR = 3.58, 95% CI = 1.61-7.92). Attitudes toward power and assimilation were not associated with perceptions of CHWs. Cultural preparedness was associated with perceived utility of CHWs in reducing health care disparities (OR = 2.33, 95% CI = 1.21-4.51). Providers and staff with greater cultural competence and preparedness have more positive expectations of CHW interventions to reduce healthcare disparities. Cultural competency training may complement the use of CHWs and support their effective integration into primary care clinics that are seeking to reduce disparities. © The Author(s) 2014.

  19. 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.

  20. 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.

  1. 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

  2. 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

    2017-05-01

    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.

  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.

    2017-01-01

    Purpose 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. Methods 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. Results 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. Conclusions 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. PMID:27988108

  4. 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 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.

  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. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    OpenAIRE

    Malheiro, Alexandra; Jalali, Marjan Sara; Farhangmehr, Minoo

    2010-01-01

    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...

  8. An examination of acquiescent response styles in cross-cultural research

    NARCIS (Netherlands)

    Fischer, R.; Fontaine, J.R.J.; van de Vijver, F.J.R.; van Hemert, D.A.; Gari, A.; Mylonas, K.

    2009-01-01

    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

  9. Culturally Responsive Social Skills Instruction for Adolescent Black Males

    Science.gov (United States)

    Robinson-Ervin, Porsha; Cartledge, Gwendolyn; Keyes, Starr

    2011-01-01

    The cultural disconnect between black males and the school environment has been correlated with poor academic achievement and high discipline rates for Black males. Instructional strategies that draw upon the learner?s cultural background hold promise as one means for intervention. This paper addresses the social skills needs of black adolescent…

  10. Applying Culturally Responsive Pedagogy to the Vocational Training of Immigrants

    Science.gov (United States)

    Wu, Ya-Ling

    2016-01-01

    Training and learning are the personal process in which individuals interact with social and cultural contexts. Immigrant trainees bring their early educational and life experiences into training classrooms, and their learning is strongly affected by their prior socialization and socio-cultural experiences. Therefore, it is necessary to provide…

  11. Cross-cultural Adaptation of the Self-care of Hypertension Inventory Into Brazilian Portuguese.

    Science.gov (United States)

    Silveira, Luana Claudia Jacoby; Rabelo-Silva, Eneida Rejane; Ávila, Christiane Whast; Beltrami Moreira, Leila; Dickson, Victoria Vaughan; Riegel, Barbara

    Lifestyle changes and treatment adherence still constitute a challenge to healthcare providers involved in the care of persons with hypertension. The lack of validated instruments measuring the ability of hypertensive patients to manage their disease has slowed research progress in this area. The Self-care of Hypertension Inventory, originally developed in the United States, consists of 23 items divided across 3 scales: Self-care Maintenance, Self-care Management, and Self-care Confidence. These scales measure how well patients with hypertension adhere to treatment and manage elevated blood pressure, as well as their confidence in their ability to perform self-care. A rigorous cross-cultural adaptation and validation process is required before this instrument can be used in other countries. The aims of this study were to translate the Self-care of Hypertension Inventory into Brazilian Portuguese with cross-cultural adaptation and to evaluate interobserver reliability and temporal stability. This methodological study involved forward translation, synthesis of forward translations, back-translation, synthesis of back-translations, expert committee review, and pretesting. Interobserver agreement and the temporal stability of the scales were assessed. The expert committee proposed semantic and cultural modifications to some items and the addition of guidance statements to facilitate administration of the scale. Interobserver analysis demonstrated substantial agreement. Analysis of temporal stability showed near-perfect agreement. Cross-cultural adaptation of the Self-care of Hypertension Inventory successfully produced a Portuguese-language version of the instrument for further evaluation of psychometric properties. Once that step is completed, the scale can be used in Brazil.

  12. Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

    Science.gov (United States)

    Northam, Holly L; Hercelinskyj, Gylo; Grealish, Laurie; Mak, Anita S

    2015-11-01

    Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning

  13. Perceptions of culturally competent diabetes management in a primary care practice.

    Science.gov (United States)

    Kirk, Julienne K; Hildebrandt, Carol; Davis, Stephen; Crandall, Sonia J; Siciliano, Alissa B; Marion, Gail S

    2014-01-01

    To evaluate whether clinicians consider the impact of culture on diabetes management, a survey was mailed to 300 randomly selected patients > or = 50 years with type 2 diabetes and 153 surveys were returned. Data were correlated with A1C values. African Americans (AA) and non-Hispanic whites (NHW), (91.9%, 97.0%) respectively, reported clinicians discussed benefits of controlling blood sugar but did not discuss effects of cultural issues on glucose control (cultural preferences than did NHWs (49.2% versus 30.6%) (P importance of their cultural beliefs with a slightly higher percentage for African American females (54.8%) versus non-Hispanic White females (48.6%). Understanding the patient's and clinician's views of cultural beliefs as they relate to diabetes self-management can provide perspectives to guide care.

  14. The quantitative measurement of organizational culture in health care: a review of the available instruments.

    Science.gov (United States)

    Scott, Tim; Mannion, Russell; Davies, Huw; Marshall, Martin

    2003-06-01

    To review the quantitative instruments available to health service researchers who want to measure culture and cultural change. A literature search was conducted using Medline, Cinahl, Helmis, Psychlit, Dhdata, and the database of the King's Fund in London for articles published up to June 2001, using the phrase "organizational culture." In addition, all citations and the gray literature were reviewed and advice was sought from experts in the field to identify instruments not found on the electronic databases. The search focused on instruments used to quantify culture with a track record, or potential for use, in health care settings. For each instrument we examined the cultural dimensions addressed, the number of items for each questionnaire, the measurement scale adopted, examples of studies that had used the tool, the scientific properties of the instrument, and its strengths and limitations. Thirteen instruments were found that satisfied our inclusion criteria, of which nine have a track record in studies involving health care organizations. The instruments varied considerably in terms of their grounding in theory, format, length, scope, and scientific properties. A range of instruments with differing characteristics are available to researchers interested in organizational culture, all of which have limitations in terms of their scope, ease of use, or scientific properties. The choice of instrument should be determined by how organizational culture is conceptualized by the research team, the purpose of the investigation, intended use of the results, and availability of resources.

  15. 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.

  16. The Correlation of a Corporate Culture of Health Assessment Score and Health Care Cost Trend.

    Science.gov (United States)

    Fabius, Raymond; Frazee, Sharon Glave; Thayer, Dixon; Kirshenbaum, David; Reynolds, Jim

    2018-02-19

    Employers that strive to create a corporate environment that fosters a culture of health often face challenges when trying to determine the impact of improvements on health care cost trends. This study aims to test the stability of the correlation between health care cost trend and corporate health assessment scores (CHAS) using a culture of health measurement tool. Correlation analysis of annual health care cost trend and CHAS on a small group of employers using a proprietary CHAS tool. Higher CHAS scores are generally correlated with lower health care cost trend. For employers with several years of CHAS measurements, this correlation remains, although imperfectly. As culture of health scores improve, health care costs trends moderate. These findings provide further evidence of the inverse relationship between organizational CHAS performance and health care cost trend.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0.

  17. Ensuring cultural sensitivity for Muslim patients in the Australian ICU: considerations for care.

    Science.gov (United States)

    Bloomer, Melissa J; Al-Mutair, Abbas

    2013-11-01

    Australia is a diverse and multicultural nation, made up of a population with a predominant Christian faith. Islam, the second largest religion in the world, has demonstrated significant growth in Australia in the last decade. Coming from various countries of origin and cultural backgrounds, Muslim beliefs can range from what is considered 'traditional' to very 'liberal'. It is neither possible nor practical for every intensive care clinician to have an intimate understanding of Islam and Muslim practices, and cultural variations amongst Muslims will mean that not all beliefs/practices will be applicable to all Muslims. However, being open and flexible in the way that care is provided and respectful of the needs of Muslim patients and their families is essential to providing culturally sensitive care. This discussion paper aims to describe the Islamic faith in terms of Islamic teachings, beliefs and common practices, considering how this impacts upon the perception of illness, the family unit and how it functions, decision-making and care preferences, particularly at the end of life in the intensive care unit. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  18. 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.

  19. 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

  20. Developing a Scale for Culturally Responsive Practice: Validation, Relationship with School Organizational Factors, and Application

    Science.gov (United States)

    Han, Jae-Bum

    2017-01-01

    The primary goal of this dissertation is to develop and provide preliminary validation for a new measure of culturally responsive practice. This instrument, which is called the Culturally Responsive Practice Scale (CRPS), includes items that reflect ways that teachers teach multicultural students in their classrooms. To accomplish the goal, three…

  1. Culturally Responsive Pedagogies in the Classroom: Indigenous Student Experiences across the Curriculum

    Science.gov (United States)

    Savage, Catherine; Hindle, Rawiri; Meyer, Luanna H.; Hynds, Anne; Penetito, Wally; Sleeter, Christine E.

    2011-01-01

    There is agreement that teaching practices should be responsive to the cultural identities of their students, but less clarity regarding both the specifics of culturally responsive pedagogies and effective strategies for implementing them in classrooms across the curriculum. A mixed-methods research approach evaluated the impact of teacher…

  2. Examining Perceptions of Culturally Responsive Pedagogy in Teacher Preparation and Teacher Leadership Candidates

    Science.gov (United States)

    Samuels, Amy J.; Samuels, Gregory L.; Cook, Tammy M.

    2017-01-01

    The study examined a multi-tiered approach for facilitating learning and examining perceptions about culturally responsive pedagogy in teacher preparation and teacher leadership programs. The study aligned with a learning unit we designed to (1) increase understanding of culturally responsive pedagogy and (2) investigate perceptions of cultural…

  3. Developing Culturally Responsive Teaching through Professional Noticing within Teacher Educator Modelling

    Science.gov (United States)

    Averill, Robin; Anderson, Dayle; Drake, Michael

    2015-01-01

    Much evidence exists that culturally responsive and equitable teaching practices are challenging to develop. Evidence exists that in-the-moment coaching of "rehearsals" of practice can help foster mathematics teaching strategies, but how such coaching can assist the development of culturally responsive practice is less clear. Drawn from…

  4. 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

    2017-12-01

    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

  5. "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…

  6. [Refusal of care by a HIV-positive adolescent: role of the cross-cultural approach].

    Science.gov (United States)

    Bouaziz, Nora; Titia Rizzi, Alice

    The refusal of treatment is frequent in human immunodeficiency virus-positive adolescents. The clinical history of a teenage girl presenting severe immunodepression secondary to the virus, a depressive disorder and a refusal of treatment, illustrates the benefit of combined paediatric, child psychiatric and cross-cultural care as proposed by the Cochin-Paris Adolescent Centre. Working on the meaning of the refusal was a prerequisite for the construction of a care project forming part of a life project, as the psychopathological work could only begin once somatic care ensuring the patient's protection was in place. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team 1

    Science.gov (United States)

    Tomazoni, Andréia; Rocha, Patrícia Kuerten; de Souza, Sabrina; Anders, Jane Cristina; de Malfussi, Hamilton Filipe Correia

    2014-01-01

    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. PMID:25493670

  8. 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. © 2013 National Medical Association. Published by Elsevier Inc. All rights reserved.

  9. Rural-Urban Disparities in Health and Health Care in Africa: Cultural ...

    African Journals Online (AJOL)

    Rural-Urban Disparities in Health and Health Care in Africa: Cultural Competence, Lay-beliefs in Narratives of Diabetes among the Rural Poor in the Eastern Cape ... to exist in the utilization of cardiac diagnostic and therapeutic procedures, prescription of analgesia for pains, treatment of diabetes (e.g. gym exercise).

  10. 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.…

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

    Directory of Open Access Journals (Sweden)

    Jung-Won Ahn, PhD

    2017-03-01

    Conclusion: 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.

  12. Psychiatric Cultures Compared : Psychiatry and Mental Health Care in the Twentieth Century: Comparisons and Approaches

    NARCIS (Netherlands)

    Gijswijt-Hofstra, Marijke; Oosterhuis, Harry; Vijselaar, Joost; Freeman, Hugh

    2005-01-01

    The history of mental health care in the twentieth century is a relatively uncharted territory. Exemplifying a new emphasis on the comparative approach, this volume offers overviews of various national psychiatric cultures and explores new research subjects. By confronting Dutch psychiatry with

  13. Cultural Perspectives on Peer Conflicts in Multicultural Dutch Child Care Centres

    Science.gov (United States)

    Rourou, Amina; Singer, Elly; Bekkema, Nienke; De Haan, Dorian

    2006-01-01

    In this paper we discuss a study of cultural perspectives on peer conflicts in multicultural child care centres. On the level of child behaviour we did not find differences between native Dutch. Moroccan-Dutch and Antillean-Dutch children with regard to occurrence, duration and actions to solve peer conflicts. On the level of mother' opinions…

  14. Response to Richard Widdess: Music, Meaning and Culture

    Directory of Open Access Journals (Sweden)

    Jerome Lewis

    2012-09-01

    Full Text Available This commentary discusses the anthropological implications of Richard Widess’ paper by summarizing some anthropological approaches to music, especially focusing on the way musical participation inculcates and transmits an aesthetic orientation that guides action across cultural domains such as politics, economics and religion. The paper ends by suggesting that the heart of human culture is more likely to be an aesthetic orientation than a script or set of rules, and traces out some reasons why music does this so well.

  15. 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.

  16. 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.

  17. Using research evidence to inform staff learning needs in cross-cultural communication in aged care homes.

    Science.gov (United States)

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

    2018-04-01

    Developed countries worldwide are facing an unprecedented demand for aged care services, with recent migrants of diverse linguistic and cultural backgrounds increasingly recruited as care workers while at the same time there is growing cultural diversity among aged care residents. This situation is compounded by rapidly changing technology and varied educational levels of care workers from diverse backgrounds. The objectives were threefold: to identify staff learning needs to enable them to provide high-quality cross-cultural care; to improve team cohesion; and identify preferred learning approaches. An interpretive qualitative study utilising focus group and interview data informed the development of an education resource. Fifty six care workers from four residential aged care facilities participated in either focus groups or interviews conducted in private meeting rooms within the care facilities. Participants included personal care attendants, registered and clinical nurses, managers, hospitality staff and allied health professionals. Focus group and interview data were categorised and thematically analysed. Data relevant to cross-cultural care, team cohesion and preferred learning approaches informed education resource development, including case studies. Major themes identified the need to promote cultural awareness and understanding, and strategies for cross-cultural care and communication. Themes related to team cohesion demonstrated that staff were already sympathetic and sensitive to cross-cultural issues, and that culturally and linguistically diverse staff add value to the workforce and are supported by the organisation. Staff required clear, uncomplicated education resources to equip them with skills to address problematic cultural situations. Preferred learning approaches varied and highlighted the need for varied educational materials and approaches, as well as time efficient, opportunistic education strategies for the busy workplace. An education

  18. 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

    2013-01-01

    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.

  19. 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.

  20. Does the Culture of Modern Day Palliative Care Social Work Leave Room for Leadership?

    Science.gov (United States)

    Davidson, Jason

    2016-04-02

    This paper describes research undertaken as part of an MA study in leadership. It draws on interviews with six high profile leaders at the fore front of end of life care sector in the UK. Its findings and emerging themes offer insights about the opportunities for social work leaders in palliative care in the future and how the profession and palliative care sector address current barriers to taking advantage of such opportunity. The main focus of this paper is leadership related to palliative care social work. However, it relates to much broader themes including the history, politics and culture of this profession and the requirements for leadership on the part of social work in the broader contexts of health and social care.

  1. 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.

  2. 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.

  3. Thermo-responsive cell culture carrier: Effects on macrophage functionality and detachment efficiency.

    Science.gov (United States)

    Rennert, Knut; Nitschke, Mirko; Wallert, Maria; Keune, Natalie; Raasch, Martin; Lorkowski, Stefan; Mosig, Alexander S

    2017-01-01

    Harvesting cultivated macrophages for tissue engineering purposes by enzymatic digestion of cell adhesion molecules can potentially result in unintended activation, altered function, or behavior of these cells. Thermo-responsive polymer is a promising tool that allows for gentle macrophage detachment without artificial activation prior to subculture within engineered tissue constructs. We therefore characterized different species of thermo-responsive polymers for their suitability as cell substrate and to mediate gentle macrophage detachment by temperature shift. Primary human monocyte- and THP-1-derived macrophages were cultured on thermo-responsive polymers and characterized for phagocytosis and cytokine secretion in response to lipopolysaccharide stimulation. We found that both cell types differentially respond in dependence of culture and stimulation on thermo-responsive polymers. In contrast to THP-1 macrophages, primary monocyte-derived macrophages showed no signs of impaired viability, artificial activation, or altered functionality due to culture on thermo-responsive polymers compared to conventional cell culture. Our study demonstrates that along with commercially available UpCell carriers, two other thermo-responsive polymers based on poly(vinyl methyl ether) blends are attractive candidates for differentiation and gentle detachment of primary monocyte-derived macrophages. In summary, we observed similar functionality and viability of primary monocyte-derived macrophages cultured on thermo-responsive polymers compared to standard cell culture surfaces. While this first generation of custom-made thermo-responsive polymers does not yet outperform standard culture approaches, our results are very promising and provide the basis for exploiting the unique advantages offered by custom-made thermo-responsive polymers to further improve macrophage culture and recovery in the future, including the covalent binding of signaling molecules and the reduction of

  4. Designing an E-Learning Application to Facilitate Health Care Professionals' Cross-Cultural Communication.

    Science.gov (United States)

    Balasubramaniam, Nagadivya; Kujala, Sari; Ayzit, Dicle; Kauppinen, Marjo; Heponiemi, Tarja; Hietapakka, Laura; Kaihlanen, Anu

    2018-01-01

    In recent times, health care professionals (HCP) have come across a number of migrants as their patients. The cultural differences lead to communicational challenges between the migrant patients and health care professionals. Our project aimed to discover HCPs' attitudes, challenges and needs on cross-cultural communication, so that we can develop an e-learning solution that would be helpful for them. By conducting interviews with HCPs, we identified five crucial categories of problems and the current solutions that experienced professionals use to tackle those problems. These interviews also helped us in understanding the motivational factors of HCPs, when using e-learning application. Health care professionals prefer a focus on examples and themes such as death and pain that they face in their everyday work. Changing attitudes by e-learning application is challenging. However, e-learning was recognized as a flexible way for supporting traditional training with HCPs who are busy at work most of the time.

  5. 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.

  6. 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.

  7. 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 Brún, M.P.; 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

  8. 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.

  9. Culturally responsible curriculum development in hospitality, tourism and events management

    Directory of Open Access Journals (Sweden)

    Erwin Losekoot

    2014-06-01

    Full Text Available This paper considers the importance of the Treaty of Waitangi (1840 to Higher Education in New Zealand and how this influences the educational experience of hospitality, tourism and event management students. The paper reviews the literature on cultural diversity, internationalization and curriculum development, the role of culture in educating domestic and international students, and how the acculturation Higher Education students experience as part of their studies might lead to a deeper understanding of culture and identity in the hospitality workplace. The gap in the literature concerns how a higher education curriculum can assist in the development of cultural awareness and an understanding of historical commitments. The paper therefore identifies a number of key principles which are regarded as essential to the identity of those living in New Zealand/Aotearoa. The paper then goes on to illustrate how these principles could be applied to Higher Education. It suggests that these principles enshrined in the Treaty of Waitangi are also worth considering when creating an inclusive curriculum which supports all hospitality, tourism and events management students, irrespective of ethnic background, culture or upbringing. Finally, this paper proposes a matrix of ‘hooks’ - tools which academics can use to ensure their lectures address the needs of all learners. This matrix is developed from a study of the educational goals of the Principles of the Treaty of Waitangi (ToW, the founding document of this country. This research adds value by creating an awareness of the diverse environment in which academics and students operate, thereby enabling students to develop a cultural sensitivity to the international hospitality industry they will be employed in on graduation.

  10. A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

    Science.gov (United States)

    Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

    2018-03-23

    The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

  11. Effect of a training programme on blood culture contamination rate in critical care.

    Science.gov (United States)

    Sánchez-Sánchez, M M; Arias-Rivera, S; Fraile-Gamo, P; Jareño-Collado, R; López-Román, S; Vadillo-Obesso, P; García-González, S; Pulido-Martos, M T; Sánchez-Muñoz, E I; Cacho-Calvo, J; Martín-Pellicer, A; Panadero-Del Olmo, L; Frutos-Vivar, F

    2018-03-30

    Blood culture contamination can occur from extraction to processing; its rate should not exceed 3%. To evaluate the impact of a training programme on the rate of contaminated blood cultures after the implementation of sample extraction recommendations based on the best evidence. Prospective before-after study in a polyvalent intensive care unit with 18 beds. Two phases were established (January-June 2012, October 2012-October 2015) with a training period between them. Main recommendations: sterile technique, surgical mask, double skin disinfection (70° alcohol and 2% alcoholic chlorhexidine), 70° alcohol disinfection of culture flasks and injection of samples without changing needles. Including all blood cultures of patients with extraction request. demographic, severity, pathology, reason for admission, stay and results of blood cultures (negative, positive and contaminated). Basic descriptive statistics: mean (standard deviation), median (interquartile range) and percentage (95% confidence interval). Calculated contamination rates per 100 blood cultures extracted. Bivariate analysis between periods. Four hundred and eight patients were included. Eight hundred and forty-one blood cultures were taken, 33 of which were contaminated. In the demographic variables, severity, diagnosis and stay of patients with contaminated samples, no differences were observed from those with uncontaminated samples. Pre-training vs post-training contamination rates: 14 vs 5.6 per 100 blood cultures extracted (P=.00003). An evidence-based training programme reduced the contamination of samples. It is necessary to continue working on the planning of activities and care to improve the detection of pollutants and prevent contamination of samples. Copyright © 2018 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. African Cultural Concept of Death and the Idea of Advance Care Directives.

    Science.gov (United States)

    Ekore, Rabi Ilemona; Lanre-Abass, Bolatito

    2016-01-01

    An advance care directive is a person's oral or written instructions about his or her future medical care, if he or she becomes unable to communicate. It may be in written or oral form. Africans ordinarily do not encourage the contemplation of death or any discussion about their own or their loved ones' death. According to the African belief system, life does not end with death, but continues in another realm. Becoming an ancestor after death is a desirable goal of every individual, a feat which cannot be achieved if an individual asks for an unnatural death by attempting to utilize advance care directives. Advance care directives are considered to be too individualistic for communitarian societies such as Africa. Coupled with the communitarian nature of African societies are issues such as lack of awareness of advance directives, fear of death and grief, and the African cultural belief system, which are potential barriers to the utilization of advance care directives in the African setting. Hence, the need for culture sensitivity which makes it imperative that patient's family and loved ones are carried along as far as possible, without compromising the autonomy of the patient in question when utilizing advance care directives.

  13. How Differences Between Manager and Clinician Perceptions of Safety Culture Impact Hospital Processes of Care.

    Science.gov (United States)

    Richter, Jason; Mazurenko, Olena; Kazley, Abby Swanson; Ford, Eric W

    2017-11-04

    Evidenced-based processes of care improve patient outcomes, yet universal compliance is lacking, and perceptions of the quality of care are highly variable. The purpose of this study is to examine how differences in clinician and management perceptions on teamwork and communication relate to adherence to hospital processes of care. Hospitals submitted identifiable data for the 2012 Hospital Survey on Patient Safety Culture and the Centers for Medicare and Medicaid Services' Hospital Compare. The dependent variable was a composite, developed from the scores on adherence to acute myocardial infarction, heart failure, and pneumonia process of care measures. The primary independent variables reflected 4 safety culture domains: communication openness, feedback about errors, teamwork within units, and teamwork between units. We assigned each hospital into one of 4 groups based on agreement between managers and clinicians on each domain. Each hospital was categorized as "high" (above the median) or "low" (below) for clinicians and managers in communication and teamwork. We found a positive relationship between perceived teamwork and communication climate and processes of care measures. If managers and clinicians perceived the communication openness as high, the hospital was more likely to adhere with processes of care. Similarly, if clinicians perceived teamwork across units as high, the hospital was more likely to adhere to processes of care. Manager and staff perceptions about teamwork and communications impact adherence to processes of care. Policies should recognize the importance of perceptions of both clinicians and managers on teamwork and communication and seek to improve organizational climate and practices. Clinician perceptions of teamwork across units are more closely linked to processes of care, so managers should be cognizant and try to improve their perceptions.

  14. Affordances of the Cultural Inquiry Process in Building Secondary Mathematics Teachers' Capacity for Cultural Responsiveness

    Science.gov (United States)

    Parker, Frieda; Bartell, Tonya; Novak, Jodie D.

    2017-01-01

    Over the last couple of decades, there has been a growing call for teachers to become more responsive to the increasing cultural diversity of students as a means of improving students' experiences in school and their learning outcomes. Challenges exist in working with secondary mathematics teachers due to the common belief that math is…

  15. 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. © 2016 Australian College of Mental Health Nurses Inc.

  16. 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.

  17. Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study.

    Science.gov (United States)

    Ben-Arye, Eran; Schiff, Elad; Silbermann, Michael; Agbarya, Abed; Bar-Sela, Gil

    2015-05-01

    There is a dearth of studies on how cultural background influences patients' attitudes and choices regarding complementary and traditional medicine (CTM) integration. To explore Arab and Jewish patients' perspectives regarding CTM use and its possible integration within conventional cancer care. This was a cross-cultural study. We developed a 27-item questionnaire that evaluates patients' perceptions regarding CTM integration in supportive cancer care. The questionnaire was administered to a convenience sample of patients receiving cancer care in community and hospital oncology centers. Of the 770 respondents (response rate 88%), 324 defined their religion as Muslim, Christian, or Druze (henceforth, regarded as Arabs) and 446 were Jews. Respondents in the two groups differed significantly in terms of age, gender, marital status, number of children, education, religiosity, and prevalence of cancer types (excluding breast cancer). Although Arab respondents reported less use of CTM for cancer-related outcomes (39.6% vs. 52.1%; P = 0.001), they expressed greater support than Jewish respondents for optional CTM consultation if provided within conventional oncology care (P < 0.0001). Respondents in both groups stated that their primary expectation from the oncologist concerning CTM was to participate in formulating a CTM treatment plan to be provided within the oncology department. Compared with Arab respondents, Jews expected CTM consultations to focus on improving daily functioning and coping, reducing chemotherapy side effects, and providing spiritual support. Although quality of life-related expectations are more pronounced among Jewish respondents, both groups share the expectation from their health care providers to be actively involved in construction of a tailored integrative CTM treatment plan. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  18. Social care going market : Institutional and cultural change regarding services for the elderly

    Directory of Open Access Journals (Sweden)

    Ingo Bode

    2015-03-01

    Full Text Available Over the last two decades or so, major Western societies have remoulded the institutional set-up by which they are deailing with social risks related to frailty during old age. While the 20th century had brought a transnational tendency towards the establishment of elderly care ‘going public’, the proliferation of more market-based services brings confusion into the societal norm-set underlying the aforementioned tendency. Marketisation has placed the emphasis on economic values engrained in liberal worldviews, leading into a new welfare culture that devaluates universalism and reemphasises the sovereignty of the individual. However, the new cult of the individual produces contradictory signals. Drawing on an encompassing study on the ‘culture of welfare markets’ in elderly care provision, covering two (post-liberal and two (post-corporatist welfare regimes (Canada, Britain; France, Germany, the paper looks at these fuzzy developments in order to assess the cultural embeddedness of what can be referred to as the mixed economy of elderly care. The analysis, charting major patterns of both institutional change and public communication around it, elucidates that we currently are facing a permanent struggle between liberal values and (renewed elements of the ‘going-public-agenda’ proliferating over the 1970s and 1980s, that is, a hybrid and ‘nervous’ cultural configuration in which senior social citizenship remains an issue, albeit on precarious foundations.

  19. Educating clinicians about cultural competence and disparities in health and health care.

    Science.gov (United States)

    Like, Robert C

    2011-01-01

    An extensive body of literature has documented significant racial and ethnic disparities in health and health care. Cultural competency interventions, including the training of physicians and other health care professionals, have been proposed as a key strategy for helping to reduce these disparities. The continuing medical education (CME) profession can play an important role in addressing this need by improving the quality and assessing the outcomes of multicultural education programs. This article provides an overview of health care policy, legislative, accreditation, and professional initiatives relating to these subjects. The status of CME offerings on cultural competence/disparities is reviewed, with examples provided of available curricular resources and online courses. Critiques of cultural competence training and selected studies of its effectiveness are discussed. The need for the CME profession to become more culturally competent in its development, implementation, and evaluation of education programs is examined. Future challenges and opportunities are described, and a call for leadership and action is issued. Copyright © 2010 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  20. Improvement of the Patient Safety Culture in the Primary Health Care Corporation - Qatar.

    Science.gov (United States)

    El Zoghbi, Mohamad; Farooq, Saad; Abulaban, Ali; Taha, Heba; Ajanaz, Sajna; Aljasmi, Jawaher; Ahmad, Shakil; Said, Hana

    2018-04-17

    Primary Health Care Corporation (PHCC) is the public primary health care provider in Qatar. Having a patient safety culture (PSC) is the keystone to enabling a continuous process to improve the quality of services and to reduce errors. The objective of this study was to assess the impact of accreditation, quality improvement trainings, and patient safety (PS) trainings on the improvement of the PSC at the PHCC in Qatar. The Medical Office Survey on Patient Safety Culture from the Agency for Healthcare Research and Quality was used in 2012 and 2015 to assess the culture of PS and health care quality in the 21 health centers. The results of the two surveys were compared using the χ test. A P value of less than 0.05 was considered significant. Out of 2689 staff working in the 21 health centers, 1810 (67.3%) completed the survey in 2012, and 2616 (70.0%) of 3735 completed the survey in 2015. The comparison between 2012 and 2015 survey's results showed a statistically significant improvement for all the 10 dimensions (P < 0.05). Although a statistically significant difference was observed between 2012 and 2015 results for work pressure and pace, three of the four questions of the work pressure and pace dimension presented nonsignificant differences. The survey was a good tool to raise awareness on PS and quality issues at PHCC. There is evidence that the implementation of accreditation program, the quality improvement trainings, and PS trainings helped the organization improve its PS culture.

  1. Experience of migrant care and needs for cultural competence training among public health workers in Korea.

    Science.gov (United States)

    Chae, Duckhee; Lee, Jina; Asami, Keiko; Kim, Hyunlye

    2018-05-01

    This study explored the experiences of public health workers (PHWs) providing health care for migrants living in Korea and clarified needs for cultural competence training. Twenty-six PHWs from five public health centers in Gwangju city, South Korea, participated in this exploratory qualitative study. Five semi-structured focus group interviews of PHWs were conducted from September to December 2016. A directed content analysis approach was conducted using four categories: perceived characteristics of migrants, interaction between PHWs and migrants, interaction between PHWs and organizations/systems, and cultural competence training needs. PHWs perceived that migrants lacked autonomy in health decisions and awareness of health behaviors. PHWs experienced difficulties in communicating and in establishing trusting relationships. They found clients hard to reach and easy to miss, a lack of continuity in health care programs, and inadequate human and material resources. They preferred passive teaching methods to activity-based simulation. PHWs believed essential training should be provided through e-learning to all PHWs, including management. PHWs reported experiencing multiple challenges from a lack of preparedness for culturally competent care and their clients' vulnerability. Development of cultural competence training is suggested through e-learning that reflects the PHWs' experiences and provides systematic support. © 2018 Wiley Periodicals, Inc.

  2. 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…

  3. Culturally Responsive Literacy Practices in an Early Childhood Community

    Science.gov (United States)

    Bennett, Susan V.; Gunn, AnnMarie Alberton; Gayle-Evans, Guda; Barrera, Estanislado S.; Leung, Cynthia B.

    2018-01-01

    Early childhood educators continue to see an increase in their culturally diverse student population. As our country continues to grow as a multicultural nation, it is imperative that our early childhood classrooms embrace this rich diversity and provide experiences that affirm all students, families and communities. We (teacher educators)…

  4. Models and Frameworks for Culturally Responsive Adaptations of Interventions

    Science.gov (United States)

    Peterson, Lisa S.; Villarreal, Victor; Castro, Maria J.

    2017-01-01

    Research suggests that culturally and linguistically diverse (CLD) youths are underserved by mental health systems; CLD youths are less likely to receive mental health services and more likely to receive services that are inappropriate or inadequate. The lack of well-established treatments for CLD youths has been cited as one contributing factor…

  5. Pure culture response of ectomycorrhizal fungi to imposed water stress

    Science.gov (United States)

    Mark D. Coleman; Caroline S. Bledsoe; William Lopushinsky

    1989-01-01

    The ability of ectomycorrhizal fungal isolates to tolerate imposed water stress in pure culture was examined in 55 isolates of 18 species. Water potential treatments, adjusted with polyethylene glycol, were applied to Petri dish units. These units allowed colony diameter measurements of fungi grown on liquid media. Delayed growth initiation and inhibition of growth...

  6. Culturally Responsive Practice and the Role of School Administrators

    Science.gov (United States)

    Minkos, Marlena L.; Sassu, Kari A.; Gregory, Jess L.; Patwa, Shamim S.; Theodore, Lea A.; Femc-Bagwell, Michele

    2017-01-01

    In recent years, student populations within public schools in the United States have become increasingly diverse, both culturally and linguistically, and are projected to continue to grow in diversity in the future. Consequently, educators must be prepared to support the needs and education of students with multicultural backgrounds who may differ…

  7. Understanding the Motivation and Transformation of White Culturally Responsive Professors

    Science.gov (United States)

    Jenkins, China; Alfred, Mary

    2018-01-01

    The purpose of this study was to examine the motivation for White professors in higher education to become culturally inclusive in their teaching practices and the transformational experiences that created this motivation and shaped their development. The findings revealed personal convictions that centred on moral obligations towards teaching was…

  8. Culturally Responsive Reading Instruction for Students with Learning Disabilities

    Science.gov (United States)

    Kourea, Lefki; Gibson, Lenwood; Werunga, Robai

    2018-01-01

    As student populations are becoming more diverse in ability and ethnicity across American classrooms, teachers are faced with instructional challenges in meeting their students' learning needs. Challenges are heightened for general and special education teachers who teach students with learning disabilities (LD) and have a culturally and…

  9. 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.

  10. Cross-Cultural Validation of the Patient Perception of Integrated Care Survey.

    Science.gov (United States)

    Tietschert, Maike V; Angeli, Federica; van Raak, Arno J A; Ruwaard, Dirk; Singer, Sara J

    2017-07-20

    To test the cross-cultural validity of the U.S. Patient Perception of Integrated Care (PPIC) Survey in a Dutch sample using a standardized procedure. Primary data collected from patients of five primary care centers in the south of the Netherlands, through survey research from 2014 to 2015. Cross-sectional data collected from patients who saw multiple health care providers during 6 months preceding data collection. The PPIC survey includes 59 questions that measure patient perceived care integration across providers, settings, and time. Data analysis followed a standardized procedure guiding data preparation, psychometric analysis, and included invariance testing with the U.S. dataset. Latent scale structures of the Dutch and U.S. survey were highly comparable. Factor "Integration with specialist" had lower reliability scores and noninvariance. For the remaining factors, internal consistency and invariance estimates were strong. The standardized cross-cultural validation procedure produced strong support for comparable psychometric characteristics of the Dutch and U.S. surveys. Future research should examine the usability of the proposed procedure for contexts with greater cultural differences. © Health Research and Educational Trust.

  11. 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. © 2016 International Union of Psychological Science.

  12. A mixed methods study of culturally responsive teaching in science and math classrooms

    Science.gov (United States)

    Holocker, Angela Y.

    Through the dawn of education, student achievement has always been the primary focus of educators. The United States has not changed the structure of their educational institutions since the Industrial Revolution. With the achievement gap between mainstream and non-mainstream students continually growing, it is the responsibility of every educator to contribute to student success. However, teachers cannot be held accountable for teaching what they do not know. This study investigates the correlation between Culturally Responsive Teaching professional development and the effects on minority students. The yearlong professional development models as well as culturally responsive strategies are discussed in great length. The study reflects the attitudes of teachers before and after participation in the culturally responsive professional development. Student growth was tracked over the school year as well as teacher implementation of the culturally responsive strategies. The final teacher survey and overall student growth was analyzed for correlation.

  13. Integrating cultural values, beliefs, and customs into pregnancy and postpartum care: lessons learned from a Hawaiian public health nursing project.

    Science.gov (United States)

    Mayberry, L J; Affonso, D D; Shibuya, J; Clemmens, D

    1999-06-01

    Determining the elements of culturally competent health care is an important goal for nurses. This goal is particularly integral in efforts to design better preventive health care strategies for pregnant and postpartum women from multiple cultural and ethnic backgrounds. Learning about the values, beliefs, and customs surrounding health among the targeted groups is essential, but integrating this knowledge into the actual health care services delivery system is more difficult. The success of a prenatal and postpartum program developed for native Hawaiian, Filipino, and Japanese women in Hawaii has been attributed to the attention on training, direct care giving, and program monitoring participation by local cultural and ethnic healers and neighborhood leaders living in the community, with coordination by public health nurses. This article profiles central design elements with examples of specific interventions used in the Malama Na Wahine or Caring for Pregnant Women program to illustrate a unique approach to the delivery of culturally competent care.

  14. Organizational capacities for 'residential care homes for the elderly' to provide culturally appropriate end-of-life care for Chinese elders and their families.

    Science.gov (United States)

    Kong, Sui-Ting; Fang, Christine Meng-Sang; Lou, Vivian Weiqun

    2017-01-01

    Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care. We conducted two phases of research, a questionnaire survey and a qualitative study, which respectively aims at (1) understanding the EoL care service demand and provision in RCHEs, including death facts and perceived barriers and challenges in providing quality end-of-life care in care homes, and (2) identifying the necessary organizational capacities for the 'relational personhood' to be sustained in the process of ageing and dying in residential care homes. Findings shed light on how to empower residential care homes with necessary environmental, structural and cultural-resource-related capacity for providing quality end-of-life care for Chinese elders and their families. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Health care staffs’ perception of patient safety culture in hospital settings and factors of importance for this

    OpenAIRE

    Nordin, Anna; Theander, Kersti; Wilde-Larsson, Bodil; Nordström, Gun

    2013-01-01

    Vitenskapelig, fagfellevurdert artikkel Many hospital patients are affected by adverse events. Managers are important when improving safety. The perception of patient safety culture varies among health care staff. Health care staff (n = 1023) working in medical, surgical or mixed medical-surgical health care divisions answered the 51 items (14 dimensions) Swedish Hospital Survey on Patient Safety Culture (S-HSOPSC). Respondents with a managerial func- tion scored higher than non-managers f...

  16. 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

  17. Understanding organizational and cultural premises for quality of care in nursing homes: an ethnographic study.

    Science.gov (United States)

    Nakrem, Sigrid

    2015-11-13

    Internationally, there are concerns about the quality of care in nursing homes. The concept of 'corporate culture' as an internal variable could be seen as the means to improve quality of care and quality of life for the residents. The aim of this article was to describe the nursing home culture from the staff's perspective and to include how the residents describe quality of care. An ethnographic design was employed. A purposive sample of four municipal public nursing homes in Norway with long-term care residents was included in the study. Data were collected by participant observation including informal conversation with the staff, and in-depth interviews with 15 residents using a narrative approach. The main findings were that organizational cultures could be seen as relatively stable corporate cultures described as 'personalities' with characteristics that were common for all nursing homes (conformity) and typical traits that were present in some nursing homes, but that they were also like no other nursing home (distinctiveness). Conformity ('Every nursing home is like all other nursing homes') meant that nursing home organizations formed their services according to a perception of what residents in general need and expect. Trait ('Every nursing home is like some other nursing homes') expressed typologies of nursing homes: residency, medical, safeguard or family orientation. The distinctness of each nursing home ('Every nursing home is like no other nursing home') was expressed in unique features of the nursing home; the characteristics of the nursing home involved certain patterns of structure, cultural assumptions and interactions that were unique in each nursing home. Nursing home residents experienced quality of care as 'The nursing home as my home' and 'Interpersonal care quality'. The resident group in the different types of nursing homes were unique, and the experience of quality of care seemed to depend on whether their unique needs and expectations

  18. Culturally and linguistically diverse students in speech-language pathology courses: A platform for culturally responsive services.

    Science.gov (United States)

    Attrill, Stacie; Lincoln, Michelle; McAllister, Sue

    2017-06-01

    Increasing the proportion of culturally and linguistically diverse (CALD) students and providing intercultural learning opportunities for all students are two strategies identified to facilitate greater access to culturally responsive speech-language pathology services. To enact these strategies, more information is needed about student diversity. This study collected descriptive information about CALD speech-language pathology students in Australia. Cultural and linguistic background information was collected through surveying 854 domestic and international speech-language pathology students from three Australian universities. Students were categorised according to defined or perceived CALD status, international student status, speaking English as an Additional Language (EAL), or speaking a Language Other than English at Home (LOTEH). Overall, 32.1% of students were either defined or perceived CALD. A total of 14.9% spoke EAL and 25.7% identified speaking a LOTEH. CALD students were more likely to speak EAL or a LOTEH than non-CALD students, were prominently from Southern and South-Eastern Asian backgrounds and spoke related languages. Many students reported direct or indirect connections with their cultural heritage and/or contributed linguistic diversity. These students may represent broader acculturative experiences in communities. The sociocultural knowledge and experience of these students may provide intercultural learning opportunities for all students and promote culturally responsive practices.

  19. Dealing with extreme response style in cross-cultural research: A restricted latent class factor approach

    NARCIS (Netherlands)

    Morren, M.H.; Gelissen, J.P.T.M.; Vermunt, J.K.

    2011-01-01

    Cross-cultural comparison of attitudes using rating scales may be seriously biased by response styles. This paper deals with statistical methods for detection of and correction for extreme response style (ERS), which is one of the well-documented response styles. After providing an overview of

  20. 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.

  1. A research-based didactic model for education to promote culturally competent nursing care in Sweden.

    Science.gov (United States)

    Gebru, Kerstin; Willman, Ania

    2003-01-01

    As Sweden changes toward a multicultural society, scientific knowledge of transcultural nursing care becomes increasingly important. Earlier studies in Swedish nursing education have demonstrated a lack of knowledge base in transcultural nursing. Through an extensive review of the literature, a didactic model was developed to help facilitate the establishment of this body of knowledge in transcultural nursing. The article demonstrates how the model applies the content and structure of Leininger's theory of culture care diversity and universality and ethnonursing method in a 3-year nursing program in theory as well as clinical education. The model includes a written guide for faculty members, with references to scientific articles and documents to be used.

  2. Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey.

    Science.gov (United States)

    Smits, Marleen; Keizer, Ellen; Giesen, Paul; Deilkås, Ellen Catharina Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

    2018-03-01

    To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience. Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors. Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents' profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: • healthcare providers in Dutch GP cooperatives

  3. 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,…

  4. Culturally Responsive Peace Education: A Case Study at One Urban Latino K-8 Catholic School

    Science.gov (United States)

    Buck, Brandon

    2016-01-01

    This paper presents a case study of a yearlong research-based peace education program at one urban K-8 private Catholic school situated in a community plagued by structural violence in an enclave of a large Midwestern city. To frame the analysis, the author employs concepts central to culturally responsive pedagogy (including cultural competence,…

  5. 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…

  6. The Impact of an In-Service Workshop on Cooperating Teachers' Perceptions of Culturally Responsive Teaching

    Science.gov (United States)

    McKoy, Constance L.; MacLeod, Rebecca B.; Walter, Jennifer S.; Nolker, D. Brett

    2017-01-01

    Culturally responsive teaching values students' identities, backgrounds, and cultural references as key tools for building meaningful learning environments. It has been adopted by many educators globally, but has not been incorporated consistently by music educators. Few researchers in music education have investigated the impact of culturally…

  7. The What, Why, and How of Culturally Responsive Teaching: International Mandates, Challenges, and Opportunities

    Science.gov (United States)

    Gay, Geneva

    2015-01-01

    This discussion acknowledges that culturally responsive teaching is relevant for international contexts. However, it needs to be nuanced to fit the specific characteristics and needs of these different settings, relative to societal dynamics, and student ethnic, cultural, racial, immigration/migration, economic, and linguistic demographics.…

  8. Autobiographies in Preservice Teacher Education: A Snapshot Tool for Building a Culturally Responsive Pedagogy

    Science.gov (United States)

    Gunn, AnnMarie Alberton; Bennett, Susan V.; Evans, Linda Shuford; Peterson, Barbara J.; Welsh, James L.

    2013-01-01

    Many scholars have made the call for teacher educators to provide experiences that can lead preservice teachers to embrace a culturally responsive pedagogy. We investigated the use of brief autobiographies during an internship as a tool (a) for preservice teachers to examine their multidimensional culture; and (b) for teacher educators to assess…

  9. How Cultural Differences Affect Written and Oral Communication: The Case of Peer Response Groups.

    Science.gov (United States)

    Nelson, Gayle L.

    1997-01-01

    Peer response groups contribute to students' effectiveness as writers in any field, but cultural differences in communication affect interactions within the group. Culture-based dimensions on which communication may differ include individualism/collectivism, power distance, concept of "face," and communication style. Recommendations are…

  10. 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.

  11. 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…

  12. Adherence to tuberculosis care in Canadian Aboriginal populations, Part 1: definition, measurement, responsibility, barriers.

    Science.gov (United States)

    Orr, Pamela

    2011-04-01

    In a 2-part series, the current literature with respect to adherence to tuberculosis care among Canadian Aboriginal populations is reviewed. In the current paper, which comprises part 1 of this review, adherence is defined, and methods of measurement, issues of responsibility and potential barriers to adherence are explored. Study design. Literature review. A systematic search and analytic review of relevant studies was undertaken, including an online search of electronic databases (PubMed, PsychINFO, MEDLINE, Native Health Database, Scopus, Social Science Citation Index) and publications by governmental and non-governmental agencies. Poor adherence to therapy for TB disease is the most common cause of initial treatment failure and of disease relapse worldwide. Adherence to care for TB disease is necessary for the health of both the affected individual and society as a whole. Adherence is a task-specific behaviour that is not inherent to ethnic identity. The term applies only when common agreement over a care plan has been reached between patient and provider. The International Standards for Tuberculosis Care and the Patients Charter outline the responsibilities for adherence on the part of both patients and providers. For Canadian Aboriginals, barriers to adherence may derive from a complex interaction between the health system, personal factors and social factors, which may include dysfunctional acute and public health systems, dissonant (between health care provider and patient) belief systems, concurrent co-morbidities and life stressors, poverty and social stigma. Adherence is a task-specific behaviour, not a personality trait. It is influenced by the interaction of systemic, personal and societal factors. These factors must be understood within the historical experience of TB and the cultural meaning of health and illness among Indigenous Canadians.

  13. 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

    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. 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. 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 organizational commitment of employees in

  14. 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

  15. The value of community-focused interprofessional care in peru for developing cultural competency in health professions students.

    Science.gov (United States)

    Allen, Carol B; Smart, Denise A; Odom-Maryon, Tamara; Swain, Deborah

    2013-07-04

    International immersion experiences for health-care students have increased over the past 10 years. Students and faculty expect these experiences to increase cultural competency; however, research on outcomes of these programs has lacked rigor. Over a 4-year period, groups of nursing and other health professions students spent 3 weeks in Peru providing primary care and health education. Students attended pre-departure seminars addressing personal travel health and safety, culture and health care in Peru, working with interpreters, and ethics of international health care. Student participants (N=77) completed an instrument assessing self-perceived cultural competency before and after the experience. Results of pre- and post-immersion scores showed significant increases in perceived cultural competency and increased self-efficacy in cultural knowledge, skills, and attitudes for four groups of students. Implications and future directions are discussed and recommended.

  16. Exploring relationships between patient safety culture and patients' assessments of hospital care.

    Science.gov (United States)

    Sorra, Joann; Khanna, Kabir; Dyer, Naomi; Mardon, Russ; Famolaro, Theresa

    2014-10-01

    The purpose of this study was to examine relationships among 2 Agency for Healthcare Research and Quality measures of hospital patient safety and quality, which reflect different perspectives on hospital performance: the Hospital Survey on Patient Safety Culture (Hospital SOPS)--a hospital employee patient safety culture survey--and the Consumer Assessment of Healthcare Providers and Systems Hospital Survey (CAHPS Hospital Survey)--a survey of the experiences of adult inpatients with hospital care and services. Our hypothesis was that these 2 measures would be positively related. We performed multiple regressions to examine the relationships between the Hospital SOPS measures and CAHPS Hospital Survey measures, controlling for hospital bed size and ownership. Analyses were conducted at the hospital level with each survey's measures using data from 73 hospitals that administered both surveys during similar periods. Higher overall Hospital SOPS composite average scores were associated with higher overall CAHPS Hospital Survey composite average scores (r = 0.41, P G 0.01). Twelve of 15 Hospital SOPS measures were positively related to the CAHPS Hospital Survey composite average score after controlling for bed size and ownership, with significant standardized regression coefficients ranging from 0.25 to 0.38. None of the Hospital SOPS measures were significantly correlated with either of the two single-item CAHPS Hospital Survey measures (hospital rating and willingness to recommend). This study found that hospitals where staff have more positive perceptions of patient safety culture tend to have more positive assessments of care from patients. This finding helps validate both surveys and suggests that improvements in patient safety culture may lead to improved patient experience with care. Further research is needed to determine the generalizability of these results to larger sets of hospitals, to hospital units, and to other settings of care.

  17. 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. © 2011 Blackwell Publishing

  18. 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

    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...... uncomplicated, symptomatic UTI. MAIN OUTCOME MEASURES: (1) Overall accuracy of POC urine culture in general practice. (2) Individual accuracy of each of the two POC tests in this study. (3) Accuracy of POC urine culture in general practice with enterococci excluded, since enterococci are known to multiply...... general practices recruited 341 patients with suspected uncomplicated UTI. The overall agreement between index test and reference was 0.76 (CI: 0.71-0.80), SEN 0.88 (CI: 0.83-0.92) and SPE 0.55 (CI: 0.46-0.64). The two POC tests produced similar results individually. Overall agreement with enterococci...

  19. Role of mobile health in the care of culturally and linguistically diverse US populations.

    Science.gov (United States)

    Tirado, Miguel

    2011-01-01

    Emerging trends in the health-related use of cell phones include the proliferation of mobile health applications for the care and monitoring of patients with chronic diseases and the rise in cell phone usage by Latinos and African Americans in the United States. This article reviews public policy in four areas with the goal of improving the care of patients belonging to culturally and linguistically diverse populations: 1) mobile health service access and the physician's duty of care, 2) affordability of and reimbursement for health related services via mobile phone, 3) protocols for mobile health enabled patient health data collection and distribution, and 4) cultural and linguistic appropriateness of health related messages delivered via cell phone. The review demonstrates the need for policy changes that would allow for reimbursement of both synchronous and asynchronous patient-provider communication, subsidize broadband access for lower-income patients, introduce standards for confidentiality of health data transmitted via cell phone as well as amplify existing cultural and linguistic standards to encompass mobile communication, and consider widespread public accessibility when certifying new technologies as "medical devices." Federal and state governments must take prompt action to ensure that the benefits of mobile health are accessible to all Americans.

  20. 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. © The Author(s) 2014.

  1. Reinscribing the Goddess into the Culturally Relative Minutiae of Tantric Texts and Practices: A Perennialist Response to Tantric Visual Culture

    Directory of Open Access Journals (Sweden)

    Jeffrey S. Lidke

    2017-10-01

    Full Text Available A celebration and critical evaluation of Sthaneshwar Timalsina’s brilliant book, Tantric Visual Culture: A Cognitive Approach. In this groundbreaking work, Timalsina utilizes the lens of cognitive studies to shed interpretive light on the Tantric visualization practices that he knows both as a scholar and lifetime practitioner. Timalsina argues that mastery of Tantric practice requires immersion in the culturally relative metonymic and holographic logic framed by the Tantric ritual texts. The conclusion that arises from his analysis is that Tantric “truths” are bound to the linguistic and cultural systems that frame them. In response, I herewith offer a perennialist critique and argument for a more nuanced consideration of the transcendent “truth” or “being” that is the stated aim of Tantric practice.

  2. 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

  3. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.

    Science.gov (United States)

    Betancourt, Joseph R; Green, Alexander R; Carrillo, J Emilio; Ananeh-Firempong, Owusu

    2003-01-01

    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. The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers. Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions--including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues--emerged to categorize strategies to address racial/ethnic disparities in health and health care. Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.

  4. Clinicians' interpretations of point of care urine culture versus laboratory culture results: analysis from the four-country POETIC trial of diagnosis of uncomplicated urinary tract infection in primary care.

    Science.gov (United States)

    Hullegie, Saskia; Wootton, Mandy; Verheij, Theo J M; Thomas-Jones, Emma; Bates, Janine; Hood, Kerenza; Gal, Micaela; Francis, Nick A; Little, Paul; Moore, Michael; Llor, Carl; Pickles, Timothy; Gillespie, David; Kirby, Nigel; Brugman, Curt; Butler, Christopher C

    2017-08-01

    Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI). Primary care clinicians used the Flexicult™-POCT, recorded their findings and took a photograph of the result, which was interpreted by microbiology laboratory technicians. Urine samples were additionally processed in routine care laboratories. Cross tabulations were used to identify important differences in organism identification, quantification and antibiotic susceptibility between these three sources of data. The influence of various laboratory definitions for UTI on culture were assessed. Primary care clinicians identified 202/289 urine samples (69.9%) as positive for UTI using the Flexicult™-POCT, whereas laboratory culture identified 94-190 (32.5-65.7%) as positive, depending on definition thresholds. 82.9% of samples identified positive for E. coli on laboratory culture were also considered positive for E. coli using the Flexicult™ -POCT, and susceptibilities were reasonably concordant. There were major discrepancies between laboratory staff interpretation of Flexicult™ photographs, clinicians' interpretation of the Flexicult™ test, and laboratory culture results. Flexicult™-POCT overestimated the positivity rate of urine samples for UTI when laboratory culture was used as the reference standard. However, it is unclear whether point-of-care or laboratory based urine culture provides the most valid diagnostic information. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Cross-cultural differences in caregiving: The relevance to community care in India

    Directory of Open Access Journals (Sweden)

    Mohan Isaac

    2016-01-01

    Full Text Available Deinstitutionalization movement in the West brought about community care movement of mentally ill. Because of this, caring for the mentally ill became an important aspect. In resource-rich countries, caregiving is done by trained persons and in resource-poor country (like India, caregiving was done by untrained family members. Cross-cultural factors such as interdependence and greater family involvement in care have contributed for family members′ decision-making in caregiving in India. Nevertheless, cross-cultural similarities in caregiving are more striking than differences. Genuine caregiving of mentally ill will make significant difference to the recipient. In India, majority of the persons with mental illness are cared by family members. Family members lack knowledge about the nature of the illness, have little support and advice by the medical professional, and have difficulties in understanding illness-related behavior. Hence, in India, there is need to develop effective, user-friendly, educational modules in all languages; to increase the knowledge of the carers about the mental illness, and help in decreasing their distress.

  6. A Website Supporting Sensitive Religious and Cultural Advance Care Planning (ACPTalk): Formative and Summative Evaluation

    Science.gov (United States)

    Mader, Patrick; O'Callaghan, Clare; Boyd, Leanne

    2018-01-01

    Background Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations. ACPTalk aimed to provide religion-specific advance care planning content and complement existing resources. Objective The purpose of this paper was to utilize the context, input, process, and product (CIPP) framework to conduct a formative and summative evaluation of ACPTalk. Methods The CIPP framework was used, which revolves around 4 aspects of evaluation: context, input, process, and product. Context: health professionals’ solutions for the website were determined through thematic analysis of exploratory key stakeholder interviews. Included religions were determined through an environmental scan, Australian population statistics, and documentary analysis of project steering committee meeting minutes. Input: Project implementation and challenges were examined through documentary analysis of project protocols and meeting minutes. Process: To ensure religion-specific content was accurate and appropriate, a website prototype was built with content review and functionality testing by representatives from religious and cultural organizations and other interested health care organizations who completed a Web-based survey. Product: Website analytics were used to report utilization, and stakeholder perceptions were captured through interviews and a website survey. Results Context: A total of 16 key stakeholder health professional (7 general practitioners, 2 primary health nurses, and 7 palliative care nurses) interviews were analyzed. Website solutions included religious and cultural

  7. A Website Supporting Sensitive Religious and Cultural Advance Care Planning (ACPTalk): Formative and Summative Evaluation.

    Science.gov (United States)

    Pereira-Salgado, Amanda; Mader, Patrick; O'Callaghan, Clare; Boyd, Leanne

    2018-04-16

    Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations. ACPTalk aimed to provide religion-specific advance care planning content and complement existing resources. The purpose of this paper was to utilize the context, input, process, and product (CIPP) framework to conduct a formative and summative evaluation of ACPTalk. The CIPP framework was used, which revolves around 4 aspects of evaluation: context, input, process, and product. Context: health professionals' solutions for the website were determined through thematic analysis of exploratory key stakeholder interviews. Included religions were determined through an environmental scan, Australian population statistics, and documentary analysis of project steering committee meeting minutes. Input: Project implementation and challenges were examined through documentary analysis of project protocols and meeting minutes. Process: To ensure religion-specific content was accurate and appropriate, a website prototype was built with content review and functionality testing by representatives from religious and cultural organizations and other interested health care organizations who completed a Web-based survey. Product: Website analytics were used to report utilization, and stakeholder perceptions were captured through interviews and a website survey. Context: A total of 16 key stakeholder health professional (7 general practitioners, 2 primary health nurses, and 7 palliative care nurses) interviews were analyzed. Website solutions included religious and cultural information, communication ideas, legal

  8. 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.

  9. The legal responsibilities of the health-care librarian.

    Science.gov (United States)

    Muir, A; Oppenheim, C

    1995-06-01

    This article discusses the legal responsibilities that information intermediaries have towards the users of their services. The areas of law that affect legal liability are contract law, tort and strict liability. The likelihood of health-care librarians being held liable for the service they provide is assessed, and methods of reducing this risk are discussed. The key issues are: whether the recipient is relying on the information you provide and whether this reliance is reasonable; whether money changed hands; and whether the institution is under a statutory obligation to provide the information. All-embracing exclusion clauses are often used as an attempt to exclude liability, but their validity in law is doubtful, and they should be replaced by more reasonable ones. Adhering to good professional practice, and avoiding interpreting information for laymen are ways of minimizing liability. If court proceedings do take place, professional indemnity insurance can reduce financial loss.

  10. A Conceptual Framework for Creating Culturally Responsive Token Economies

    Science.gov (United States)

    LeBlanc, Gess

    2016-01-01

    Numerous studies indicate that token economy systems continue to be used by teachers as a means to either increase or decrease behaviours observed in their classrooms. However, studies find that student demographic characteristics such as ethnicity, race, and gender inform teachers' identification of target behaviours. In response to these…

  11. Supervising Research in Maori Cultural Contexts: A Decolonizing, Relational Response

    Science.gov (United States)

    Berryman, Mere; Glynn, Ted; Woller, Paul

    2017-01-01

    We have collaborated for 25 years as indigenous Maori and non-Maori researchers undertaking research with Maori families, their schools and communities. We have endeavored to meet our responsibilities to the Maori people (indigenous inhabitants of New Zealand) and communities with whom we have researched, as well as meet the requirements and…

  12. 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. © Society for Community Research and Action 2016.

  13. 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.

  14. 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.

  15. From acute care to home care: the evolution of hospital responsibility and rationale for increased vertical integration.

    Science.gov (United States)

    Dilwali, Prashant K

    2013-01-01

    The responsibility of hospitals is changing. Those activities that were once confined within the walls of the medical facility have largely shifted outside them, yet the requirements for hospitals have only grown in scope. With the passage of the Patient Protection and Affordable Care Act (ACA) and the development of accountable care organizations, financial incentives are focused on care coordination, and a hospital's responsibility now includes postdischarge outcomes. As a result, hospitals need to adjust their business model to accommodate their increased need to impact post-acute care settings. A home care service line can fulfill this role for hospitals, serving as an effective conduit to the postdischarge realm-serving as both a potential profit center and a risk mitigation offering. An alliance between home care agencies and hospitals can help improve clinical outcomes, provide the necessary care for communities, and establish a potentially profitable product line.

  16. An experimental strategy validated to design cost-effective culture media based on response surface methodology.

    Science.gov (United States)

    Navarrete-Bolaños, J L; Téllez-Martínez, M G; Miranda-López, R; Jiménez-Islas, H

    2017-07-03

    For any fermentation process, the production cost depends on several factors, such as the genetics of the microorganism, the process condition, and the culture medium composition. In this work, a guideline for the design of cost-efficient culture media using a sequential approach based on response surface methodology is described. The procedure was applied to analyze and optimize a culture medium of registered trademark and a base culture medium obtained as a result of the screening analysis from different culture media used to grow the same strain according to the literature. During the experiments, the procedure quantitatively identified an appropriate array of micronutrients to obtain a significant yield and find a minimum number of culture medium ingredients without limiting the process efficiency. The resultant culture medium showed an efficiency that compares favorably with the registered trademark medium at a 95% lower cost as well as reduced the number of ingredients in the base culture medium by 60% without limiting the process efficiency. These results demonstrated that, aside from satisfying the qualitative requirements, an optimum quantity of each constituent is needed to obtain a cost-effective culture medium. Study process variables for optimized culture medium and scaling-up production for the optimal values are desirable.

  17. Logo design: examining consumer response to figurativeness across cultures

    OpenAIRE

    Machado, Joana César; Vacas de Carvalho, Leonor; Torres, Anna; Van de Velden, Michel; Costa, Patrício

    2014-01-01

    Literature concerned with logo strategy suggests that the aesthetic appeal of brand logo significantly influences consumer reactions. The main purpose of this research is to study the influence of the different categories of figurative logo designs on consumer response. Through two studies in three countries, this research sheds light on consumer logo preferences, by investigating the psychological properties of the figurativeness of logo design. Results showed that figurativeness is an essen...

  18. Response to: Chimpanzee culture extends beyond matrilineal family units.

    Science.gov (United States)

    Wrangham, Richard W; Worthington, Steven; Bernard, Andrew B; Koops, Kathelijne; Machanda, Zarin P; Muller, Martin N

    2017-06-19

    We thank van Leeuwen et al.[1] for their response to our finding that matrilineal relationships strongly influence the style of high-arm grooming in wild chimpanzees of the Kanyawara community. We agree with them that grooming styles could be transmitted by different mechanisms in different contexts, and we appreciate their effort to assess whether the transmission of grooming styles within two captive groups in Chimfunshi accords with our result. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 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…

  20. The Impact of Learning Culture on Worker Response to New Technology

    Science.gov (United States)

    Reardon, Robert F.

    2010-01-01

    Purpose: The aim of this paper is to provide a framework to measure the response of blue-collar workers to new technology in manufacturing and to establish the relationship between learning culture and that response. Design/methodology/approach: The data were collected with a survey questionnaire from 12 manufacturing sites that were implementing…

  1. Effects of cortisol on the primary response of mouse spleen cell cultures to heterologous erythrocytes

    International Nuclear Information System (INIS)

    Dracott, B.N.

    1974-01-01

    Cell viability and the production of direct PFC were studied in mouse spleen cell cultures after cortisol treatment in vivo or in vitro at various times relative to primary stimulation with SRBC in vitro. Cortisol treatment in vivo reduced spleen cell numbers by 88 percent after 48 hr, but cultures of the remaining cells produced as many PFC in vitro as did cultures of equal numbers of normal spleen cells. In normal spleen cell cultures incubated with cortisol for 4 hr prior to the addition of antigen, peak responses of PFC/culture and PFC/10 6 cells occurred 24 hr later than in controls and averaged, respectively, 27 and 141 percent of control values. Minimum viable cell numbers were observed in cortisol-treated cultures after 3 days; thereafter cell numbers gradually increased. These results were not significantly altered when cultures were treated simultaneously with cortisol and antigen. The response was not suppressed if the addition of antigen preceded that of cortisol by more than 4 hr. Suppression was also considerably reduced if fetal calf serum was used when preparing cells for culture

  2. 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.

  3. Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice.

    Science.gov (United States)

    Slemon, Allie; Jenkins, Emily; Bungay, Vicky

    2017-10-01

    The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

  4. 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.

  5. 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

  6. Communication in cancer care: psycho-social, interactional, and cultural issues. A general overview and the example of India

    OpenAIRE

    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 i...

  7. 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.

  8. The culture of massage therapy: valued elements and the role of comfort, contact, connection and caring.

    Science.gov (United States)

    Smith, Joanna M; Sullivan, S John; Baxter, G David

    2009-08-01

    To explore the attributes of the therapy encounter valued by repeat users of health-related massage therapy. A qualitative design with telephone focus group methodology was used. A total of 19 repeat users of massage therapy participated in three telephone focus groups where audiotaped semi-structured interviews were conducted. Telephone focus group with massage clients from a range of provincial and urban regions in New Zealand. Summary of reported themes of the massage experience. Data were thematically analysed using the general inductive approach. Six valued elements of the massage encounter (time for care and personal attention, engaging and competent therapist, trust partnership, holism and empowerment, effective touch and enhancing relaxation), four modulators (comfort, contact, connection and caring) and two themes relating to adding experiential value (enjoyment, escapism) characterize the massage therapy culture. The culture of massage therapy care incorporates a number of characteristics that are congruent with the complementary and alternative medicine approach to health. In addition, massage specific factors were identified. The humanistic aspects of the therapy encounter valued by clients offer insight into the growing use of massage therapy and the success of massage therapy outcomes.

  9. 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; OʼKeeffe, Daniel F

    2015-05-01

    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 a role 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.

  10. 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. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  11. 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

  12. Ethical control and cultural change (in cultural dreams begin organizational responsibilities)

    NARCIS (Netherlands)

    S.J. Magala (Slawomir)

    2010-01-01

    textabstractEthical control is based on transparent access to the accounts of responsible behaviour on the part of individual and organizational actors. It is usually linked to the idea of a checkpoint: where celibate rules, no sexual interaction can be allowed. However, organizing and managing

  13. Metabolism of pharmaceutical and personal care products by carrot cell cultures

    International Nuclear Information System (INIS)

    Wu, Xiaoqin; Fu, Qiuguo; Gan, Jay

    2016-01-01

    With the increasing use of treated wastewater and biosolids in agriculture, residues of pharmaceutical and personal care products (PPCPs) in these reused resources may contaminate food produce via plant uptake, constituting a route for human exposure. Although various PPCPs have been reported to be taken up by plants in laboratories or under field conditions, at present little information is available on their metabolism in plants. In this study, we applied carrot cell cultures to investigate the plant metabolism of PPCPs. Five phase I metabolites of carbamazepine were identified and the potential metabolism pathways of carbamazepine were proposed. We also used the carrot cell cultures as a rapid screening tool to initially assess the metabolism potentials of 18 PPCPs. Eleven PPCPs, including acetaminophen, caffeine, meprobamate, primidone, atenolol, trimethoprim, DEET, carbamazepine, dilantin, diazepam, and triclocarban, were found to be recalcitrant to metabolism. The other 7 PPCPs, including triclosan, naproxen, diclofenac, ibuprofen, gemfibrozil, sulfamethoxazole, and atorvastatin, displayed rapid metabolism, with 0.4–47.3% remaining in the culture at the end of the experiment. Further investigation using glycosidase hydrolysis showed that 1.3–20.6% of initially spiked naproxen, diclofenac, ibuprofen, and gemfibrozil were transformed into glycoside conjugates. Results from this study showed that plant cell cultures may be a useful tool for initially exploring the potential metabolites of PPCPs in plants as well as for rapidly screening the metabolism potentials of a variety of PPCPs or other emerging contaminants, and therefore may be used for prioritizing compounds for further comprehensive evaluations. - Highlights: • Five phase I metabolites of carbamazepine were identified in carrot cell cultures. • The metabolism potentials of 18 PPCPs were evaluated using carrot cell cultures. • Four PPCPs may partially form glycoside conjugates as phase II

  14. 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.

  15. Clinicians' interpretations of point of care urine culture versus laboratory culture results : Analysis from the four-country POETIC trial of diagnosis of uncomplicated urinary tract infection in primary care

    NARCIS (Netherlands)

    Hullegie, Saskia; Wootton, Mandy; Verheij, Theo J.M.; Thomas-Jones, Emma; Bates, Janine; Hood, Kerenza; Gal, Micaela; Francis, Nick A.; Little, Paul; Moore, Michael; Llor, Carl; Pickles, Timothy; Gillespie, David; Kirby, Nigel; Brugman, Curt; Butler, Christopher C.

    2017-01-01

    Background. Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care.  Objective. To identify the degree to which clinicians'

  16. Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital.

    Science.gov (United States)

    Arnold, R; van Teijlingen, E; Ryan, K; Holloway, I

    2015-01-01

    To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies. Qualitative ethnographic study. A maternity hospital, Afghanistan. Doctors, midwives and care assistants. Six weeks of observation followed by 22 semi-structured interviews and four informal group discussions with staff, two focus group discussions with women and 41 background interviews with Afghan and non-Afghan medical and cultural experts. The culture of care in an Afghan maternity hospital. A large workload, high proportion of complicated cases and poor staff organisation affected the quality of care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers. Nepotism and cronyism created inequality in clinical training and support and undermined the authority of management to improve standards of care. Staff without powerful connections were vulnerable in a punitive inequitable environment-fearing humiliation, blame and the loss of employment. Suboptimal care put the lives of women and babies at risk and was, in part, the result of conflicting priorities. The underlying motivation of staff appeared to be the socio-economic survival of their own families. The hospital culture closely mirrored the culture and core values of Afghan society. In setting priorities for women's health post-2015 Millennium Development Goals, understanding the context-specific pressures on staff is key to more effective programme interventions and sustainability. © 2014 Royal College of Obstetricians and Gynaecologists.

  17. Cultural Differences and Similarities in Responses to the Silver Drawing Test in the USA, Brazil, Russia, Estonia, Thailand, and Australia.

    Science.gov (United States)

    Silver, Rawley

    2003-01-01

    Summarizes cross-cultural studies of cognitive skills, emotions, and self-images found in responses to drawing tasks by children, adolescents, and adults. Its aim is to find out whether cultural differences in scores on the Silver Drawing Test can illuminate cultural preferences and contribute to cultural practices. (Contains 21 references.) (GCP)

  18. Digital Repatriation: Constructing a Culturally Responsive Virtual Museum Tour

    Directory of Open Access Journals (Sweden)

    Loriene Roy、Mark Christal

    2002-04-01

    Full Text Available

    頁次:14-18

    This paper describe a project that involved educators and three Native American communities in the construction of a virtual tour now available on the Web site of the National Museum of the American Indian(http://www. conexus.si.edu/. In fall 1998, the Pueblo of Laguna Department of Education, the College of Education and Graduate School of Library and Information Science at The University of Texas at Austin, and the Smithsonians National Museum of the American Indian (NMAI began the first collaboration that brought Native American students, teachers, and cultural representatives to the NMAI George Gustav Heye Center in New York City. The virtual tour makes extensive use of QuickTime Virtual Reality (QTVR. The panoramas of the exhibition space serve as an interface for accessing the featured objects selected by the students. Clicking on a hot spot over the museum display of a featured object causes the QTVR object to load in a separate Webpage frame accompanied by an interpreted essay written by a student. Clickable floor plans of the exhibition- space offer another method of navigating the virtual tour and accessing the virtual objects.

  19. Cross cultural training in primary mental health care consultations in Moldova - The tEACH perspective.

    Science.gov (United States)

    Møller, Jane Ege; van Weel-Baumgarten, Evelyn

    2017-09-01

    This article reports experiences and challenges encountered in a cross-cultural training project in Moldova that was undertaken by tEACH, the teaching subcommittee of EACH: International Association for Communication in Healthcare, in cooperation with local and international stakeholders. As part of a major health policy reform, the aim was to equip a group of trainers with the skills to train Moldovan professionals in skills for primary mental health care, including communication skills. The project consisted of 3 weeks of training using mainly experiential teaching methods to allow participants to practice content and methods, including interactive lecturing, roleplay, feedback and video. A majority of the participants reported that they acquired key facilitation skills. They valued the opportunity to practice and receive feedback. However, some reported that there was too much focus on communication skills, which was thought to be less relevant in a Moldovan context. Furthermore our learner-centered approach was occasionally experienced as a lack of structure CONCLUSION: The tEACH expertise plays an important role in supporting trainers in cross-cultural contexts with effective communication skills methods. Teaching in a cross-cultural context is only successful through continuous dialogue with stakeholders and demands attention to cultural differences. Copyright © 2017. Published by Elsevier B.V.

  20. Community helping services: dynamic of formation and expressiveness of the cultural care.

    Science.gov (United States)

    Landim, Fátima Luna Pinheiro

    2006-01-01

    Community helping services is an expression used by the social movements to designate families that live in shacks installed in a public area intended for building of own house at a community helping system. Studies in ethnonursing that aimed: in order to detail dynamic configuration in a community helping service. It took place in an community helping area located in the outskirts of Fortaleza, Ceará. The community members acting as general informants from the local culture, while eight (8) women heads-of-families, working as key informers. The data collect used the Observation-Participation-Reflection Model. The analyses were processing by the time that the dates were collected, considering the categories: inserting in the community helping culture to obtain their history; community helping is not a slum -describing the formation dynamic. Established that the formation dynamic of the community helping go on the own house representation as a symbol of " a better life". To assimilate such expression introducing in own cultural universe is a challenge for the nursing to assist a care culture congruent.

  1. How does the culture of medical group practices influence the types of programs used to assure quality of care?

    Science.gov (United States)

    Kaissi, Amer; Kralewski, John; Curoe, Ann; Dowd, Bryan; Silversmith, Janet

    2004-01-01

    It is widely acknowledged that the culture of medical group practices greatly influences the quality of care, but little is known about how cultures are translated into specific types of programs focused on quality. This study explores this issue by assessing the influence of the organizational culture on these types of programs in medical group practices in the upper Midwest. Data were obtained from two surveys of medical group practices. The first survey was designed to assess the culture of the practice using a nine-dimension instrument developed previously. The second survey was designed to obtain organizational structure data including the programs identified by the literature as important to the quality of care in medical practices. Completed surveys were obtained from eighty-eight medical groups. The relationship of the group practice culture to structural programs focused on quality of care was analyzed using logistic regression equations. Several interesting patterns emerged. As expected, practices with a strong information culture favor electronic data systems and formal programs that provide comparative or evidence-based data to enhance their clinical practices. However, those with a quality-centered culture appear to prefer patient satisfaction surveys to assess the quality of their care, while practices that are more business-oriented rely on bureaucratic strategies such as benchmarking and physician profiling. Cultures that emphasize the autonomy of physician practice were negatively (but not at a statistically significant level) associated with all the programs studied. Practices with a highly collegial culture appear to rely on informal peer review mechanisms to assure quality rather than any of the structural programs included in this analysis. This study suggests that the types of quality programs that group practices develop differ according to their cultures. Consequently, it is important for practice administrators and medical directors to

  2. The effects of corporate social responsibility on employees' affective commitment: a cross-cultural investigation.

    Science.gov (United States)

    Mueller, Karsten; Hattrup, Kate; Spiess, Sven-Oliver; Lin-Hi, Nick

    2012-11-01

    This study investigated the moderating effects of several Global Leadership and Organizational Behavior Effectiveness (GLOBE) cultural value dimensions on the relationship between employees' perceptions of their organization's social responsibility and their affective organizational commitment. Based on data from a sample of 1,084 employees from 17 countries, results showed that perceived corporate social responsibility (CSR) was positively related to employees' affective commitment (AC), after controlling for individual job satisfaction and gender as well as for nation-level differences in unemployment rates. In addition, several GLOBE value dimensions moderated the effects of CSR on AC. In particular, perceptions of CSR were more positively related to AC in cultures higher in humane orientation, institutional collectivism, ingroup collectivism, and future orientation and in cultures lower in power distance. Implications for future CSR research and cross-cultural human resources management are discussed. (c) 2012 APA, all rights reserved.

  3. Dose response of tracheal epithelial cells to ionizing radiation in air-liquid interface cultures

    International Nuclear Information System (INIS)

    Fukutsu, K.; Yamada, Y.; Shimo, M.

    2002-01-01

    The dose-response relationships of tracheal epithelial cells to ionizing radiation was examined in air-liquid interface cultures, which were developed for the purpose of simulating in vivo conditions. The cultures investigated in this study were expected to be advantageous for the performance of irradiation experiments using short-range α rays. The level of dose response of air-liquid interface cultures to ionizing radiation proved to be the same as that for in vivo conditions. This result indicates that air-liquid interface cultures will prove most useful, to facilitate future studies for the investigation of the biological effects induced in tracheal epithelial cells by ionizing radiation, especially by α-rays. (orig.)

  4. Exploring the Influence of Nursing Work Environment and Patient Safety Culture on Missed Nursing Care in Korea.

    Science.gov (United States)

    Kim, Kyoung-Ja; Yoo, Moon Sook; Seo, Eun Ji

    2018-04-20

    This study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. A cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t-test or ANOVA, Pearson correlation and multiple regression analysis. Missed nursing care was found to be correlated with clinical career, nursing work environment and patient safety culture. The regression model explained approximately 30.3 % of missed nursing care. Meanwhile, staffing and resource adequacy (β = -.31, p = .001), nurse manager ability, leadership and support of nurses (β = -.26, p = .004), clinical career (β = -.21, p = .004), and perception on patient safety culture within unit (β = -.19, p = .041) were determined to be influencing factors on missed nursing care. This study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture. Copyright © 2018. Published by Elsevier B.V.

  5. CMA Announces the 1996 Responsible Care Catalyst Awards Winners

    Science.gov (United States)

    1996-06-01

    Eighteen exceptional teachers of science, chemical technology, chemistry, and chemical engineering have been selected to receive a Responsible Care Chemical Manufacturers Association's 1996 Catalyst Award. The Responsible Care Catalyst Awards Program honors individuals who have the ability to inspire students toward careers in chemistry and science-related fields through their excellent teaching ability in and out of the classroom. The program also seeks to draw public attention to the importance of quality chemistry and science teaching at the undergraduate level. Since the award was established in 1957, 502 teachers of science, chemistry, and chemical engineering have been honored. Winners are selected from a wide range of nominations submitted by colleagues, friends, and administrators. All pre-high school, high school, two and four-year college, or university teachers in the United States and Canada are eligible. Each award winner will be presented with a medal and citation. National award winners receive 5,000; regional award winners receive 2,500. National Winners. Martin N. Ackermann, Oberlin College, Oberlin, OH Kenneth R. Jolls, Iowa State University, Ames, IA Suzanne Zobrist Kelly, Warren H. Meeker Elementary School, Ames, IA John V. Kenkel, Southeast Community College, Lincoln, NE George C. Lisensky, Beloit College, Beloit, WI James M. McBride, Yale University, New Haven, CT Marie C. Sherman, Ursuline Academy, St. Louis, MO Dwight D. Sieggreen, Cooke Middle School, Northville, MI Regional Winners Two-Year College. East-Georgianna Whipple-VanPatter, Central Community College, Hastings, NE West-David N. Barkan, Northwest College, Powell, WY High School. East-John Hnatow, Jr., Emmaus High School, Northampton, PA South-Carole Bennett, Gaither High School, Tampa, FL Midwest-Kenneth J. Spengler, Palatine High School, Palatine, IL West-Ruth Rand, Albuquerque, Albuquerque, NM Middle School. East-Thomas P. Kelly, Grandville Public Schools, Grandville, NH West

  6. 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.

  7. 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

  8. 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

    2015-12-01

    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

  9. Cell-cycle distributions and radiation responses of Chinese hamster cells cultured continuously under hypoxic conditions

    International Nuclear Information System (INIS)

    Tokita, N.; Carpenter, S.G.; Raju, M.R.

    1984-01-01

    Cell-cycle distributions were measured by flow cytometry for Chinese hamster (CHO) cells cultured continuously under hypoxic conditions. DNA histograms showed an accumulation of cells in the early S phase followed by a traverse delay through the S phase, and a G 2 block. During hypoxic culturing, cell viability decreased rapidly to less than 0.1% at 120 h. Radiation responses for cells cultured under these conditions showed an extreme radioresistance at 72 h. Results suggest that hypoxia induces a condition similar to cell synchrony which itself changes the radioresistance of hypoxic cells. (author)

  10. Influence of encoding instructions and response bias on cross-cultural differences in specific recognition.

    Science.gov (United States)

    Paige, Laura E; Amado, Selen; Gutchess, Angela H

    2017-10-01

    Prior cross-cultural research has reported cultural variations in memory. One study revealed that Americans remembered images with more perceptual detail than East Asians (Millar et al. in Cult Brain 1(2-4):138-157, 2013). However, in a later study, this expected pattern was not replicated, possibly due to differences in encoding instructions (Paige et al. in Cortex 91:250-261, 2017). The present study sought to examine when cultural variation in memory-related decisions occur and the role of instructions. American and East Asian participants viewed images of objects while making a Purchase decision or an Approach decision and later completed a surprise recognition test. Results revealed Americans had higher hit rates for specific memory, regardless of instruction type, and a less stringent response criterion relative to East Asians. Additionally, a pattern emerged where the Approach decision enhanced hit rates for specific memory relative to the Purchase decision only when administered first; this pattern did not differ across cultures. Results suggest encoding instructions do not magnify cross-cultural differences in memory. Ultimately, cross-cultural differences in response bias, rather than memory sensitivity per se, may account for findings of cultural differences in memory specificity.

  11. Culturally Relevant Palliative and End-of-Life Care for U.S. Indigenous Populations: An Integrative Review.

    Science.gov (United States)

    Isaacson, Mary J; Lynch, Anna R

    2018-03-01

    American Indians/Alaska Natives (AIs/ANs) have higher rates of chronic illness and lack access to palliative/end-of-life (EOL) care. This integrative review ascertained the state of the science on culturally acceptable palliative/EOL care options for Indigenous persons in the United States. Databases searched: CINAHL, PubMed/MEDLINE, SocINDEX, PsycINFO, PsycARTICLES, ERIC, Health Source: Nursing/Academic Edition, and EBSCO Discovery Service 1880s-Present. Key terms used: palliative care, EOL care, and AI/AN. peer-reviewed articles published in English. Findings/Results: Twenty-nine articles were identified, 17 remained that described culturally specific palliative/EOL care for AIs/ANs. Synthesis revealed four themes: Communication, Cultural Awareness/Sensitivity, Community Guidance for Palliative/EOL Care Programs, Barriers and two subthemes: Trust/Respect and Mistrust. Limitations are lack of research funding, geographic isolation, and stringent government requirements. Palliative/EOL care must draw on a different set of skills that honor care beyond cure provided in a culturally sensitive manner.

  12. Development and validation of a cross-cultural EORTC measure of spiritual wellbeing (swb) for palliative care patients with cancer

    NARCIS (Netherlands)

    Vivat, B.; Young, T.; Winstanley, J.; Arraras, J. I.; Bennett, M. I.; Brédart, A.; Costantini, A.; Fisher, S. E.; Greimel, E.; Guo, J.; Irarrazaval, M. E.; Kobayashi, K.; Kruizinga, R.; Navarro, M.; Omidvari, S.; Rohde, G. E.; Serpentini, S.; van Laarhoven, H. W. M.; Yang, G.

    2014-01-01

    Spiritual care and spiritual wellbeing (SWB) are central to palliative care, but no measures of SWB have yet been developed cross-culturally. In 2002 the EORTC Quality of Life (QL) Group began international development of an SWB measure for palliative patients. Three domains of SWB were initially

  13. Understanding asexual identity as a means to facilitate culturally competent care: A systematic literature review.

    Science.gov (United States)

    Jones, Catriona; Hayter, Mark; Jomeen, Julie

    2017-12-01

    To provide a contemporary overview of asexuality and the implications this has for healthcare practice. Individuals belonging to sexual minority groups face many barriers in accessing appropriate health care. The term "sexual minority group" is usually used to refer to lesbian women, gay, bisexual and transgender individuals. Anecdotal and research evidence suggests that those who identify as asexual have similar poor experiences. Systematic review and qualitative analysis. This work uses a systematic review and qualitative analysis of the existing interview data from self-identified asexuals, to construct features of the asexual identity. The findings will help practitioners and health professionals develop an understanding of this poorly understood construct. Ultimately this work is aimed at facilitating culturally competent care in the context of asexuality. Qualitative analysis produced three themes, which can be used, not only