Nurses' experiences of providing transcultural nursing care to minority patients in Yunnan province: A descriptive qualitative study

Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high-quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals.

White and non-White Australian mental health care practitioners' desirable responding, cultural competence, and racial/ethnic attitudes

Background

Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country’s population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia’s population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners’ attitudes toward this diversity and their level of cultural competence.

Aim

Given the relationship between practitioner cultural competence and the mental health outcomes of non-White clients, this study aimed to identify factors that influence non-White and White practitioners’ cultural competence.

Methods

An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Balanced Inventory of Desirable Responding (BIDR); the Multicultural Counselling Inventory (MCI); and the Color-blind Racial Attitudes Scale (CoBRAS). Descriptive statistics were used to summarise participants’ demographic characteristics. One-way ANOVA and Kruskal–Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence and racial and ethnic blindness. Correlation analyses were conducted to determine the association between participants’ gender or age and cultural competence. Hierarchical multiple regression analysis was conducted to predict cultural competence.

Results

The study demonstrates that non-White mental health practitioners are more culturally aware and have better multicultural counselling relationships with non-White people than their White counterparts. Higher MCI total scores (measuring cultural competence) were associated with older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to think more highly of themselves (e.g., have higher self-deceptive positive enhancement scores on the BIDR) than those with lower MCI total scores.

Conclusion

The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners’ age, racial/ethnic background and practitioner engagement with prior cultural competence training.

Reported outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education: A narrative systematic review

OBJECTIVE

To identify outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education.

DESIGN

A systematic review of the literature was conducted in keeping with JBI methods.

DATA SOURCES

A range of databases were searched, including Medline, Embase, ERIC, CINAHL, ProQuest Central and DOAJ. Studies published in English from 2010 to 2020 were considered.

STUDY ELIGIBILITY CRITERIA

The review included qualitative and quantitative primary peer-reviewed research studies involving nursing or midwifery students who participated in international educational programs in their pre-registration education.

REVIEW METHODS

Thematic analysis informed by Braun and Clarke was used to identify key outcomes emerging.

RESULTS

56 studies were included. The results highlight similarities in outcomes for students who had undertaken international educational programs in three thematic areas: Cultural learning, Personal growth, and Professional development. Short-term outcomes are well documented, however there is a lack of research investigating long-term outcomes.

CONCLUSIONS

Further research is required to investigate long-term outcomes of international educational programs and means for measuring the effects on students' future professional practice. In addition, further research is needed to explore the perspectives of, and impact on, others including host communities and universities, and other stakeholders.

Undergraduate nursing students' transformative learning through disorientating dilemmas associated with end-of-life care simulation: A narrative inquiry study

BACKGROUND

Despite attempts, there remains a theory practice gap for undergraduate nursing students transitioning to clinical practice on graduation, especially for specialty areas of clinical practice, such as palliative care, where there are limited opportunities to gain specialty knowledge and skills. As a result, undergraduate nursing students largely feel unprepared for end-of-life care in clinical practice. End-of-life care simulation is gaining momentum for helping prepare students to undertake this important care. However, little is known of whether end-of-life care simulation is a transformative learning strategy that can be transferred to clinical practice.

AIM

The aim of this paper is to report on undergraduate nursing students transformative learning through end-of-life care simulation.

DESIGN

A qualitative research design using narrative inquiry was used with data collected through semi-structured interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry.

METHODS

Eighteen 3rd year undergraduate nursing students enrolled in a compulsory palliative care unit, at an Australian university participated in an immersive end-of-life care simulation. Data were collected through semi-structured interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry.

RESULTS

This study revealed that transformative learning occurred through three disorientating dilemmas of: caring for a dying patient; approaching difficult conversations; and witnessing death for the first time. Knowledge of palliative care and clinical skills were also found to be transferred to clinical practice.

CONCLUSIONS

End-of-life care simulation can be an effective method of promoting transformative learning and can help to reduce the gap from nursing theory to clinical practice.

Embodied good deaths and disembodied bad deaths: Undergraduate nursing students narratives of experience

BACKGROUND

The concept of "good and bad deaths" has been widely addressed in the literature. However, little is known of undergraduate nursing students' experiences with death in clinical practice or how they perceive good and bad deaths.

OBJECTIVE

To explore undergraduate nursing students' personal and professional/clinical experiences of death and dying.

DESIGN

A qualitative narrative inquiry design.

SETTING AND PARTICIPANTS

Eighteen third year Bachelor of Nursing students participated in the study.

METHODS

Data was collected through individual participant interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry (temporality, sociality and place).

RESULTS

A key finding of the study revealed that students' death experiences are shaped by the role of others, especially experienced nurses in clinical practice. Embodied good death experiences were influenced by the presence of nurses who guided students through the experience. Disembodied bad death experiences were influenced by undignified care, ritualistic post-mortem care and the physical coldness of the deceased and the environment.

CONCLUSION

Nursing students need meaningful preparation to undertake end of life care in clinical practice, including post-mortem care and the possibility of bad deaths. End of life care education and end of life care simulation play a role in preparing students for end of life care in clinical practice. End of life care education needs to be commenced early in the undergraduate degree. Furthermore, nursing clinicians need to be aware of the impact that they have in shaping good and bad death experiences for undergraduate nursing students, the Registered Nurses of the future.

Coping: "This Is More Than a Trip-It Is a Journey"

A 2-week community health clinical experience in Ghana, Africa, provided undergraduate nursing students a study abroad opportunity to expand their cross-cultural skills. Journal entries (N = 512) of four cohorts were analyzed for common themes using Atlas.ti 7 in this descriptive qualitative study. No emphasis was placed on how to cope with cultural shock in Ghana, nor any attempt made to teach effective coping skills during the trips. Bochner's ABC cultural learning response model provided the framework for grouping themes. Positive coping skills included the need for control, humor, normalizing, and reframing as well as a need for a break and relaxation. Venting, frustration, and physical ailments were coded as negative responses to culture shock. Due to these findings, student preparation for short-term study abroad should include discussions on effective coping with culture shock during orientation sessions and on-going debriefing.

Engaging Nursing Students in a Rural Native American Community to Facilitate Cultural Consciousness

Integrating cultural consciousness into nursing curricula is important for preparing a global nursing workforce. This article evaluated the impact of a teaching strategy designed to facilitate nursing students' cultural consciousness beyond the classroom during a 1-week field experience within a rurally isolated Native American community. Cultural consciousness health care is a central element of health care delivery that integrates clinical knowledge, sensitivity, and cultural understanding. This study used an intrinsic single case study design bounded by 30 nursing students' perceptions of their week-long immersion experience within a rurally isolated American Indian community. The reality of the situations they encountered did not match their expressed expectations nor their tacit assumptions. Evidence taken in situ from clinical reflections demonstrated most of the students wrestled with this mismatch, although they improved their clinical assessment, technical nursing, and intercultural communication skills. Evidence from end of course reflections demonstrated that two-thirds of the students integrated their preconceptions and their immersion experiences with cultural consciousness emerging in their reflections.

How do we facilitate international clinical placements for nursing students: A cross-sectional exploration of the structure, aims and objectives of placements

BACKGROUND

International clinical placements provide undergraduate students with a unique and complex clinical learning environment, to explore cultural awareness, experience different health care settings and achieve clinical competencies. Higher education institutions need to consider how to structure these placements to ensure appropriate and achievable aims and learning outcomes.

OBJECTIVES

In this study we described the structure, aims and learning outcomes associated with international clinical placement opportunities currently undertaken by Australian undergraduate nursing students in the Asia region.

PARTICIPANTS

Forty eight percent (n = 18) of the institutions invited responded. Eight institutions met the inclusion criteria, one of which offered three placements in the region, resulting in 10 international placements for which data were provided.

METHODS

An online survey tool was used to collect data during August and September 2015 on international clinical placements conducted by the participating universities. Descriptive data on type and numbers of placements is presented, along with results from the content analysis conducted to explore data from open ended questions on learning aims and outcomes.

RESULTS

One hundred students undertook 10 International Clinical Placements offered in the Asian region by eight universities. Variations across placements were found in the length of placement, the number of students participating, facilitator to student ratios and assessment techniques used. Five categories related to the aims of the programs were identified: 'becoming culturally aware through immersion', 'working with the community to promote health', 'understanding the role of nursing within the health care setting', 'translating theory into professional clinical practice', and 'developing relationships in international learning environments'. Four categories related to learning outcomes were identified: 'understanding healthcare and determinants of health', 'managing challenges', 'understanding the role of culture within healthcare' and 'demonstrating professional knowledge, skills and behaviour'.

CONCLUSIONS

International clinical placements in the Asia region appear to vary greatly from one education institution to the next with no clear consensus from either this study's findings or the literature on which structure, support and assessments lead to greater student learning.

INTERNACIONALIZAÇÃO DA ENFERMAGEM BRASILEIRA: DOUTORADO SANDUÍCHE NA REGIÃO DA CATALUNHA - ESPANHA

RESUMO Objetivo: relatar a experiência vivenciada no exterior por estudante de doutorado e apresentar as atividades com suas produções científicas. Método: relato de experiência de um estudante de doutorado em enfermagem brasileiro que realizou oito meses de atividades de doutorado sanduíche no exterior. Resultados: idealização do doutorado sanduíche no exterior e efetivação deste; socialização científica e internacionalização do conhecimento; e internacionalização dos programas de pós-graduação brasileiros. Conclusão: os ganhos nesta experiência abarcam o aprimoramento profissional, teórico-científico, e a obtenção de valores sociais e culturais. O contato com outras pessoas e instituições de ensino permitem o desenvolvimento de diferentes habilidades didáticas, pedagógicas e interpessoais. O intercâmbio possibilita o fortalecimento e o reconhecimento das instituições brasileiras de ensino, encoraja outros alunos a conhecer realidades distintas e assim fortalece a internacionalização das pesquisas em enfermagem.