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Taylor TA, Beban G, Yi E, Veukiso M, Sang-Yum G, Dewes O, Wrapson W, Taufa N, Campbell ART, Siegert RJ, Shepherd P. Empowering Pacific Patients on the Weight Loss Surgery Pathway: A Co-designed Evaluation Study. Obes Surg 2024; 34:959-966. [PMID: 38345730 PMCID: PMC10899268 DOI: 10.1007/s11695-024-07084-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Despite having the highest medical needs by population for weight loss treatment, Pacific patients in Aotearoa New Zealand face substantial levels of attrition in publicly funded weight loss surgery programs. In collaboration with the Auckland City Hospital bariatric surgery team, a Pacific-led preoperative weight loss surgery program was co-designed, delivered, and evaluated between 2020 and 2023. MATERIALS AND METHODS This was a single-arm, prospective co-designed evaluation study that took place at Auckland City Hospital in Aotearoa New Zealand. Participants were Pacific patients (n = 14) referred to the weight loss surgery program. Survey and video diaries were analyzed to determine if the program had the potential to increase Pacific patient retention through the preoperative stage of weight loss surgery, increase surgery completion rates, and improve the quality of treatment experiences. RESULTS Nine out of 14 participants attended all preoperative sessions. Six participants subsequently underwent weight loss surgery. Program components that had positive impacts on patient success and satisfaction were accessibility, information quality, having Pacific role models, cultural safety, and the group support system. The patients found the program to be culturally anchored and there was support for the implementation of the program going forward. CONCLUSION This study demonstrated how a culturally anchored intervention can increase patient retention for those patients who may not respond to mainstream treatment. Adjusting existing preoperative weight loss surgery programs to integrate Pacific-led models of healthcare has the potential to increase Pacific patient resiliency to follow through with surgery.
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Affiliation(s)
- Tamasin Ariana Taylor
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Room 1090, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Grant Beban
- General Surgery Department, Auckland City Hospital, Te Whatu Ora, Te Toka Tumai, 2 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Elaine Yi
- General Surgery Department, Auckland City Hospital, Te Whatu Ora, Te Toka Tumai, 2 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Michael Veukiso
- School of Social Work, College of Health, Massey University, Albany, North Shore, Auckland, 0745, New Zealand
| | - Genevieve Sang-Yum
- School of Social Work, College of Health, Massey University, Albany, North Shore, Auckland, 0745, New Zealand
| | - Ofa Dewes
- Centre of Methods and Policy Application in the Social Sciences, The Faculty of Arts, University of Auckland, 12 Grafton Road, Auckland, 1010, New Zealand
- Langimalie Research Centre, Tongan Health Society, M20 Business Park, 86F Plunket Avenue, Manukau, Auckland, 2104, New Zealand
| | - Wendy Wrapson
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Auckland, 0627, New Zealand
| | - Nalei Taufa
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Room 1090, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Andrew R T Campbell
- Department of Anthropology, The Faculty of Arts, The University of Auckland, 22 Symonds Street, Auckland, 1010, New Zealand
| | - Richard J Siegert
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Auckland, 0627, New Zealand
| | - Peter Shepherd
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Building 507, Room 1090, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
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Pokharel B, Yelland J, Hooker L, Taft A. A Systematic Review of Culturally Competent Family Violence Responses to Women in Primary Care. Trauma Violence Abuse 2023; 24:928-945. [PMID: 34629009 PMCID: PMC10009494 DOI: 10.1177/15248380211046968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Existing culturally competent models of care and guidelines are directing the responses of healthcare providers to culturally diverse populations. However, there is a lack of research into how or if these models and guidelines can be translated into the primary care context of family violence. This systematic review aimed to synthesise published evidence to explore the components of culturally competent primary care response for women experiencing family violence. We define family violence as any form of abuse perpetrated against a woman either by her intimate partner or the partner's family member. We included English language peer-reviewed articles and grey literature items that explored interactions between culturally diverse women experiencing family violence and their primary care clinicians. We refer women of migrant and refugee backgrounds, Indigenous women and women of ethnic minorities collectively as culturally diverse women. We searched eight electronic databases and websites of Australia-based relevant organisations. Following a critical interpretive synthesis of 28 eligible peer-reviewed articles and 16 grey literature items, we generated 11 components of culturally competent family violence related primary care. In the discussion section, we interpreted our findings using an ecological framework to develop a model of care that provides insights into how components at the primary care practice level should coordinate with components at the primary care provider level to enable efficient support to these women experiencing family violence. The review findings are applicable beyond the family violence primary care context.
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Affiliation(s)
- Bijaya Pokharel
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
- Bijaya Pokharel, Judith Lumley Centre,
School of Nursing and Midwifery, La Trobe University, Plenty Rd &, Kingsbury
Dr, Bundoora VIC 3086, Australia.
,
| | - Jane Yelland
- Murdoch Children’s Research
Institute, Parkville, VIC,
Australia
| | - Leesa Hooker
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
| | - Angela Taft
- Judith Lumley
Centre, School of Nursing and
Midwifery, La Trobe
University, Bundoora, VIC, Australia
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Farokhzadian J, Nematollahi M, Dehghan Nayeri N, Faramarzpour M. Using a model to design, implement, and evaluate a training program for improving cultural competence among undergraduate nursing students: a mixed methods study. BMC Nurs 2022; 21:85. [PMID: 35410203 PMCID: PMC8996203 DOI: 10.1186/s12912-022-00849-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to changing population, culturally diverse clients with different perceptions of illness and health are present in healthcare settings. Therefore, it is increasingly important for nursing students to have high levels of cultural competence in order to meet diverse client needs. A training program is essential to enhance students' cultural competence. This study aimed to design, implement, and evaluate a cultural care-training program to improve cultural competence of undergraduate nursing students. METHODS This exploratory mixed methods study used six steps proposed in the Talbot and Verrinder model to design a training program. In the first step, a conventional qualitative study was conducted and 18 participants were interviewed using purposive sampling. In the second and third steps, literature review and the classic Delphi technique were used for initiation and finalization of the program. The fourth, fifth, and sixth steps were completed by implementing, monitoring, and evaluating the cultural care program (five two-hour sessions) among 73 nursing students using a quasi-experimental design. Finally, effectiveness of program was evaluated through the cultural care inventory before and 1 month after the program. Data were analyzed via SPSS25, independent samples t- test, paired t- test, chi-square test, analysis of covariance, and multivariate linear regression tests. RESULTS A systematic model was used to identify key elements of a cultural care program, including main topics, educational objectives and contents, assignments and activities for students, teaching and evaluation methods. The curricular objectives and educational contents were implemented in five sessions to produce measurable results. The quantitative step showed that nursing students' cultural competence in the intervention group (184.37 ± 22.43) improved significantly compared with the control group (153.19 ± 20.14) (t = 6.24, p = 0.001) after intervention. CONCLUSION A cultural care training program can be designed by the model applied in this study in order to improve cultural competence of nursing students. This training program will be effective if students' learning needs, appropriate assignments, and acceptable teaching methods are addressed. Therefore, nurse educators can design comprehensive training programs to improve nursing students' cultural competence in different cultures and contexts. This training program is highly efficient because it is applicable in many disciplines of nursing education.
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Affiliation(s)
| | | | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Centre, School of nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Motahareh Faramarzpour
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran. .,Clinical Research Development Center of Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran.
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Abstract
Disparities in the quality of health care for the black population have been apparent for many decades, evidenced by the high mortality and morbidity rates for the black/African American community. Major health care organizations have recognized that a culturally diverse nursing workforce is essential to improve the health of this community. Recruitment of prenursing students from the black population is vital to building a diversified workforce sensitive to the community's needs. In recent years, innovative projects have evolved to increase nurse workforce's diversity by recruiting black/African American students. This article provides background, identifies challenges, recommends solutions, and showcases successful programs.
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Affiliation(s)
- Denise Dawkins
- The Valley Foundation School of Nursing, San Jose State University, One Washington Square, San Jose, CA 95112, USA.
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Vaughan L, Schubert L, Mavoa H, Fa'avale N. 'Hey, We Are the Best Ones at Dealing with Our Own': Embedding a Culturally Competent Program for Māori and Pacific Island Children into a Mainstream Health Service in Queensland, Australia. J Racial Ethn Health Disparities 2017; 5:605-616. [PMID: 28707268 DOI: 10.1007/s40615-017-0406-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/24/2017] [Accepted: 06/26/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We present the results of one component of an external evaluation of Good Start Program (GSP), a community-based program for the prevention of chronic disease among Maori and Pacific Island (MPI) communities living in the state of Queensland, Australia. DESIGN An evaluation of the GSP was undertaken using a mixed methods approach. This paper reports on the qualitative component where interview and focus group data was collected, using Talanoa, a culturally tailored research methodology. Respondents included school students, community groups, teachers and parents, as well as the Good Start implementation team. RESULT(S) The five broad themes that emerged from this evaluation related to (i) components of cultural-competence and (ii) perceived impact of the program. The views of all participants reinforced the importance of culturally appropriate programs and highlighted how the multicultural health workers (MHWs) contributed to the program's perceived success. The challenges in understanding restrictions of the mainstream health service framework were noted indicating the need for it to be flexible in incorporating culturally appropriate components if a program was to be embraced. CONCLUSION The qualitative evaluation of the GSP suggests that culturally tailored programs, delivered by MHWs, have the potential to impact positively on community-level behavioural changes that improve health. These findings, supported by studies from other countries, contribute to the evidence that cultural-tailoring of programs is critical for ensuring that culturally appropriate initiatives are embedded in health care systems that support multicultural communities. Embedding includes the development of culturally appropriate policies, a culturally competent workforce and long-term funding to support culturally competent initiatives.
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Affiliation(s)
- Lisa Vaughan
- School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, 4th Floor, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
| | - Lisa Schubert
- School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, 4th Floor, Public Health Building, Herston Road, Herston, QLD, 4006, Australia
| | - Helen Mavoa
- School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, 4th Floor, Public Health Building, Herston Road, Herston, QLD, 4006, Australia
| | - Nicola Fa'avale
- School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, 4th Floor, Public Health Building, Herston Road, Herston, QLD, 4006, Australia
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
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Abstract
The Prince & Princess of Wales Hospice in Glasgow is committed to developing culturally competent, sensitive services to meet the needs of local ethnic minority communities. The clinical nurse specialist for widening access travelled to India, funded by a travel scholarship from the Florence Nightingale Foundation. The main rationale for this visit was to observe and compare palliative care practice in India in community, hospice and hospital settings with the current service provision by the hospice/hospital palliative care teams in Glasgow. A second focus was to study the cultural differences and potential challenges of providing palliative care to a diverse Indian population from multi-faith communities and different socio-economic classes. Throughout the visit the barriers to accessing palliative care services in India were observed as well as cultural norms that might impact on clinical practice in the UK.
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Affiliation(s)
| | - Audra Cook
- Clinical Governance Coordinator, The Prince & Princess of Wales Hospice, Glasgow
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