Faculty and Student Cross-Cultural Learning Through Teaching Health Promotion in the Community

Cross-cultural learning for nursing students and faculty increased through a collaborative venture of teaching health promotion classes in a Hmong community. Through the learning process, nursing students and faculty learned about Hmong culture, and Hmong participants learned about health. The purpose of this article is to describe the process and evaluation of health promotion classes in a Hmong community.

Hmong/medicine interactions: improving cross-cultural health care

BACKGROUND AND OBJECTIVES

There are now more than 100,000 Hmong (Southeast Asian) refugees in the United States. This study examined interactions between Hmong patients and their health care providers and identified specific factors that either enable or obstruct health care delivery.

METHODS

We used semistructured interview techniques to investigate patients' and providers' experiences, looking for attitudes, ideas, or behaviors that could be modified to improve health care delivery. Interviews with 23 Hmong patients, 18 health care providers, and six translators were audiotaped, transcribed, and analyzed by a multidisciplinary team. Methods included text analysis, theme identification, rank ordering, participant observation, immersion-crystallization, and open-ended discussion.

RESULTS

Hmong patients and their US-trained health care providers have different health belief systems. Both linguistic and cultural translation were seen as problematic. Additionally, an overwhelming number of patients identified kindness, caring, and a positive attitude as important provider characteristics. Providers noted difficulties in understanding Hmong conceptions of acute versus chronic diseases, illness prevention, and pain, both physical and psychological. Many respondents gave suggestions for improvement: 1) learn more about each other's cultures, 2) be patient, kind, and positive, 3) avoid negative statements or predictions, 4) improve translation quality, 5) explain medical terms using visual aids, 6) respect Hmong family-centered decision making, 7) increase the time allotted for translated clinical encounters, and 8) train Hmong health care providers.

CONCLUSIONS

Many basic issues in relations between clinicians and Hmong patients must be addressed to improve health care communication.

Linking research and practice through discussion

PURPOSE

To describe the process and outcomes of a researcher-initiated discussion group with nurses in clinical practice.

DESIGN

Descriptive case study. The study, which began in 1991, included one group of four acute care nurses. Between 1992-1996, three other groups of nurses participated.

METHODS

Nurses in practice read and discussed articles from a program of research on breast cancer during a series of group sessions. The semi-structured sessions were tape-recorded.

RESULTS

Participants suggested how to make article content more understandable to clinicians; they affirmed findings relevant to practice; and identified ways to integrate research in practice.

CONCLUSIONS

Discussion served as a means for the researcher and nurses to connect the research-practice gap through learning the practice perspective and the process and value of research. Discussion groups are recommended to enhance science-based clinical practice.

Health professional training for multi-disciplinary care of elderly patients with type II diabetes

With funding support from the Northern Wisconsin Area Health Education Center, we conducted a survey to assess continuing education needs of health care professionals providing diabetes self-care management and nutrition therapy to patients with Type II diabetes in rural northern Wisconsin and conducted a conference to address the identified needs. Of the topics surveyed, respondents ranked themselves lowest in knowledge and experience in the following areas: 1) application of revised guidelines for medical nutrition therapy, 2) considering patients, differing cultural needs, and 3) team management of diabetes. They were most comfortable with the technical aspects of care, e.g., insulin administration and blood glucose monitoring. One hundred seven health care professionals attended a one-day continuing education conference sponsored by the Eau Claire Family Practice Residency and the University of Wisconsin-Eau Claire School of Nursing, to address the topics identified by the needs assessment survey.