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Effective communication and delivery of culturally competent health care

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Abstract

Effective communication between patients and health care providers is a critical element to quality health care. Becoming aware of patients' attitudes, beliefs, biases, and behaviors that may influence patient care can help clinicians improve access to and quality of care. Health care providers should develop a strategic plan for improvement, then implement and evaluate the plan to include structured, continuously improving progress toward achieving cultural competency goals. In this challenging health care environment, health care providers need the skills to explore the meaning of illness, to determine patient's social and family context, and provide patient-centered and culturally competent care.

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... However, cultural differences between nurses and patients increases the likelihood that accessible, quality care will be compromised (OMH, 2001a;2001b;Sullivan Commission, 2004). Effective communication between nurses and patients speaking diverse languages is important to support safe, patient centered and culturally competent care (Andrulis & Brach, 2007;Markova & Broome, 2007). Cultural competency is the possession of adequate cultural knowledge, attitude, and skills required to deliver patient care (Calvillo, et al., 2009). ...
... Further, nurses practice within the context of their own cultural beliefs, behaviors, and needs as presented by consumers and their communities. Lack of cultural competency within the hospital organization can compromise nurse-patient communication placing patients at risk for harm (Barnes, 2004;Markova & Broome, 2007). Cultural competency training serves to increase awareness, knowledge, and skills with the intention that it will lead to nurse behavior change and improved patient-nurse communication (American Institutes for Research, 2002). ...
... Culturally and linguistically appropriate nursing care is foundational to patient safety (Markova & Broome, 2007;OMH, 2001a Limited English proficiency is a likely contributor to patient vulnerability (Markova & Broome, 2007;OMH, 2001a). Persons with LEP are people who speak English less than very well. ...
... Caregivers without equal attention to the individual in a holistic sense can determine incorrect behavior; Communication, therefore, impacts the patient-nurse relationship, which should be based on intrinsic values such as trust, responsibility and support [5]. In this setting, communicative competence becomes a professional skill and changes attitude towards patients in a two-way process in which a message is sent, must be correctly received and understood [6]. ...
... When this occurs, patients gain confidence, feel respected and involved in the treatment process. They, also, can express feelings, improving therapeutic adherence and treatment outcomes [3,6]. ...
... Finally "paraverbal" consists of the use of the voice referring to the timbre, tone and pauses and volume. Without one of these components, communication becomes difficult to understand and cannot be understood by the patients [6]. ...
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Background Communication is an essential tool for health promotion. Effective healthcare communication has great therapeutic value. Objective The aim of the study is to assess the degree of patient satisfaction related to nursing communication in the various stages of hospital stay. Methods Patients admitted to General University Hospital in medical and surgical department were subjected to this survey using a questionnaire, structured in four sections (acceptance, hospital stay, discharge, pain and new drugs management). Chi-square and multivariate logistic regression models were used to test the association between the outcome of interest defined as the satisfaction of nursing communication and the independent variables. Results One thousand three hundred seventy questionnaires were administered. In acceptance, among patients satisfied with nursing skills related to explaining the department's functioning, most were satisfied with nursing communication (972 vs 87 p <0.005). Also during the hospital stay, among patients satisfied with nursing Skills and Manner relating to communication most were significantly satisfied with the nursing communication (849 vs 74 p <0.005 and 987 vs 55 p <0.001). At the discharge, the number of patients satisfied with nursing communication was greater among patients who considered the length of hospital stay adequate (1020 vs 65 p <0.001). Data are confirmed by the multiple logistic regression analysis. Conclusion Our study shows how nursing communication is the key to establishing a good therapeutic care relationship and how it can be associated with patient satisfaction in various phases of hospital stay.
... Sanattomaan viestintään kuuluvat muun muassa ilmeet, eleet, kehonviestintä ja muu sanaton viestintä. Nämä edellä mainitut asiat saattavat vaikuttaa viestin ymmärtämiseen enemmän kuin sanat kommunikaatiotilanteessa (Hahn 1997, Markova & Broome 2007, Maier-Lorentz 2008) (Hahn 1997, Markova & Broome 2007, Maier-Lorentz 2008) Sanattomalla viestinnällä pyritään havaitsemaan kokonaisviestintää. Tärkeää on ymmärtää, miten ihminen vastaanottaa viestejä, valikoi ja käsittelee niitä sekä muodostaa niistä tulkinnan. ...
... Sanattomaan viestintään kuuluvat muun muassa ilmeet, eleet, kehonviestintä ja muu sanaton viestintä. Nämä edellä mainitut asiat saattavat vaikuttaa viestin ymmärtämiseen enemmän kuin sanat kommunikaatiotilanteessa (Hahn 1997, Markova & Broome 2007, Maier-Lorentz 2008) (Hahn 1997, Markova & Broome 2007, Maier-Lorentz 2008) Sanattomalla viestinnällä pyritään havaitsemaan kokonaisviestintää. Tärkeää on ymmärtää, miten ihminen vastaanottaa viestejä, valikoi ja käsittelee niitä sekä muodostaa niistä tulkinnan. ...
Thesis
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Growing number of the immigrants set new demands especially to the workers of the home care. The significance of the communication will be emphasized when the worker meets an immigrant patient who comes from the foreign culture. The confidence requires the reciprocal understanding of verbal and non-verbal messages, listening and faculty for the empathy. It has to be an own desire to understand, to appreciate and to accept differences between cultures. The most important thing is that the patient feels he has been heard and understood. The aim of the study was to describe how the workers of the home care estimate their own communicative skill (verbal/non-verbal communicative skills, listening skill and empathy ability) in the transcultural nursing. All the workers (N = 593) who work in the one community home health care in south Finnish town were as a subject of the study. The participants were public health nurses, nurses, practical nurses, home aids and home helps by education. A quantitative descriptive cross-sectional design was used. The data were collected using a structured questionnaire designed for the study. The survey included 51 items and three open-ended questions. The material was collected in March 2012. The response rate was 57 % (n = 338). The data were analyzed statistically. The open questions were analyzed by the content analysis. More than half (56 %) of the respondents estimated their own empathy ability as best of the communicative skill (mean 2,3) in the transcultural nursing. According of the results, especially the non-verbal communicative skills was as a strength of own communicative skills. An own estimate of the non-verbal (mean 2,8) communicative skills and of listening skills (mean 2,7) were at nearly the same level. The results of the study showed that the workers of the home care estimate their own verbal communicative skills (mean 3,2) to be their worst. When the age and work experience increases, the workers own estimate of verbal and wordless communicative skills, listening skill and empathy ability will worsen in the transcultural nursing (p < 0.001). The results of this study describe the part of the ones that have been examined of the present situation but the generalizations from the results cannot be made. On the basis of these results one can state that the importance of communicative skills of the workers of the home care must be make more seen. The supplementary education which is related to the immigrants and to interpreter service can be used to develop the transcultural nursing more patient centeredness and culture sensitive. Key words: transcultural nursing, cultural sensitivity, communication skills, home health care
... In addition, subject matter experts participated in the validation phase of the developed scenarios. For instance, SimCARE employed the two communication models; BATHE (Background, Affect, Trouble, Handling, Empathy) (Markova & Broome, 2007) and LEARN (Listen, Explain, Acknowledge, Recommend, Negotiate) (Berlin & Fowkes, 1983). Those models help design authentic scenarios where users communicate with culturally diverse patients empathically and efficientl y. ...
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The importance of cultural diversity and competency in library services has been gradually increasing along with rapid growth of international residents (3.3% of total population) in South Korea. Along with a multi- cultural population, marginalized communities including disabled per- sons, financially disadvantaged persons, and seniors over 65 years old are growing. To fulfill the South Korean government’s goal of becoming an Innovative Inclusive Nation, public libraries and librarians need to better prepare for these significant changes and work to become more socially inclusive. While librarians need to continuously promote cultural competence, empathy, communication and other critical skills through their professional development training, studies show that little of such training exists in South Korea. In this study, we review related literature and analyze three example cases of Virtual Reality (VR) simulations developed for service-oriented professions, nurses, dentists, and teachers, for the purposes of providing core foundations and best practices to guide the design and development of training programs for pre- and in-service librarians. Amid an ongoing pandemic, and the advent of the metaverse and Fourth Industrial Revolution, VR-based, online, and mixed face-to-face professional development are likely to become more in demand and will help librarians to become future ready and socially inclusive.
... Recommendations for health-literate sensitive communication include using plain language, breaking down instructions into small specific steps, using pictures or diagrams and ensuring that any printed information or resources are written at or below fifth-grade reading level. These precautions should be applied universally, that is, to all patients regardless of their literacy levels [27,31]. ...
Article
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Continuing professional development (CPD) is an essential component of professional practice for registered health practitioners to maintain and enhance knowledge, skills and abilities. There are many topics that practitioners may pursue relevant to their practice environment, and, in recent years, providing culturally safe and respectful practice is an emerging area of need. Unfortunately, many health professionals, whilst willing to offer cultural safe healthcare, may be uncertain of how to enact that practice. The World Health Organisation recognises attainment of the highest possible standard of health as a basic human right, and cultural safety is increasingly becoming an expectation of health professionals. To address this need and the insufficiency of support in the literature, the authors have presented a discussion paper on various aspects of cultural safety and the underlying constructs, such as cultures, that support it. The discussion takes into account core constructs that signpost the path to cultural safety and recognises the role and accountability of all levels of the healthcare system, not merely the practitioner. Finally, we propose a model program for a cultural humility CPD activity incorporating pre-work, online modules, interactive workshop, reflection on professional practice and a post-workshop evaluation.
... These factors are transmitted from person to person by non-verbal communication and the body language of friendship may play a critical supportive role in cross-cultural communication between health care personnel and patients. 17 Effective communication between patients and health care providers is an important element in quality health care. In challenging health care environments, health care providers need the skills to explore the meaning of illness, determine patients' social and family contexts, and provide patient-centred and culturally competent care as an aspect of ethical responsibility. ...
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Many Turkish people migrated to Germany between 1955 and 1975. This study was carried out in Göttingen, Germany. Fifty Turkish people (described as patients) were asked about the care they had received from German health care personnel, and 50 German nurses and 50 German physiotherapists were questioned about care they had given to Turkish patients. Significant findings were the needs of the Turkish patients for good communication, physical contact and understanding of their culture-based expressions of illness. The German nurses and physiotherapists expressed the need for language barriers to be minimized and for education in the specific culture of Turkish patients. Our findings are discussed from an ethical viewpoint. The International Council of Nurses' code of ethics is used to guide the ethical debate about the findings within the context of transcultural and multicultural care. Suggestions for better transcultural health care paradigms are made for relating to patients from different cultures when patients and care providers have little understanding of each other's needs and expectations.
... When patients feel that their health care provider uses a patient-centered approach, they are more likely to share important information regarding their health (Zanten, Boulet, & McKinley, 2007). Furthermore, effective communication improves outcomes such as patient satisfaction, adherence to treatment plans, and alleviation of medical problems (Markova & Broome, 2007; Rider & Keefer, 2006). Although abundant research has been conducted on various aspects of the health care provider-patient communication relationship, relatively little investigation has occurred on the communication behaviors that health care providers use during the patient medical interview (Cegala, Gade, Broz, & McClure, 2004). ...
Article
Abstract The purpose of this study was to investigate the extent to which the self-reported rhetorical sensitivity of a sample of athletic training students is positively related to successfully performing a patient medical interview. Particularly, the study focused on if athletic training students' reported communication behaviors is related to their ability to communicate effectively during a patient evaluation. Thirty-nine senior undergraduate athletic training students from seven accredited athletic training education programs in the central part of the Midwest participated. The students answered a questionnaire that measured rhetorical sensitivity. Next, they performed a patient medical interview on a standardized patient. Athletic training students were instructed to gather important medical information, perform a clinical examination and discuss possible findings with the standardized patient. The patient medical interview provided the researcher an opportunity to observe and rate the athletic training students' communication behaviors. Plus, the patient medical interview gave a chance for the standardized patient to rate her satisfaction with the patient care provided by the athletic training student. The study found that the athletic training students have moderate levels of self-reported rhetorical sensitivity and that they met expectations of successfully performing a patient medical interview. The results indicated a relationship between self-reported rhetorical sensitivity and observed effective communication behaviors during a patient medical interview. However, the results did not indicate a significant correlation between self-reported rhetorical sensitivity and standardized patient satisfaction. In conclusion, the results of this study support the necessity for including communication skills training for athletic training students.
... When patients feel that their health care provider uses a patient-centered approach, they are more likely to share important information regarding their health (Zanten, Boulet, & McKinley, 2007). Furthermore, effective communication improves outcomes such as patient satisfaction, adherence to treatment plans, and alleviation of medical problems (Markova & Broome, 2007;Rider & Keefer, 2006). Although abundant research has been conducted on various aspects of the health care provider-patient communication relationship, relatively little investigation has occurred on the communication behaviors that health care providers use during the patient medical interview (Cegala, Gade, Broz, & McClure, 2004). ...
... This demographic transformation is not without its problems, however, as massive disparities in the health status of the population are evident, negatively affecting primarily ethnic and cultural minority groups3456. The successful delivery of health care in a multicultural setting is often hampered by a host of factors, including chiefly language and non-verbal communication barriers between carer and patient [7, 8] , lack of respect and/or awareness of cultural traditions and beliefs in the practitioner–client International Journal for Quality in Health Care © The Author 2013. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved Page 1 of 9 relationship91011 and interpersonal as well as institutional stereotyping and prejudice121314. ...
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Purpose: To examine the effectiveness of patient-centered care (PCC) models, which incorporate a cultural competence (CC) perspective, in improving health outcomes among culturally and linguistically diverse patients. Data sources: The search included seven EBSCO-host databases: Academic Search Complete, Academic Search Premier, CINAHL with Full Text, Global Health, MEDLINE with Full Text, PsycINFO PsycARTICLES, PsycEXTRA, Psychology and Behavioural Sciences Collection and Pubmed, Web of Knowledge and Google Scholar. Study selection: The review was undertaken following the preferred reporting items for systematic reviews and meta-analyses, and the critical appraisals skill program guidelines, covering the period from January 2000 to July 2011. Data extraction Data were extracted from the studies using a piloted form, including fields for study research design, population under study, setting, sample size, study results and limitations. Results of data synthesis: The initial search identified 1450 potentially relevant studies. Only 13 met the inclusion criteria. Of these, 11 were quantitative studies and 2 were qualitative. The conclusions drawn from the retained studies indicated that CC PCC programs increased practitioners' knowledge, awareness and cultural sensitivity. No significant findings were identified in terms of improved patient health outcomes. Conclusion: PCC models that incorporate a CC component are increased practitioners' knowledge about and awareness of dealing with culturally diverse patients. However, there is a considerable lack of research looking into whether this increase in practitioner knowledge translates into better practice, and in turn improved patient-related outcomes. More research examining this specific relationship is, thus, needed.
... A research survey in Australia revealed that 94.1% of nurses identified communication skills as the most important educational area, compared with 93.7% for infection control and 91.4% for first aid (9). Nurses can maintain sustained partnerships with patients when they know how to communicate with them (10,11). Better communication skills increase nurses' job satisfaction and decrease their work-related stress (5). ...
Article
Background: Effective communication skills have been found to be one of the pivotal factors in building positive interpersonal relationships. Little is known about nursing undergraduates' perspectives on communicating with patients. Objective: This study aimed to explore nursing students' perspectives and experiences of nurse-patient communication in their clinical placement. Methods: The participants included 21 second-year undergraduates and 21 first-year master's students. Interviews were conducted in Cantonese and then transcribed in Chinese and translated into English. A content analysis approach was adopted to analyze the data. Results: Five themes emerged from the interview data. 'The necessity of nurse-patient communication' reveals why the students valued nurse-patient communication. 'The conversation contents' describes the content of the conversations that students typically had with patients. The third theme is 'self-reflection on the nurse-patient communication'. The last two themes, 'the communication pattern in different hospital settings' and 'the obstacles impeding nurse-patient communication', are about the students' communication styles in different hospitals and the barriers they encounter. Discussion: To improve students' communication skills, educators and clinical staff should listen to students, enhance students' reflective skills and strengthen their confidence. Conclusion: Through understanding students' difficulties in the nurse-patient communication experience and the skills that they lack, educators can provide them with helpful recommendations to improve their communication skills in clinical practice. Practice implications: The results of this study reveal that students' nurse-patient communication skills need to be improved.
... Effective communication between nurses and patients and families with LEP is essential to provide safe, culturally competent and patient-centred care (Andrulis & Brach 2007, Markova & Broome 2007. This is especially true for the patient and family with LEP (Hasain-Wynia et al. 2009), as English is the predominant language used in the US healthcare system. ...
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Aims and objectives: To explore the lived experiences of acute care bedside nurses caring for patients and their families with limited English proficiency (LEP). Background: Approximately 8.6% of the total United States population is considered limited English proficient. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals is essential when providing quality health care. There are only few published studies about registered nurses' experiences caring for patients with language barriers, but studies among nurses' experiences on patients with LEP and their families in an acute-care setting have not been explored. Design: A qualitative exploratory study was performed. Methods: The phenomenology research approach provides the most meaningful ways to describe and understand the entirety of the bedside nurses' experiences. A convenience, purposive sample of 40 registered nurses who work in bedside care in a 380-bed hospital in the western United States were interviewed. Each nurse had a minimum of 3 years of acute-care experience. The sample size was determined by data saturation. Results: Four themes emerged from the data of this research including: Desire to Communicate; Desire to Connect; Desire to Provide Care; and Desire to Provide Cultural Respect and Understanding. Conclusions: Care of patients with LEP is a challenge to many nurses and other health care providers. This study reinforces the need to give acute-care nurses a voice to share their experiences and ideas for solutions to the challenges they face in the care they provide. Findings from this study have the potential to identify clinically relevant concerns, barriers to communication, resources for effective communication, and needs or concerns of the bedside nurses when providing care. This article is protected by copyright. All rights reserved.
... La comunicazione è un processo a due vie in cui viene inviato un messaggio che deve essere correttamente ricevuto e compreso (Tay LH, et al., 2011). Quando ciò si verifica l'utente acquista fiducia, si sente rispettato e coinvolto nel processo di cura e può esternare i propri sentimenti, condizione ideale per il miglioramento dell'aderenza terapeutica e degli esiti di cura (Tay LH, et al., 2011;Markova T, et al., 2007). La comunicazione efficace tra l'infermiere e l'utente può essere insegnata e sostenuta nel tempo e ne rafforza la collaborazione (Doss S, et al., 2011); la letteratura corrente descrive la collaborazione tra l'infermiere e l'utente come un "rapporto interpersonale tra due o più persone che lavorano insieme verso un reciproco scopo definito" (Gallant MH, et al., 2002), con l'obiettivo di fornire all'utente maggior potere decisionale nel processo di cura (Doss S, et al., 2011). ...
Article
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Introduction The therapeutic nurse-user relationship can provide a personalized nursing care, greater satisfaction and better outcomes of care. The aim of this study is to describe the elements that characterize the nurse-user relationship and how to make it effective. Methods A review of the literature through biomedical databases was carried out; results’ analysis and synthesis is reported in narrative form. Results The goal of a nurse-patient partnership development is to increase the patient empowerment in the process of care. Effective communication creates and maintains a good relationship, it is essential but not still sufficiently considered and this influences the degree of involvement and active participation. The mutuality of purpose and the negotiation of goals allow the provision of centered and shared welfare benefits. Prerequisite for a therapeutic nurse-user relationship is a deep knowledge of the patient. Conclusion The therapeutic relationship centered on the partnership promotes the empowerment of the user and is the maximum expression of nurse-patient cooperation but it requires effective communication, and a facilitating context and organizational model. Further studies to assess the impact of sociodemographic variables, and organizational context in influencing the quality and outcomes of a nurse-user therapeutic relationship would be desirable.
... Ingredients that are necessary for an adequate encounter are often highlighted and professional and caring attitudes and empathy are frequently mentioned in this context (99,100). A professional attitude refers to the ability of the healthcare provider not to be directed by his/her own needs and feelings, but instead to be focused on issues that benefit the patient. ...
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Cross-cultural encounters through interpreter - experiences of patients, interpreters and healthcare professionals Nabi Fatahi Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden. Background: A mutual understanding between patients and providers has a significant impact on the outcome of healthcare consultations. If the patient and the professional do not share the same mother tongue an interpreter is usually necessary and the contact is facilitated. In order to reach satisfactory communication the competence and neutrality of the interpreter are crucial. Aims: The overall aim of this project was to study difficulties and possibilities in communication between non-Swedish-speaking patients and Swedish authorities (healthcare providers and social welfare service personnel). Views of refugees (Study I), interpreters (Study II), general practitioners (GPs) (Study III) and nurse radiographers (Study IV) were especially in focus. Material and method: Individual interviews (I) and focus group interviews (II, III, IV) were carried out with refugees, interpreters, general practitioner and nurse radiographers. A qualitative content analysis method was used in Studies I, III and IV and a phenomenographic method was used in Study II. Results: Study I Kurdish war-wounded refugees stressed the value of the interpreters’ competence and the patients’ confidence in the interpreter. Often the interpreters were selected based on the refugees’ citizenship rather than on the mother tongue, leading to a more complex, tri-lingual interpretation situation. Study II Interpreters experienced a number of difficulties, mainly related to complexity in balancing the triad relation (patient-interpreter-provider). The time aspect of the translation procedure and problems of diverse health beliefs and cultural inequalities were also stated. Study III GPs stressed the necessity of involving all the persons in the triad situation to enhance the interchange and facilitate the contact. The interpreter has a key role to balance support between the GP and the patient. Adequate length of time was stressed and consciousness as to how to organize facilities was highlighted. Study IV The need for an interpreter in the radiological examination was strongly associated with the type of examination. For interventional procedures and contrastenhanced examinations a professional interpreter was needed. Shortage of time and lack of specific knowledge about radiological procedures and cultural aspects were other identified factors that obstructed the communication process. Interpreters’ knowledge of terminology and staff training in cultural diversities were suggested in order to improve the quality of radiological examinations.
... A research survey in Australia revealed that 94.1% of nurses identified communication skills as the most important educational area, compared with 93.7% for infection control and 91.4% for first aid (9). Nurses can maintain sustained partnerships with patients when they know how to communicate with them (10,11). Better communication skills increase nurses' job satisfaction and decrease their work-related stress (5). ...
Article
Background: When caring for a family as a unit, it is as crucial to communicate with the family members of a patient as it is with the patient. However, there is a lack of research on the views of nursing students on communicating with the family members of patients, and little has been mentioned in the nursing curriculum on this topic. Aim: The aim of this study was to explore nursing students' experiences of communicating with the family members of patients. Design: A qualitative descriptive study. Methods: A total of 42 nursing students (21 undergraduate year-two students and 21 were master's year-one students) from one school of nursing in Hong Kong participated in in-depth individual interviews. Content analysis was adopted. The trustworthiness of this study was ensured by enhancing its credibility, confirmability, and dependability. Results: Two main themes were discerned. The first, "inspirations gained from nursing student-family communication", included the following sub-themes: (a) responding to enquiries clearly, (b) avoiding sensitive topics, (c) listening to the patient's family, and (d) sharing one's own experiences. The second, "emotions aroused from nursing student-family communication", had the following sub-themes: (a) happiness, (b) anger, (c) sadness, and (d) anxiety. Conclusions: More studies on the perspectives of nursing students on communicating with family members should be conducted, to strengthen the contents and learning outcomes of nursing student-family communication in the existing nursing curriculum.
... As per the Joint Commission's analysis, poor communication among health professionals was one of the top primary causes of these sentinel events (Goeckner et al., 2006;Joint Commission, 2008). In previous literature (Joekes et al., 2007;Markova and Broome, 2007;Kourkouta and Papathanasiou, 2014), effective communication among nurses lead to decreased medical errors, an increased sense of safety and protection, improved levels of patient satisfaction, and greater adherence to treatment plans among patients. Therefore, effective communication is crucial for enhancing positive outcomes for nurses and the patients under their care. ...
Article
Background: Effective communication is important for nurse and patient outcomes. Nursing students often feel unprepared to communicate effectively with patients and other healthcare workers within the clinical environment. Blended learning pedagogy-based communication skills training can provide an alternative to traditional methods of teaching to enhance students' satisfaction and self-efficacy levels in communicating with others. Objectives: To examine the effectiveness of blended learning pedagogy in a redesigned communication module among nursing undergraduates in enhancing their satisfaction levels and attitudes towards learning communication module as well as self-efficacy in communication. Design: A single group pre-test and post-test quasi-experimental design was adopted. Settings and participants: Data were collected from August 2016 to November 2016 from 124 nursing undergraduates from a leading nursing school. Methods: Blended learning pedagogy was adopted to redesign a communication module that offered a wide array of learning opportunities via face-to-face classroom and online sessions. Validated and reliable instruments were used to measure satisfaction levels with blended learning pedagogy, attitudes towards learning communication, and communication self-efficacy. Descriptive and inferential statistics were used to analyze the data. Results: Participants had enhanced satisfaction levels with blended learning pedagogy, better attitudes in learning communication skills, and improved communication self-efficacies at posttest (week 13 of the semester) when compared with their pre-test scores (week one of the semester). Participants scored higher in the Blended Learning Satisfaction Scale, the Communication Skills Attitude Scale, and the communication skills subscale of the Nursing Students Self-Efficacy Scale. Conclusions: Blended learning pedagogy can be effectively used in facilitating communication modules and enhancing student outcomes among nursing undergraduates. The long-term effectiveness of using blended learning pedagogy in facilitating communication modules should be evaluated from students' and patients' perspectives. Additionally, the technology should be constantly improved by incorporating more interactive functions and should be tested to accommodate the learners' needs.
... The importance of communication in any physician-patient relationship cannot be over emphasized. 42,43 Even when the needs and expectations of women cannot be met for systemic reasons that cannot be addressed by the provider, simple communication may help to ease the problem. ...
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Objective: To improve women's childbirth experiences in health facilities, their psychosocial and communication needs have to be met. However, what constitutes these specific needs is poorly understood, particularly in Sub-Saharan Africa. This paper explores women's needs for communication and emotional support during facility-based childbirth. Methods: Qualitative research was conducted in a large referral maternity hospital and its catchment communities in Akure, Nigeria. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted among women of reproductive age, midwives, doctors, and facility administrators. Thematic analysis was used to synthesize findings, and then interpreted within the context of this study and existing quality of care framework. Results: Forty-two IDIs and 10 FGDs are included in this analysis. Participants reported such needs as communication in simple words in local language by healthcare staff, having their husbands as birth companions, spiritual support, and prayers from family members and healthcare providers. Conclusion: To increase, improve, and sustain facility-based childbirth in Nigeria, health systems should appreciate the uniqueness and importance of each woman's needs during childbirth. Practical and sustainable actions should be taken to meet these needs, within the confines of the acceptable sociocultural norms.
... The capacity for culturally competent and culturally humble communication is an important aptitude for clinicians (e.g., Hadwiger, 1999), not only in working directly with clients, but also in writing client reports, giving and receiving consultations, and presenting to colleagues. Clinical writing skills are an important dimension of the broader skills of cultural competent communication in health care providers, which has positive implications for patient adherence to treatment and long-term health (Markova & Broome, 2007;Taylor & Lurie, 2004). ...
Article
Training professional psychologists in a time of increasingly complex diversity-related issues requires innovative approaches to teaching cultural competency and cultural humility at the doctoral level. However, there is currently little empirical evidence to support effective teaching techniques in cultural competency training. To address this pedagogical need, the authors implemented and tested the utility of a 2-stage, developmental approach to using cultural formulation (CF) assignments. Students in a doctoral-level course on cultural competency were given a CF assignment at the course midpoint and a second assignment at the end of the academic term. Students were given extensive feedback after CF1, with the goal of providing direction for improvement of their cultural considerations in CF2. Using a thematic content analysis approach, each set of CF assignments were coded into themes demonstrating core competencies for cultural competence and cultural humility, and tallied to assess improvement in levels of competency across the 2 assignments. Results demonstrated several emergent themes: perspective taking, acknowledging intersections of identity, cultural self-awareness, scientific mindedness, and unsupported cultural statements. Related tallies reflect an overall improvement between the 2 assignments. This article therefore provides support for the use of 2-stage CF assignments as a tool for developing and measuring dimensions of cultural competence and cultural humility. Limitations and implications of the findings for clinical training are discussed.
... In order to enhance the quality of patient care and patient satisfaction, firstly the communication skills between the nurse and the personnel need to be improved (11,12). When the related literature was examined, it was observed that nurses had problems both with patients and physicians from time to time due to insufficient communication (13)(14)(15). It is stated that patients and their relatives feel emotionally better with the effectively established communication; on the other hand, when insufficient communication is established, those receiving care experience uncertainty and dissatisfaction and they feel anxious (16). ...
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Aim: This descriptive and cross-sectional research aims to determine effective speech skills of pediatric nurses and their affecting factors. Materials and Methods: The study population consisted of 124 nurses working in pediatric clinics of one university hospital, two state hospitals and two private hospitals located in the Province of Erzurum, Turkey. The research data were obtained using a “Demographic Information Form” and an “Effective Speech scale (ESS)”. In the analysis of the data, percentile distributions, averages, t-test, One-Way variance analysis, Kruskal-Wallis variance analysis and Cronbach’s alpha coefficient were used. Ethical principles were adhered to when conducting the study. Results: In the study, it was found that the vast majority of nurses did not receive training to improve effective speaking skills (76.6%). It was determined that the mean ESS score was 98.40±11.08, and that the average score of the nurses who received training on effective speech skills was higher (p
... Typically, gaining awareness of culture commences with awareness of one's own cultural beliefs and identifying potential biases and prejudice through self-reflection and self-critique (Rao et al., 2018). This combined with knowledge of different cultural attitudes, lifestyles and practices should enable health care providers to take account of individual preferences, positively impacting communication and decision-making (Markova and Broome, 2007). However, the complex dynamics arising from racial and ethnic differences, the educational status and language barriers create a challenging environment in which health care providers are required to operate (Rao et al., 2018). ...
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Purpose: The aim of this study was to understand how cancer survivors and nurses define and experience cultural care and to make recommendations toward improvements in nursing practice. Methods: The study used a descriptive qualitative design. Data were collected from 29 cancer survivors and 23 oncology nurses by using in-depth semi-structured interviews. Data were transcribed and themes identified. Results: Three themes emerged from the data; 1) cross-cultural care expectations, 2) reality of cross-cultural care activities, and 3) improving culturally sensitive care. Conclusions: The data reveals that relationship between the nurse and cancer survivor is critical to an awareness of cultural needs but that nurses need help in raising their own awareness and appreciation of the benefits and impact of culturally competent care. It is only through creating self-awareness amongst nurses, in the context of each survivor and their needs and beliefs, will the standards of practice improve delivering the health outcomes that those in their care deserve.
... Every individual has a slightly different culture and culturally determined perspective affecting his or her understanding, expectations and styles of communicating [3]. Thus, every clinical encounter is potentially cross-cultural [4]. Cultural responsiveness within healthcare services has been seen to improve health outcomes, reduce health disparities and contribute to shaping the healthrelated values, beliefs and behaviours of marginalised communities [5][6][7]. ...
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Australia has had over five decades of permanent immigrant settlement programmes, and faces the challenge of negotiating approaches to health service delivery that meet the needs of a diverse population. This paper reports the findings of a major review of one Australian state health system's cultural and linguistic diversity, cultural competence requirements, minimum standards and benchmarks. Drawing on the framework of the Australian Charterof Healthcare Rights, the review examined culture, cultural diversity and cultural competence in healthcare services for culturally and linguistically diverse (CALD) communities. Multiple sources of information were used, namely relevant literature, consultations with health service agencies, organisations working with CALD communities, and focus groups with consumer advisory bodies within health services. The findings identified the strategies adopted by healthcare services in delivering healthcare to CALD clients, and the barriers to accessing care and treatment. Cultural competence was not well defined, and caused confusion. The paper concludes by recommending a cultural responsiveness framework which can be more easily adapted by healthcare systems and staff.
Having an infant admitted to the neonatal intensive care unit (NICU) can be a frightening experience for parents. However, it can be even more frightening for them when they are from a different culture and speak a different language than the health care team. Hence, a nurse needs to be culturally competent in order to provide proper care to a multicultural society. The purpose of this article is to describe how NICU nurses can communicate with one such culture, the Chinese American, the largest Asian group in the United States. A transcultural nursing model will be described to use as a guide to help the nurse. The culture, Chinese Americans, will be described to help nurses provide culturally competent care. Research studies will be presented so the reader can develop an understanding of how parents of Chinese descent perceive the care they receive. Interventions and recommendations will be presented on how to enhance communication between the nurses and this cultural group.
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Effective communication is critical to providing quality health care and can be affected by a number of modifiable organizational factors. The authors performed a prospective multisite validation study of an organizational communication climate assessment tool in 13 geographically and ethnically diverse health care organizations. Communication climate was measured across 9 discrete domains. Patient and staff surveys with matched items in each domain were developed using a national consensus process, which then underwent psychometric field testing and assessment of domain coherence. The authors found meaningful within-site and between-site performance score variability in all domains. In multivariable models, most communication domains were significant predictors of patient-reported quality of care and trust. The authors conclude that these assessment tools provide a valid empirical assessment of organizational communication climate in 9 domains. Assessment results may be useful to track organizational performance, to benchmark, and to inform tailored quality improvement interventions.
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Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respectfully deliver health care to the increasingly diverse populations of the United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.