School of Philosophy, Anthropology and Social Inquiry, University of Melbourne, Melbourne, Australia.
Int J Qual Health Care. 2011 Jun;23(3):247-57. doi: 10.1093/intqhc/mzr008. Epub 2011 Apr 4.
Culturally inappropriate health services contribute to persistent health inequalities. This article reviews approaches to indigenous cultural training for health workers and assesses how effectively they have been translated into training programmes within Australia.
CINAHL PLUS, MEDLINE, Wiley InterScience, ATSIHealth and ProQuest.
The review focuses on the conceptual and empirical literature on indigenous cultural training for health workers within selected settler-colonial countries, together with published evaluations of such training programmes in Australia. Data extraction Information on conceptual models underpinning training was extracted descriptively. Details of authors, year, area of investigation, participant group, evaluation method and relevant findings were extracted from published evaluations.
Six models relevant to cultural training were located and organized into a conceptual schema ('cultural competence, transcultural care, cultural safety, cultural awareness, cultural security and cultural respect'). Indigenous cultural training in Australia is most commonly based on a 'cultural awareness' model. Nine published evaluations of Australian indigenous cultural training programmes for health workers were located. Of the three studies that assessed change at multiple points in time, two found positive changes. However, the only study to include a control group found no effect.
This review shows that the evidence for the effectiveness of indigenous cultural training programmes in Australia is poor. Critiques of cultural training from indigenous and non-indigenous scholars suggest that a 'cultural safety' model may offer the most potential to improve the effectiveness of health services for indigenous Australians.
文化不适宜的卫生服务是导致持续存在健康不平等的原因之一。本文综述了针对卫生工作者的土著文化培训方法，并评估了这些方法在澳大利亚培训计划中的实施效果。
CINAHL PLUS、MEDLINE、Wiley InterScience、ATSIHealth 和 ProQuest。
本综述重点关注选定的定居者殖民国家中针对卫生工作者的土著文化培训的概念和实证文献，以及澳大利亚此类培训计划的已发表评估。
对培训所依据的概念模型的信息进行了描述性提取。从已发表的评估中提取了作者、年份、调查领域、参与者群体、评估方法和相关发现的详细信息。
找到了六个与文化培训相关的模型，并将其组织到一个概念框架中（“文化能力、跨文化护理、文化安全、文化意识、文化保障和文化尊重”）。澳大利亚的土著文化培训通常基于“文化意识”模型。共找到九项针对澳大利亚卫生工作者土著文化培训计划的已发表评估。在三个在多个时间点评估变化的研究中，有两项研究发现了积极的变化。然而，唯一一项纳入对照组的研究未发现效果。
本综述表明，澳大利亚土著文化培训计划的有效性证据不足。土著和非土著学者对文化培训的批评表明，“文化安全”模型可能最有潜力提高澳大利亚土著居民获得卫生服务的效果。
