Department of Nursing and Midwifery, Health Science Building, University of Limerick, Limerick, Ireland.
School of Health and Social Sciences, Middlesex University, London, UK.
J Clin Nurs. 2018 Jan;27(1-2):e259-e268. doi: 10.1111/jocn.13926. Epub 2017 Aug 3.
To explore the experiences of both student and qualified nurses of caring for patients from diverse cultural, ethnic and linguistic backgrounds, in one region of Ireland. Hearing the stories, experiences and attitudes of nurses has the potential to influence future clinical practice and has implication for nurses, nurse educators and nurse managers and leaders.
There is a wealth of international literature highlighting the importance of providing culturally sensitive care. However, global reports of culturally insensitive care continue. There is a paucity of in-depth research exploring the actual concerns and challenges nurses experience when caring for patients from diverse cultural and ethnic backgrounds, as well as what influences their actions and omissions of care in practice.
A qualitative exploratory descriptive design adopting the principles of a classic grounded theory approach was used.
Focus groups (n - 10) and individual face-to-face interviews (n - 30) were conducted with student and qualified nurses studying and working in one region of Ireland. As data were collected, it was simultaneously analysed using the classic grounded theory methodological principles of coding, constant comparison and theoretical sampling.
Uncertainty was the consistent main concern that emerged. Feelings of ambiguity of how to act were further influenced by a lack of knowledge, an awareness of ethnocentric beliefs and the culture of the organisation in which participants learn and work in. Instead of finding answers to uncertainties, participants demonstrated a lack of commitment to meeting patients' needs in a culturally appropriate way.
This study adds new perspectives to our understanding of enablers and barriers to culturally sensitive care. It explains the poignant effect of uncertainty and describes how nurses were unable (or unwilling) to find answers when in doubt. It raises questions that remain unanswered in the existing literature, as to why nurses feel it is acceptable to choose to do nothing about their lack of cultural knowledge and the uncertainties which follow.
Identifying the nature and implications of the uncertainty experienced when providing care for patients from diverse cultural and ethnic backgrounds is an important contributing factor to improving cultural sensitivity and quality care.
探索在爱尔兰一个地区，学生护士和合格护士照顾来自不同文化、种族和语言背景的患者的经验。倾听护士的故事、经验和态度有可能影响未来的临床实践，并对护士、护士教育者和护士管理者和领导者产生影响。
有大量国际文献强调提供文化敏感护理的重要性。然而，全球仍有报道称存在文化不敏感的护理。缺乏深入研究，探讨护士在照顾来自不同文化和种族背景的患者时所面临的实际问题和挑战，以及哪些因素影响他们在实践中的护理行为和疏忽。
采用经典扎根理论方法的定性探索性描述设计。
对在爱尔兰一个地区学习和工作的学生和合格护士进行了焦点小组（n=10）和个人面对面访谈（n=30）。随着数据的收集，同时使用经典扎根理论方法的编码、不断比较和理论抽样原则进行分析。
出现的一致主要关注点是不确定性。对如何行动的模糊感进一步受到缺乏知识、意识到种族中心主义信念以及参与者学习和工作的组织文化的影响。参与者没有找到不确定性的答案，而是表现出缺乏承诺，无法以文化上适当的方式满足患者的需求。
本研究为我们理解文化敏感护理的促进因素和障碍提供了新的视角。它解释了不确定性的明显影响，并描述了护士在有疑问时如何无法（或不愿意）找到答案。它提出了一些问题，这些问题在现有文献中仍未得到解答，即为什么护士认为对自己缺乏文化知识和随之而来的不确定性选择无所作为是可以接受的。
确定在为来自不同文化和种族背景的患者提供护理时所经历的不确定性的性质和影响，是提高文化敏感性和护理质量的一个重要因素。
