Chae Duckhee, Kim Jinhee, Kim Suhee, Lee Jina, Park Seojin
College of Nursing, Chonnam National University, Gwangju, South Korea.
Department of Nursing, Chosun University, Gwangju, South Korea.
Jpn J Nurs Sci. 2020 Jul;17(3):e12326. doi: 10.1111/jjns.12326. Epub 2020 Feb 6.
This systematic review aimed to identify, appraise, and synthesize the best available evidence for the effectiveness of cultural competence educational interventions on health professional and patient outcomes.
We conducted a systematic review of randomized and non-randomized controlled trials. We searched seven electronic databases including MEDLINE, EMBASE, Cochrane Library, and four Korean databases in June 2018. Studies that provided cultural competence educational interventions for health professionals and measured the impact on health professional outcomes, patient outcomes, or both were included. A narrative synthesis of study findings was performed.
Eleven studies met the inclusion criteria. Studies used a randomized (n = 5) and a non-randomized controlled trial (n = 6) design and were conducted in the USA (n = 7), South Korea (n = 3), and Sweden (n = 1). Cultural competence education was provided mostly to those of single occupations, nurses (n = 5) or physicians (n = 4). The delivery mode was classroom (n = 7), online (n = 3), or blended learning (n = 1), using mainly lectures, discussions, and case studies as teaching and learning methods. Education duration ranged from less than 1 hr to 3 days. Nine studies reported significantly improved health professional outcomes compared to the control group. Patient outcomes were reported in three studies. Only one study reported significant effect on patient satisfaction (d = 0.94) and trust (d = 0.71). There was no significant effect on patient physiological outcomes.
Cultural competence educational interventions had a positive effect on health professional outcomes. There is a considerable lack of research assessing patient outcomes, and there is limited evidence on whether interventions can change patient outcomes.
本系统评价旨在识别、评估和综合现有最佳证据，以探讨文化能力教育干预对卫生专业人员和患者结局的有效性。
我们对随机和非随机对照试验进行了系统评价。2018年6月，我们检索了7个电子数据库，包括MEDLINE、EMBASE、Cochrane图书馆以及4个韩国数据库。纳入为卫生专业人员提供文化能力教育干预并测量对卫生专业人员结局、患者结局或两者影响的研究。对研究结果进行了叙述性综合分析。
11项研究符合纳入标准。研究采用随机（n = 5）和非随机对照试验（n = 6）设计，在美国（n = 7）、韩国（n = 3）和瑞典（n = 1）开展。文化能力教育主要针对单一职业的人员，护士（n = 5）或医生（n = 4）。授课方式为课堂教学（n = 7）、在线教学（n = 3）或混合式学习（n = 1），主要教学方法为讲座、讨论和案例研究。教育时长从不到1小时到3天不等。9项研究报告称，与对照组相比，卫生专业人员结局有显著改善。3项研究报告了患者结局。只有1项研究报告对患者满意度（d = 0.94）和信任度（d = 0.71）有显著影响。对患者生理结局无显著影响。
文化能力教育干预对卫生专业人员结局有积极影响。评估患者结局的研究相当缺乏，关于干预措施是否能改变患者结局也证据有限。
