Birmingham City University, Birmingham, UK.
J Adv Nurs. 2024 Jan;80(1):161-175. doi: 10.1111/jan.15780. Epub 2023 Jul 10.
To explore nurses' experiences of providing support to South Asian (SA) people with dementia and their family carers and to identify barriers and enablers of good transcultural care.
A qualitative, phenomenological design was used.
Fifteen registered community and in-patient nurses were recruited via one NHS Mental Health Foundation Trust. Nurses were from diverse backgrounds (Black, Ghanaian, Irish, Mauritian and White), 13 females and 2 males, and had been qualified from between 2 and 49 years. One-to-one semi-structured interviews were conducted between July and October 2019.
A thematic analysis identified three themes. 'Communication challenges' highlighted the impact of language barriers and the consequences of misunderstandings due to a dissonance in cultural values between nurses and interpreters. 'The bi-directional impact of culture' identified the two-way dynamics of transcultural work, the process of countering mutual stigma, and revealed an original perspective on how 'cultural desire' grows through practice experiences rather than being a prior motivation for learning. 'Learning experiences' showed that most learning was informal, experiential and prolonged, with nurses feeling they had unmet learning needs.
Nurses have minimal training opportunities and are under-supported in their transcultural work, potentially perpetuating the disadvantages that SA people with dementia and their families face in relation to healthcare. Enhanced cultural understanding of self and others and application of specific communication strategies could support nurses, together with interpreters, to build rapport and effective working relationships with each other and service users.
Transcultural nursing is a key competency, but nurses experience difficulties with providing care which is recognized as effective by SA family carers. The development of more acceptable and effective services requires improved mutual cultural understanding between nurses, interpreters and families, underpinned by joint brief training interventions, leading to more effective professional communication, better care outcomes and improved satisfaction with services.
探索护士为南亚(SA)痴呆患者及其家庭照顾者提供支持的经验,确定跨文化护理的障碍和促进因素。
采用定性、现象学设计。
通过一个 NHS 心理健康基金会信托基金,招募了 15 名注册社区和住院护士。护士来自不同背景(黑人、加纳人、爱尔兰人、毛里求斯人、白人),其中 13 名女性,2 名男性,从 2 年到 49 年不等。2019 年 7 月至 10 月期间,对 15 名护士进行了一对一的半结构化访谈。
主题分析确定了三个主题。“沟通挑战”突出了语言障碍的影响,以及由于护士和口译员之间的文化价值观不和谐而导致误解的后果。“文化的双向影响”确定了跨文化工作的双向动态,消除相互污名化的过程,并揭示了一个关于“文化欲望”如何通过实践经验而不是学习动机来增长的原始观点。“学习经验”表明,大多数学习是非正式的、经验性的和长期的,护士们感到自己有未满足的学习需求。
护士接受跨文化培训的机会有限,在跨文化工作中支持不足,这可能使南亚痴呆患者及其家属在医疗保健方面面临的劣势持续存在。增强对自我和他人的文化理解,并应用特定的沟通策略,可以支持护士与口译员建立相互信任和有效的工作关系,以及与服务使用者建立关系。
跨文化护理是一项关键能力,但护士在提供被南亚家庭照顾者认为有效的护理方面存在困难。需要提高护士、口译员和家庭之间的相互文化理解,通过联合简短的培训干预措施,为更有效的专业沟通、更好的护理结果和提高对服务的满意度奠定基础,从而开发出更能被接受和有效的服务。