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重新思考老年人护理中文化能力的概念。

Re-thinking the Concept of Cultural Competency in Nursing Care of Older Adults.

作者信息

Mohamed Amany Farag Hassan, Modanloo Shokoufeh

机构信息

Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada.

出版信息

Can J Nurs Res. 2025 Mar;57(1):140-146. doi: 10.1177/08445621241272673. Epub 2024 Aug 11.

Abstract

The influx of migrants to Canada has resulted in a shift in the country's demographic landscape. Individuals often interpret and approach health and wellness through the lens of their cultural heritage, which has led to stereotyping behaviors and discriminatory practices, exacerbating the notion of "Othering". Immigrant older adults are likely to experience discrimination in a more dreadful way in the form of societal isolation and marginalization due to the collective systems of power such as ageism, ableism, and racism. This paper results from continuous thought-provoking discussions initiated by the first author (AM) in her doctoral program at the University of Western Ontario for the Philosophy of Nursing Science course, taught and facilitated by the second author (SM). After studying the course materials on "revolutionary science" and reflection on the process of paradigm shift introduced by Thomas Khun and engaging in critical discussions on a range of relevant philosophical concepts such as bio-power, othering, silencing and ignorance, marginalization, oppression, neoliberalism, health equity, and social justice, we have been prompted to rethink the concept of cultural competence in nursing education and healthcare practices, particularly in the context of nursing care of older adults. Therefore, in this paper, we will critique the concept of cultural competency in the context of an anti-racist and anti-oppressive lens and suggest a pivotal response to move towards an inquiry-driven approach based on cultural humility and respect in the nursing care of older adults.

摘要

移民涌入加拿大导致了该国人口结构的变化。人们常常通过其文化传统的视角来理解和对待健康与福祉,这导致了刻板行为和歧视性做法,加剧了“他者化”的观念。由于年龄歧视、能力歧视和种族主义等集体权力体系,移民老年人可能会以社会孤立和边缘化这种更可怕的形式遭受歧视。本文源于第一作者(AM)在西安大略大学攻读博士学位期间,在第二作者(SM)教授并主持的护理科学哲学课程中引发的一系列发人深省的讨论。在学习了关于“革命科学”的课程材料,反思了托马斯·库恩提出的范式转变过程,并就生物权力、他者化、沉默与无知、边缘化、压迫、新自由主义、健康公平和社会正义等一系列相关哲学概念进行批判性讨论之后,我们开始重新思考护理教育和医疗实践中的文化能力概念,尤其是在老年人护理的背景下。因此,在本文中,我们将从反种族主义和反压迫的视角批判文化能力的概念,并提出一个关键回应,即在老年人护理中朝着基于文化谦逊和尊重的探究驱动方法迈进。

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