1Department of Nursing, Masan University, Changwon, Korea.
2College of Nursing, Moi-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.
© 2016 Korean Academy of Community Health Nursing
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hypothesis 1. The public health nurses in the experimental group receiving the cultural competence training program will have a higher TSE score than the control group.
Hypothesis 2. The culturally diverse clients receiving nursing care by public health nurses in the experimental group will have a higher client-nurse trust score than the control group.
Hypothesis 3. The culturally diverse clients receiving nursing care by public health nurses in the experimental group will have a higher nursing satisfaction score.
AO=advance organizers; AR=anticipated regret; D=discussion; GP=guided practice; I=individualization; IES=improving emotional states; PCR=provide contingent rewards; RE=repeated exposure; SOB=self-monitor of behavior; SP=shifting perspective; SRI=scenario-based risk information; TE=theoretical method; VP=verbal persuasion.
This manuscript is a revision of the first author's doctoral dissertation from Yonsei University.
This study was supported by the Moi-Im Kim Nursing Research Institute at Yonsei University fund.
Method | Criteria | Title & contents | Teaching method | TE | Time | |
---|---|---|---|---|---|---|
Offline education | Cognitive dimension | Module 1· Concept and importance of cultural competence in nursing science · Reality of multi-cultures in Korea · Cultural factors which have an influence on nursing care and healthcare · Key concepts pertaining to the concept of cultural competence · Culturally competent care & health outcome |
· Lecture (PPT) · Group performing mind map regarding cultural competence |
· VP · D |
50 min | |
Cognitive dimension | Module 2· Cultural issues & change of multicultural policy and healthcare policy in community nursing practice · Reality of foreign population in communities · Problems occurring in Korea's culturally diverse community · Multicultural policy · Actual condition of healthcare for culturally diverse clients |
· Lecture (PPT) · Group discussion: Role and responsibilities of public health nurses in culturally diverse community· |
· VP · D |
50 min | ||
Cognitive dimension | Module 3· Culture and nursing care: Impact of clients' cultural factors in nursing care · Cultural perspectives regarding belief and behavior in health care · Cultural perspectives regarding pregnancy and childbirth · Cultural perspectives regarding family structure, role & decision-making · Cultural perspectives regarding religion and death · Cultural differences in healthcare regarding religion |
· Lecture (PPT) · Role play & group discussion: Qualitative study stories regarding pregnancy and childbirth of marriage -migrants women· |
· VP · D |
90 min | ||
Affective dimension | Module 4· Recognizing and accepting ones' own culture and others· · Culturally competent attitude · Cultural diversity · Identity of race and nation · My prejudice/bias/discrimination/racism · Problems of cognition of time-space distancing |
· Lecture (PPT) · Self-reflection questionnaires · Watching video & discussion: 'Two faces of man' |
· VP · AR |
60 min | ||
Practical dimension | Module 5· Effective communication with culturally diverse clients · Communication and cultures · Korean culture and characteristics of their communication · Elements of verbal and non-verbal intercultural communication: Case study 1· Infant immunization at public health center · CLAS (Culturally and Linguistically Appropriate Services) · Strategies for communication with culturally diverse clients · Methods of and cautions for communication aided by interpreter: Case study 2· The son's translation to perform consent for surgery |
· Watching movie & discussion: 'Never ending peace and love' directed by Park, Chan-wook · Lecture (PPT) · Case study & discussion |
· VP · SRI · SP |
100 min | ||
Practical dimension | Module 6· Cultural assessment skills for culturally diverse clients · Cultural perspectives and cultural assessment for history taking and physical assessment · Giger and Davidhizar's cultural assessment tool · Nurses' attitude in cultural assessment |
· Lecture (PPT) · Demonstration & practice: Cultural assessment on pregnant women (role play) |
· VP · GP |
50 min | ||
Online education: E-mail newsletter | Affective dimension | · Vol· 1 | · Documentary film, EBS–Socⓔity Hijab · What is culture? (Book: We all are a bit strangers) |
· E-mail newsletters | · I · RE |
2 times per week |
· Vol· 2 | · Racial discrimination map (Chosun daily article) · Vietnamese culture |
|||||
· Vol· 3 | · Documentary film, EBS –Socⓔity Skin color · Who is 100% Korean? (Book: We all are a bit strangers) |
|||||
· Vol· 4 | · Racial prejudice against immigrant foreigners is becoming more and more common (YTN's article) · Philippine culture |
|||||
· Vol· 5 | · Documentary film, EBS –Peoplⓔ Stranger · Man who insulted foreigner' was indicted for the first time in Korea (Chosun Daily editorial)· |
|||||
· Vol· 6 | · 'Black people's mind is dark' (YTN's article) · Thai culture |
|||||
Online education: SNS (BAND) | Affective dimension | · Freely posting pictures regarding cultural competence | · SNS (BAND): Posting pictures | · PCR | Anytime | |
Practical dimension | · Useful multilingual expressions (greetings and appreciation) · Strategies of communication with culturally diverse clients · Communication with interpreter · The actual cultural assessment · Cultural assessment on pregnant women |
· SNS (BAND): Memory card | · AO · RE |
Anytime | ||
Cognitive dimension | · Sharing opinions | · SNS (BAND): Reflective writing | · SOB · IES |
Anytime |
Variables | Categories | Exp. (n=21) | Cont. (n=20) | x2 | p |
---|---|---|---|---|---|
n (%) or M±SD | n (%) | ||||
Age (year) | <40 | 8 (38.1) | 12 (60.0) | 1.97 | .161 |
≥40 | 13 (61.9) | 8 (40.0) | |||
42.3±7.68 | 37.5±6.00 | ||||
Education level | Association degree | 15 (71.4) | 14 (70.0) | 0.01 | .920 |
≥Bachelor's degree | 6 (28.6) | 6 (30.0) | |||
Marital status | Not married | 1 (4.8) | 1 (5.0) | >.999† | |
Married | 20 (95.2) | 19 (95.0) | |||
Religion | Yes | 13 (61.9) | 7 (35.0) | 2.97 | .085 |
No | 8 (38.1) | 13 (65.0) | |||
Career as a public health nurse (year) | <5 | 8 (38.1) | 4 (20.0) | 1.70 | .427 |
5~<7 | 8 (38.1) | 9 (45.0) | |||
≥7 | 5 (23.8) | 7 (35.0) | |||
Type of employment | Permanent | 5 (23.8) | 3 (15.0) | 0.51 | .477 |
Temporal | 16 (76.2) | 17 (85.0) | |||
Staying abroad over one month | Yes | 1 (4.8) | - | >.999† | |
No | 20 (95.2) | 20 (100.0) | |||
Foreign language ability | Yes | 5 (23.8) | 7 (35.0) | 0.62 | .431 |
No | 16 (76.2) | 13 (65.0) | |||
Participation in education regarding culturally diverse client care | Yes | 7 (33.3) | 7 (35.0) | 0.01 | .910 |
No | 14 (66.7) | 13 (65.0) | |||
Frequency of providing nursing care to culturally diverse clients (times/yr) | ≥10 | 8 (38.1) | 5 (25.0) | 0.81 | .368 |
<10 | 13 (61.9) | 15 (75.0) |
Variables | Time | Exp. (n=21) | Cont. (n=20) | F | p | |
---|---|---|---|---|---|---|
M±SD | M±SD | |||||
Transcultural self-efficacy | Pretest | 5.79±1.50 | 6.00±1.09 | Group | 2.63 | .113 |
Posttest 1 | 6.62±1.20 | 5.99±0.88 | Time | 15.91 | <.001 | |
Posttest 2 | 7.59±1.48 | 6.67±0.92 | Group×Time | 3.54 | .034 | |
Cognitive dimension | Pretest | 6.59±1.45 | 6.28±1.15 | Group | 3.70 | .062 |
Posttest 1 | 6.80±1.29 | 6.36±0.85 | Time | 11.64 | <.001 | |
Posttest 2 | 7.83±1.36 | 7.07±0.85 | Group×Time | 0.52 | .598 | |
Practical dimension | Pretest | 4.95±1.65 | 5.66±1.06 | Group | 1.43 | .239 |
Posttest 1 | 6.41±1.58 | 5.51±1.21 | Time | 16.32 | <.001 | |
Posttest 2 | 7.27±1.49 | 6.31±1.38 | Group×Time | 6.57 | .002 | |
Affective dimension | Pretest | 5.90±1.79 | 6.09±1.33 | Group | 1.82 | .185 |
Posttest 1 | 6.68±1.44 | 6.16±1.03 | Time | 10.50 | <.001 | |
Posttest 2 | 7.69±1.78 | 6.30±1.05 | Group×Time | 2.76 | .070 |
Variables | Time | Exp. (n=20) | Cont. (n=20) | Z or F | p | |
---|---|---|---|---|---|---|
M±SD | M±SD | |||||
Client-nurse trust | Pretest | 3.85±0.42 | 4.01±0.46 | −2.42 | .018 | |
Posttest | 4.11±0.53 | 3.94±0.44 | ||||
Satisfaction with nursing care | Pretest | 3.69±0.66 | 3.98±0.83 | Group | 0.01 | .910 |
Posttest | 4.09±0.50 | 3.76±0.35 | Time | 0.86 | .358 | |
Group×Time | 9.22 | .004 |
AO=advance organizers; AR=anticipated regret; D=discussion; GP=guided practice; I=individualization; IES=improving emotional states; PCR=provide contingent rewards; RE=repeated exposure; SOB=self-monitor of behavior; SP=shifting perspective; SRI=scenario-based risk information; TE=theoretical method; VP=verbal persuasion.
Exp.=experimental group; Cont.=control group; †Fisher's exact test.
Exp.=experimental group; Cont.=control group.
Exp.=experimental group; Cont.=control group.