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Cultural Awareness in Health and Social Care Research (Lumby & Foskett…
Cultural Awareness in Health and Social Care Research
Instructions
How do assumptions of cultural awareness influence ethical aspects of my research?
Issues of concern during your research process requiring understanding of cultural awareness with regards to recruitment and sampling of participants, data collection and data analysis.
Critically discuss significance and principles of cultural awareness in the research process.
The text covers aspects of cultural awareness from the perspectives of ethics, sampling and recruitment, data collection and analysis.
The text critically discuss the research concerning strength and weaknesses in relation to aspects of cultural awareness.
Ethical aspects
Influences of assumptions
The fact that members are often unconscious of the nature of the assumptions in no way detracts from the power of culture to shape human activity
It is part of a long tradition which has viewed culture as a tool to discern patterns in human behaviour such as is necessary in order to make meaning.
Research process
Recruitment
Sample of participants
Data collection
Data analysis
Cultural Awareness
Strength
Regarding internationalization. Enhancement of cultural understanding across and between societies by deepen and broaden understandings of different cultures
Lumby & Foskett, 2016
Weaknessess
Merely raising individuals’ conscious awareness of cultural diversity does not ensure cultural competence occurs
Rew et al, 2003
Regarding internationalization and five myths about it. The presence of the ‘sign’ may be no more than a formal process in operation, and may not necessarily have led to significant evidence of cultural change throughout the organization
Lumby & Foskett, 2016
Gaps between the rhetoric and reality of cultural change
Foskett, 2010
More self-awareness is needed, for example challenging such ubiquitous, simplistic and apolitical metaphors for action, such as diversity as melting pot or as salad bowl, which fade out important cultural and power relativities between different groups
Lumby & Foskett, 2016
Significance and Principles
Ensure that all people receive equitable, effective health care, particularly those from culturally and linguistically diverse (CALD) backgrounds
Horvat et al, 2014
Cultural competence continues to be developed as a major strategy to address health inequities
Horvat et al, 2014
To meet the health care needs of a multicultural population, the nursing discipline must educate individuals from diverse cultural and ethnic backgrounds
Rew et al, 2003
Cultural competence has been identified as a critical component of nursing research
Rew et al, 2003
Diversity is a neutral term indicating a range of distinguishing features among a number of phenomena
Lumby & Foskett, 2016
Horvat et al, 2014
Knowledge, skills and attitudes of health professionals in delivering culturally competent care; and healthcare organisation performance in culturally competent care
Recommendation to use non-comparative research design
Awad et al, 2016
Only RCTs were included
Comparative design regarding descriptions of participants
“Racial” differences
“Caucasian” and “non-Causcasian” patients
Described as Latino, African American, Asian and others
non-Western patients and Western doctors
Described mainly as Turkish,Moroccan, Cape Verdean and Surinamese patients
“Black” patients
“Black” women
Patient-reported outcomes
Treatment outcomes
Health behavoiurs
Involvement in care
Evaluation of care
The quality of the evidence was low and more data are needed
Rew et al, 2003
Cultural Awareness Scale
Cultural awareness, sensitivity
Competence in nursing
Categories
Cognitive awareness
Research issues
Behaviors/comfort with interactions
Patient care/clinical issues
General educational experience
Due to anticipation of an increasingly more diverse population in the next century, issues related to cultural diversity have become more central to nursing education
The American Association of Colleges of Nursing (AACN) 1997
The Pathways Model
“Diversity of roads traveled by students entering the learning environment…”
“A learning landscape that contains a wide variety of signs, maps, tour guides, and other resources…”
“Unique self-built pathways leading the student into the world of professional nursing practice.”
Limitations
Relatively small sample
Not so diverse sample
Definitions
The concept of cultural competence
“a complex integration of knowledge, attitudes, and skills that enhances cross-cultural communication and appropriate effective interactions with others”
The American Academy of Nursing (Rew et al, 2003)
Ambiguity of terms
Cultural sensitivity
Multicultural awareness
Cultural competence
Cultural competence
Cultural awareness
Affective dimension
Cultural sensitivity
Attitudinal dimension
Cultural knowledge
Cognitve dimension
Cultural skills
Behavioral dimension
Each of these components of cultural competence should be addressed in research
Rew et al, 2003
Culture is seen as the patterns of values, beliefs, behaviour and symbolic artefacts, which together characterize one group as distinctive from another and underpin the usually unspoken assumptions that guide thought and action within an organization
Lumby & Foskett, 2016
Lumby & Foskett, 2016
Generic definition of internationalization
‘The integration of an international or intercultural
dimension into the tripartite mission of teaching, research and service functions’.
Internationalization has been impelled by four rationales, political, academic,
economic and cultural/social
A respond to the changing demands of the external cultural context of an institution (society)
A process of internal cultural change
Two distinctive key drivers
A philosophical dimension
The value it adds to the educational experience of both ‘home’ and ‘international’ students, and the contribution it makes to addressing global needs and global issues.
An economic and market dimension
A business opportunity, a potential income
stream and a way of expanding an educational institution’s and a nation’s operations.
Increase both student numbers and research funding
5 myths of internationalization
foreign students indicate an internationalized university;
international reputation is a proxy for quality
international institutional agreements indicate internationalization
international accreditations indicate internationalization
global branding is a sign of internationalization
The growth of internationalization reflects the high value ascribed to ‘being international’
Internationalization, therefore, clearly, has high cultural value and is regarded as a key element of the cultural capital of a university
Becoming internationalized
Melting pot
To join a club of like-minded members, and become an insider of that group
Salad bowl
To ensure diversity and differences by engaging with others with clear differences, operating in different contexts, and with different challenges in a respectful way
Research has always been based on the exchange of knowledge
across boundaries
Awad et al, 2016
By 2043 people from non-White
groups will constitute the majority in the United States
The tipping point for youth is much earlier at 2026, and Whites are already the numerical minority in the pre- school population
Instrument development
Cross-cultural adaption of instruments