Cultural Diversity

文化多样性
  • 文章类型: Journal Article
    辅助死亡,也通常被称为安乐死和医生协助自杀,在许多国家都是合法的。由于社会对良好死亡的理解和对选择的渴望不断发展,对辅助死亡的兴趣正在增长。伦理法律观点是众所周知的,但是随着社会变得更加异质,对不同种族的人的观点有更多的了解,民族,和文化背景是必要的。
    为了探索来自不同种族的人的观点,关于辅助死亡的种族和文化背景。
    带叙事综合的范围审查。该协议已在开放科学框架中注册。
    Medline,CINAHL完成,从成立之初到2023年5月,搜索了PsycINFO和ProQuest论文和论文Global。根据纳入和排除标准独立评估引文。
    在纳入的17项研究中,根据宗教提出了辅助死亡的观点,宗教信仰,灵性,种族,种族和祖先。视角多样,呈现更多的光谱,具有多个交叉点和互连。根据文化属性,对辅助死亡的支持和/或反对是不同的,但是即使在那些具有相似文化属性的人中,根据生活经历和苦难观念的不同,视角也不同。
    关于辅助死亡的观点是动态的和不断发展的。即使在辅助死亡合法化的地方,个人的文化属性有助于将辅助死亡作为临终选择的独特视角。因此,了解一个人的文化,信仰,疾病的期望和选择,治疗目标和护理是根本的,超出了可能已经被认为是临床医生-患者护理关系和常规提前护理计划的一部分。
    UNASSIGNED: Assisted dying, also commonly known as euthanasia and physician-assisted suicide, is legal in many countries. Interest in assisted dying is growing due to evolving societal understandings of a good death and a desire for choice. Ethico-legal perspectives are well-known, but as societies become more heterogenous, a greater understanding of the perspectives of people from diverse racial, ethnic, and cultural backgrounds is needed.
    UNASSIGNED: To explore perspectives of people from diverse racial, ethnic and cultural backgrounds about assisted dying.
    UNASSIGNED: Scoping review with narrative synthesis. The protocol was registered with Open Science Framework.
    UNASSIGNED: Medline, CINAHL Complete, PsycINFO and ProQuest Dissertations & Theses Global were searched from inception to May 2023. Citations were independently assessed against inclusion and exclusion criteria.
    UNASSIGNED: Of the 17 included studies, perspectives of assisted dying were presented according to religion, religiosity, spirituality, race, ethnicity and ancestry. Perspectives were diverse, presenting more as a spectrum, with multiple intersections and interconnections. Support and/or opposition for assisted dying differed according to cultural attributes, but even amongst those with similar cultural attributes, perspectives differed according to life experiences and notions of suffering.
    UNASSIGNED: Perspectives on assisted dying are dynamic and evolving. Even where assisted dying is legalised, individual\'s cultural attributes contribute to unique perspectives of assisted dying as an end-of-life option. Thus, understanding a person\'s culture, beliefs, expectations and choices in illness, treatment goals and care is fundamental, extending beyond what may be already considered as part of clinician-patient care relationships and routine advance care planning.
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  • 文章类型: Journal Article
    目的:本综述综合了在随机对照试验中招募和留住种族多样性参与者的方法的证据,并报告和分析了与种族多样性相关的变量。
    方法:雨伞综述。
    方法:OvidMEDLINE,OvidEmbase,CINAHL,PsycINFO和Cochrane和Campbell图书馆在2010年1月1日至2024年5月13日之间发表的评论论文。
    方法:英语系统评价侧重于种族变量的纳入和报告。使用AMSTAR2工具评估方法学质量。
    结果:纳入62篇系统综述。研究结果表明,试验中种族多样性的代表性和报告有限。审查通常报告的招聘策略是社区参与,广告,面对面招募,文化定位,临床转诊,社区介绍,使用技术,激励措施和与社区的研究伙伴关系。评论强调的保留策略包括对参与者进行频繁的随访,以检查他们在研究中的表现。提供激励措施,使用量身定制的方法和文化上适当的干预措施。研究结果表明,即使在试验中报告了与试验中种族多样性相关的变量,对分析的关注也有限。
    结论:在增加试验中种族多样性参与者的招募和保留以及在临床试验中与多样性相关的变量的分析和报告方面需要显著改进。
    CRD42022325241。
    OBJECTIVE: This umbrella review synthesises evidence on the methods used to recruit and retain ethnically diverse participants and report and analyse variables related to ethnic diversity in randomised controlled trials.
    METHODS: Umbrella review.
    METHODS: Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO and Cochrane and Campbell Libraries for review papers published between 1 January 2010 and 13 May 2024.
    METHODS: English language systematic reviews focusing on inclusion and reporting of ethnicity variables. Methodological quality was assessed using the AMSTAR 2 tool.
    RESULTS: Sixty-two systematic reviews were included. Findings point to limited representation and reporting of ethnic diversity in trials. Recruitment strategies commonly reported by the reviews were community engagement, advertisement, face-to-face recruitment, cultural targeting, clinical referral, community presentation, use of technology, incentives and research partnership with communities. Retention strategies highlighted by the reviews included frequent follow-ups on participants to check how they are doing in the study, provision of incentives, use of tailored approaches and culturally appropriate interventions. The findings point to a limited focus on the analysis of variables relevant to ethnic diversity in trials even when they are reported in trials.
    CONCLUSIONS: Significant improvements are required in enhancing the recruitment and retention of ethnically diverse participants in trials as well as analysis and reporting of variables relating to diversity in clinical trials.
    UNASSIGNED: CRD42022325241.
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  • 文章类型: Journal Article
    跨文化护理是一门强调对不同人群的文化胜任护理的学科,认识到文化对健康信念的影响,值,实践,和结果。它要求护士尊重文化的差异和相似性,但是在课程设计方面面临挑战,教师发展,和学生评估。本文探讨了跨文化护理教育的现状和未来发展方向,向美国护理学院协会致辞,将文化内容纳入护理课程,回顾马德琳·莱宁格的跨文化护理理论,多样性,股本,和包容性概念,并讨论了跨文化护理教育的主要挑战,包括缺乏学生多样性,培训,和资源。克服这些挑战的策略包括跨专业合作,文化沉浸,和循证实践。本文最后介绍了急诊科护士应如何将其纳入实践。
    Transcultural nursing is a discipline that emphasizes culturally competent care for diverse populations, recognizing the influence of culture on health beliefs, values, practices, and outcomes. It requires nurses to respect cultural differences and similarities, but faces challenges in curriculum design, faculty development, and student assessment. This paper explores transcultural nursing education\'s current state and future directions, addressing the American Association of Colleges of Nursing essentials for integrating cultural content into nursing curricula, reviewing Madeleine Leininger\'s transcultural nursing theory, diversity, equity, and inclusion concepts, and discussing the main challenges of transcultural nursing education, including lack of student diversity, training, and resources. Strategies to overcome these challenges include interprofessional collaboration, cultural immersion, and evidence-based practice. The paper concludes with how emergency department nurses should incorporate this into practice.
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  • 文章类型: Journal Article
    背景:随着全球迁移的增加,护士经理在多元文化护理工作环境中的有效性是至关重要的,因为医疗团队中文化多样性的增加。尽管国际上越来越多地招募合格的护士来解决全球护理短缺的问题,没有研究综合护士管理者属性对多元文化护理团队护士的影响。因此,进行了一项文献综述,旨在综合现有的关于护士经理的人格特质,能力,行为,领导风格会影响多元文化护理团队的护士结局。
    方法:根据JoannaBriggsInstitute指南进行的范围审查,以绘制护士经理人格特征的关系或影响,能力,行为,和领导风格对护士在不同临床环境中的多元文化环境的结果。通过电子数据库进行搜索,如CINAHL和MEDLINE,还有灰色文学。
    结果:本综述包括39项研究,突出29个性格特征,9个能力,115种行为,和5种影响护士结果的领导风格。主要发现强调了护士管理者支持的重要性,文化能力强,和有效的沟通者,变革型领导风格特别有益。
    结论:这些发现为规划和制定培训计划提供了见解,以使当前和未来的护士管理人员具备有效领导多元文化护理环境的技能。
    BACKGROUND: As global migration increases, nurse managers\' effectiveness in multi-cultural nursing work environments is crucial due to the rising cultural diversity within healthcare teams. Despite the increasing international recruitment of qualified nurses to address the worldwide nursing shortage, no studies have synthesised the impact of nurse managers\' attributes on nurses in multi-cultural nursing teams. Therefore, it was conducted a literature review aimed to synthesise the available literature on how nurse managers\' personality traits, competencies, behaviours, and leadership styles influence nurse outcomes in multi-cultural nursing teams.
    METHODS: Scoping review conducted according to the Joanna Briggs Institute guidelines to map the relationship or influence of nurse managers\' personality traits, competencies, behaviours, and leadership styles on the outcomes of nurses in multi-cultural settings across various clinical environments. Searches were conducted across electronic databases such as CINAHL and MEDLINE, along with grey literature.
    RESULTS: This review included 39 studies, highlighting 29 personality traits, 9 competencies, 115 behaviours, and 5 leadership styles that impact nurses\' outcomes. Key findings emphasise the importance of nurse managers being supportive, culturally competent, and effective communicators, with transformational leadership style being particularly beneficial.
    CONCLUSIONS: These findings provide insights for planning and developing training programmes to equip current and future nurse managers with skills to effectively lead in multi-cultural care settings.
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  • 文章类型: Journal Article
    在随机对照试验(RCT)中,历史上代表性不足的人群的代表性不足和虚假陈述可能会影响研究结果的有效性及其在不同人群中的应用。为了评估历史语言的代表性,种族方面,和骨科随机对照试验(RCT)中种族代表性不足的参与者,并评估翻译和文化适应的患者报告结局指标(PROM)的使用。
    PubMed的单独和全面的文献检索,WebofScience,根据2021年期刊引文报告数据库,在2012年至2022年的前五名最高5年影响因素骨科期刊中,使用了Embase数据库来识别RCT。感兴趣的主要结果包括语言报告,试验参与者的种族和民族人口统计学特征以及翻译的PROMs的使用情况使用Jadad标准评估每个临床试验的方法学质量.
    230项RCT符合纳入标准。在搜索已发表的文本和临床试验注册信息时,14%的试验和17%的试验报告了参与者的语言。此外,11%的试验报告了种族和/或族裔,7%的试验报告了翻译的PROM的使用。在六项跨国研究中,没有人报告研究人群的语言,也没有使用翻译的PROM。值得注意的是,4项研究(2%)报告使用文化适应的PROM,平均Jadad评分为3.07。
    参与者语言,种族,在骨科临床试验中很少报道种族,潜在地限制了研究结果的应用和解释。同样,使用的PROM的语言和文化适应通常没有报告,这也限制了对骨科研究结果的有效性和普遍性的解释。研究人员和期刊应促进人口统计数据和PROM适应方法的标准报告,以确保结果可推广到不同的患者人群。
    III.
    UNASSIGNED: Underrepresentation and misrepresentation of historically underrepresented populations in randomized controlled trials (RCTs) may have implications for the validity of research results and their application for diverse populations. To evaluate the representation of historically linguistically, racially, and ethnically underrepresented participants in orthopaedic randomized controlled trials (RCTs) and to assess the use of translated and culturally adapted patient reported outcome measures (PROMs).
    UNASSIGNED: Separate and comprehensive literature searches of PubMed, Web of Science, and Embase databases were performed to identify RCTs utilizing PROMs between the years 2012 - 2022 among the top five highest 5-year impact factor orthopaedic journals according to the 2021 Journal Citation Reports database. The primary outcomes of interest included reporting of linguistic, racial and ethnic demographic characteristics of trial participants and the utilization of translated PROMs. The methodological quality of each clinical trial was assessed using the Jadad Criteria.
    UNASSIGNED: 230 RCTs met inclusion criteria. The language of participants was reported in 14% of trials and in 17% of trials when searching both the published text and clinical trial registration information. In addition, race and/or ethnicity was reported in 11% of trials, and the use of translated PROMs was reported in 7% of trials. Among the six multinational studies, none reported the language of the study population nor the use of translated PROMs. Notably, four studies (2%) reported utilizing culturally adapted PROMs. The average Jadad score was 3.07.
    UNASSIGNED: Participant language, race, and ethnicity are infrequently reported in orthopaedic clinical trials, potentially limiting the application and interpretation of study results. Similarly, the linguistic and cultural adaptation of PROMs utilized are often not reported, which also limits interpretations of the validity and generalizability of orthopedic study results. Researchers and journals should promote standard reporting of demographic data and methods of PROM adaptation to ensure results are generalizable to diverse patient populations.
    UNASSIGNED: III.
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  • 文章类型: Journal Article
    目的:描述临床医生如何在血液透析中心为不同文化的肾衰竭患者提供文化响应性护理。
    背景:接受中心维持性血液透析的文化多样性个体具有独特的文化需求。未满足的文化需求会损害并深刻影响他们的经历。鉴于文化敏感的护理有可能增强文化多样性人群的体验,了解临床医生如何提供符合文化的护理至关重要.
    方法:使用Arksey和OMalleys框架进行范围审查。五个数据库:Medline和CINAHLComplete(EBSCO),PsycINFO,搜索Embase(OVID)和ProQuest论文和论文数据库,以获取1990年至2023年之间以英语发表的研究文献。叙事合成用于合成数据。
    结果:从筛选的17,271条记录中,报告14项研究的17篇论文符合纳入标准。叙事综合揭示了两个主题:(i)交流促进因素和障碍,包括语言差异,专业和外行口译员使用;以及(Ii)文化的重要性,其中包括承认文化优先事项,适应文化饮食偏好和获得文化培训。
    结论:虽然与血液透析相关的竞争优先事项对临床医生来说可能是一个挑战,认识到文化护理需求的重要性并将其纳入护理中很重要。必须通过促进血液透析中肾衰竭患者的独特文化需求来表现出对文化多样性的尊重并提供以人为本的护理。
    结论:文化反应性护理是复杂和多维的。应该承认个人的文化关怀需求,尊敬的,并被照顾。
    没有患者或公众捐款。研究方案在开放科学框架中注册。https://osf.io/uv8g3.
    OBJECTIVE: To describe how clinicians provide culturally responsive care to culturally diverse people with kidney failure in haemodialysis centres.
    BACKGROUND: Culturally diverse individuals receiving in-centre maintenance haemodialysis have unique cultural needs. Unmet cultural needs can impair and profoundly affect their experiences. Given culturally responsive care has the potential to enhance the experiences of culturally diverse people, it is vital to understand how clinicians provide culturally responsive care.
    METHODS: A scoping review was undertaken using Arksey and OMalleys framework. Five databases: Medline and CINAHL Complete (EBSCO), PsycINFO, Embase (OVID) and ProQuest Theses and Dissertation databases were searched for research literature published in English between 1990 and 2023. Narrative synthesis was used to synthesise the data.
    RESULTS: From the 17,271 records screened, 17 papers reporting 14 studies met the inclusion criteria. Narrative synthesis revealed two themes: (i) communication enablers and barriers including linguistic differences, professional and lay interpreter use; and (ii) the importance of culture, which encompassed acknowledging cultural priorities, accommodating cultural food preferences and access to cultural training.
    CONCLUSIONS: While competing priorities associated with haemodialysis may be a challenge for clinicians, recognising the significance of cultural care needs and accommodating them in care is important. Demonstrating respect towards cultural diversity and providing person-centred care by facilitating the unique cultural needs of people with kidney failure in haemodialysis is imperative.
    CONCLUSIONS: Culturally responsive care is complex and multidimensional. Individuals\' cultural care needs should be acknowledged, respected, and accommodated in care.
    UNASSIGNED: No patient or public contribution. The study protocol was registered in the Open Science Framework. https://osf.io/uv8g3.
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  • 文章类型: Journal Article
    背景:全球,文化和语言多样化(CALD)的人口正在增加,预计到2050年将达到4.05亿。由于文化原因,为CALD人群提供紧急护理可能会很复杂,社会,语言因素。文化的程度,社会,目前尚不清楚背景因素对来自CALD背景的患者在整个急诊护理过程中的护理交付的影响。使用系统的方法,这篇综述旨在绘制现有证据,为来自CALD背景的患者提供紧急医疗服务,并使用社会生态框架提供更广泛的文化视角。社会,以及情境对急诊护理服务的影响。
    方法:将使用JoannaBriggsInstitute(JBI)范围审查方法来指导本次审查。人口是来自CALD背景的患者,他们接受了护理,并提供了直接护理的急诊护理临床医生。该概念是从CALD背景向患者提供医疗保健。背景是紧急护理。这项审查将包括定量,定性,和混合方法研究从2012年1月1日起以英文发表。搜索将在CINAHL(EBSCO)的数据库中进行,MEDLINE(Ovid),Embase(Elsevier),Socindex(EBSCO),Scopus(Elsevier),和谷歌学者的网络搜索。PRISMA(系统审查和荟萃分析的首选报告项目)流程图将用于介绍搜索决策过程。所有包含的文章将使用混合方法评估工具(MMAT)进行评估。数据将以表格形式呈现,并附有文献的叙述性综合。
    结论:尽管来自CALD背景的患者越来越多地使用急诊护理服务,在急诊护理背景(ED和院前设置)中,没有对来自CALD背景的患者的医疗保健交付进行全面审查,包括考虑文化,社会,和上下文的影响。此范围审查的结果可用于为未来的研究和策略提供信息,这些研究和策略旨在为需要紧急护理的来自CALD背景的人提供护理服务和经验。
    背景:此范围审查已在OpenScienceFrameworkhttps://doi.org/10.17605/OSF中注册。IO/HTMKQ。
    BACKGROUND: Worldwide, the culturally and linguistically diverse (CALD) population is increasing, and is predicted to reach 405 million by 2050. The delivery of emergency care for the CALD population can be complex due to cultural, social, and language factors. The extent to which cultural, social, and contextual factors influence care delivery to patients from CALD backgrounds throughout their emergency care journey is unclear. Using a systematic approach, this review aims to map the existing evidence regarding emergency healthcare delivery for patients from CALD backgrounds and uses a social ecological framework to provide a broader perspective on cultural, social, and contextual influence on emergency care delivery.
    METHODS: The Joanna Briggs Institute (JBI) scoping review methodology will be used to guide this review. The population is patients from CALD backgrounds who received care and emergency care clinicians who provided direct care. The concept is healthcare delivery to patients from CALD backgrounds. The context is emergency care. This review will include quantitative, qualitative, and mixed-methods studies published in English from January 1, 2012, onwards. Searches will be conducted in the databases of CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), SocINDEX (EBSCO), Scopus (Elsevier), and a web search of Google Scholar. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram will be used to present the search decision process. All included articles will be appraised using the Mixed Methods Appraisal Tool (MMAT). Data will be presented in tabular form and accompanied by a narrative synthesis of the literature.
    CONCLUSIONS: Despite the increased use of emergency care service by patients from CALD backgrounds, there has been no comprehensive review of healthcare delivery to patients from CALD backgrounds in the emergency care context (ED and prehospital settings) that includes consideration of cultural, social, and contextual influences. The results of this scoping review may be used to inform future research and strategies that aim to enhance care delivery and experiences for people from CALD backgrounds who require emergency care.
    BACKGROUND: This scoping review has been registered in the Open Science Framework https://doi.org/10.17605/OSF.IO/HTMKQ.
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  • 文章类型: Journal Article
    背景:多样性,股本,早在COVID-19大流行以及社会对社会不公正和种族主义的同时承认之前,包容性就一直是SAGES的有意关注焦点。我们社会中长期存在的不平等现象,healthcare,在Covid前后引起人们关注的事件之后,外科行业已经曝光。这样做,他们带来了焦点差异,不公正,以及长期以来在外科领域存在的不平等,有选择地影响最脆弱的人。
    方法:本白皮书探讨了外科手术和SAGES(美国胃肠和内窥镜外科医生学会)方法领域的多样性现状,以及为实现有意义的变化铺平道路的努力。我们描述了多样性的必要性,股本,和包容所有人。所有,我们的意思是包容性别和性取向的多样性,种族,种族,地理,性别,和手术领域的残疾。
    结果:SAGES是一个生活在教育和创新交汇处的组织。它在协助外科专业解决这些问题和需求方面发挥着至关重要的作用,并与其他人一起推动持续和必要的变革。SAGES只能通过在组织的各个方面嵌入多样性的承诺来实现这些目标,股本,并融入我们的面料中。
    结论:真正的多样性,股本,纳入外科组织对其寿命至关重要,增长,相关性,和影响。不幸的是,DEI的缺席限制了机会,在集体智慧的存在至关重要的环境中掠夺集体智慧的组织,导致健康不平等,并使社会中的所有人及其对与之接触的所有人的价值变得贫困。SAGES是一个生活在教育和创新的交叉点的组织。它在协助外科专业解决这些问题和需求方面发挥着至关重要的作用,并与其他人一起推动持续和必要的变革。SAGES只能通过在组织的各个方面嵌入多样性的承诺来实现这些目标,股本,并融入我们的面料中。本白皮书中强调的策略,可能在我们的掌握范围内,如果我们将来留在谦卑和可教的地方,我们可以学到更多。
    BACKGROUND: Diversity, equity, and inclusion have been an intentional focus for SAGES well before the COVID-19 pandemic and the coincident societal recognition of social injustices and racism. Longstanding inequities within our society, healthcare, and the surgery profession have come to light in the aftermath of events that rose to attention around the time of Covid. In so doing, they have brought into focus disparities, injustices, and inequalities that have long been present in the field of surgery, selectively affecting the most vulnerable.
    METHODS: This White paper examines the current state of diversity within the field of surgery and SAGES (Society of American Gastrointestinal and Endoscopic Surgeons) approach and effort to pave the way forward to meaningful change. We delineate the imperative for diversity, equity, and inclusion for all. By all, we mean to be inclusive of the diversity of gender and sexual orientation, race, ethnicity, geography, sex, and disability in the field of surgery.
    RESULTS: SAGES is an organization that lives at the intersection of education and innovation. It has a vital role in assisting the surgical profession in addressing these issues and needs and being a force alongside others for sustained and necessary change. SAGES can only realize these goals through a commitment across all aspects of the organization to embed diversity, equity, and inclusion into our very fabric.
    CONCLUSIONS: True diversity, equity, and inclusion within a surgical organization is vital for its longevity, growth, relevance, and impact. Unfortunately, the absence of DEI limits opportunity, robs the organization of collective intelligence in an environment in which its presence is critical, contributes to health inequities, and impoverishes all within the society and its value to all with whom it interfaces. SAGES is an organization that lives at the intersection of education and innovation. It has a vital role in assisting the surgical profession in addressing these issues and needs and being a force alongside others for sustained and necessary change. SAGES can only realize these goals through a commitment across all aspects of the organization to embed diversity, equity, and inclusion into our very fabric. Strategies like those highlighted in this White Paper, may be within our grasp and we can learn yet more if we remain in a place of humility and teachability in the future.
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  • 文章类型: Journal Article
    2011年,医学研究所的护理未来:引领变革,推进健康报告宣布需要增加护理的多样性。全国护理联盟表示,护理管道计划对于增加多样性至关重要。然而,没有关于定义的细节,建筑,或护理管道的实施在立场声明中可用。
    进行了包容性综合文献综述。目的是研究旨在增加护理教育计划多样性的干预措施。
    评论中包含了12篇文章。护理教育计划使用了类似的干预措施;这些措施包括提高准学生对护理的认识的策略,preen-try准备,整体招生,奖学金,家教,指导,和有针对性的建议。
    证据表明,旨在保留高危个体的干预措施是成功的。需要进行更多的研究,以制定针对不同人群的有效招募策略。[J护士教育。2024;63(6):387-393。].
    UNASSIGNED: In 2011, the Institute of Medicine\'s The Future of Nursing: Leading Change, Advancing Health report declared the need to increase diversity in nursing. The National League for Nursing stated that nursing pipeline programs would be essential to create increased diversity. However, no details regarding the definition, construction, or implementation of a nursing pipeline were available within the position statement.
    UNASSIGNED: An inclusive integrative literature review was conducted. The aim was to examine interventions targeted toward increasing diversity in nursing education programs.
    UNASSIGNED: Twelve articles were included in the review. Similar interventions were used by nursing education programs; these included strategies to raise awareness about nursing to prospective students, preen-try preparation, holistic admissions, scholarships, tutoring, mentoring, and targeted advising.
    UNASSIGNED: Evidence indicates interventions aimed at the retention of at-risk individuals are successful. Additional research is needed to develop effective recruitment strategies for diverse populations. [J Nurs Educ. 2024;63(6):387-393.].
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  • 文章类型: Journal Article
    背景:提供对多样性敏感的护理是减少健康差异的一种有希望的方法。最近的批评和科学差距表明,需要从患者的角度看待多样性敏感的护理。本系统综述旨在描述患者的观点,包括病人的经历,期望,以及对医疗保健提供者提供的多样性敏感护理的满意度。
    方法:2022年12月,MedlineALL,Embase,WebofScience核心合集,Cochrane中央控制试验登记册,CINAHL,搜索了PsycINFO和GoogleScholar,以寻找描述或测量患者期望的原始研究,经验,和/或满意度,特别关注医疗保健提供者的文化或多样性能力。使用基于主题综合的会聚混合方法设计对收集的数据进行分析。
    结果:从最初的5,387篇文章中,117人被选中进行全文筛选,最终,这项研究包括34篇文章。观察到多样性敏感性护理的概念包括三个组成部分。第一部分侧重于以患者为中心的护理,包括清晰和直接的沟通等能力。共同决策,个性化护理,同理心,和考虑。第二个组成部分的中心是提供文化定制的信息,根据文化需求调整护理,与口译员一起工作,allyship,社区伙伴关系,自我意识,文化知识,并建立在第一个组件上。在多样性敏感护理的前两个组成部分中,患者报告说,他们的医疗保健提供者遇到了不满和缺点,有时会导致与提供者护理有关的第三个也是最后一个组成部分。这一部分强调了语言的重要性,民族,文化,以及在提供优质护理方面的性别一致性。
    结论:结论:患者对多样性敏感护理的观点包括多个组成部分,从以患者为中心的护理到和谐护理。这些组件包括各种能力作为沟通技巧,同理心,自我意识和调整照顾文化需求。患者报告说,医疗保健提供者提供的多样性敏感护理的所有组成部分都存在不满和缺点。
    BACKGROUND: The provision of diversity-sensitive care is a promising approach towards reducing health disparities. Recent criticism and a scientific gap demonstrate the need for the patient perspective on diversity-sensitive care. This systematic review aims to describe the patient perspective, including patient experiences, expectations, and satisfaction with diversity-sensitive care provided by healthcare providers.
    METHODS: In December 2022 the Medline ALL, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO and additionally Google Scholar were searched for original studies that described or measured patient expectations, experiences, and/or satisfaction, specifically focusing on cultural or diversity competence of healthcare providers. Analysis of the collected data was performed using a convergent mixed-methods design based on thematic synthesis.
    RESULTS: From initially 5,387 articles, 117 were selected for full-text screening, and ultimately, 34 articles were included in this study. The concept of diversity-sensitive care was observed to comprise three components. The first component is focused on patient-centered care and includes competencies such as clear and direct communication, shared decision-making, individualized care, empathy, and consideration. The second component centers on providing culturally tailored information, adjusting care to cultural needs, working with interpreters, allyship, community partnerships, self-awareness, and cultural knowledge, and builds upon the first component. Across the first two components of diversity-sensitive care, patients have reported experiencing dissatisfaction and encountering shortcomings in their healthcare providers, sometimes resulting in the third and final component pertaining to provider care. This component underscores the importance of linguistic, ethnic, cultural, and gender concordance in delivering quality care.
    CONCLUSIONS: In conclusion, the patient perspective on diversity-sensitive care encompasses multiple components, from patient-centered care to concordant care. The components incorporate various competencies as communication skills, empathy, self-awareness and adjusting care to cultural needs. Patients reported experiencing dissatisfaction and shortcomings across all components of diversity-sensitive care provided by healthcare providers.
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