A valid and reliable scale to assess cultural sensibility in nursing

Background: Cultural sensibility is an important concept linked to the achievement of cultural competence. Health professionals must first improve their cultural sensibility to become culturally competent and to be able to offer competent care to culturally diverse populations. Aim To develop and psychometrically test the Cultural Sensibility Scale for Nursing (CUSNUR), a cultural sensibility scale that can be used in nursing for the achievement of competencies needed to care for culturally diverse populations. Design and methods: The cross-sectional survey was conducted over two stages. The first stage involved the cross- cultural and discipline-specific adaptation of an existing scale addressing this concept in the field of law using the reverse translation method. Second, validation of the scale was carried out from October 2016–June 2017 by studying the psychometric properties of the questionnaire through an analysis of content acceptability and reliability and through exploratory factor analysis (EFA). Results: The questionnaire was designed to be clear, easy to understand, and of adequate length, and experts involved in content validation agreed that the scale meets these criteria. A total of 253 nursing students participated in the validation stage. Four factors were identified from the EFA: (1) patient and health professional behaviours, (2) self-assessments, (3) self-awareness, and (4) cultural influence. Two items were excluded. Factorial saturation is adequate for all factors (>0.30). The Cronbach alpha was measured as 0.75. Conclusions: This study presents the first version of the CUSNUR and demonstrates that the scale is valid and reliable

El comienzo de la lactancia: experiencias de madres primerizas

Fundamento. La lactancia materna es importante para promover el desarrollo saludable del recién nacido. A pesar de sus beneficios, el abandono es masivo durante el primer trimestre de vida. El objetivo de esta investigación fue explorar cómo las madres primerizas percibían y experimentaban la lactancia materna para poder identificar así los aspectos que influyen en su instauración. Material y métodos. Se llevó a cabo un estudio cualitativo con un enfoque fenomenológico descriptivo, en el que participaron 12 madres primíparas que fueron entrevistadas en profundidad en dos ocasiones, una los primeros días tras el parto y otra al mes de haber dado a luz. Los datos obtenidos se grabaron y transcribieron para analizarlos con el método de Giorgi. Resultados. El significado esencial de la experiencia vivida por las madres que participaron en este estudio se puede resumir en los cinco temas que se detallan a continuación: la idealización de la lactancia; la incertidumbre ante las dificultades; el deseo de privacidad durante las tomas; la responsabilidad compartida con el niño para lograr el éxito; y finalmente, la desorganización en sus vidas y la modificación del rol de la mujer. Conclusiones. Conocer las experiencias de las madres primíparas en la etapa de instauración de la lactancia, permitirá a los profesionales diseñar intervenciones específicas adaptadas a ellas. Los profesionales deberían tener en cuenta las expectativas de cada madre y cómo hace frente al nuevo rol, la necesidad de proporcionar apoyo práctico y emocional con unanimidad de criterios y la importancia del apoyo del padre.Background. Breastfeeding is important for promoting the healthy development of the newborn. Despite its benefits, the abandonment of breastfeeding is massive in the first three months of life. The aim of this research was to explore how first-time mothers perceived and experienced breastfeeding in order to identify issues affecting its establishment Methods. A qualitative study with a descriptive phenomenological approach was used. Twelve first-time mothers were interviewed in-depth on two occasions: once a few days after childbirth, and another time one month from giving birth. The data were recorded and transcribed verbatim. Giorgi’s method was used for the analysis. Results. The essential meaning of the experience undergone by the mothers who took part in this study can be described by the following five themes: an idealization of breastfeeding; uncertainty over the difficulties; a desire for privacy during breastfeeding; shared responsibility with the child for breastfeeding to succeed; and, finally, disruption to the women’s lives and changes in their role. Conclusions. This study allowed access to the experiences of first-time mothers during the establishment of breastfeeding. This information will facilitate the design of tailored interventions taking into account the mothers’ reports. Health professionals should: consider women’s expectations and how they face their new role, provide practical and emotional support, be consistent and avoid giving conflicting advice, and acknowledge the importance of the fathers’ support

Connections between family assets and positive youth development: the association between parental monitoring and affection with leisure-time activities and substance use

This study aimed to determine the associations between parental monitoring and affection and three adolescent lifestyle aspects: constructive leisure, non-constructive leisure and substance use. A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru). Adolescents aged 12¿15 self-completed a multi-purpose questionnaire. Multiple logistic regressions were performed to analyse the association between the parental monitoring and affection variables and the outcomes in terms of the children¿s lifestyles. The results indicate that parental monitoring is conducive to more constructive leisure and less non-constructive leisure and seems to be conducive to the prevention of substance use. Furthermore, parental affection is conducive to constructive leisure and the prevention of substance use. The discussion focuses on the fact that the family can be a protective resource associated with positive adolescent development

Five paradoxes in health promotion

The World Health Organization states that health promotion is a key strategy to improve health, and it is conceived as a global process of enabling people to increase control over, and to improve, their health. Health promotion does not focus solely on empowering individuals dealing with their knowledge, attitudes and skills, but it also takes political, social, economic and environmental aspects influencing health and wellbeing into account. The complexity of applying these concepts is reflected in the five paradoxes in health promotion; these arise in between the rhetoric in health promotion and implementation. The detected paradoxes which are described herein involve the patient versus the person, the individual versus the group, disease professionals versus health professionals, disease indicators versus health indicators, and health as an expense versus health as an investment. Making these contradictions explicit can help determine why it is so complex to put the concepts related to health promotion into practice. It can also help to put forward aspects that need further work if health promotion is to put into practice. (C) 2017 SESPAS: Published by Elsevier Espaila, S.L.U

Los retos de la promoción de la salud en una sociedad multicultural: revisión narrativa de la literatura

La realidad multicultural en la que vivimos hoy en día, hace que los profesionales de la salud interactúen a diario con personas y familias de culturas diversas. La interacción entre una persona o familia y un profesional de la salud de una cultura diferente se denomina “encuentro cultural”. Los encuentros no van a estar exentos de dificultades a las que los profesionales van a tener que hacer frente para poder proporcionar un buen cuidado y promover estilos de vida saludables. En la revisión narrativa llevada a cabo se han observado que las dificultades están relacionadas con factores culturales y linguísticos, la alfabetización en salud, las desventajas en el estado socio-económico y los prejuicios y estereotipos de los profesionales de la salud. Las estrategias sugeridas para vencer esas dificultades son: el desarrollo de programas culturalmente adaptados; utilizar una pedagogía y recursos apropiados, y materiales cultural y lingüísticamente adaptados; el uso de intérpretes y la organización de cursos para aprender el idioma mayoritario. Además de esas estrategias, la bibliografía enfatiza la necesidad de un cambio de enfoque en el que el objetivo sea la formación de los profesionales de la salud para el desarrollo de lo que los autores denominan “competencia cultural”. La formación en competencia cultural está orientada a favorecer que los profesionales ofrezcan y promuevan cuidados congruentes y adaptados a los valores culturales, creencias y prácticas de cualquier persona, familia o grupo sin caer en prejuicios ni estereotipos.Nowadays multicultural reality leads health professionals to interact in their daily work with individuals and families from diverse cultures. The interaction between a person or family and a health professional from a different culture is called “cultural encounter”. These encounters involve difficulties, complications and barriers, which health professionals will have to face in order to provide good care and promote healthy lifestyles. This narrative review shows that the difficulties are related to cultural and linguistic factors, health literacy, disadvantages in socio-economic status and the prejudices and stereotypes of healthcare professionals. Different strategies are described in the literature that could help health professionals to overcome these difficulties, namely: the development of culturally appropriate programmes; appropriate pedagogy and resources, and the use of culturally and linguistically sensitive materials; the use of interpreters and the organization of courses to learn the most widely spoken language. In addition to these strategies, the need is underscored for a change of approach in which the objective should be training health professionals to achieve “cultural competence”. Training in cultural competence would encourage professionals to offer tailored care plans, taking into account the cultural values, beliefs and practices of any person or family, and would help them to avoid stereotypes and prejudices

Los retos de la promoción de la salud en una sociedad multicultural: revisión narrativa de la literatura

La realidad multicultural en la que vivimos hoy en día, hace que los profesionales de la salud interactúen a diario con personas y familias de culturas diversas. La interacción entre una persona o familia y un profesional de la salud de una cultura diferente se denomina “encuentro cultural”. Los encuentros no van a estar exentos de dificultades a las que los profesionales van a tener que hacer frente para poder proporcionar un buen cuidado y promover estilos de vida saludables. En la revisión narrativa llevada a cabo se han observado que las dificultades están relacionadas con factores culturales y linguísticos, la alfabetización en salud, las desventajas en el estado socio-económico y los prejuicios y estereotipos de los profesionales de la salud. Las estrategias sugeridas para vencer esas dificultades son: el desarrollo de programas culturalmente adaptados; utilizar una pedagogía y recursos apropiados, y materiales cultural y lingüísticamente adaptados; el uso de intérpretes y la organización de cursos para aprender el idioma mayoritario. Además de esas estrategias, la bibliografía enfatiza la necesidad de un cambio de enfoque en el que el objetivo sea la formación de los profesionales de la salud para el desarrollo de lo que los autores denominan “competencia cultural”. La formación en competencia cultural está orientada a favorecer que los profesionales ofrezcan y promuevan cuidados congruentes y adaptados a los valores culturales, creencias y prácticas de cualquier persona, familia o grupo sin caer en prejuicios ni estereotipos.Nowadays multicultural reality leads health professionals to interact in their daily work with individuals and families from diverse cultures. The interaction between a person or family and a health professional from a different culture is called “cultural encounter”. These encounters involve difficulties, complications and barriers, which health professionals will have to face in order to provide good care and promote healthy lifestyles. This narrative review shows that the difficulties are related to cultural and linguistic factors, health literacy, disadvantages in socio-economic status and the prejudices and stereotypes of healthcare professionals. Different strategies are described in the literature that could help health professionals to overcome these difficulties, namely: the development of culturally appropriate programmes; appropriate pedagogy and resources, and the use of culturally and linguistically sensitive materials; the use of interpreters and the organization of courses to learn the most widely spoken language. In addition to these strategies, the need is underscored for a change of approach in which the objective should be training health professionals to achieve “cultural competence”. Training in cultural competence would encourage professionals to offer tailored care plans, taking into account the cultural values, beliefs and practices of any person or family, and would help them to avoid stereotypes and prejudices

Los retos de la promoción de la salud en una sociedad multicultural: revisión narrativa de la literatura

La realidad multicultural en la que vivimos hoy en día, hace que los profesionales de la salud interactúen a diario con personas y familias de culturas diversas. La interacción entre una persona o familia y un profesional de la salud de una cultura diferente se denomina “encuentro cultural”. Los encuentros no van a estar exentos de dificultades a las que los profesionales van a tener que hacer frente para poder proporcionar un buen cuidado y promover estilos de vida saludables. En la revisión narrativa llevada a cabo se han observado que las dificultades están relacionadas con factores culturales y linguísticos, la alfabetización en salud, las desventajas en el estado socio-económico y los prejuicios y estereotipos de los profesionales de la salud. Las estrategias sugeridas para vencer esas dificultades son: el desarrollo de programas culturalmente adaptados; utilizar una pedagogía y recursos apropiados, y materiales cultural y lingüísticamente adaptados; el uso de intérpretes y la organización de cursos para aprender el idioma mayoritario. Además de esas estrategias, la bibliografía enfatiza la necesidad de un cambio de enfoque en el que el objetivo sea la formación de los profesionales de la salud para el desarrollo de lo que los autores denominan “competencia cultural”. La formación en competencia cultural está orientada a favorecer que los profesionales ofrezcan y promuevan cuidados congruentes y adaptados a los valores culturales, creencias y prácticas de cualquier persona, familia o grupo sin caer en prejuicios ni estereotipos.Nowadays multicultural reality leads health professionals to interact in their daily work with individuals and families from diverse cultures. The interaction between a person or family and a health professional from a different culture is called “cultural encounter”. These encounters involve difficulties, complications and barriers, which health professionals will have to face in order to provide good care and promote healthy lifestyles. This narrative review shows that the difficulties are related to cultural and linguistic factors, health literacy, disadvantages in socio-economic status and the prejudices and stereotypes of healthcare professionals. Different strategies are described in the literature that could help health professionals to overcome these difficulties, namely: the development of culturally appropriate programmes; appropriate pedagogy and resources, and the use of culturally and linguistically sensitive materials; the use of interpreters and the organization of courses to learn the most widely spoken language. In addition to these strategies, the need is underscored for a change of approach in which the objective should be training health professionals to achieve “cultural competence”. Training in cultural competence would encourage professionals to offer tailored care plans, taking into account the cultural values, beliefs and practices of any person or family, and would help them to avoid stereotypes and prejudices

Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study

Aims: To determine the associations between internal assets (planning and decision- making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs).Design: A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru).Methods: Adolescents aged 12–18 self-completed a multi-purpose questionnaire be-tween 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision- making, interpersonal competence, and commitment to learning) and sub-stance use.Results: The results indicate that planning and decision- making and commitment to learning are conducive to the prevention of substance use. On the contrary, interper-sonal competence was not associated with substance use.Conclusion: The present study shows that planning and decision- making and com-mitment to learning can be relevant factors in explaining substance use during ado-lescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These find-ings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adoles-cents. Furthermore, the Developmental Assets framework has been proved as a suit-able frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use

Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study

Aims: To determine the associations between internal assets (planning and decision- making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs).Design: A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru).Methods: Adolescents aged 12–18 self-completed a multi-purpose questionnaire be-tween 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision- making, interpersonal competence, and commitment to learning) and sub-stance use.Results: The results indicate that planning and decision- making and commitment to learning are conducive to the prevention of substance use. On the contrary, interper-sonal competence was not associated with substance use.Conclusion: The present study shows that planning and decision- making and com-mitment to learning can be relevant factors in explaining substance use during ado-lescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These find-ings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adoles-cents. Furthermore, the Developmental Assets framework has been proved as a suit-able frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use

El comienzo de la lactancia: experiencias de madres primerizas

Fundamento. La lactancia materna es importante para promover el desarrollo saludable del recién nacido. A pesar de sus beneficios, el abandono es masivo durante el primer trimestre de vida. El objetivo de esta investigación fue explorar cómo las madres primerizas percibían y experimentaban la lactancia materna para poder identificar así los aspectos que influyen en su instauración. Material y métodos. Se llevó a cabo un estudio cualitativo con un enfoque fenomenológico descriptivo, en el que participaron 12 madres primíparas que fueron entrevistadas en profundidad en dos ocasiones, una los primeros días tras el parto y otra al mes de haber dado a luz. Los datos obtenidos se grabaron y transcribieron para analizarlos con el método de Giorgi. Resultados. El significado esencial de la experiencia vivida por las madres que participaron en este estudio se puede resumir en los cinco temas que se detallan a continuación: la idealización de la lactancia; la incertidumbre ante las dificultades; el deseo de privacidad durante las tomas; la responsabilidad compartida con el niño para lograr el éxito; y finalmente, la desorganización en sus vidas y la modificación del rol de la mujer. Conclusiones. Conocer las experiencias de las madres primíparas en la etapa de instauración de la lactancia, permitirá a los profesionales diseñar intervenciones específicas adaptadas a ellas. Los profesionales deberían tener en cuenta las expectativas de cada madre y cómo hace frente al nuevo rol, la necesidad de proporcionar apoyo práctico y emocional con unanimidad de criterios y la importancia del apoyo del padre.Background. Breastfeeding is important for promoting the healthy development of the newborn. Despite its benefits, the abandonment of breastfeeding is massive in the first three months of life. The aim of this research was to explore how first-time mothers perceived and experienced breastfeeding in order to identify issues affecting its establishment Methods. A qualitative study with a descriptive phenomenological approach was used. Twelve first-time mothers were interviewed in-depth on two occasions: once a few days after childbirth, and another time one month from giving birth. The data were recorded and transcribed verbatim. Giorgi’s method was used for the analysis. Results. The essential meaning of the experience undergone by the mothers who took part in this study can be described by the following five themes: an idealization of breastfeeding; uncertainty over the difficulties; a desire for privacy during breastfeeding; shared responsibility with the child for breastfeeding to succeed; and, finally, disruption to the women’s lives and changes in their role. Conclusions. This study allowed access to the experiences of first-time mothers during the establishment of breastfeeding. This information will facilitate the design of tailored interventions taking into account the mothers’ reports. Health professionals should: consider women’s expectations and how they face their new role, provide practical and emotional support, be consistent and avoid giving conflicting advice, and acknowledge the importance of the fathers’ support