“Would you decide to keep the power?”: reflexivity on the interviewer–interpreter–interviewee triad in interviews with female punjabi rheumatoid arthritis patients

This article presents methodological reflections on the different streams of knowledge that are drawn upon during interpreted interviews and the shifts of power between (1) the interviewer, (2) the interpreter/co-researcher, and (3) the interviewee. Interpreters are increasingly seen as active agents in the interview process, and they act as cultural brokers.Interpretation by a nurse researcher introduces further challenges and benefits to the interview dynamic, which was explored through reflexive discussions with an independentresearcher. These challenges include conducting interviews in a clinical setting, where the health professional–patient relationship remains active. A modified discourse analysis was used to examine the subject positioning in the interview situation and the power negotiationsthat ensued. The main conclusion that can be drawn from these reflexive accounts is that the use of different streams of knowledge (experiential, clinical, cultural, and academic)enhanced the interview interaction, and power relations were successfully negotiated to facilitate rapport and data collection. Reflexivity provides an important tool for identifying,and learning from, the challenges and benefits of working with an interpreter, who is also a co-researcher with multiple professional roles

Developing and integrating cultural competence into nursing education curricula : a qualitative grounded theory approach

The changing demographic UK population in terms of cultural, racial and ethnic mix demands mental health nurses to be educated in ways that will enable them to provide care that is both efficient and culturally appropriate to the diverse population they will serve. However, reported studies indicate that professional nurses, particularly mental health nurses, are not ready to meet the challenges posed by an increasingly culturally diverse society. These have raised questions about the undergraduate nursing education's readiness to develop a mental health work force that is capable of delivering effective mental health services to a multicultural population. The aim of the study was to explore and gain an understanding of cultural competence education from the perspectives of the key participants involved in the undergraduate mental health nursing education within the UK context, and to use the findings to develop a conceptual framework of developing cultural competence. Qualitative grounded theory approach was the method of inquiry used to collect and analyse interview data from the experiences and views of senior lecturers, third year mental health student nurses, clinical sign-off mentors and student mentors within the universities that offer pre-registration mental health nurse training in the West Midlands Region. Analysis of the research findings resulted in an emergent conceptual framework that explains how cultural competence is developed in the undergraduate mental health nursing curriculum in terms of content, processes, strategies, actions and approaches that are considered effective. The findings of this study revealed a degree of consistency between the views of the current study participants and what the literature describes as frameworks for developing cultural competence. The main theoretical constructs emerging from the study fit into a cultural competence frameworks encompassing awareness, knowledge and skills. Whilst some of the themes and theoretical constructs emerging from the results of the interview data were generally consistent with those indicated in the cultural competence literature, there were some other themes that emerged from the study participants on what was required within the curriculum in order to educate student nurses in ways that will enable them to work effectively and culturally appropriately with clients from diverse cultural backgrounds. The additional bridging theoretical construct included ‘conscious of the dynamics and discourse of intercultural education’ which was a result of the differing ideological views about current curricula and how issues of cultural competence could best be addressed within the curricula. The strategies of ‘engagement of local experts to assist in teaching cultural competence specific areas’ and ‘creating educational activities that challenge stereotypes, prejudice, discrimination and religious intolerance’ also expands the current literature by providing evidence to support some of the conceptualisations regarding some of the educational intervention strategies to cultural competence. This study is significant as it represents the first attempt to develop a conceptual framework of developing cultural competence within the UK context based on the perspectives of those directly experiencing the undergraduate mental health nursing education, using qualitative grounded theory approaches. Exploring and developing the conceptual framework from the perspectives of the neglected silent voices of the key participants who are directly involved in the undergraduate nurse training within the UK context, contributes to the existing research in this area and provides a view not currently presented in the nursing literature.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Tuberculosis/HIV/AIDS coinfection in Porto Alegre, RS/Brazil - invisibility and silencing of the most affected groups

OBJECTIVE: To analyze how belonging to certain social groups contributes to constituting the vulnerabilities associated with illnesses due to tuberculosis/HIV/AIDS coinfection. METHODOLOGYThis is a qualitative study carried out in the city of Porto Alegre, state of Rio Grande do Sul, in regions of high social vulnerability. Twenty coinfected people were interviewed in specialized health services between August and December 2016. The analysis was based on the frameworks The Sound of Silence and Vulnerability and Human Rights. RESULTS: Socioeconomic conditions were decisive for the constitution of the vulnerability conditions. Processes of people invisibilization, and the silencing of their voices, in a scenario marked by economic, racial and gender inequalities, contributed for their health needs not to be understood and effectively taken into account in the services actions. FINAL CONSIDERATIONS: The more effective strategies are to legitimize voices and to understand the needs of those affected by coinfection, the greater the chances that programmatic responses to the problem will be successful

The Silences Framework: A Method for researching sensitive themes and marginalized health perspectives (English version)

Objective: To describe the experience of applying of The Silences Framework to underpin health research investigating Tuberculosis/HIV/AIDS coinfection . Method: The Silences Framework originally developed following a study exploring the decisions and silences surrounding black Caribbean men living in England, discussing the themes 'sexual health' and 'ethnicity'. Following this study a conceptual a theory for research on sensitive issues and health care of marginalized populations was developed called 'Screaming Silences' which forms the foundation of The Silences Framework. Screaming Silences define research areas and experiences that are poorly studied, little understood or silenced. Results: The Silences Framework supports researchers in revealing "silences" in the subjects they study - as such results may reflect how beliefs, values, and experiences of some groups influence their health. This framework provides the application of four complementary stages: working the silences, hearing silences, voicing silences and working with the silences. The analysis occurs cyclically and can be repeated as long as the silences inherent in a study are not revealed. Conclusion: this article presents The Silences Framework and the application of the notion of "sounds of silence", mapping an antiessentialist theoretical framework for its use in sensitive research in health and nursing areas, being a reference for other researchers in studies involving marginalized populations. KEYWORDS: Inequalities in health. Methods. Nursing. Coinfection. Research. Tuberculosis. Acquired immunodeficiency syndrome

Identification of nursing assessment models/tools validated in clinical practice for use with diverse ethno-cultural groups: an integrative review of the literature

<p>Abstract</p> <p>Background</p> <p>High income nations are currently exhibiting increasing ethno-cultural diversity which may present challenges for nursing practice. We performed an integrative review of literature published in North America and Europe between 1990 and 2007, to map the state of knowledge and to identify nursing assessment tools/models which are have an associated research or empirical perspective in relation to ethno-cultural dimensions of nursing care.</p> <p>Methods</p> <p>Data was retrieved from a wide variety of sources, including key electronic bibliographic databases covering research in biomedical fields, nursing and allied health, and culture, e.g. CINAHL, MEDline, PUBmed, Cochrane library, PsycINFO, Web of Science, and HAPI. We used the Critical Appraisal Skills Programme tools for quality assessment. We applied Torraco's definition and method of an integrative review that aims to create new knowledge and perspectives on a given phenomena. To add methodological rigor with respect to the search strategy and other key review components we also used the principles established by the Centre for Reviews and Dissemination.</p> <p>Results</p> <p>Thirteen thousand and thirteen articles were retrieved, from which 53 full papers were assessed for inclusion. Eight papers met the inclusion criteria, describing research on a total of eight ethno-cultural assessment tools/models. The tools/models are described and synthesized.</p> <p>Conclusions</p> <p>While many ethno-cultural assessment tools exist to guide nursing practice, few are informed by research perspectives. An increased focus on the efficiency and effectiveness of health services, patient safety, and risk management, means that provision of culturally responsive and competent health services will inevitably become paramount.</p

Uniting health care quality and equity: the challenge of measurement

Uniting health care quality and equity: The challenge of measuremen

The National Strategy for Sexual Health and HIV: issues for community practitioners

Sexual health and the choices people make in relation to their health behaviour are influenced by a range of factors including social grouping, education, peer pressure and access to services/information.1-3 The impact of the negative choices made by an individual on society as a whole is reflected in high rates of unwanted pregnancy and increasing rates of sexually transmitted infections and a continued rise in HIV infection.4 The public and social burden of sexual ill-health means that sexual health issues cannot be viewed as acts concerning only the ..

Men and sexual health

Men and sexual healt

Introduction and overview of research with black families

This edited book provides a valuable, unique and scholarly contribution to the study of Black families (African and African Caribbean) in the UK. It combines a systematic yet clear-headed approach with up-to-date and well-researched data to support its many stimulating assertion

Making my mark: 'You could have been a doctor'

Laura Serrant-Green talks about why she decided to be a nurse, her work in research, what she has learned during her career, as well as the women who have helped her along the way as she prepares to embark on her third year as editor of Nurse Researcher