Assessment of Care for Cultural Competence in Healthcare Services: A Systematic Rewiev of Qualitative Studies

Background: Societies have a multicultural structure characterized by the spread of cultural diversity and having to live together with different ethnic origins, languages, and racial individuals. This requires that health professionals should adopt a care approach regarding cultural competence in order to prevent health inequalities due to cultural differences, to meet the health needs at desired level, and to enable maintenance of evidence‐based care. Objective: To assess the cultural competence of the care provided in healthcare services. Methods: Academic Search Complete, CINAHL, Proquest, Sage, and ScienceDirect databases were scanned; seven articles matching the criteria were evaluated. Findings: (1) The number of articles that examined clearly and comprehensively in the context of qualitative research relationship between cultural competence and healthcare services was few, (2) the results couldn’t be combined into a common pavilion because many of the studies have processed on independent topics by addressing different dimensions of cultural competence, (3) in studies, it has been found that important components of care such as mutual communication, trust‐based care environment, positive and non‐judgmental approaches of health professionals, clinical skills, and linguistic differences were effective for cultural competence of healthcare services

A STUDY OF THE VALIDITY AND RELIABILITY OF THE "ELDERLY DIABETES BURDEN SCALE" FOR THE TURKISH SOCIETY

WOS: 000303335200012Introduction: This study was realized methodologically with the objective of examining the validity and reliability of the "Elderly Diabetes Burden Scale", which was developed in 2003 by Araki and Ito, to determine the burdens stemming from diabetes mellitus in elderly individuals with diabetes, for the Turkish society. Materials and Method: In the study, based on the fact that the size of the sampling in validity and reliability studies should be a minimum of five-fold and moreover, ideally ten-fold the number of items, 230 elderly diabetics were contacted for the 22-item "Elderly Diabetes Burden Scale". Results: At the end of the factor analysis applied to the scale, 6 factors were obtained, which explored 74.8% of the total variance of the scale. The Cronbach's alpha value was found to be 0.92 for the internal consistency of the scale and this value shows that the scale is highly reliable. Conclusion: In conclusion, "Elderly Diabetes Burden Scale" measuring instrument has been found as reliable and valid for the Turkish society

Nursing students' attitudes toward ageism in Turkey

This research involved a descriptive study with the goal of examining the attitudes of 145 Turkish nursing students studying toward ageism and the factors affecting ageism views. A Student Description Form and the Ageism Attitude Scale (AAS) were the data collection instruments used in this study. Statistical evaluation of the data included percentage, median and Kruskal Wallis Test and Mann-Whitney U-test. The average age of student participants was 20.10 +/- 3.52; further 37.9% of these students were 1st year nursing students, 25.5% of were 2nd year, 11.7% were 3rd year, and 24.8% were 4th year students. Of the students in this study 63.4% had completed coursework in elderly health as part of undergraduate study. Average scores on the AAS students were 84.01 +/- 7.61 points. Most female students who completed classes related to elderly health, either lived with or planned to live with at least one elderly parent after starting a family or already experienced having an elderly relative in their home. These students tended to have positive attitudes toward aging. (C) 2011 Elsevier Ireland Ltd. All rights reserved.https://doi.org/10.1016/j.archger.2011.02.00

The Investigation of Nursing Students’xx Attitudes Towards Death

Amaç: Bu çalışmanın amacı, hemşirelik öğrencilerinin ölüme yönelik tutumlarını ve etkileyen faktörleri belirlemektir. Gereç ve Yöntemler: Çalışma Eylül 2016-Eylül 2017 tarihleri arasında, İzmir ve Eskişehir’deki hemşirelik ve sağlık bilimleri fakültelerinde öğrenim gören 400 hemşirelik öğrencisi ile yürütülmüştür. Çalışmanın uygulanabilmesi için etik kurul onayı, kurum izni ve öğrencilerden yazılı onam alınmıştır. Verilerin toplanmasında Öğrenci Tanıtım Formu ve Ölüme Karşı Tutum Ölçeği (ÖKTÖ) kullanılmıştır. Veriler anket tekniğiyle toplanmıştır. Verilerin değerlendirilmesinde IBM SPSS Statistics 21,0 (IBM SPSS Statistics 20) paket programı kullanılmıştır. Bulgular: Araştırmaya katılan öğrencilerin %81,3’ü kadın ve yaş ortalamaları 21,35±1,65 yıldır. Öğrencilerin %41,3’ü, ölümü “yaşamın sonu, ayrılık” olarak tanımladığını, %36,5’i “yeni bir hayatın başlangıcı” olarak gördüğünü belirtmiştir. Öğrencilerin en yüksek puanı (60,31±13,77) ÖKTÖ tarafsız kabullenme ve yaklaşım kabullenme alt boyutlarından, en düşük puanı (21,00±6,47) ise kaçış kabullenme alt boyutundan aldıkları saptanmıştır. Sonuç: Araştırma sonuçlarına göre hemşirelik müfredatında ölüme yönelik eğitimlerin artırılması ve öğrencilerin yaşam sonu bakımın verildiği alanlarda daha sık uygulama yapma olanağının sağlanması önerilmektedir.Objective: the aim of this study was to determine the attitude and factors affecting nursing students. Material and Methods: the study was carried out between September 2016 and September 2017 in Izmir and Eskişehir with 400 nursing students studying in the faculty of nursing and health sciences. in order to implement the study, ethics committee approval, the permission of the institution and the written consent of the students were taken. Student Information Form and Death Attitude Scale were used to collect the data. Data were collected by survey technique. IBM SPSS Statistics 21.0 (IBM SPSS Statistics 20) was used to evaluate the data. Results: the mean age of the student’s was female 81.3% and 21.35±1.65 years, respectively. 41.3% of the students described death as in “end of life, separation” and 36.5% considered “the beginning of a new life”. It was determined that the students received the highest score from the sub-dimension of neutral acceptance and approach acceptance (60.31±13.77) and the lowest core from the subdimension of escape acceptance (21.00±6.47). Conclusion: According to the results of the research, it is recommended to increase the education in the nursing curriculum and to enable the students to practice more frequently in the areas where end-of-life care is given

Effect of Peer Teaching Used in Nursing Education on the Performance and Competence of Students in Practical Skills Training

Peer teaching is an effective educational approach for nursing students. It has been used in nursing as an adjunct to lectures and to support learning in clinical practice. This study evaluated the efficacy of peer teaching model which is used in skills training of student nurses. As an experimental study, it included 57 first years and 10 senior students from the nursing department. First years constituted the interventional group and the control group while seniors made up the peer educators. This study revealed that the experimental group students had obtained adequate skills in nasopharyngeal aspiration, permanent bladder catheterization practices and take blood pressure compare to their counterparts (p<0.05). The approach is helpful for improving students' ability in practical training. The study results add to the literature supporting the use of peer teaching approach in nursing training practical education

Clinical features of generalized lipodystrophy in Turkey: A cohort analysis

Aim: To describe the Turkish generalized lipodystrophy (GL) cohort with the frequency of each complication and the death rate during the period of the follow-up. Methods: This study reports on 72 patients with GL (47 families) registered at different centres in Turkey that cover all regions of the country. The mean ± SD follow-up was 86 ± 78 months. Results: The Kaplan–Meier estimate of the median time to diagnosis of diabetes and/or prediabetes was 16 years. Hyperglycaemia was not controlled in 37 of 45 patients (82.2%) with diabetes. Hypertriglyceridaemia developed in 65 patients (90.3%). The Kaplan–Meier estimate of the median time to diagnosis of hypertriglyceridaemia was 14 years. Hypertriglyceridaemia was severe (≥ 500 mg/dl) in 38 patients (52.8%). Seven (9.7%) patients suffered from pancreatitis. The Kaplan–Meier estimate of the median time to diagnosis of hepatic steatosis was 15 years. Liver disease progressed to cirrhosis in nine patients (12.5%). Liver disease was more severe in congenital lipodystrophy type 2 (CGL2). Proteinuric chronic kidney disease (CKD) developed in 32 patients (44.4%) and cardiac disease in 23 patients (31.9%). Kaplan–Meier estimates of the median time to diagnosis of CKD and cardiac disease were 25 and 45 years, respectively. Females appeared to have a more severe metabolic disease, with an earlier onset of metabolic abnormalities. Ten patients died during the follow-up period. Causes of death were end-stage renal disease, sepsis (because of recurrent intestinal perforations, coronavirus disease, diabetic foot infection and following coronary artery bypass graft surgery), myocardial infarction, heart failure because of dilated cardiomyopathy, stroke, liver complications and angiosarcoma. Conclusions: Standard treatment approaches have only a limited impact and do not prevent the development of severe metabolic abnormalities and early onset of organ complications in GL

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research