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Background: Primary health care is the first point of contact for patients from refugee backgrounds in the Australian health system. Sociocultural factors, including beliefs and value systems, are salient determinants of health literacy and access to primary health care services. Although African refugees in Australia have diverse sociocultural backgrounds, little is known about the influence of sociocultural factors on their experiences of accessing primary health care services. Guided by the theoretical framework of access to health care, this study examined from the perspective of African refugees how culturally and religiously conditioned, constructed and bound health beliefs, knowledge and practices influence their experiences of access to, acceptance and use of primary health care services and information in Australia. Methods: This exploratory, qualitative study involved 19 African refugees from nine countries living in New South Wales, Australia. Semi-structured interviews were conducted and recorded using Zoom software. The interviews were transcribed verbatim and analysed using a bottom-up thematic analytical approach for theme generation. Results: Four main themes were identified. The themes included: participants' experiences of services as inaccessible and monocultural and providing information in a culturally unsafe and insensitive manner; the impact of the clinical care environment; meeting expectations and needs; and overcoming access challenges and reclaiming power and autonomy through familiar means. The findings generally support four dimensions in the access to health care framework, including approachability, acceptability, availability and accommodation and appropriateness. Conclusion: African refugees experience significant social and cultural challenges in accessing primary health care services. These challenges could be due to a lack of literacy on the part of health services and their providers in servicing the needs of African refugees. This is an important finding that needs to be addressed by the Australian health care system and services. Enhancing organisational health literacy through evidence-informed strategies in primary health systems and services can help reduce disparities in health access and outcomes that may be exacerbated by cultural, linguistic and religious differences. [ABSTRACT FROM AUTHOR]

One of the crucial factors in changing behaviour towards pro‐environmental actions is climate change perception. The latest measurement tool for assessing this variable is the Climate Change Perception Scale (CCPS). However, CCPS has not gained widespread adoption and usage across different cultures, including Indonesia, and no analyses have been conducted to adapt and validate CCPS in the Indonesian context. Therefore, this study aimed to adapt, validate, and assess the measurement tool's consistency in Indonesia's cultural context. To investigate the instrument's psychometric properties, two studies (n = 358, 415) were conducted in Indonesia to provide evidence of the internal consistency, convergent validity, and predictive validity of CCPS. The results of a confirmatory factor analysis (CFA) showed that the Indonesian version of CCPS, which consists of 15 items, with three for each dimension, accurately and reliably measured perception of climate change. CCPS also demonstrated good convergent validity, as indicated by the significant correlations with a nature relatedness (r = 0.425, p < 0.01) and biospheric value (r = 0.341, p < 0.01) construct. Furthermore, it exhibited predictive validity by predicting pro‐environmental behaviour, β = 0.243, b = 0.176, t(413) = 5.10, p < 0.01. However, the Indonesian version of CCPS still needs to be tested and confirmed through various studies, considering the poor validity of the temporal dimension and the weak factor loading of the consequence dimension in Study 2. [ABSTRACT FROM AUTHOR]

The affordances of social media, have significantly transformed how patients seek and process health information online, including those with chronic diseases like irritable bowel disease (IBD). Few studies have explored how information processing may impact symptom management. Guided by social cognitive theory, this study investigates how Chinese and U.S. patients (N = 838) process health information in a cross-cultural setting and the impact on symptom management. It finds that efficient information processing improves treatment understanding and symptom management for IBD patients, regardless of their cultural backgrounds. It also reveals a U-shaped quadratic relationship between IBD severity and emotional and peer support, indicating varying support needs at different IBD stages. These findings provide valuable insights for healthcare professionals, patients, and caregivers in designing interventions for chronic diseases. The study underscores the importance of recognizing the dynamics of health information processing and the need for a more nuanced approach to patient support and care. [ABSTRACT FROM AUTHOR]

Background: The cultural competence of nurses is crucial in providing nursing care for patients from different cultures. The absence of cultural competence can negatively impact the entire course of care; however, implementing cultural competence in critical care unit can be complicated. Aim: This study aimed to determine nurses' perceptions regarding cultural competence in critical care units. Study Design: This study used a qualitative design with semi‐structured interviews with nurses (n = 10) working in critical unites. Data were collected from February to June 2022 and then categorized and evaluated. Atlas.ti was used for the inductive thematic content analysis. Results: Three key areas identified were as follows: (1) nurses and culturally competent care in critical care, (2) cultural challenges in practice and (3) suggestions for improving culturally competent care. The participants expressed that culturally competent care in critical care units has specific limitations because of the nature of the intensive care units (ICUs). Additional learning included opportunities to improve culturally competent care, such as raising cultural awareness, developing language skills and promoting culturally competent care. Conclusions: Providing culturally competent care in critical care units is an understudied area. Identifying barriers and cultural challenges is one strategy nurses can use to improve culturally competent ICU care. Relevance to Clinical Practice: Creating cultural awareness by training nurses in their own culture, in cultural diversity, and in overcoming prejudices and stereotypes is an essential step towards increasing cultural competence. Understanding nurses' perceptions on this topic can provide valuable insights into the challenges and opportunities for providing culturally sensitive care in a critical care setting. [ABSTRACT FROM AUTHOR]

Diet has been repeatedly shown to affect mental and sleep health outcomes. However, it is well known that there are cross‐cultural differences in dietary practices as well as the prevalence of mental and sleep health outcomes. Given that the dietary inflammatory potential of diets has been linked to mental and sleep health outcomes, in the current study we sought to assess the inflammatory status of habitual diets and examine its relationship with mental and sleep health outcomes in both the United Kingdom and Japan. Our aim was to determine if the associations between the dietary inflammation index (DII) score and these health outcomes could elucidate any potential cross‐cultural differences in health. Online survey data was collected from 602 participants (aged 18–40 years) in the United Kingdom (n = 288) and Japan (n = 314). Participants self‐reported their dietary intakes, as well as current mental health and sleep patterns. The DII score was calculated (score range − 2.79 to 3.49) We found that although participants in the United Kingdom reported better overall mental wellbeing, participants in Japan reported less severe depression, anxiety and stress and better subjective sleep quality, less sleep disturbances and daytime dysfunction, despite sleeping shorter, and a better adherence to an anti‐inflammatory diet. Moreover, across the United Kingdom and Japan, adherence to more anti‐inflammatory diets predicted higher levels of subjective sleep quality, fewer sleep disturbances, less use of sleep medicine and less daytime dysfunction. In conclusion, there are several differences between mental and sleep health outcomes in the United Kingdom and Japan, which could be attributable to the inflammatory potential of respective regional diets. Future studies are warranted to examine the mental and sleep health benefits of adhering to anti‐inflammatory traditional Japanese diets in clinical and subclinical cohorts. [ABSTRACT FROM AUTHOR]

Internalized sexual stigma is an important contributor to LGBT mental health disparities. In Thailand, the absence of validated instruments represents a research barrier. The study's purpose was to translate and evaluate the psychometric properties of the Revised Internalized Homophobia (IHP-R) scale. Based on the cross-cultural principle, team translation was applied. The IHP-R was translated by the principal author and reviewed by bilingual Thai nurses, and clarifications were made. Multidisciplinary experts provided back translation and reconciled the finalized Thai version. The psychometric properties were established in 412 Thai LGBT individuals. Data was collected via online and paper-pencil surveys and analyzed using SPSS. Most participants were male, age ranged 18–53, with moderate levels of internalized homophobia (M = 2.3, SD = 1.04). The inter-item and item-total correlations were.38-.63 and.55-.68. The content validity index was high (I-CVI, S-CVI/UA/Ave = 1). The exploratory factor analysis confirmed one construct of internalized sexual self-stigma (factor loading =.702–.816). Scores on IHP-R were correlated with stress and experiences of discrimination (r =.14 and.12). Internal consistency reliability was also high (Cronbach's alpha coefficient =.83). The IHP-R Thai version has high psychometric properties and is appropriate for LGBT research in Thailand. [ABSTRACT FROM AUTHOR]

BACKGROUND: This project aims to characterize the extent and nature of impostor phenomenon (IP) among women surgeons in Canada. IP is well documented among medical professionals and trainees. It is known to have significant impacts on mental health and career trajectory. STUDY DESIGN: We conducted a cross-sectional survey of self-identifying women who have completed a surgical residency and currently or most recently practiced in Canada. RESULTS: Among 387 respondents, 98.7% have experienced IP. Median IP score corresponded to frequent impostor feelings or high impostorism. Self-doubt affects most women surgeons for the first time during training. It tends to be most intense in the first 5 years of practice and lessens over time. One hundred twelve (31.5%) surgeons experience self-doubt in the operating room (OR). Due to self-doubt, 110 (28.4%) respondents preferred to work with a more experienced assistant in the OR, whereas 40 (10.4%) stated that they would only operate with an experienced assistant. Few surgeons take on less OR time due to self-doubt (29 [7.5%]), but 60 (16.5%) take on fewer complex cases due to self-doubt. A small but important number of surgeons (11 [2.8%]) had given up operating altogether due to self-doubt. Due to feelings of self-doubt, 107 (21.4%) respondents were hesitant to take on a leadership role in the workplace. CONCLUSIONS: IP is a nearly universal experience among women surgeons and is influential in their professional lives. This study contributes to scientific knowledge that can advance gender equity in medicine and leadership. [ABSTRACT FROM AUTHOR]

Rationale: Workplace attitudes among nurses with back pain disability are usually unsupportive as nurses tend to rely on passive approaches like pain medications and taking sick leave to manage the impact of their back pain experiences. Aims and Objectives: To lessen the burden of back pain disability, this paper aimed to collate information from publicly accessible health resources such as posters, pamphlets, and electronic resources and cross‐culturally validate this information for nurses in Zambia. Methods: Focus group discussions were used to produce the validation data for this study's qualitative research design. For cross‐cultural validation, deductive analysis was carried out using Herdman's framework for Conceptual Equivalence, Item Equivalence, and Semantic Equivalence. Results and Conclusion: The 14 messages on back pain given to the participants were reviewed to enhance clarity, applicability, and acceptability. Messages with similar meanings were merged, reducing the total number to 7. The revisions made to the 14 back pain messages aimed to improve understanding, acceptability, and relevance within the contexts and circumstances in which nurses' practice. This is important because the messages adapted for use in low‐ and middle‐income countries like Zambia are equivalent and applicable to those originally developed in high‐income countries. [ABSTRACT FROM AUTHOR]

Purpose: To systematically identify knowledge patterns and gaps in the appropriateness of nursing home (NH) to emergency department (ED) transitional care for older adults with dementia. Method: A systematic search of multiple information sources was performed from July to August 2023 using predesigned search strategies. Results: From 13 articles, 54 identified pieces of specific care evidence were grouped into six major care domains: (1) Resource Support for Assessing Transfer Needs and Patient Status; (2) Resource Support, Shared Decision Making, and Early Advance Care Planning; (3) Standardized Multimodal Information Transfer; (4) Designated ED and NH Transition Coordinators; (5) Enhanced Interfacility Collaboration; and (6) Appropriate Transitional Care Education, Research, and Policy Beyond the Transfer Interface. Conclusion: A comprehensive, consensus-based body of evidence is lacking. Despite person-centered, standardized, and professional resources supporting transitional care, reorienting NH cultural models remains unclear. Gaps include evidence tailored to diverse participants and contexts. Thus, a focus on policies, education, and research is required. [Journal of Gerontological Nursing, 50(9), 37–45.] [ABSTRACT FROM AUTHOR]

To explore the transition from correctional facilities to community among women living with HIV in Vancouver, Canada, we interviewed 19 recently incarcerated women and 6 service providers. Findings highlighted heightened risk of violence at release, a lack of immediate supports, challenges accessing safe housing and addictions treatment, and interruptions in HIV treatment and care. In the face of structural barriers, women blamed themselves for not being able to break the cycle of incarceration. There is a critical need for enhanced pre-release planning with a priority on housing and substance use services, alongside supports that are trauma-and violence-informed and culturally safe. [ABSTRACT FROM AUTHOR]

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful , cross-cultural connections , the importance of language , increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions. [ABSTRACT FROM AUTHOR]

Background: Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child's bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is worth exploring. Methods: A systematic academic database and grey literature search strategy was conducted using CINAHL, Medline Psych Info, and Google Scholar. Keywords used included truth, children, nurse, disclosure, serious illness, and communication. A total of 17 publications of varying types were included in the final data set. Ethical Considerations: As this was a review of the literature, there were no direct human participants. Empirical studies included in the review had received ethics approval. Results: Of the 17 articles included in the review, only one directly reported on the experiences of nurses asked to withhold the truth from patients. Empirical studies were limited to HIV-positive children and children diagnosed with cancer and the dying child. Conclusion: A paucity of literature exploring the experiences, attitudes, and beliefs of nurses with regard to truth-telling to seriously ill children is evident. Little consideration has been given to the role nurses play in communicating medical information to children in a hospital setting. The 17 articles included in the review focused on cancer, and HIV, diagnosis, and end-of-life care. Further research should be undertaken to explore the experiences and attitudes of nurses to clinical information sharing to children hospitalised with a wide range of serious illnesses and in diverse clinical scenarios. [ABSTRACT FROM AUTHOR]

The unique health-related traditions, perceptions, and communication patterns of Ethiopian immigrants are challenging to Israeli healthcare providers who are trained in western medicine. The aim of this review was to conduct a survey of traditions, beliefs, and symptom reporting by Ethiopian immigrants and culturally oriented interventions to improve the care of Ethiopian immigrants. We used the keywords "Ethiopian immigrants Israel" and "Ethiopian Jews." Of 418 articles initially retrieved, 35 satisfied the inclusion and exclusion criteria. We described health-related traditions and their possible complications. Possession syndrome was frequently misdiagnosed as a neurological or psychiatric disorder. The medical staff was unfamiliar with these health and illness beliefs, somatization patterns, and the communication style of Ethiopian immigrants. There were successful interventions that involved liaisons from the Ethiopian community and community-based educational activities. Medical professionals working with African immigrants worldwide can use the Israeli experience to develop effective, culturally oriented interventions to optimize the health care for these immigrants. [ABSTRACT FROM AUTHOR]

Inequitable pregnancy care experiences and outcomes disproportionately affect refugee background women in Australia. Culturally safe care is essential for achieving health equity, however, cultural safety can only be determined by the person receiving care. To our knowledge, women of refugee background in Australia are yet to be asked what culturally safe pregnancy care is to them. Specifically, this study aimed to explore what culturally safe pregnancy care is to Karen women (from Burma) of refugee background. A photovoice study founded on community-based participatory research principles was undertaken with a Karen community of refugee background living in Victoria, Australia. A community advisory group was established, guiding study design and conduct. Five S'gaw Karen-speaking women with experience of pregnancy care in Australia were invited to take photos within their community. Participants shared their photos and stories with each other in four online discussion groups. Reflexive thematic analysis guided by a critical constructionist lens developed three themes: Building foundations for belonging; cultivating reciprocal curiosity; and storytelling as an expression of self and shared power. These themes sit within the overarching theme When I can be my whole authentic self, I feel safe and know that I belong. When Karen women can embrace their cultural and spiritual identity without fear of discrimination, including racism, culturally safe pregnancy care is possible. This study contributes to the design and delivery of maternity services by providing insights that can enhance equitable and culturally safe pregnancy care for Karen women of refugee background. [ABSTRACT FROM AUTHOR]

Introduction: Culturally and linguistically diverse population groups disproportionately experience higher weight and other non–weight‐related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight‐related healthcare experiences of individuals of Arab heritage with higher weight in Australia. Methods: A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribed and thematically analysed. Results: Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8) and all were Muslim (n = 15). Four main themes were identified: (1) appearance‐based judgement, (2) generalised advice and assumptions, (3) cultural responsiveness and (4) healthcare system constraints. Conclusion: Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight‐inclusive and acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reform and weight‐inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holistic and culturally safe care. Patient or Public Contribution: Insights gained from conversations with Arab heritage community members with lived experiences regarding weight‐related healthcare encounters informed the study design and approach. [ABSTRACT FROM AUTHOR]

To translate the Hand-Use-at-Home questionnaire (HUH), assesses the amount of spontaneous use of the affected hand in children with 18 bimanual activities, into Turkish and examine its validity and reliability on children with neonatal brachial plexus palsy (NBPP) or unilateral cerebral palsy (UCP). The HUH was translated and cross-culturally adapted to Turkish and administered to children with NBPP (n = 25) and UCP (n = 42) between 3 and 10 years. The psychometric analyses included reliability by internal consistency (Cronbach's alpha) and test/retest reliability (intraclass correlation coefficient, ICC) structural validity was evaluated with exploratory factor analysis, and construct validity was investigated by matching the HUH with the Pediatric Outcome Data Collection Instrument Upper Extremity Scale (PODCI) (NBPP only), and Children's Hand-Use Experience Questionnaire (CHEQ) (UCP only). HUH showed excellent test–retest reliability (ICC2,1 = 0.988 Cl (0.977–0.992)), excellent internal consistency (Cronbach's-α = 0.989), and moderate correlation with CHEQ (rs = 0.558) in UCP and high correlation with PODCI Scale (rs = 0.789) in NBPP group. The HUH had low and moderate correlation respectively lesion-extent levels (r=-0.457) in NBPP and 5 Manual Ability Classification System levels (r=-0.688) in the UCP group. The HUH is a valid and reliable tool to assess the amount of spontaneous use of the affected hand in Turkish children with NBPP and UCP. The Hand-Use-at-Home (HUH) questionnaire is a reliable and good valid outcome measure to evaluate the amount of spontaneous use of the affected hand. We suggest the Turkish version of the HUH be used in the Turkish children to indicate small changes in the severity of disorder of children until a normal quality of life is achieved. The HUH can be used with high reliability and validity by experienced and inexperienced doctors and physiotherapists. [ABSTRACT FROM AUTHOR]

Purpose: Although more people from Middle Eastern countries are visiting South Korea for medical treatment, Korean nurses lack experience in treating them. Understanding and describing Korean nurses' experiences can help them provide quality care to these patients by enhancing their competency in culturally appropriate care. This study described the experiences of nurses who provide care to Middle Eastern patients in clinical settings in South Korea. Methods: We conducted a phenomenological study to describe nurses' experience of caring for patients from Middle Eastern countries. Ten nurses with prior experience in caring for these patients were recruited from a university-affiliated tertiary hospital. Semi-structured face-to-face interviews were conducted between May 1 and June 4, 2020. The transcribed data were analyzed using Giorgi's phenomenological method to identify the primary and minor categories representing nurses' experiences. Results: Four major categories (new experiences in caring for culturally diverse patients, challenges in caring for patients in a culturally appropriate manner, nursing journey of mutual agreement with culturally diverse patients, and being and becoming more culturally competent) and 11 subcategories were identified. Conclusion: Nurses experience various challenges when caring for Middle Eastern patients with diverse language and cultural needs. However, nurses strive to provide high-quality care using various approaches and experience positive emotions through this process. To provide quality care to these patients, hospital environments and educational programs must be developed that center on field nurses and students and support them in delivering quality care while utilizing their cultural capabilities. [ABSTRACT FROM AUTHOR]

Gender differences exist in mental and physical health in schizophrenia, and healthcare education is part of the associated clinical approach. The main goal of the present paper is to describe a women's clinic for schizophrenia and carry out a narrative review about innovative healthcare and learning strategies in the context of women who suffer from schizophrenia, and to discuss innovative strategies for both healthcare and learning projects to be applied in this context. Observing the development of our unit, four clear innovation phases can be distinguished: the generation of new ideas (clinical and social needs), strategic planning (five observatories), the execution of these strategies (observatories/teams/interventions) and feedback, iteration and scaling. We found that the observatory for morbi-mortality adopted a retroactive proactive approach, and the observatory for hyperprolactinemia was proactive and deliberate. We describe the innovation aspects, both clinical and educational, as incremental. There was one exception, the introduction of a social exclusion and discrimination observatory, that from our perspective, was not gradual, but transformative. Future learning projects should include the role of social sciences and humanities and new technologies. Our pilot project gave us the opportunity to apply new learning methods to a relatively neglected field of care. [ABSTRACT FROM AUTHOR]

Background: This paper describes how First Nations Kidney Warriors (Aboriginal and Torres Strait Islander people living with kidney disease), dental hygienists, kidney health care professionals, an Aboriginal hostel accommodation manager and researchers co-designed an approach to improve oral health in South Australia. Kidney Warriors have strong connection to Country, Community and family that underpins health, wellbeing and approaches to research. However, significant colonisation, racism and marginalisation have impacted Kidney Warriors' social, cultural and financial determinants of health, leading to increased chronic conditions including kidney disease. Access to culturally safe, affordable and responsive oral health care is vital but challenging for First Nations Peoples undergoing dialysis and kidney transplantation; Australian oral health care is generally provided privately, in metropolitan centres, by professionals who may hold unconscious bias about First Nations Peoples and incorrect assumptions regarding equal access to care. Methods: The AKction – Aboriginal Kidney Care Together Improving Outcomes Now kidney care oral health working group codesigned strategies to address disparities and gaps in care, and co-create more accessible, responsive, culturally safe and sustainable models of care. A decolonising and collaborative participatory action research was informed by Dadirri Deep Listening and Ganma Knowledge Sharing with repeated cycles of Look and Listen, Think and Discuss, Take Action Together. A small pilot evaluation survey of clinical placement in an Aboriginal setting was undertaken. Results: Four phases of collaboration were undertaken. Community and health professional consultations identified key gaps and priorities. Clinical yarning and cultural safety training and an interprofessional skills day was co-facilitated. Dental hygienist student clinical placement at Kanggawodli Aboriginal Hostel was initiated and evaluated. First Nations Kidney Warriors were positioned as educators and experts of their own lives and health care needs. A new framework for kidney health—oral health cultural safety and clinical education was developed. Conclusion: This codesigned approach involving inter-professional collaboration and joint decision making with community members has significantly informed improvements in oral health care information, services and referral with and for First Nations Peoples with kidney disease. This project provides a working example of how to decolonise health service and education programs from the ground up. Trial registration: NHMRC PAR 2004389. [ABSTRACT FROM AUTHOR]

Background: Caregiver self-efficacy is crucial in improving patient outcomes and caregiver well-being, but there is a lack of suitable scales to assess this concept within the context of Chinese culture. This study aimed to cross-culturally translate the Caregiver Self-Efficacy in Contributing to Patient Self-Care (CSE-CSC) Scale and evaluate its psychometric properties using classical test theory and item response theory. Methods: The CSE-CSC scale was adapted using Brislin's translation model after obtaining authorization from the original author. A multicenter, cross-sectional study was conducted to assess the psychometric properties of this scale. Classical test theory was used to evaluate reliability (internal consistency, test-retest reliability), validity (content validity, structural validity, convergent validity), and floor and ceiling effects. Item response theory was employed to assess the fit of the rating scale model, reliability, item difficulties, and measurement invariance. Results: The translation and cultural adaptation process was completed. Classical test theory demonstrated good internal consistency (Cronbach's α = 0.935) and test-retest reliability (ICC from 0.784 to 0.829, p<0.001). The I-CVI and K* of each item ranged from 0.875 to 1.00 and 0.871 to 1.00. The first-order 2-factor model fit well (χ2/df = 3.71, RMSEA = 0.082, SRMR = 0.032, CFI = 0.973, TLI = 0.60). Convergent validity showed that the CSE-CSC scores had a strong positive correlation with three separate scales of the CC-SC-CII. There was no floor and ceiling effect in this scale. Rasch analysis showed that the CSE-CSC scale demonstrated a good fit to the rating scale model and exhibited excellent reliability (person/item separation index>2, person/item reliability coefficients>0.8). The Wright map showed that item difficulty matched the respondents' measured abilities. The analysis of differential item functioning (DIF) showed that all items were comparable in gender. Conclusions: This study indicated that the CSE-CSC scale had good reliability, validity, difficulty degree, and measurement invariance. The CSE-CSC scale can be used to measure caregiver self-efficacy of Chinese patients with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context. Methods: Following Beaton et al.'s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates a good internal consistency and stability, making it suitable for assessing nursing students during clinical internships and practicing nurses. The availability of Italian tools promotes healthcare research, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is a chronic disease that can cause psychological stress. This study was conducted to perform the translation and cross-cultural adaptation of the QSD-R for diabetic patients into Portuguese (Brazil). Methods: This study was a cross-cultural adaptation process carried out in a public university in São Paulo, Brazil, in three stages: translation and backtranslation by two native-speaking independent professionals, analysis by a committee of specialists, and a pre-test phase. Results: The final version was created by seven experts after making semantic, idiomatic, and cultural changes to eighteen items. The results indicated a satisfactory content validation index (CVI ≥ 0.80). This version was applied to 30 patients. No item was excluded from the instrument. Conclusion: The translated version of the QSD-R was considered adequate and culturally adapted for use in Brazil to enable the psychometric validation of the instrument. [ABSTRACT FROM AUTHOR]

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 howemergency department nurses should incorporate this into practice. [ABSTRACT FROM AUTHOR]

Stigma remains a significant barrier preventing individuals from seeking the support they need, particularly for individuals with East Asian heritages. To explore potential mechanisms, this study examined links from East Asian ideologies to mental health help‐seeking attitudes and peace of mind across five cultural groups: 322 respondents in China, 400 in Japan, 362 in Taiwan, 319 Asian Americans, and 688 white Americans. The three teachings of East Asia accounted for 31%–85% of the cross‐cultural differences in mental health attitudes and peace of mind. Empowering Confucian tenets (self‐cultivation, leading by example, and human heartedness), Taoism, and Buddhism all uniquely predicted greater peace of mind across most of the groups. Empowering Confucianism also predicted lower mental health stigma whereas Buddhism predicted greater stigma. Finally, Restrictive Confucian tenets (e.g., interpersonal harmony, propriety, and relational hierarchy) predicted greater stigma and lower peace of mind. Implications for addressing stigma/resistance within treatment and for promoting mental health across cultures are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to transcreate a manualized cognitive-behavioral therapy (CBT) intervention to address depression and anxiety among Hispanic cancer survivors. Stakeholders reviewed the CBT workbook for language, content, and cultural relevance. We designed semi-structured interview guides to elicit intervention feedback. Stakeholder participants were Hispanic cancer survivors (n = 4), bilingual mental health providers (n = 2), and oncology professionals (n = 4). Transcreation was conducted by initial translation of the workbook followed by incorporation of stakeholder feedback. A bilingual (Spanish and English) interviewer conducted stakeholder interviews. The study team discussed themes/suggestions before refining the workbook. Stakeholders reported enthusiasm for the intervention. We gathered significant feedback regarding wording, images, and resources for the workbook. Development of culturally appropriate mental health resources for Hispanic cancer survivors is critical. By broadening research on psychosocial care to the Hispanic population, we increase the reach of evidence-based psychological care. Future research should fully evaluate the adapted CBT intervention among Hispanic survivors. [ABSTRACT FROM AUTHOR]

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid‐1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care. [ABSTRACT FROM AUTHOR]

Despite wide agreement among practitioners on the need for integration, mental health and peacebuilding practice remain siloed in conflict‐affected contexts. Yet before the integration of these two fields should occur, a revaluation of existing practice is needed. Within the field of mental health and psychosocial support (MHPSS), critics have long questioned dominant assumptions and treatment models, raising concerns about top‐down implementation, Western‐centric approaches, and a lack of community leadership. These criticisms are largely echoed within peacebuilding literature. Furthermore, both fields underappreciate the overlap between their practices. For example, the relationship between the structural drivers of poor mental health or the social‐psychological drivers underpinning peacebuilding. Accordingly, this article seeks to contribute to the development of a novel, integrated approach to MHPSS and peacebuilding—or 'psychosocial peacebuilding'. In doing so, we address dominant critiques of both fields, before discussing the relevance of critical (community) psychology as an ideal means in which to bridge a theoretical and practical gap between fields. Using quality peace as a guiding normative theory, we will also reinforce the argument that working to address mental health concerns is essential to creating peace in post‐conflict contexts. It concludes by exploring potential avenues for further research. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Objectives Using the concept of relational solidarity, we examine how autonomy, equality, dignity, and personhood are practiced in the care of people living with dementia at home in urban India. Methods Video interviews with 19 family carers and 25 health providers conducted in English, Hindi, and Kannada in Bengaluru between March and July 2022. Data were translated into English and thematically analyzed. Results Family carers and providers unanimously agreed that people with dementia should be respected and cared for. Concurrently, they perceived people with dementia as being "like a kid" and used the analogy of a parent–child relationship to understand their care responsibilities. This analogy informed how ethical principles such as personhood and equality were reframed in the relationships between family carers and people with dementia, as well as how carers and providers maintained the safety but undermined the autonomy of people with dementia through restricting their movements inside and outside the home. Discussion There can be relational solidarity in dementia care at home in urban India but also contradictions in the interpretations and applications of the ethical principles of autonomy, equality, dignity, and personhood. As such, a more organic, grassroots model of ethical practice is needed to frame care and provide material support to families in India. [ABSTRACT FROM AUTHOR]

A 2017 randomised controlled trial in Guerrero State, Mexico, showed supporting Indigenous traditional midwives on their own terms improved traditional childbirths without inferior maternal health outcomes. This narrative evaluation complements the trial to document participant experience of safer birth in cultural safety, transformative dynamics and implementation issues of the intervention. Stories came from 26 traditional midwives, 28 apprentices, 12 intercultural brokers and 20 Indigenous women who experienced the intervention. Their accounts indicate the intervention revitalised traditional midwifery and consolidated local skills through traditional midwife apprentices and intercultural brokers to support safe birth. According to the stories, communities reintroduced traditional perinatal care and reported positive health impacts for mothers, children, and other adults, which contributed to early collaboration with official health services. Challenges included remuneration and disinterest of younger apprentices and brokers. The intervention seems to have improved interaction between traditional and Western services, setting the stage for further intercultural dialogue. [ABSTRACT FROM AUTHOR]

No existing conceptual framework can describe the family precursors and dynamics that explain East Asian American (EAA) youth's mental health problems in their cultural context. To address this conceptual gap and better elucidate EAA youth's mental health issues, we present a conceptual framework that combines two existing theories: the triadic model of family process and acculturation gap-distress theory. We selected these two theories because they address youth mental health problems as a common outcome explained by family domains and complement each other by addressing certain processes in more depth. Using a cultural lens that allows researchers to reconstruct assumptions of theory in specific cultural contexts, the presented integrative framework of family processes identifies how universal and East Asian-specific aspects of familial factors influence the mental health problems of EAA youth. This framework is intended to guide future research efforts on EAA youth development and provide preliminary guidelines for social workers working with EAA families to provide culturally responsive care and services. [ABSTRACT FROM AUTHOR]

In this study, 349 Han and 217 Tibetan college students were investigated via the Templer Death Anxiety Scale in order to assess the potential class and influencing factors of death anxiety among them. In addition, Mplus software was used to analyse the latent categories of their death anxiety, and an R3STEP approach was adopted to perform a multinomial logistic regression of its influencing factors. Whilst the results of the former indicated that there are two latent classes, respectively, defined as 'high death anxiety type' (Han 65.20%; Tibetan 30.30%) and 'low death anxiety type' (Han 34.80%; Tibetan 69.70%), the latter demonstrated that compared with the 'low death anxiety type', the occurrence ratio of the 'high death anxiety type' was 47.00 and 34.04 percentage points higher with each increase in age. Furthermore, the stress and anxiety of Han and Tibetan college students were found to constitute factors that affect death anxiety. More specifically, the death anxiety of Tibetan college students was determined to be deeply influenced by a belief in the afterlife. [ABSTRACT FROM AUTHOR]

Indigenous Psychology within Australia reflects the traditional knowledges of Aboriginal and Torres Strait Islander Peoples and their understanding of the cultivation of relational social and emotional wellbeing (SEWB). However, these perspectives are poorly incorporated into dominant "Western" psychological theories and practice, such as Cognitive Behaviour Therapy (CBT). This represents a barrier to the cultural safety of current mental health practice and its decolonisation within Australia. This study brought together CBT Practitioners and Practitioners of an Aboriginal Wellbeing practice ("Wayapa") to engage in a series of yarns (guided focus groups) to share perspectives, insights, and stories on their own and each other's practices. Indigenous qualitative research approaches including Research Topic Yarning were engaged to decolonise the research environment and support dialogue at the cultural interface of the two practices. Through experiencing Wayapa, CBT practitioners reflected on gaps in their own practice, with an enthusiasm for the opportunities that Wayapa provided to decolonise their practice. Wayapa practitioners were able to celebrate the holistic nature of their practice and the possibility for it to inform dominant "Western" psychological theories and practice, such as CBT, and encourage a more connected and culturally safe way of working with First Nations peoples. Creating safe cultural interfaces between "Western" and Indigenous Psychologies, and building awareness of the value of Aboriginal grounded wellbeing models, can help to promote and expand culturally safe practices within Australian psychological practice. What is already known about this topic: The cultural safety and relevance of CBT for Aboriginal and/or Torres Strait Islander Peoples remains uncertain. There is limited knowledge of Aboriginal wellbeing practices and Indigenous Psychologies amongst non-Indigenous Australian mental health practitioners, including psychologists. Broadened understanding of Aboriginal wellbeing practices such as Wayapa Wurrrk, may contribute to decolonising psychology in Australia. What this topic adds: CBT and Wayapa share common and unique tools and concepts that can support the social emotional wellbeing of all Australians. Wayapa Wurrrk concepts such as earth mindfulness and the centring of Country as a foundation for wellness and social emotional wellbeing represent gaps in current CBT practice. Work at the cultural interface of "Western" and Indigenous Psychology offers a pathway to promote appreciation for, and active utilisation of, Indigenous psychologies including the social emotional wellbeing framework (SEWB). In this article, we recognise both Aboriginal and Torres Strait Islander Peoples as the First Nations of Australia. We acknowledge and pay respect to the knowledge that Aboriginal and Torres Strait Islander cultures are unique, all with their own languages, knowledge systems, beliefs, and histories. We recognise the collective terms they prefer also vary. With respectful consideration to these preferences, typically we will specify Aboriginal and/or Torres Strait Islander Peoples when referring to First Nations Peoples in this article. From time to time, we use the term Indigenous. However, we note that for many Aboriginal and Torres Strait Islander Peoples, this is not preferred. As such, we have only used this where we are referencing it's use from another source, or it is the established use of the term, such as its use in "Indigenous knowledges". Where referring to individual Aboriginal and/or Torres Strait Islander people, we have endeavoured to incorporate their preferences, including for example, reference to the Country they are connected to. [ABSTRACT FROM AUTHOR]

While previous systematic reviews have focused on individual interventions for refugees, the current study aims to contribute to the literature by systematically reviewing the effectiveness of group and community-based interventions, to provide insight into ways current treatments can be scaled and integrated into stepped-care interventions. A systematic review was conducted. In September 2022, PsycINFO, PubMed, Scopus, Embase and CINAHL were systematically searched and findings were analysed using narrative thematic analysis. Key findings were that in general the group format was effective, especially when paired with an intervention such as cognitive behavioural therapy. The findings also point to barriers and facilitators for accessing group interventions, including language, cultural safety, and gender considerations. In general, while groups were not typically seen as a replacement for individual therapy, the included studies suggested the complementary value of group modalities, as well as their utility as an early access intervention. Ultimately, the existing body of research concerning group interventions indicates that treatments delivered in a group format have utility and scalability and should be considered for integration into stepped models of care for people with refugee backgrounds. What is already known about this topic: Stepped care enhances access to mental health care. Refugees have a higher vulnerability to developing mental illness and lower access to services. Group programmes are often more culturally responsive for refugees. What this topic adds: Stepped care should include group-based and community interventions at the lower tiers of stepped care models. In-language culturally adapted group interventions are generally effective and accessible for refugees. To enhance accessibility, practitioners should consider providing transport and childcare as part of facilitating group-based interventions. [ABSTRACT FROM AUTHOR]

Objective:To identify the perceptions of the patients who received alternative care by telepsychiatry at the Cayetano Heredia Hospital (HCH). Methods:This research consisted of two phases: (1) transcultural adaptation of the Telehealth Usability Questionnaire (TUQ) with three experts and (2) application of the questionnaire in 183 patients from psychiatry in HCH. Nonparametric tests were used to determine the association between variables. Results:We applied 20 questions to 60 men and 123 women, with a median age of 45. The ease of using the virtual consultation service, the comfort with its use, and the general satisfaction had a score of 6 out of 7 and are associated with the number of devices that patients have and their degree of education. The usefulness, communication by virtual means, and the solution of technical problems had scores higher than 6, being considered acceptable by the patients. Willingness to have a teleconsultation again was high and was associated with patient satisfaction with the consultation. Conclusions:Most patients were satisfied with telepsychiatry via telemonitoring during the COVID-19 pandemic. The usage of validated tools such as TUQ might be included as part of evaluations of new telemedicine services. [ABSTRACT FROM AUTHOR]

Background: Many healthcare professionals and services strive to improve cultural safety of care for Australia's First Nations people. However, they work within established systems and structures that do not reliably meet diverse health care needs nor reflect culturally safe paradigms. Journey mapping approaches can improve understanding of patient/client healthcare priorities and care delivery challenges from healthcare professionals' perspectives leading to improved responses that address discriminatory practices and institutional racism. This project aimed to review accessibility and usability of the existing Managing Two Worlds Together (MTWT) patient journey mapping tools and resources, and develop new Health Journey Mapping (HJM) tools and resources. Method: Four repeated cycles of collaborative participatory action research were undertaken using repeated cycles of look and listen, think and discuss, take action together. A literature search and survey were conducted to review accessibility and usability of MTWT tools and resources. First Nations patients and families, and First Nations and non-First Nations researchers, hospital and university educators and healthcare professionals (end users), reviewed and tested HJM prototypes, shaping design, format and focus. Results: The MTWT tool and resources have been used across multiple health care, research and education settings. However, many users experienced initial difficulty engaging with the tool and offered suggested improvements in design and usability. End user feedback on HJM prototypes identified the need for three distinct mapping tools for three different purposes: clinical care, detailed care planning and strategic mapping, to be accompanied by comprehensive resource materials, instructional guides, videos and case study examples. These were linked to continuous quality improvement and accreditation standards to enhance uptake in healthcare settings. Conclusion: The new HJM tools and resources effectively map diverse journeys and assist recognition and application of strengths-based, holistic and culturally safe approaches to health care. We have co-designed Health Journey Mapping tools and resources with First Nations patients and families and with First Nations and non-First Nations healthcare professionals to address current gaps in care. These pragmatic, strengths-based tools and resources enhance and incorporate cultural safety, continuous quality and improvement and comprehensive care and can be used collaboratively by healthcare consumers and professionals to assess and improve the quality, access, experiences and outcomes of care. [ABSTRACT FROM AUTHOR]

Objective: Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. Methods: We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. Results: Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. Conclusions: A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services. [ABSTRACT FROM AUTHOR]

This study examines the use of verbal (Arabic/Hebrew), cultural (collectivist/individual), and therapeutic languages (bibliotherapy/psychotherapy) among Israeli-Arab bibliotherapists. Semi-structured in-depth interviews were conducted among 10 therapists to ascertain how their multilingualism influences their dialogues among themselves, with their patients, as well as which literature they integrate into their work. Three main findings emerged: (1) Lingual choice to reflect proximity or distance from emotional issues in therapy, or from their own culture at supervision; (2) Literature selection based on their patient's needs and to reduce diglossia; and (3) A need to translate the professional glossary to Arabic, and to group with Israeli-Arab colleagues. In conclusion, the therapists created an integrative and hybrid identity moving between different languages in order to meet the needs of proximity or distance from themselves, their patients, and their culture. This study can help multicultural therapists better conceptualize their experiences, and consolidate their identities. [ABSTRACT FROM AUTHOR]

Indigenous community-controlled health care organizations provide timely, sustained, and culturally safe care. However, their expertise is often excluded from health professional education. This limits the transfer of knowledges and protocols to future practitioners--those positioned to shape health care systems and practices that could achieve the health rights of Indigenous people and reduce health and social inequities. In Australia, despite national government commitments to transforming curricula, services, and systems related to Indigenous health, health care training organizations such as universities generally have low numbers of Indigenous staff and few strategies to engage Indigenous experts. The authors of this paper are part of the Bunya Project, an Indigenous-led participatory action research effort designed to support non-Indigenous university staff and curriculum development through partnerships with Indigenous community-controlled organizations. We conducted 24 interviews with Indigenous individuals to ascertain recommendations for health care curricula. Three themes emerged: (1) role-modeling and leadership of Indigenous-controlled health organizations; (2) specific learnings for health professionals; and (3) achieving human rights in practice. Interviews also highlighted the need for health professionals' extension beyond clinical caregiving, and staff and students' development of knowledge, skills, and actions regarding client self-determination in order to promote clients' rights across all aspects of their health care. Critical self-reflection by health professionals is a foundational individual-level skill necessary for cultural safety. [ABSTRACT FROM AUTHOR]

Grounded in human rights approaches, truth and reconciliation commissions (TRCs) explore an event or process that did widespread and systematic intentional harm to a group of people. Health as a fundamental right is an important component addressed by TRCs. Yet despite TRCs often having recommendations for health care systems, it is unknown how well these recommendations are being translated within health care settings. Therefore, the overarching purpose of our scoping review was to identify academic articles that discussed health care system discourse or responses to TRCs in the context of Indigenous Peoples. Our thematic analysis of the included articles identified three main themes for health care system responses to TRCs: (1) the acknowledgment of multiple ways of knowing, being, and doing in health systems; (2) current interventions as responses within health systems; and (3) suggestions for change within health systems. Although a TRC may create a specific road map and mandate for health care systems, we found considerable variability in the uptake of these actions across institutions. Concerted efforts within and around health care systems and across sectors are therefore necessary to achieve large-scale, meaningful change for Indigenous Peoples post-TRCs and to maintain accountability as a foundational human rights principle. [ABSTRACT FROM AUTHOR]

Background. Cardiovascular disease is a major health issue for Māori that requires timely and effective first-response care. Māori report culturally unsafe experiences in health care, resulting in poor health outcomes. Research in the pre-hospital context is lacking. This study aimed to explore experiences of cultural (un)safety for Māori and their whānau who received acute pre-hospital cardiovascular care from paramedics. Methods. Utilising a qualitative descriptive methodology and Kaupapa Māori Research (KMR), in-depth semi-structured interviews were undertaken with 10 Māori patients and/or whānau, and a general inductive approach was used for analysis. Results. Three key themes were identified: (1) interpersonal workforce skills, (2) access and service factors and (3) active protection of Māori. Participants described paramedics' clinical knowledge and interpersonal skills, including appropriate communication and ability to connect. Barriers to accessing ambulance services included limited personal and community resources and workforce issues. The impact of heart health on communities and desire for better preventative care highlighted the role of ambulance services in heart health. Conclusion. Māori experience culturally unsafe pre-hospital care. Systemic and structural barriers were found to be harmful despite there being fewer reports of interpersonal discrimination than in previous research. Efforts to address workforce representation, resource disparities and cultural safety education (focussing on communication, partnership and connection) are warranted to improve experiences and outcomes for Māori. [ABSTRACT FROM AUTHOR]

Background: Training in speaking up skills for nursing professionals provides the groundwork for promoting a culture of curiosity and inquiry. At the foundation of speaking up is psychological safety for team members to disagree, offer alternative ideas, and ask questions. Method: A large-scale training session, Finding Your Voice: Speaking Up & Listening Skills, was designed and delivered to 1,306 nurses at an academic medical center. Results: Most participants reported that the session met the training goals (97%). There was an increase in participants' confidence in speaking up (pretraining 69% ± 19%; posttraining 73% ± 15%; p <.0001), and listening (pretraining 68% ± 19%; post-training 74% ± 15%; p <.0001). Leaders showed greater increases in confidence in listening and responding to nurses speaking up (leaders 5.6% vs. nonleaders 4.2%, p <.00001). Conclusion: Nurses benefited from an interactive educational experience by practicing strategies for speaking up and listening. [J Contin Educ Nurs. 2024;55(6):309–316.] [ABSTRACT FROM AUTHOR]

Objective: This study examines the impacts of urbanisation‐induced displacement on rural older villagers and the issues of rebuilding ageing in place in Suzhou Municipality in China's Jiangsu Province. Methods: The study employed a qualitative research method involving three measures of data collection, including 20 older‐adult interviews, 14 key informant interviews (with street and community administrators, managers of service companies, managers of nursing homes and community doctor) and participant observation of older villagers' daily life in urban resettlement communities. Results: The displacement and resettlement of villagers for urbanisation had serious negative impacts on older villagers, including financial insecurity, relative deprivation and radical changes to the living environment. The community services were limited and insufficient, but the resettlement of the whole village in the same place enabled the village community to maintain social and cultural continuities, which facilitated older villagers' adaptation to the new urban place. Filial piety, though weakened and transformed, continued to play an important role in regulating old‐age support, but descending familism reduced family resources for old‐age support. Conclusions: This study highlights the importance of examining the impacts of external social and economic forces, such urbanisation in China, on ageing in place. We draw three conclusions based on empirical research in Suzhou: (1) the resettlement of older villagers in urban areas did not significantly narrow the rural–urban gap in old‐age support in Suzhou; (2) urbanisation‐induced displacement in China affected older residents differently from gentrification in Western countries, due to different processes of compensation and resettlement as well as China's rural–urban welfare gap; and (3) community services for displaced older villagers are limited, but social and cultural continuities before and after resettlement have helped older villagers adapt to the new urban place. [ABSTRACT FROM AUTHOR]

Background: Indigenous palliative persons and their families often have different values, spiritual traditions, and practices from Western culture and Canadian health systems. Additionally, many healthcare policies and practices have been established without adequate consultation of the Indigenous populations they are meant to serve. This can result in barriers to Innu receiving culturally safe end-of-life care. Innu community leaders from Sheshatshiu, Labrador, have identified a need for further research in this area. The purpose of this study is to: (1) describe the cultural and spiritual practices related to death and dying of the Innu in Sheshatshiu; (2) identify aspects of current end-of-life care delivery that serve and/or fail to meet the cultural and spiritual needs of the Innu in Sheshatshiu; and (3) explore ways to integrate current end-of-life care delivery practices with Innu cultural and spiritual practices to achieve culturally safer care delivery for the Innu. Methods: This qualitative patient-oriented research study was co-led by Innu investigators and an Innu advisory committee to conduct semi-structured interviews of 5 healthcare providers and 6 decision-makers serving the community of Sheshatshiu and a focus group of 5 Innu Elders in Sheshatshiu. Data was analyzed thematically from verbatim transcripts. The codebook, preliminary themes, and final themes were all reviewed by Innu community members, and any further input from them was then incorporated. Quotations in this article are attributed to Innu Elders by name at the Elders' request. Results: The findings are described using eight themes, which describe the following: relationships and visitation support a "peaceful death"; traditional locations of death and dying; the important role of friends and community in providing care; flexibility and communication regarding cultural practices; adequate and appropriate supports and services; culturally-informed policies and leadership; and Innu care providers and patient navigators. Conclusions: The Innu in Sheshatshiu have a rich culture that contributes to the health, care, and overall well-being of Innu people approaching end of life. Western medicine is often beneficial in the care that it provides; however, it becomes culturally unsafe when it fails to take Innu cultural and spiritual knowledge and traditions into account. [ABSTRACT FROM AUTHOR]

Background: Understanding how the general practice medical workforce defines cultural safety may help tailor education and training to better enable community-determined culturally safe practice. This project seeks to explore how Australian general practice registrars define cultural safety with Aboriginal and Torres Strait Islander patients and alignment with an Australian community derived definition of cultural safety. Methods: This mixed method study involved a survey considering demographic details of general practice registrars, questionnaire, and semi-structured interviews to explore how general practice registrars defined cultural safety and a culturally safe consultation. Results: Twenty-six registrars completed the survey. Sixteen registrars completed both the survey and the interview. Conclusion: This study shows amongst this small sample that there is limited alignment of general practice registrars' definitions of cultural safety with a community derived definition of cultural safety. The most frequently cited aspects of cultural safety included accessible healthcare, appropriate attitude, and awareness of differences. [ABSTRACT FROM AUTHOR]

Background: Maternal parenting self‐efficacy plays a critical role in facilitating positive parenting practices and successful adaption to motherhood. The Perceived Maternal Parenting Self‐Efficacy Scale (PMPS‐E), as a task‐specific measure, confirms its psychometric properties in cultural contexts. Compared with other tools, the advantages of the PMPS‐E are as follows: (i) specific context or time period during the lifespan of a child, (ii) explicitly assess parenting self‐efficacy across a diverse enough range of parenting tasks or activities during the perinatal/postnatal period and (iii) having robust psychometric properties. The aim of this study was to translate and determine the psychometric properties of the PMPS‐E among Chinese postpartum women (C‐PMPS‐E). Method: The cross‐cultural adaptation process followed Beaton et al.'s intercultural debugging guidelines. A total of 471 women were included to establish the psychometric properties of the C‐PMPS‐E. Mothers were asked to complete the C‐PMPS‐E, Edinburgh Postnatal Depression Scale (EPDS), the Generalized Anxiety Disorder‐7 (GAD‐7) and several demographic questions. The psychometric testing of the C‐PMPS‐E was established through item analysis, construct validity and internal consistency reliability. Results: Item analysis showed that the critical ratios of all items were greater than 3 between the low‐score group and high‐score group, and all item–total correlation coefficients were greater than 0.4. The fit indices showed that the original correlated four‐factor model of C‐PMPS‐E was observed to be an excellent fit to the data. The PMPS‐E was negatively correlated with the EPDS and GAD‐7 demonstrating its discriminant validity. As expected, no significant correlation was found between PMPS‐E total or subscale scores and mothers' age. In addition, statistically significant differences for parity were detected for C‐PMPS‐E total and subscale scores with multipara having higher scores. This was taken as further evidence of the scale known‐groups discriminant validity. In terms of internal consistency, the Cronbach's alpha of the C‐PMPS‐E total scale was 0.950, and subscales ranged from 0.76 to 0.89. Furthermore, a ROC curve analysis was conducted to establish the ability of the C‐PMPS‐E to distinguish between symptoms of depression and symptoms of anxiety. A cut‐off value of 55 was identified that resulted in good specificity and fair sensitivity. Conclusion: The C‐PMPS‐E is a reliable and valid tool to assess maternal parenting self‐efficacy in a Chinese context. [ABSTRACT FROM AUTHOR]

National and state governments in settler colonial countries are increasingly committing to policies and practices aimed at strengthening Indigenous frameworks, programmes and leadership in child protection services. However, research‐based information on Indigenous child welfare services and programmes is sparse. This qualitative literature review explores and documents key features of Indigenous child welfare and protection models and/or frameworks in an international context, with a specific focus on Indigenous children, young people, families, and communities. Twenty‐four publications meeting the inclusion criteria were included in the analysis. Published frameworks, models, services, interventions and/or programmes within the broader area of child welfare and children protection that are Indigenous‐designed and/or led or developed in partnership or collaboration with Indigenous peoples were identified. The review highlights 11 key dimensions that underpin the frameworks, models, services, interventions and/or programmes. Findings of the review also reveal commonalities across Indigenous cultures and contexts that from an Indigenous perspective are considered fundamental to supporting Indigenous children, young people and families involved with child protective services. Additionally, the findings point to the critical need for ongoing advocacy for Indigenous‐designed and led services and programmes, including support for Indigenous research, evaluation and intellectual leadership. [ABSTRACT FROM AUTHOR]

Research in the U.S. and other Western countries shows that children's early gesture use, which starts prior to verbal communication, is an important predictor of children's later language development. Despite increasing efforts to study gesture use in diverse contexts, most of our knowledge on the role of gesture is largely based on populations of Western countries. In this study, we add to the growing body of international research by examining gesture use by 31 mothers and their 14‐month‐old infants (12 girls) in South Korea and investigate the gestures used during interaction, and whether early gesture use at 14 months predicts Korean children's later language skills at 36 months. The results showed that in addition to using gestures observed in other cultural contexts, Korean mother‐child dyads used culturally specific gesture (i.e., bowing), showing an early sign of socialization that starts with preverbal children. In addition, Korean infants' index‐finger pointing, but not showing and giving, predicted their later receptive and expressive vocabulary skills at 36 months, providing additional support for the importance of pointing in early language development. [ABSTRACT FROM AUTHOR]

Background: Project ECHO® networks at Children's Health Queensland Hospital and Health Service (CHQHHS) are communities of practice designed to mitigate services and systems fragmentation by building collaborative partnerships addressing priority child and youth health needs. Aboriginal and Torres Strait Islander people experience the negative impacts of fragmentation in addition to historical challenges of absent or culturally inappropriate health services. Access to culturally safe and responsive services can be improved by engaging Aboriginal and Torres Strait Islander Health Workers and similar roles in an online community of practice, supporting the integration of cultural and clinical knowledge and self-determination of Aboriginal and Torres Strait Islander consumers in decisions affecting their health. Analysing professional support networks and knowledge sharing patterns helps identify enablers and barriers to partnerships. Using social network research, the multilevel network inclusive of ECHO network members and their colleagues was studied to identify interdisciplinary and cross-sector advice exchange patterns, explore the position of cultural brokers and identify common relational tendencies. Methods: Social network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings. Results: Brokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% of network). Professionals who occupy brokerage positions outside the ECHO network tend to be more connected with co-members within the network. Conclusions: This study is the first application of contemporary social network theories and methods to investigate an ECHO network. The findings highlight the connectivity afforded by brokers, enabling the coordination and collaboration necessary for effective care integration. Inclusion of cultural brokers in an ECHO network provides sustained peer group support while also cultivating relationships that facilitate the integration of cultural and clinical knowledge. [ABSTRACT FROM AUTHOR]

Aim: This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people. Design: Integrative review. Data Sources: An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted. Results: Forty‐two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person‐centred cancer care services that address practical needs. Conclusion: Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs. Patient or Public Contribution: Our team includes both First Nations people, non‐First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work. Implications for Nursing Practice: Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up‐to‐date cultural safety training and stand together with Indigenous and non‐Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP. [ABSTRACT FROM AUTHOR]