The purpose of this study was to investigate associations between school nurses' self‐assessed cultural competence in health visits with children of foreign origin and demographic variables, by using a cross‐sectional design. A Web‐based questionnaire assessing cultural competence and demographic variables was distributed to a nationally representative sample (n = 816) of school nurses in Sweden. Data were analyzed using regression analysis. School nurses assessed themselves as culturally aware and moderately culturally competent, but not as culturally knowledgeable, culturally skilled, or comfortable in cultural encounters. Cultural competence was related to education in cultural diversity, how often nurses encounter children of foreign origin, and nurses' country of origin. In total, these variables explained 23.6% of the variation in school nurses' cultural competence. Because school nurses regard themselves as moderately culturally competent, a foundation for promoting children's health on equal terms in school health care exists. However, education in cultural diversity combined with other additional strategies is needed to further strengthen school nurses' cultural knowledge, skills, and comfort level in encounters with children of foreign origin.
Background School nurses in the school health services are assigned to promote health and participation among children when conducting health visits. Still, for children of foreign origin this promotion of participation might be hampered by challenges related to cultural diversity and language barriers. Therefore, knowledge needs to be developed regarding how these children’s participation can be promoted, to support them in sharing and describing matters important for their health. The aim was to investigate school nurses’ descriptions of promoting participation for children of foreign origin in health visits. Methods A content analysis of 673 Swedish school nurses’ answers to eight open-ended questions regarding promotion of participation for children of foreign origin was conducted. The open-ended questions were part of a larger web-based cross-sectional survey distributed to school nurses in Sweden. Results The results show that school nurses use three main approaches during the health visit: adjusting according to the child’s proficiency in Swedish and/or cultural or national background, adjusting according to the child’s individual needs, and doing the same for all children regardless of their origin. Yet, adjustments according to the child’s proficiency in Swedish and/or cultural or national background were the most common. Conclusions By combining the approaches of adjusting, a child-centered care that contributes to children’s participation in health visits and equity in health could be provided.
Introduction: Encounters with children of foreign origin call for school nurses’ cultural competence during the health visits. This study aimed to investigate the statistical associations between the cultural constructs described by the Process of Cultural Competence in the Delivery of Healthcare Services (PCCDHS) model and whether school nurses’ cultural encounters, cultural knowledge, and cultural skill could statistically predict their cultural awareness. Methodology: Spearman correlation and hierarchical regression analyses were conducted using cross-sectional secondary data from 816 Swedish school nurses. The cultural constructs in the theoretical description of the PCCDHS model guided the selection and sorting of the items on cultural competence. Results: The constructs of cultural knowledge, cultural skill, cultural encounters, and cultural awareness were positively correlated with each other. However, becoming culturally aware was not statistically predicted by included cultural constructs ( R2 = 13.4, p = .06). Discussion: Despite the interrelations between the investigated cultural constructs of the PCCDHS model, understanding cultural awareness development requires further empirical testing.
Background All children in Sweden are invited to health visits to the school nurse to talk about their health. However, health visits with children of foreign origin might involve challenges when the child and school nurse do not share language and or culture. Such challenges might hinder the child's participation as e.g. sharing needs and experiences important for their health. Hence, school nurses' promotion of participation for these children need to be clarified to develop knowledge on how to promote health. The aim was to investigate school nurses' descriptions of promoting participation for children of foreign origin in health visits. Methods A cross-sectional study was conducted, using a web-based questionnaire distributed to all school nurses in Sweden. It contained eight open-ended questions regarding promotion of participation for children of foreign origin. Answers were provided by 673 Swedish school nurses and analyzed using qualitative content analysis. Results The preliminary result shows that school nurses use three approaches to promote participation: 1) adjusting according to the child's proficiency in Swedish and/or cultural or national background, 2) adjusting according to the child's individual needs, and 3) doing the same for all children regardless of their origin. These approaches are used throughout the health visit, although the most commonly was number 1. Such adjustments included the school nurse considering cultural aspects, simplifying their way of talking, or asking the child about their culture or background. Conclusions Adjustment according to the child's proficiency in Swedish and/or cultural or national background are warranted to promote participation in health visits with children of foreign origin. These will strengthen the opportunities for children to share their experiences as well as the encounter between school nurses and children. Key messages School nurses adjust promotion of participation when encountering children of foreign origin. Adjusting promotion of participation in health visits will enable children to share their health needs.
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