Migrants' and professionals' views on culturally sensitive pre-hospital emergency care

Kietzmann, Diana; Hannig, Christian; Schmidt, Silke

doi:10.1016/j.socscimed.2015.06.022

Cited by 12 publications

(16 citation statements)

References 16 publications

(25 reference statements)

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“…The second stage, code reduction, was achieved by convergence of codes that related to similar data and was conducted both within and across professional groups and then research sites. All data matrices were cross-checked to identify the stability of codes within the interview framework and across professional groups and research sites [ 19 ]. A third analytical step identified a set of themes and sub-themes.…”

Section: Methodsmentioning

confidence: 99%

Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T3 trial): a qualitative study

et al. 2020

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Background The implementation of evidence-based protocols for stroke management in the emergency department (ED) for the appropriate triage, administration of tissue plasminogen activator to eligible patients, management of fever, hyperglycaemia and swallowing, and prompt transfer to a stroke unit were evaluated in an Australian cluster-randomised trial (T3 trial) conducted at 26 emergency departments. There was no reduction in 90-day death or dependency nor improved processes of ED care. We conducted an a priori planned process influential factors that impacted upon protocol uptake. Methods Qualitative face-to-face interviews were conducted with purposively selected ED and stroke clinicians from two high- and two low-performing intervention sites about their views on factors that influenced protocol uptake. All Trial State Co-ordinators (n = 3) who supported the implementation at the 13 intervention sites were also interviewed. Data were analysed thematically using normalisation process theory as a sensitising framework to understand key findings, and compared and contrasted between interviewee groups. Results Twenty-five ED and stroke clinicians, and three Trial State Co-ordinators were interviewed. Three major themes represented key influences on evidence uptake: (i) Readiness to change: reflected strategies to mobilise and engage clinical teams to foster cognitive participation and collective action; (ii) Fidelity to the protocols: reflected that beliefs about the evidence underpinning the protocols impeded the development of a shared understanding about the applicability of the protocols in the ED context (coherence); and (iii) Boundaries of care: reflected that appraisal (reflexive monitoring) by ED and stroke teams about their respective boundaries of clinical practice impeded uptake of the protocols. Conclusions Despite initial high ‘buy-in’ from clinicians, a theoretically informed and comprehensive implementation strategy was unable to overcome system and clinician level barriers. Initiatives to drive change and integrate protocols rested largely with senior nurses who had to overcome contextual factors that fell outside their control, including low medical engagement, beliefs about the supporting evidence and perceptions of professional boundaries. To maximise uptake of evidence and adherence to intervention fidelity in complex clinical settings such as ED cost-effective strategies are needed to overcome these barriers. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12614000939695).

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Section: Methodsmentioning

confidence: 99%

Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T3 trial): a qualitative study

et al. 2020

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“…Kietzmann, Hannig y Schmidt (19) , resaltan que los pacientes dan prioridad a las competencias básicas de los profesionales relacionados con los servicios de emergencias tales como como la cortesía y apoyo emocional o mental, y habilidades de comunicación, llama la atención el tema de las barreras lingüísticas y la necesidad de disminuir esta barrera mediante el habla pausado e implementación adicional del lenguaje corporal y apoyo de intérpretes; mientras que por el lado de los profesionales se considera necesario el conocímiento cultural, como básico para la comprensión de la persona atendida, sus creencias y necesidades a fin de mejorar la atención, mediante un cambio de actitud.…”

Section: Resultsunclassified

Humanización en Los Servicios De Urgencia: Revisión Narrativa

Leguia

Trujillo²,

García³

et al. 2022

Horiz Enferm

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INTRODUCCIÓN: En Colombia, el tema de la humanización de los servicios de salud se encuentra estrechamente ligado a los aspectos normativos, los cuales datan de la conceptualización de la Constitución Política del país y otras normas anteriores que reglamentan la conducta médica y del personal que presta servicios de salud. OBJETIVO: Describir los aspectos relacionados con la humanización en los servicios de urgencia, en publicaciones científicas, mediante una revisión narrativa. MÉTODO: Se realizó una búsqueda bibliográfica, de artículos originales de acceso abierto publicados entre 2010 y 2020 en inglés, español y portugués. La búsqueda se concentró en los meses de marzo a julio de 2020 en cinco bases de datos disponibles en el servicio de biblioteca de la Universidad de Cartagena. RESULTADOS: Se recuperaron 17 artículos que aportaron significativamente al análisis y comprensión de la situación; el 100% en idioma inglés, de estudios desarrollados en cuatro continentes (América, Europa, Asia y Oceanía); los profesionales de enfermería cuentan con mayor número de publicaciones orientadas al conocimiento de la humanización de los servicios de salud. CONCLUSIÓN: Los resultados demuestran un necesario cambio de actitudes frente a la humanización, capacitación y reconocimiento del otro como ser humano. Es frecuente que se normalice la violencia en los servicios de urgencia, situación que es contraria a los criterios de humanización de los servicios de salud.

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“…The convenience of these concepts is that they can become interpretive lenses which ‘simplify the cultural complexities surrounding the position(s) of both the health care providers and their clients’ (Dorazio-Migliore et al, 2005: 339). Indeed, the very notion of cultural competence is problematic, and the line between general competence and cultural competence is unclear (Kietzmann et al, 2015). ‘Awareness’, for example, is difficult to pin down in terms of attainment, while the relational aspects of competence (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…empathy) are already key to person-centred care. Moreover, achieving cultural competence often entails a procedural implication of culture as a separate or distinct area, further reinforcing the grouping or categorising of 'culture' within healthcare (see Kietzmann et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Individualising difference, negotiating culture: Intersections of culture and care

Broom¹,

Kirby

Kokanović

et al. 2019

Health (London)

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In this article, we focus on developing a critical sociology of ‘cultural and linguistic diversity’ as evident in cancer care praxis, drawing on the perspectives of cancer care health professionals. Set within the context of increasing efforts on the part of healthcare providers to ‘accommodate difference’ and ‘incorporate diversity’, we aimed to utilise participants’ accounts of practice to ask: how do we and how should we think about and operationalise ‘culture’ (if at all) in cancer care settings. Drawing on eight focus groups with doctors, nurses, allied health staff and multicultural community workers, here we explore their accounts of: othering and over-simplification; the role of absences in biographical reciprocity; intimacy, care and carelessness; and entanglements of culture with other aspects of the person. Based on their accounts, we argue for a broadening of the examination of the nexus of culture and care, to focus on the problematics of othering, intimacy, reciprocity and complexity.

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Migrants' and professionals' views on culturally sensitive pre-hospital emergency care

Cited by 12 publications

References 16 publications

Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T3 trial): a qualitative study

Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T3 trial): a qualitative study

Humanización en Los Servicios De Urgencia: Revisión Narrativa

Individualising difference, negotiating culture: Intersections of culture and care

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