شناسایی عوامل موثر بر شایستگی فرهنگی پزشکان و پرستاران سازمان‌های دولتی بخش بهداشت ودرمان ایران
محورهای موضوعی : -مدیریت خدمات بهداشتی و درمانی
اقبال محمدپور
1
,
منصور ایراندوست
2
,
حمید لرستانی
3
,
جلیل سحابی
4
1 - دانشجوی دکترای مدیریت دولتی، واحد سنندج، دانشگاه آزاد اسلامی، سنندج، ایران
2 - استادیار گروە مدیریت، واحد سنندج، دانشگاە آزاد اسلامی، سنندج ایران
3 - استادیار گروە ریاضی و آمار، واحد سنندج، دانشگاە آزاد اسلامی، سنندج، ایران
4 - استادیار گروە علوم اجتماعی، واحد سنندج، دانشگاە آزاد اسلامی، سنندج، ایران
کلید واژه: پزشکان و پرستاران, بخش بهداشت و درمان دولتی, تکنیک دلفی, شایستگی فرهنگی, روش فراترکیب,
چکیده مقاله :
مقدمه: شایستگی فرهنگی، قابلیت پاسخ به تنوع فرهنگی در داخل سیستم‌های بهداشت و درمان است . مقاله حاضر با هدف شناسایی عوامل موثر بر شایستگی فرهنگی پزشکان و پرستاران سازمان های دولتی بخش بهداشت ودرمان ایران انجام شد. روش پژوهش: برای تحلیل ادبیات پژوهش از روش فراترکیب استفاده شد سپس با استفاده از نظرات 10 خبره دانشگاهی با پرسشنامه، و روش دلفی دومرحله ای برای نهایی کردن مدل استفاده گردید. یافته‌ها: ابتدا با مرور نظام مند 198 سند، که پس از پالایش به عدد 32 رسید و با بررسی این پژوهش ها به 7 شاخص و 26 زیرشاخص موثر بر شایستگی فرهنگی استخراج شد که در پرسشنامه ای از 10 نفر از خبرگان متخصص در دور اول ضریب کندال 512/. حاصل شد و با حذف یک عامل که از منظر خبرگان دارای روایی کمتری بود و نیز اصلاح 3 عامل دیگر نهایتا در دور دوم دلفی عدد 704/. حاصل شد که حکایت از روایی بالای این شاخص ها دارد. نتیجه‌گیری: شاخص های تنوع فرهنگی، برخورد فرهنگی، میل فرهنگی، فروتنی فرهنگی، شایستگی انسان گرایانه، آمادگی آموزشی و حمایت سازمانی، هفت شاخص نهایی می باشند، کاربست مدل استخراج شده ی شایستگی فرهنگی در بخش بهداشت و درمان دولتی می تواند ابزاری برای ارزیابی و اولولیت بندی شایستگی فرهنگی کادر درمان در بخش دولتی ایران بوده و نتایجش نیز مبنای انجام اقدامات مدیریتی برای اصلاح و بهبود سازمانی واقع گردد.
Introduction: Cultural competence, which is the ability to respond to cultural diversity within health care systems. The aim of this article was to identify the factors affecting the cultural competence of physicians and nurses of government organizations in the health sector of Iran. Methods: To analyze the research literature, the Meta-synthesis method was used, then using the opinions of 10 organizational experts with a questionnaire, the two-stage Delphi method was used to finalize the model. Results: In the first phase, with a systematic review of 198 documents, which after refinement reached 32 and by reviewing these studies, we obtained 7 effective indicators and 26 sub-indicators affecting cultural competence, which in a questionnaire of 10 experts In the first round, the Kendall coefficient is ./512 It was obtained by removing a factor that had less credibility from the experts' point of view, as well as correcting 3 other factors, and finally in the second round of Delphi, the number ./704 It was found that it indicates the high validity of these indicators. Conclusion: Indicators of cultural diversity, cultural attitude, cultural desire, cultural humility, humanistic competence, educational readiness and organizational support are the seven final indicators. The application of the extracted model of cultural competence in public health can be a tool for Assessing and prioritizing the cultural competence of medical staff in the public sector of Iran and its results should be the basis for taking managerial measures for organizational reform and improvement.
1- Cai, D. Y. A concept analysis of cultural competence. International Journal of Nursing Sciences, 2016; 3(3): 268-273.
2- Cram, B. & Alkadry, M. Social Equity Leadership. In A. Farazmand (Ed.) Global encyclopedia of public administration and public policy. Springer; 2018
3- Kohli, H. K., Kohli, A. S., Huber, R., & Faul, A. C. Assessing cultural competence in graduating students. International Journal of Progressive Education, 2010; 6(1).
4- Betancourt, J.R., Green, A.R., Carrillo, J.E., Park, E.R., Cultural competence and health care disparities: key perspectives and trends. Health Aff. (Millwood), 2005; 24 (2), 499–505.
5- Dudas KI. Cultural competence: an evolutionary concept analysis. Nurs Educ Perspect, 2012; 33(5): 317e21
6- Schim, S. M., Doorenbos, A. Z., & Borse, N. N. Cultural competence among hospice nurses. Journal of Hospice & Palliative Nursing, 2006; 8(5), 302-307.
7- Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. Cultural competence in nursing: A concept analysis. International journal of nursing studies, 2019; 99: 103386.
8- Brach, C., & Fraserirector, I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical care research and review, 2000; 57(1_suppl): 181-217.
9- Khezerloo, S., & Mokhtari, J. Cultural competency in nursing education: A review article, 2016
10- Henderson, P., Islam, R., Bachman, P., Pineau, J., Precup, D., & Meger, D. Deep reinforcement learning that matters. In Proceedings of the AAAI Conference on Artificial Intelligence, 2018; 32(1).
11- Steefel, L. Cultural humility: An active concept to drive correctional nursing practice. Journal of forensic nursing, 2018; 14(1): 27-30.
12- Foronda, C. L., Swoboda, S. M., Hudson, K. W., Jones, E., Sullivan, N., Ockimey, J., & Jeffries, P. R. Evaluation of vSIM for Nursing™: A trial of innovation. Clinical Simulation in Nursing, 2016; 12(4): 128-131.
13- Dreher, M., & MacNaughton, N. Cultural competence in nursing: Foundation or fallacy? Nursing outlook, 2002; 50(5): 181-186.
14- Jirwe, M., Gerrish, K., & Emami, A. The theoretical framework of cultural competence. Journal of Multicultural Nursing & Health, 2006; 12(3): 6.
15- Taylor, R., 2005. Addressing barriers to cultural competence. J. Nurses Staff Dev. 21 (4), 135–142.
16- Taylor, R.A., Alfred, M.V. Nurses’ perceptions of the organizational supports needed for the delivery of culturally competent care. West. J. Nurs. Res. 2010; 32 (5): 591–609.
17- Norman-Major, K. A., & Gooden, S. T. (2014). Cultural competency for public administrators. Routledge.
18- Nasresfahani, F., Karimi, F., Nadi, M. Designing a Model for Overcoming Social Undermining in Clinical Wards Authorities of Isfahan’s Hospitals (Qualitative Research). Journal of healthcare management, 2020; 11(37): 91-100. [Persian]
19- Nourian Zavareh, Sara, Sadeghi Arani, Zahra. Develop a model of risks in the field of human resources in the field of health and treatment by using systematic review and Delphi technique. Health management, 1400; 12(3): 47-59. Doi: 10.30495/jhm.2022.62873.10980 [Persian]
20- Suh EE. The model of cultural competence through an evolutionary concept analysis. J Transcult Nurs, 2004; 15(2): 93e102.
21- Campinha-Bacote, J. The process of cultural competence in the delivery of healthcare services: A model of care. Journal of transcultural nursing, 2002; 13(3): 181-184.
22- Rollins, A. C., & Grooms, W. Public administrator practice as recognition: A philosophical case for public sector cultural competence. Administrative Theory & Praxis, 2019; 41(2): 110-128.
23- Cho, M. K., & Kim, M. Y. Factors Affecting the Global Health and Cultural Competencies of Nursing Students. International Journal of Environmental Research and Public Health, 2022; 19(7): 4109.
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1- Cai, D. Y. A concept analysis of cultural competence. International Journal of Nursing Sciences, 2016; 3(3): 268-273.
2- Cram, B. & Alkadry, M. Social Equity Leadership. In A. Farazmand (Ed.) Global encyclopedia of public administration and public policy. Springer; 2018
3- Kohli, H. K., Kohli, A. S., Huber, R., & Faul, A. C. Assessing cultural competence in graduating students. International Journal of Progressive Education, 2010; 6(1).
4- Betancourt, J.R., Green, A.R., Carrillo, J.E., Park, E.R., Cultural competence and health care disparities: key perspectives and trends. Health Aff. (Millwood), 2005; 24 (2), 499–505.
5- Dudas KI. Cultural competence: an evolutionary concept analysis. Nurs Educ Perspect, 2012; 33(5): 317e21
6- Schim, S. M., Doorenbos, A. Z., & Borse, N. N. Cultural competence among hospice nurses. Journal of Hospice & Palliative Nursing, 2006; 8(5), 302-307.
7- Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. Cultural competence in nursing: A concept analysis. International journal of nursing studies, 2019; 99: 103386.
8- Brach, C., & Fraserirector, I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical care research and review, 2000; 57(1_suppl): 181-217.
9- Khezerloo, S., & Mokhtari, J. Cultural competency in nursing education: A review article, 2016
10- Henderson, P., Islam, R., Bachman, P., Pineau, J., Precup, D., & Meger, D. Deep reinforcement learning that matters. In Proceedings of the AAAI Conference on Artificial Intelligence, 2018; 32(1).
11- Steefel, L. Cultural humility: An active concept to drive correctional nursing practice. Journal of forensic nursing, 2018; 14(1): 27-30.
12- Foronda, C. L., Swoboda, S. M., Hudson, K. W., Jones, E., Sullivan, N., Ockimey, J., & Jeffries, P. R. Evaluation of vSIM for Nursing™: A trial of innovation. Clinical Simulation in Nursing, 2016; 12(4): 128-131.
13- Dreher, M., & MacNaughton, N. Cultural competence in nursing: Foundation or fallacy? Nursing outlook, 2002; 50(5): 181-186.
14- Jirwe, M., Gerrish, K., & Emami, A. The theoretical framework of cultural competence. Journal of Multicultural Nursing & Health, 2006; 12(3): 6.
15- Taylor, R., 2005. Addressing barriers to cultural competence. J. Nurses Staff Dev. 21 (4), 135–142.
16- Taylor, R.A., Alfred, M.V. Nurses’ perceptions of the organizational supports needed for the delivery of culturally competent care. West. J. Nurs. Res. 2010; 32 (5): 591–609.
17- Norman-Major, K. A., & Gooden, S. T. (2014). Cultural competency for public administrators. Routledge.
18- Nasresfahani, F., Karimi, F., Nadi, M. Designing a Model for Overcoming Social Undermining in Clinical Wards Authorities of Isfahan’s Hospitals (Qualitative Research). Journal of healthcare management, 2020; 11(37): 91-100. [Persian]
19- Nourian Zavareh, Sara, Sadeghi Arani, Zahra. Develop a model of risks in the field of human resources in the field of health and treatment by using systematic review and Delphi technique. Health management, 1400; 12(3): 47-59. Doi: 10.30495/jhm.2022.62873.10980 [Persian]
20- Suh EE. The model of cultural competence through an evolutionary concept analysis. J Transcult Nurs, 2004; 15(2): 93e102.
21- Campinha-Bacote, J. The process of cultural competence in the delivery of healthcare services: A model of care. Journal of transcultural nursing, 2002; 13(3): 181-184.
22- Rollins, A. C., & Grooms, W. Public administrator practice as recognition: A philosophical case for public sector cultural competence. Administrative Theory & Praxis, 2019; 41(2): 110-128.
23- Cho, M. K., & Kim, M. Y. Factors Affecting the Global Health and Cultural Competencies of Nursing Students. International Journal of Environmental Research and Public Health, 2022; 19(7): 4109.