Kje smo in kam gremo: eksperti o kulturni kompetentnosti v slovenskem zdravstvu
DOI:
https://doi.org/10.55707/jhs.v12i1.175Ključne besede:
raznolikost, zdravstveni sistem, odzivnost, kulturne kompetencePovzetek
Slovenska družba postaja vse bolj raznolika, kar zahteva, da zdravstveni sistem razvije kulturno kompetentnost. Ta je ključna za zagotavljanje pravične in kakovostne oskrbe za vse. Prvi korak v razvoju kulturne kompetentnosti je ocena trenutnega stanja na tem področju, kar je bil osnovni namen naše raziskave. Temeljila je na kvalitativni metodologiji – osmih polstrukturiranih intervjujih s strokovnjaki na preučevanem področju. S pomočjo usmerjene vsebinske analize smo pridobljene podatke uvrstili v 6-stopenjski kontinuum odzivov na raznolikost po Crossu. Kulturne destruktivnosti nismo zaznali. Identificirali smo elemente kulturne nezmožnosti (strah, predsodki) ter kulturne slepote (univerzalni pristopi brez prilagoditev, pomanjkanje kulturne občutljivosti). Največ podatkov je kazalo na kulturno predkompetentnost v zdravstvenem sistemu, ki jo označujejo naraščajoče zavedanje o raznolikosti, prvi zametki izobraževanj ter projekti na področju kulturne kompetentnosti, ni pa še sistemskih rešitev. Sklepamo, da se zdravstveni sistem premika v smeri kulturne kompetentnosti, čeprav nas čaka še dolga pot. Družbene spremembe in politični diskurz lahko hitro vplivajo na nazadovanje sistema.
Literatura
Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., & Normand, J. (2003). Culturally competent healthcare systems: A systematic review. American Journal of Preventive Medicine, 24(3S), 68–79. https://doi.org/10.1016/S0749-3797(02)00657-8
Antón-Solanas, I., Huércanos-Esparza, I., Hamam-Alcober, N., Vanceulebroeck, V., Dehaes, S., Kalkan, I., Kömürcü, N., ... Solano, J. (2021). Nursing lecturers’ perception and experience of teaching cultural competence: A European qualitative study. International Journal of Environmental Research and Public Health, 18(3), Article 1357. https://doi.org/10.3390/ijerph18031357
Betancourt, J. R., Green, A. R., & Carrillo, J. E. (2002). Cultural competence in health care: Emerging frameworks and practical approaches (Field Report). The Commonwealth Fund.
Betancourt, J. R., Green, A. R., Carrillo, J. E., & Park, E. R. (2005). Cultural competence and health care disparities: Key perspectives and trends. Health Affairs, 24(2), 499–505. https://doi.org/10.1377/hlthaff.24.2.499
Bogataj, U., Prosen, M., Karnjuš, I., Rebec, D., & Ličen, S. (2019). Current issues and future possibilities for improving healthcare for migrant women in Slovenia. In I. Karnjuš, S. Ličen, & M. Prosen (Eds.), Women, migrations and health: Ensuring transcultural healthcare (pp. 107–116). University of Primorska Press. https://doi.org/10.26493/978-961-7055-43-6.107-116
Chiarenza, A. (2012). Developments in the concept of cultural competence. In D. Ingleby, A. Chiarenza, W. Devillé, & I. Kotsioni (Eds.), Inequalities in health care for migrants and ethnic minorities (pp. 66–81). Garant.
Chiarenza, A., Horvat, L., Lanting, K., Ciannameo, A., & Suurmond, J. (2019). Addressing healthcare for migrants and ethnic minorities in Europe: A review of training programmes. Health Education Journal, 78(1), 9–23. https://doi.org/10.1177/0017896918793164
Claeys, A., Berdai-Chaouni, S., Tricas-Sauras, S., & De Donder, L. (2021). Culturally sensitive care: Definitions, perceptions, and practices of health care professionals. Journal of Transcultural Nursing, 32(5), 484–492. https://doi.org/10.1177/1043659620970625
Cormier, D. R. (2021). Assessing preservice teachers’ cultural competence with the cultural proficiency continuum Q-sort. Educational Researcher, 50(1), 17–29. https://doi.org/10.3102/0013189X20936670
Cross, T. L., Bazron, B. J., Dennis, K. W., & Isaacs, M. R. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. CASSP Technical Assistance Center, Georgetown University Child Development Center.
Diaz-Cruz, E. S., & Hagan, A. M. (2020). Developing a co-curricular activity to introduce student pharmacists to the cultural proficiency continuum framework. Innovations in Pharmacy, 11(1), Article 1. https://doi.org/10.24926/iip.v11i1.2185
Dreachslin, J. L., Weech-Maldonado, R., Gail, J., Epané, J. P., & Wainio, J. A. (2017). Blueprint for sustainable change in diversity management and cultural competence: Lessons from the National Center for Healthcare Leadership diversity demonstration project. Journal of Healthcare Management, 62(3), 171–183. https://doi.org/10.1097/JHM-D-15-00029
Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Engebretson, J., Mahoney, J., & Carlson, E. D. (2008). Cultural competence in the era of evidence-based practice. Journal of Professional Nursing, 24(3), 172–178. https://doi.org/10.1016/j.profnurs.2007.10.012
Gulati, S., & Weir, C. (2022). Cultural competence in healthcare leadership education and development. Societies, 12(2), Article 39. https://doi.org/10.3390/soc12020039
Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLOS ONE, 14(7), e0219971. https://doi.org/10.1371/journal.pone.0219971
Hofstede, G. (1985). The interaction between national and organizational value systems. Journal of Management Studies, 22(4), 347–357. https://doi.org/10.1111/j.1467-6486.1985.tb00001.x
Hofstede, G. (2011). Dimensionalizing cultures: The Hofstede model in context. Online Readings in Psychology and Culture, 2(1). https://doi.org/10.9707/2307-0919.1014
Huber, I., Lipovec Čebron, U., & Pistotnik, S. (Eds.). (2020). Neenakosti in ranljivosti v zdravju v Sloveniji: Kvalitativna raziskava v 25 okoljih. Nacionalni inštitut za javno zdravje.
Jongen, C., McCalman, J., Bainbridge, R., & Clifford, A. (2018). Cultural competence in health: A review of the evidence. Springer. https://doi.org/10.1007/978-981-10-5293-4
Kumagai, A. K., & Lypson, M. L. (2009). Beyond cultural competence: Critical consciousness, social justice, and multicultural education. Academic Medicine, 84(6), 782–787. https://doi.org/10.1097/ACM.0b013e3181a42398
Li, S., Miles, K., George, R. E., Ertubey, C., Pype, P., & Liu, J. (2023). A critical review of cultural competence frameworks and models in medical and health professional education: A meta-ethnographic synthesis: BEME Guide No. 79. Medical Teacher, 45(10), 1085–1107. https://doi.org/10.1080/0142159X.2023.2174419
Lin, M.-H., & Hsu, H.-C. (2020). Effects of a cultural competence education programme on clinical nurses: A randomised controlled trial. Nurse Education Today, 88, 104385. https://doi.org/10.1016/j.nedt.2020.104385
Lipovec Čebron, U. (2017). »Ko nujno postane nenujno«: Raziskovanje zdravstvenih vidikov migracije v Sloveniji. Glasnik Slovenskega etnološkega društva, 57(1–2), 54–64.
Lipovec Čebron, U., Pistotnik, S., Farkaš Lainšček, J., & Huber, I. (2019). Medkulturne kompetence in zdravstvena oskrba v Sloveniji. In B. Filej & B. M. Kaučič (Eds.), Medkulturna oskrba v zdravstvu: Znanstvena monografija (pp. 35–49). Visoka zdravstvena šola v Celju.
Lipovec Čebron, U. (2021). Language as a trigger for racism: Language barriers at healthcare institutions in Slovenia. Social Sciences, 10(4), Article 125. https://doi.org/10.3390/socsci10040125
Lipovec Čebron, U., & Bombač, L. (2018). Pregnant women on the move and the response of the Slovenian health system to their needs. Glasnik Etnografskog instituta SANU, 66(3), 657–673. https://doi.org/10.2298/GEI1803657L
Marcelin, J. R., Siraj, D. S., Victor, R., Kotadia, S., & Maldonado, Y. A. (2019). The impact of unconscious bias in healthcare: How to recognize and mitigate it. The Journal of Infectious Diseases, 220(2), S62–S73. https://doi.org/10.1093/infdis/jiz214
Milavec Kapun, M., Lipovec Čebron, U., Korošec, T., Pistotnik, S., Jazbinšek, S., & Homar, V. (2017). Strategije premagovanja jezikovnih ovir med medicinskimi sestrami. In S. Majcen Dvoršak et al. (Eds.), Medicinske sestre in babice – ključne za zdravstveni sistem: Zbornik prispevkov z recenzijo (pp. 564–573). Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Mlinšek, A. (2012). Etičnost razmišljanja in diskriminacija v zdravstveni negi. Revija za univerzalno odličnost, 1(1), 20–29.
Perko, D., Poldrugovac, M., Potisek, R., Kasapinov, B., Simončič, M., Vinko, M., Josar, D., Zupančič, V., Presečnik, M., Jacović, A., & Grech, K. (2019). Health system performance assessment for Slovenia. https://www.gov.si/assets/ministrstva/MZ/DOKUMENTI/Kakovost-zdravstvenega-varstva/HEALTH-SYSTEM-PERFORMANCE-ASSESSMENT-FOR-SLOVENIA.pdf
Pistotnik, S. (2019). Pravni statusi nedržavljanov in z njimi povezane ovire pri dostopu do zdravstvene obravnave. In N. K. Pokorn & U. Lipovec Čebron (Eds.), Večjezično zdravje: Komunikacijske strategije in večkulturni stiki s tujejezičnimi bolniki v slovenskem zdravstvenem sistemu (pp. 66–77). Znanstvena založba Filozofske fakultete.
Pokorn, N. K. (2019). Reševanje jezikovnih ovir v slovenskem zdravstvu: Analiza stanja. In N. K. Pokorn & U. Lipovec Čebron (Eds.), Večjezično zdravje: Komunikacijske strategije in večkulturni stiki s tujejezičnimi bolniki v slovenskem zdravstvenem sistemu (pp. 30–47). Znanstvena založba Filozofske fakultete.
Shepherd, S. M. (2019). Cultural awareness workshops: Limitations and practical consequences. BMC Medical Education, 19(1), Article 14. https://doi.org/10.1186/s12909-018-1450-5
Sorensen, J., Norredam, M., Dogra, N., Essink-Bot, M.-L., Suurmond, J., & Krasnik, A. (2017). Enhancing cultural competence in medical education. International Journal of Medical Education, 8, 28–30. https://doi.org/10.5116/ijme.587a.0333
Sorensen, J., Norredam, M., Suurmond, J., Carter-Pokras, O., Garcia-Ramirez, M., & Krasnik, A. (2019). Need for ensuring cultural competence in medical programmes of European universities. BMC Medical Education, 19(1), Article 21. https://doi.org/10.1186/s12909-018-1449-y
Tehee, M., Isaacs, D., & Domenech Rodríguez, M. M. (2020). The elusive construct of cultural competence. In L. Benuto, F. Gonzalez, & J. Singer (Eds.), Handbook of cultural factors in behavioral health: A guide for the helping professional (pp. 11–24). Springer International Publishing. https://doi.org/10.1007/978-3-030-32229-8_2
Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: A systematic review of reviews. BMC Health Services Research, 14(99), Article 99. https://doi.org/10.1186/1472-6963-14-99
UNESCO. (2017). A guide for ensuring inclusion and equity in education. UNESCO. http://unesdoc.unesco.org/images/0024/002482/248254e.pdf
Uzun, Ö., & Sevinç, S. (2015). The relationship between cultural sensitivity and perceived stress among nurses working with foreign patients. Journal of Clinical Nursing, 24(23–24), 3400–3408. https://doi.org/10.1111/jocn.12982
Van Ngo, H. (2009). Patchwork, sidelining and marginalization: Services for immigrant youth. Journal of Immigrant & Refugee Studies, 7(1), 82–100. https://doi.org/10.1080/15562940802687280
World Health Organization. (2000). The world health report 2000: Health systems: Improving performance. WHO Press.
Wright, S. C., & Taylor, D. M. (2007). The social psychology of cultural diversity: Social stereotyping, prejudice, and discrimination. In M. A. Hogg & J. Cooper (Eds.), The SAGE handbook of social psychology: Concise student edition (pp. 361–387). SAGE Publications Ltd. https://doi.org/10.4135/9781848608221.n16
Prenosi
Objavljeno
Kako citirati
Številka
Rubrike
Licenca
Avtorske pravice (c) 2025 Helena Kristina Halbwachs, Helena Blažun Vošner, Marija Ovsenik
To delo je licencirano pod Creative Commons Priznanje avtorstva 4.0 mednarodno licenco.
