Yoğun Bakım Hemşirelerinin Kültürel Çeşitliliğe İlişkin Deneyimleri: Nitel Bir Çalışma

Öz

Giriş: Yoğun Bakım Ünitesi (YBÜ) hemşireleri genellikle farklı kültürden hastalarla iletişimde kültürel ve dil farklılıkları nedeniyle çeşitli zorluklarla karşı karşıya kalmaktadır. İletişimde yaşanan yanlış anlaşılmalar kültürel çatışmalara neden olmakta ve bu durumlarda da YBÜ hemşireleri hastaya en iyi bakımı verebilmek için sorunu çözmek durumunda kalmaktadırlar. Bu çalışmanın amacı, yoğun bakım hemşirelerinin farklı kültürlerden gelen hastalara bakım verirkenki deneyimleri ve yaşadıkları zorlukları tanımlamaktır. Gereç ve Yöntemler: Bu nitel araştırmada veriler, farklı kültürlerden hastalara bakım veren on YBÜ hemşiresinden oluşan iki odak grup görüşmesi yapılarak toplanmıştır. Özel ve devlet hastanesinden olmak üzere belirlenen iki odak gruba beş hemşire dahil edilmiştir. Veriler tematik analiz yönetemiyle analiz edilmiştir. Bulgular: Yapılan tematik analiz sonucunda Türkiye'deki YBÜ'lerde farklı kültürden hastaya bakım verirken yaşanan zorlukların tıbbi terminolojide yetenekli tercüman eksikliği, hemşirelerin çaresizlik duyguları, artan iş yükü ve kültürel farklılıklara dair hemşirelerin yeterince farkındalklarının olmaması şeklinde belirlenmiştir. Sonuç: Elde edilen bulgular, akut bakım ortamlarında, hemşirelerin farklı dilleri konuşan ve farklı kültürel değerleri olan hastalara bakım verirken ve iletişim birçok zorluklarla karşı karşıya kaldıklarını göstermektedir. Kültürel açıdan farklı olan hastaları tanılama ve bütüncül bakımı sağlayabilmek ve kültürel yetkinlik kazandırmak amacıyla standardize eğitim programlarının yoğun bakım hemşirelerine katkısı olacaktır. Ayrıca, kültürel açıdan hastaları tanılama klavuzların klinik uygulama sırasında kullanımının klinisyenlere katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler

• Kültürel farklılık
• hemşire
• yoğun bakım

Kaynakça

1. Refereans1. The United Nations Department Of Economic And Social Affairs (UNDESA). The number of international migrants reaches 272 million, continuing an upward trend in all world regions, 2019, https://www.un.org/en/desa/international-migration-2020-highlights Accessed: 01/02/2021
2. Refereans2. Baban F, Ilcan S, Rygiel, K. Syrian refugees in Turkey: pathways to precarity, differential inclusion, and negotiated citizenship rights. Journal of Ethnic and Migration Studies 2017: 43: 41-57.
3. Refereans3. Knappert L, Kornau A, Figengül M. Refugees' exclusion at work and the intersection with gender: Insights from the Turkish-Syrian border. J. Vocat. Behav, 2017: 105: 62-82.
4. Refereans4. The UN Refugee Agency (UNHCR). Turkey- October 2019, Https://Data2.Unhcr.Org/En/Documents/Download/73192, Accessed: 01/02/2021
5. Refereans5. Refugees Community Center (RCC). Türkiye’deki Suriyeli Sayisi-2019, Https://Multeciler.Org.Tr/Turkiyedeki-Suriyeli-Sayisi/, Accessed: 01/02/2021
6. Refereans6. Garneau A.B, Pepin J. A constructivist theoretical proposition of cultural competence development in nursing. Nurse Educ. Today 2015; 35(11), 1062-1068.
7. Refereans7. Renzaho A. M. N., Romios P, Crock C, Sønderlund A. L. The effectiveness of cultural competence programs in ethnic minority patient-centered health care—a systematic review of the literature. Int J Qual Health Care 2013; 25(3), 261-269.
8. Refereans8. Hemberg, JAV, Vilander S. Cultural and communicative competence in the caring relationship with patients from another culture. Scand J Caring Sci 2017: 31: 822-829.

9. Refereans9. Pottie K, Ng E, Spitzer D, Mohammed A, Glazier R. Language proficiency, gender and self-reported health: an analysis of the first two waves of the longitudinal survey of immigrants to Canada. Can J Public Health, 2008:505-510.
10. Refereans10. Curwick K, Dutt T, Hulyalkar M, Sarvottam K, Erwin P. and Kashyap R Cultural Competence In Acute And Critical Care Medicine: Literature Review And Recommendations. Crit. Care Med, 2015:43(12): 142.
11. Refereans11. Shafipour V, Mohammad E, Ahmadi F. Barriers to nurse-patient communication in cardiac surgery wards: a qualitative study. Glob J Health Sci, 2014: 6, 234.
12. Refereans12. World Federation Of Critical Care Nurses Association (Wfccna). Brisbane Declaration: Culturally Sensitive Critical Care Nursing. 2016, Http://www.Hdmsarist.Hr/Wp-Content/Uploads/2016/10/WFCCN-Brisbane Declaration.Pdf., Accessed: 01/02/2021.
13. Refereans13. Vydelingum V. Nurses’ experiences of caring for South Asian minority ethnic patients in a general hospital in England. Nurs. Inq, 2006: 13: 23-32.
14. Refereans14. Ogunsiji O, Ng Chok H, Mashingaidze G, Wilkes L. “I am still passionate despite the challenges”: Nurses navigating the care for refugees. J Clin Nurs, 2018: 27(17): 3335-3344.
15. Refereans15. Attree M. Patients’ and relatives’ experiences and perspectives of ‘good’and ‘not so good’quality care. J Adv Nurs, 2001: 33: 456-466
16. Refereans16. Hamilton J, Woodward-Kron R. Developing cultural awareness and intercultural communication through multimedia: A case study from medicine and the health sciences. System 2010: 38: 560-568.
17. Refereans17. Pronovost P, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C. Improving communication in the ICU using daily goals. J. Crit. Care, 2003: 18: 71-75.
18. Refereans18. Ozga D, Zdun A. Multicultural Care In European Intensive Care Units (MICE-ICU)- An International Project For Nurses Working At Icus. Anaesth Intens Care, 2017: 3(1): B1-B2.
19. Refereans19. Yılmaz M, Cansu YE, Emine AV, Neslihan UL. Aile sağlığı merkezlerinde çalışan hemşire/ebelerin kültürel duyarlılık ve kültürel beceri düzeylerinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2019: 12(3): 170-178.
20. Refereans20. Ceylantekin Y, Öcalan D. Hemşirelik Öğrencilerinin Kültürel Farkindaliği ve Kültürlerarasi Hemşirelik Dersine Yönelik Düşünceleri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2016: 5(4): 45-53.
21. Refereans21. Karakus Z, Babadag B, Abay H, Akyar İ, Şenol Çelik S. Nurses’ Views Related to Transcultural Nursing in Turkey, Int. J. Nurs. Sci., 2013: 6(2):201-207
22. Refereans22. Patak L, Gawlinski A, Fung N.I, Doering L, Berg J, Henneman, E. A. Communication boards in critical care: patients' views. Appl Nurs Res, 2006: 19: 182-190.
23. Refereans23. Richardson A, Thomas VN, Richardson A. “Reduced to nods and smiles”: experiences of professionals caring for people with cancer from black and ethnic minority groups. Eur J Oncol Nurs, 2006: 10: 93-101.
24. Refereans24. Garra G, Albino H, Chapman H, Singer AJ, Thode HC. The impact of communication barriers on diagnostic confidence and ancillary testing in the emergency department. J Emerg Med 2010: 38: 681-685.
25. Refereans25. Høye S, Severinsson E. Professional and cultural conflicts for intensive care nurses. J Adv Nurs 2010: 66: 858-867.
26. Refereans26. Crawford T, Candlin S, Roger P. New perspectives on understanding cultural diversity in nurse–patient communication. Collegian 2017: 24: 63-69.
27. Refereans27. Doolen J, York Nancy L. Cultural Differences with End-Of-Life Care In The Critical Care Unit, Dimens Crit Care Nurs 2007: 26(5):194-198.
28. Refereans28. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups, Int J Qual Health C 2007:19: 349–357.
29. Refereans29. Bloor M, Jane F, Michelle T, Kate R. Focus Groups in Social Research. Thousand Oaks, CA: Sage 2001
30. Refereans30. Reed J, Payton VR. Focus groups: issues of analysis and interpretation. J Adv Nurs 1997: 26: 765-771.
31. Refereans31. Krueger R.A, Casey M.A. Focus groups: A practical guide for applied research. Sage, Newbury Park 2000
32. Refereans32. Plummer-D'Amato P. Focus group methodology Part 1: Considerations for design. Int J Rehabil Res 2008: 15(2): 69-73.
33. Refereans33. Halcomb EJ, Gholizadeh L, Digiacomo M, Phillips J, Davidson PM. Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups. J Clin Nurs 2007:16: 1000–1011
34. Refereans34. Hurworth R. Qualitative methodology: Common questions about running focus groups during evaluations. Evaluation news and comment 1996: 5: 48-52.
35. Refereans35. Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed. Thousand. Oaks, CA: Sage Publications, Inc. 2008
36. Refereans36. Holloway I, Freshwater D. Vulnerable story telling: Narrative research in nursing. J Res Nurs 2007:12: 703-711.
37. Refereans37. Jirwe M, Gerrish K, Emami A. Student nurses’ experiences of communication in cross‐cultural care encounters. Scand J Caring Sci 2010: 24: 436-444.
38. Refereans38. Brown L, Holloway I. The initial stage of the international sojourn: excitement or culture shock? British Journal of Guidance & Counselling 2008:36: 33-49.
39. Refereans39. Goodman P, Edge B, Agazio J, Prue-Owens K. Cultural awareness: nursing care of iraqi patients. J. Transcult. Nurs. 2015: 26: 395-401.
40. Refereans40. Brisset C, Leanza Y, Laforest K. Working with interpreters in health care: A systematic review and meta-ethnography of qualitative studies. Patient Educ Couns 2013: 91: 131-140.
41. Refereans41. Angelelli CV. Validating professional standards and codes: Challenges and opportunities. Interpreting 2006:8: 175-193.
42. Refereans42. Nailon RE. Nurses’ concerns and practices with using interpreters in the care of Latino patients in the emergency department. J Transcult Nurs 2006:7: 119–28
43. Refereans43. Al‐Amer R, Ramjan L, Glew P, Darwish M, Salamonson Y. Translation of interviews from a source language to a target language: examining issues in cross‐cultural health care research. J Clin Nurs 2015: 24:1151-1162.
44. Refereans44. Listerfelt S, Fridh, I, Lindahl B. Facing the unfamiliar: Nurses’ transcultural care in intensive care–A focus group study. Intens Crit Care Nur 2019:55: 1-8
45. Refereans45. Samarasinghe K.L. A conceptual model facilitating the transition of involuntary migrant families. ISRN nurs 2011: 1-6.
46. Refereans46. Pasco ACY, Morse J.M, Olson JK. Cross‐Cultural Relationships Between Nurses and Filipino Canadian Patients. J. Nurs. Scholarsh. 2004: 36: 239-246.
47. Refereans47. Wikberg A, Bondas T. A patient perspective in research on intercultural caring in maternity care: A meta-ethnography. Int. J. Qual. Stud. Health Well-being 2010: 5:1-15.
48. Refereans48. Tuohy D, McCarthy J, Cassidy I, Graham M. Educational needs of nurses when nursing people of a different culture in Ireland. Int. Nurs. Rev. 2008:55: 164-170.