Paper
Thursday, July 14, 2005
Enhancing Cultural Competence among Hospice Workers
Stephanie Schim, PhD, RN, Family, Community, and Mental Health, Wayne State University, Detroit, MI, USA and Ardith Doorenbos, PhD, RN, College of Nursing, Michigan State University, East Lansing, MI, USA.
| Learning Objective #1: Explain the rationale for enhancing cultural competence among hospice workers and other health care providers |
| Learning Objective #2: Critique the research process and decide how findings apply in other clinical practice settings |
There is a widely recognized need to improve cultural competence among health care staff because of the growing ethnic and cultural diversity in the United States. Healthcare and government organizations have been responding to these societal changes with guidelines that require health care providers to be “culturally competent.” Although most Americans have access to services, many from traditionally underrepresented minority groups do not use hospice for end-of-life care. Enhancement of cultural competence among hospice staff serves to enhance the quality and acceptability of care. The overall goal of this quasi-experimental study using a crossover design was to examine the effectiveness of an educational / experiential cultural competence development program with diverse hospice staff. 8 hospice offices (n=150) were randomly assigned to one of two groups. A cultural competence development session (intervention) was alternated with a non-culture specific educational program (control). Cultural competence outcomes, measured with the Cultural Competence Assessment (CCA) tool was assessed at the end of the education sessions and after 4 months and compared with baseline data. The hypothesis that hospice employees who received the intervention would report greater cultural knowledge, more positive attitudes about culturally diverse patients and families, and report making more frequent cultural adaptations in practice was supported using Hierarchical Linear Modeling. Findings from this research supported the effectiveness of an educational/experiential approach to enhancing cultural competence with hospice nurses and the multi-level interdisciplinary team. Lessons learned and implications for ongoing work in measurement and education for cultural competence are discussed.