Articulando conocimientos y prácticas frente al Covid-19: Acciones de enfermeros técnicos indígenas en salud intercultural.

A partir de entrevistas y conversaciones a profundidad con cinco enfermeros técnicos de los pueblos Yine y Shipibo-Konibo que laboran en establecimientos de salud en la Amazonía de Ucayali en Perú, este estudio muestra que las prácticas desplegadas para atender a los enfermos con síntomas de Covid-19 hicieron uso de terapias y nociones biomédicas e indígenas. Dichas prácticas reflejaron su formación en salud intercultural y su capacidad para adecuar las normas establecidas por el Ministerio de Salud. En función de los síntomas observados en los pacientes, los enfermeros indígenas usaron una variedad de prácticas: vaporaciones, masajes, baños, infusiones y remedios. Las nociones de salud y enfermedad que los enfermeros técnicos indígenas comparten con sus pacientes fueron la base para interpretar el Covid-19 y estuvieron presentes en las atenciones brindadas. Esto se nutrió de la existencia de un sistema de cuidado familiar bastante articulado que fue tejiéndose y siendo negociado en función de los síntomas y las terapias aplicadas. Sus prácticas demuestran la creatividad en los pueblos indígenas. En ese sentido, el sector salud necesita repensar su mirada sobre la medicina indígena, a la que denomina "tradicional" y nos muestra la necesidad de repensar las ideas sobre adecuación de los servicios para la población indígena para colocar en el centro del debate el significado de interculturalidad en salud desde la perspectiva indígena.

Health Care Utilization and Perceived Quality of Care in a Colombian Indigenous Health Organization.

Indigenous governance of health care has increasingly been advocated among Indigenous peoples in many countries. However, there is limited research that has empirically examined its benefits. In 2020/21, we conducted a survey of 2113 Indigenous Wayuu individuals in Colombia who received services from the Indigenous Wayuu led health care insurance organization Anas Wayuu and its network of service providers, and Wayuu individuals who received services from non-Indigenous health insurance organizations. We compared their health care utilization and perception of quality of care. A main finding of the study was that Anas Wayuu enrollees were more than twice as likely to access health care than enrollees from non-Indigenous health insurance organizations, even when controlling for the demographic and health characteristics. The study provided compelling evidence suggesting that Anas Wayuu, being an Indigenous led health organization improves access to, and quality of care, among Indigenous health service recipients.

The relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students: A descriptive and multi-centric study.

BACKGROUND: Xenophobia plays a pivotal role in influencing the delivery of culturally competent care. Nevertheless, the relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students remains undetermined. AIM: This study aimed to determine the relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students. METHODS AND PARTICIPANTS: The study involved 1045 nursing students from six universities in Türkiye. Data were collected using the "Participant Information Form," the "Intercultural Sensitivity Scale," the "Ethnocentrism Scale," and the "Xenophobia Scale." Multiple linear regression was employed for the analysis. RESULTS: Intercultural sensitivity (ß = -0.09; p = 0.028) emerged as a negative predictor of xenophobia levels in students, while ethnocentrism (ß = 0.17; p = 0.000) was identified as a positive predictor of xenophobia levels. Additionally, socio-demographic characteristics, including age, living in an extended family, academic year, participation in intercultural nursing courses, and interaction with immigrant neighbors, were established as significant predictors of xenophobia. CONCLUSION: This study revealed a direct correlation between higher intercultural sensitivity and reduced xenophobia, whereas an increase in ethnocentrism was linked to elevated levels of xenophobia. These results offer valuable insights for educators and policymakers to combat xenophobia and design targeted interventions.

The effects of video-based simulation in Collaborative Learning in a Student-led Global Classroom (CLSGC) program on non-technical skills among undergraduate nursing students in three regions: A mixed-methods study.

BACKGROUND: Global nursing shortages and increasing cultural diversity in healthcare necessitate the development of culturally sensitive nurses. Intercultural learning and exchange programs have been shown to enhance nursing students' intercultural knowledge, cultural awareness, and sensitivity. However, non-technical skills such as communication, leadership, and teamwork are less emphasized in existing programs, despite their importance in facilitating adaptation to clinical contexts and ensuring patient safety across different ethnic groups. OBJECTIVE: This study aims to evaluate the effectiveness of a Collaborative Learning in a Student-led Global Classroom (CLSGC) program that employs video-based learning and student-led debriefings to enhance non-technical skills, and to explore the experiences of undergraduate nursing student participants from three different regions. METHODS: Seventy-eight nursing students from the Hong Kong Polytechnic University, Malmo University, and La Trobe University participated in the program. The program included three webinars on teamwork, communication skills, and leadership, facilitated through student-led discussions and video simulations. Data were collected using the Team Strategies and Tools to Enhance Performance and Patient Safety Teamwork Attitudes Questionnaire, and qualitative methods including focus groups and reflective journals. A paired t-test and manifest content analysis were used to analyze the quantitative and qualitative data, respectively. RESULTS: The quantitative results indicated significant improvements in the students' attitudes towards teamwork, communication, and leadership. The qualitative data shed light on the students' learning experiences, highlighting the value of cultural exchanges in exploring the importance of non-technical skills in practice, and the effectiveness of the program structure. CONCLUSIONS: The CLSGC program effectively improved nursing students' non-technical skills and enriched their clinical practice. Integrating simulation-based learning and student-led debriefing sessions to enhance nursing students' knowledge and attitudes towards teamwork, communication, and leadership is recommended in nursing education. Continuous exposure to simulation should be part of nursing education to reinforce the significance of non-technical skills in practice.

Work-Related Strain, Sense of Coherence and Intercultural Sensitivity Among Mental Health Nurses in Qatar: A Cross-Sectional Study.

Migrant nurses face many challenges as they adapt and assimilate into their new working environments. The aim of this cross-sectional study was to investigate the perceptions of work-related strain, sense of coherence and intercultural sensitivity among nurses who were employed at a public mental health facility in Qatar. We used three self-report questionnaires: the work-related strain inventory, sense of coherence scale and an intercultural sensitivity scale. A cohort of 136 nurses voluntarily engaged in the study. The majority of participants were male, migrated from South Asia and were in their mid-30s. The study found that both sense of coherence and intercultural sensitivity were inversely proportional to work-related strain. Work-related strain was found to be lower than expected; the factors that appear to protect against work-related strain include longer clinical experience, a high sense of coherence, and intercultural sensitivity. Additionally, greater age and extended clinical experience, combined with a history of work in three or more countries, associated with higher scores on the sense of coherence scale. Lastly, being female, having a postgraduate degree and holding a senior-level position were associated with increased intercultural sensitivity. As nurses' migration across national and international borders increases in response to global demand, this study has important implications for nursing administrators, educators and policymakers in relation to the development and implementation of strategies to enhance nurses' sense of coherence and intercultural sensitivity and prevent work-related strain. Trial Registration number: NCT04196751.

Profiles of intercultural sensitivity of healthcare students: a person-centred approach.

Objectives: We aimed to explore healthcare students' intercultural sensitivity profiles and their relationship with empathy to develop effective education methods that promote non-discriminatory patient care. Methods: We conducted a cross-sectional questionnaire study, involving a total of 508 international (n= 100) and local (n= 408) healthcare students in Hungary by convenience sampling. The survey included demographics, the Intercultural Sensitivity Scale, and the Interpersonal Reactivity Index. We applied latent profile analysis to identify distinct sensitivity profiles and used multinomial logistic regression to estimate the predictive power of several background variables on profile group membership. Results: A four-profile solution emerged: "Interculturally average" (n= 241), "Interculturally uncertain" (n= 76), "Interculturally sensitive" (n= 132), and "Interculturally refusing" (n= 54). The model (R2= 0.123; p= 0.001) revealed that psychology major tended to predict "uncertain" group membership (OR= 0.56, p= 0.08) and higher personal distress was a significant predictor of this group (OR=1.11, p= 0.002). Male gender (OR= 3.03, p= 0.001), medicine major (OR= 5.49, p= 0.01), lower perspective-taking (OR= 0.91, p= 0.007) and higher personal distress (OR= 1.09, p= 0.028) were identified as predictors of "refusing" group membership, compared to the "average" group. Conclusions: By exploring the ways students experience intercultural situations, a more personalized medical education can be developed with a special focus on vulnerable subgroups. For the "uncertain" group, the focus should be more on developing confidence, and intercultural experiences, whereas in the "refusing" group on strengthening empathy. In general, it can be useful to create mixed-gender, multidisciplinary, and intercultural learning environments.

"If They Help Us, We Can Help Them": First Nations Peoples Identify Intercultural Health Communication Problems and Solutions in Hospital in Northern Australia.

Effective intercultural communication between First Nations peoples and healthcare providers in colonised countries is required to deliver equitable healthcare and improve patient experiences and health outcomes. This paper presents First Nations peoples' perspectives and proposed solutions to problematic communication experiences at Royal Darwin Hospital in northern Australia. The study's methodological foundations comprise decolonising principles rooted in Critical Race Theory, Freirean pedagogy, and cultural safety. Eleven individuals from diverse First Nations backgrounds receiving treatment at the largest hospital in the Northern Territory, participated in in-depth interviews conducted in their preferred languages. Data were inductively analysed, adapted from a constructivist grounded theory approach and guided by First Nations knowledges. First Nations patients at Royal Darwin Hospital described a culturally unsafe hospital due to ineffective intercultural communication. Patient "counterstories" recounted instances of confusion, aggression, healthcare provider resistance to shared decision-making opportunities, pressure to abandon cultural protocols, and institutional neglect. Poor communication incited anger among staff and patients, and contributed to experiences of racism, missed appointments, clinical mistakes, patients prematurely discharging before completing treatment, and patients experiencing financial troubles and homelessness. In a spirit of generosity, patients proposed solutions focused on relationship building and mutual understanding so that new decolonised systems, which draw on First Nations and Western knowledges, can be codesigned. This study serves as a call to action for policymakers, administrators, and healthcare providers to prioritise improving intercultural communication by addressing the behaviour of staff and changing systemically racist policies in the pursuit of health equity and cultural safety for First Nations peoples.

Why don't Chinese college students seek help from the National Health Service (NHS)? Chinese college students' use of medical services in the UK.

Background: International students have a lower utilization rate of the local medical service system for studying abroad, and it has been found that there may be multiple reasons behind this phenomenon. This study explores the usage of medical service systems by international students and the underlying logical factors through a study of the usage of National Health Service (NHS) of Chinese students in the UK. Methods: To address the research questions, this study employed an online survey methodology that ran between 1st May and August 20, 2019 facing the Chinese students in the UK. A total of 1,050 questionnaires were distributed and 1,001 questionnaires were recovered, of which 977 contained valid responses (questionnaire response rate was 95.3 % and validity rate was 97.6 %). Before the questionnaire was designed and after it was issued, two focus group interviews were conducted to provide reliable and detailed information to inform the questionnaire design and to supplement the questionnaire survey data with more profound psychological qualitative data. The two focus groups consisted of 10 and 12 Chinese students studying in the UK and each lasted more than 3 h. Results: The survey data showed that the medical services utilization rate of Chinese students in the UK is relatively low compared to UK residents and domestic Chinese students. Their decisions and behaviours around medical services usage in the UK are not significantly related to age, gender, and monthly income, but are instead related to their current education status, types of disease suffered, and information acquisition about the UK medical services before coming to the UK. When getting sick, in addition to seeking help from official medical services, Chinese students studying in the UK tend to self-diagnose and self-medicate; seeking help from social networks based on friendship and domestic relatives are also alternatives to accessing medical services. Conclusion: Combining the theories of 'sick role' and 'illness experience', the decisions and behaviours related to medical services usage by Chinese students in the UK are significantly influenced by their understanding of medical services, which is socially and culturally learned in China. Understanding the perspective of the 'sick role' and the 'illness experience' of Chinese students may help to better think about how improvements can be made to their utilization rate of medical services and their health status during their studies in the UK. This study not only provides us with specific information and understanding on the usage of medical services for Chinese students in the UK, but the research results may also provide a reference for other similar research on the health and medical service use of other international students studying in the cross-cultural contexts.

"Business as usual won't work ": Therapists' experiences and preparedness for providing refugees with trauma-related interventions.

OBJECTIVE: Worldwide, the numbers of refugees and displaced people being exposed to traumatic and inhumane experiences are escalating, resulting in an enhanced need for appropriate psychological management of trauma in this at-risk group. This study explores therapists' perspectives on and preparedness for supporting adult refugees with trauma-related interventions. METHOD: Therapists (N = 17), with varying ranges of experiences supporting adult refugee clients, were recruited nationally, and participated in semi-structured interviews, exploring their experiences and preparedness for therapeutically supporting refugee clients with trauma-related interventions. Data were analyzed using reflexive thematic analysis. A Patient Public Involvement (PPI) approach was embedded within this study. RESULTS: Five major themes were developed throughout the analysis: (i) Therapists' Fears and Apprehensions in Meeting Client Complexities, (ii) Preparation and Support for Competency Development, (iii) Adjusting Preconceptions of the Nature of Therapeutic Work, (iv) Humanity Within the Therapeutic Relationship, and (v) Balancing Therapeutic Meaningfulness and Hardships. CONCLUSION: Therapist training must reflect trauma-informed care and inter-cultural awareness to allow therapists to feel better prepared within mainstream and specialist services. Further, therapists' well-being needs to be prioritized to prevent vicarious trauma, burn-out and ultimately, improve interventions for clients.

The Chinese version of the tendency to stigmatize epidemic diseases scale: a translation and validation study.

Objective: To translate the Tendency to Stigmatize Epidemics Diseases Scale (TSEDS) into Chinese and to evaluate its psychometric properties. Methods: Translation and cross-cultural adaptation using the Brislin translation model, and pre-testing to form a Chinese version of TSEDS. A total of 434 adults participated in the study and the TSEDS were measured using the critical ratio method, Pearson correlation analysis, retest reliability, content validity, structural validity, and concurrent validity. Results: The Chinese version of the TSEDS scale contains 27 items in 5 dimensions, including structural stigma, perceived stigma, organizational stigma, internalized stigma, and social stigma. The average content validity index of the scale was 0.975. The goodness of fit index (χ2/df= 1.981, RMSEA = 0.067, CFI= 0.930, IFI = 0.931, TLI = 0.922) indicated a good model fit. The Cronbach's alpha coefficient was 0.962 and the dimensionality ranged from 0.882 to 0.928. The retest reliability was 0.912. Conclusion: The Chinese version of TSEDS has good reliability and validity, which can be used to assess the epidemiological stigma tendency of Chinese adults.

The Relationships of Self-Sustained English Learning, Language Mindset, Intercultural Communicative Skills, and Positive L2 Self: A Structural Equation Modeling Mediation Analysis.

Learning English as a second language (ESL) has garnered significant attention from researchers and practitioners over the past few decades, with numerous ESL learning outcomes examined in the literature. However, self-sustained learning (SSL), a crucial factor in promoting students' sustained learning and development within a sustainable society, has long been overlooked. To deepen the understanding of SSL, especially in the context of ESL in China, this study examined the direct and indirect effects of intercultural communicative skills, language mindset, and positive L2 self on sustained English learning among 1238 Chinese college students through descriptive statistics and a Structural Equation Modeling (SEM) mediation analysis. The results indicated that Chinese college students exhibited a strong language mindset and positive L2 self. They also scored high in intercultural communicative skills and long-term self-sustained English learning. SEM analysis showed that, after controlling for students' demographic characteristics, both intercultural communicative skills and language mindset positively predicted positive L2 self and self-sustained English learning. Moreover, intercultural communicative skills and language mindset had significant and positive indirect effects on self-sustained English learning through positive L2 self, underscoring the significant mediating role of positive L2 self in the relationships between intercultural communicative skills, language mindset, and self-sustained English learning. These findings suggest that, to promote self-sustained learning among English learners, instructors should enhance students' intercultural communicative skills, foster a growth language mindset, and cultivate positive language learning beliefs.

Interaction Processes between Health Professionals and Moroccan Immigrant Women in Reproductive Healthcare: The Disagreement in the Encounter-A Qualitative Study.

INTRODUCTION: Spain is a multicultural society and has been defined by several authors as an immigrant-receiving country. Moroccan women of childbearing age constitute 28.20% of Moroccan immigrants. OBJECTIVES: describe the interaction processes that occur between health professionals and Moroccan immigrant women in reproductive healthcare. METHODS: Qualitative descriptive study based on Grounded Theory. Thirty immigrant women from Morocco and thirty-five health professionals participated in the study. Specific dimensions of analysis were defined and used to design the interview guide and focus groups. RESULTS: In the healthcare encounter, the construction of an effective communicative space between the people involved in it is essential; however, the language barrier and the interpersonal relationships characterized by silence in the encounter make a meaningful healthcare relationship difficult for those who participate in it. CONCLUSIONS: There are communication and relationship problems that alter healthcare and the professional-patient relationship which require the use of translation programs, the incorporation of intercultural meters, and the development of cultural competence in health professionals.

World-wide-working-web: How to be successful on global teams.

The day and age where pharmaceutical institutions were securely nestled within solid walls in one country, without much communication and collaboration with other sites and external collaborators, are long gone. The move to more global communication and collaboration has been beneficial for science exploration, however, it has presented scientists with the challenge of working on global teams. This article will explore this world-wide-working web and provide guidance on how to be successful in this new environment in the pharmaceutical industry and related work institutions. Four angles will be explored - intercultural awareness, virtual working and non-standard working hours, personal and team goals and how to be authentic in this new environment. The article will conclude with a road-map that the reader can follow, when embarking on the global team journey.

Intercultural competence development: A qualitative case study.

AIM: The aim of this study was to explore Bachelor of Science in Nursing (BSN) students' perceptions of the effectiveness of a unique teaching-learning strategy using their results from the Intercultural Development Inventory (IDI), an instrument for the assessment of intercultural competence, with their customized Intercultural Development Plan (IDP) in enhancing their cultural competence development in a nursing senior practicum. The study also examined student insights about how having a plan to develop their intercultural competence will have an impact on their future nursing practice. BACKGROUND: Intercultural competence is vital for providing quality healthcare, yet there is a gap in understanding how educational interventions are designed and implemented to enhance cultural competence among nursing students. This paper describes a strategy for developing intercultural competence. The IDI was administered to Bachelor of Science in Nursing (BSN) students in the fourth semester of a five-semester BSN program. Based on their IDI results, each student received a customized IDP that suggested specific activities and encouraged guided self-reflection to enhance intercultural competence development. In the fifth-semester senior practicum course, the students developed personal intercultural competence development goals based on their IDP. They also kept weekly journals on their intercultural competence development during their practicum. DESIGN: This study used a Qualitative Case Study design. METHODS: This study was conducted from January to July 2021 with 47 senior practicum students in a large BSN program in the Southeastern United States. Data consisted of student written responses to prompts on how the IDI/IDP influenced their intercultural development and its potential effect on their future practice. The data were analyzed through inductive content analysis. RESULTS: Three key themes emerged: self-awareness, recognition of cultural influences and growth goals. Student reflections suggested that they desired to develop intercultural competence so they could provide the best possible nursing care for their patients. Still, most students did not have a plan for how to grow in this area. Many students reported that their IDI/IDP heightened cultural awareness throughout their practicum, guiding their development of intercultural competence and leading to a deeper and broader understanding of culture. Students suggested that this enhanced cultural understanding, along with their IDP, will facilitate their continued development of intercultural competence in their future professional practice. CONCLUSION: This study contributes to existing knowledge about intercultural competence development and effective teaching methods by providing empirical evidence of the positive impact of the IDI/IDP on nursing students' perceived intercultural development. These findings can inform the development and implementation of pedagogical strategies to enhance intercultural competence, which will ultimately improve patient care outcomes in all healthcare settings.

Professionals' and Intercultural Mediators' Perspectives on Communication With Ukrainian Refugees in the Czech Healthcare System.

INTRODUCTION: A growing body of research is examining how healthcare systems are responding to the increasing numbers of migrants and the resulting superdiversity of patients. The aim of this article is to identify and explain communication barriers in the provision of healthcare to Ukrainian war refugees in the Czech Republic from the perspectives of healthcare professionals and intercultural mediators. METHODS: The exploratory case study is based on a qualitative analysis of semi-structured interviews with frontline health professionals: 20 with doctors and 10 with nurses. The second source of data is two focus groups aimed at capturing communication problems from the perspective of intercultural mediators who accompany refugees to health facilities. The interview transcripts and FGs were analysed using six-stage thematic coding. RESULTS: The survey identified five main themes related to barriers to communication: (1) language barriers and interpreting, (2) cultural barriers, (3) differing expectations of health and the healthcare systems in the Czech Republic and Ukraine, (4) prejudices and negative attitudes and unethical behaviour towards refugees and migrants and (5) lack of awareness of patient rights. CONCLUSIONS: The arrival of large numbers of migrants has highlighted deficiencies in the system that may affect other vulnerable groups and the general population. These include the lack of general communication skills and legal awareness among many health professionals, which are barriers to the development of patient-centred care. The involvement of intercultural mediators fundamentally improves communication between health professionals and (not only) migrant patients. Nevertheless, it is necessary to legally anchor and define the position of intercultural mediators within the healthcare system. PATIENT OR PUBLIC CONTRIBUTION: Collaboration with intercultural mediators who interpreted the extensive experiences of Ukrainian refugee patients and also have personal experience as migrant or migrant-origin patients contributed to shaping research questions, facilitating study participation and enriching evidence interpretation. Researchers with multicultural backgrounds and experience with working with people from refugee backgrounds were involved in the study design and analysis.

The dynamics of intercultural clinical encounters in times of pandemic crisis. Swedish healthcare providers' reflections on social norms in relation to sexual and reproductive healthcare.

BACKGROUND: Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms. METHODS: A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis. FINDINGS: Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation. CONCLUSION: The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike.

Listening to caregivers' voices about the experience of integrating music therapy-informed activity in community-based rehabilitation in rural India.

BACKGROUND: This project is part of a four-year intercultural collaboration between Indian and Australian stakeholders studying to use of music therapy (MT)-informed activity in community-based rehabilitation (CBR) with disabled children and their families in rural Maharashtra. This paper presents a qualitative study of caregiver perspectives. METHODS: Interviews with four participating caregivers were thematically analysed, with an emphasis on participant voices. The combined thematic analysis of the four interviews revealed shared five themes. RESULTS: Data analysis revealed caregivers' perception that music in CBR supported existing CBR goals. Furthermore, caregivers reported that music in CBR enhanced motivation and participation for children and families and fostered community connection. Importantly, caregivers noted that music made CBR fun and was a pre-existing resource. CONCLUSIONS: Findings were congruent with research with other stakeholders in the intercultural collaboration. Caregiver perspectives offer new insight into the priorities of families in CBR, which has wider relevance arts and health workers in community-based practice.

Intercultural therapy with Ultra-Orthodox Jews in Israel: the complexity of the encounter between secular therapists and Haredi clients.

This paper explores the exceptional intercultural encounter between secular therapists and Ultra-Orthodox Jews in Israel, focusing on two key aspects. Firstly, it explores the distinctive attributes and conflicts inherent in treating Ultra-Orthodox individuals. On the one hand is the secular Israeli therapist, whose base is in Western philosophy that prioritizes individuality, cultural diversity, and tolerance of differences. On the other hand is the Haredi client, entrenched in values from Jewish tradition and religious principles that amplify solidarity and collectivism while rejecting prevalent secular culture. The existing socio-political climate in Israel often positions these two as potentially conflicting cultures. Secondly, the paper seeks to illuminate the uncommon dynamics of the minority-majority power balance within the therapeutic relationship. In contrast to prevalent literature in intercultural therapy, which typically frames the client as a representative of a disadvantaged minority and the therapist as a representative of a dominant majority, this article aims to unravel a nuanced power balance, where those in the minority perceive the dominant culture both as a threat to its way of life and as a despised entity, but paradoxically rely entirely on its financial support. This reveals a complex and intricate interplay of dominance and dependence, shaping a therapeutic relationship that defies conventional expectations.

A Digital Sexual Health Education Web Application for Resource-Poor Regions in Kenya: Implementation-Oriented Case Study Using the Intercultural Research Model.

BACKGROUND: Developing a digital educational application focused on sexual health education necessitates a framework that integrates cultural considerations effectively. Drawing from previous research, we identified the problem and essential requirements to incorporate cultural insights into the development of a solution. OBJECTIVE: This study aims to explore the Solution Room of the self-established Intercultural Research Model, with a focus on creating a reusable framework for developing and implementing a widely accessible digital educational tool for sexual health. The study centers on advancing from a low-fidelity prototype (She!Masomo) to a high-fidelity prototype (We!Masomo), while evaluating its system usability through differentiation. This research contributes to the pursuit of Sustainable Development Goals 3, 4, and 5. METHODS: The research methodology is anchored in the Solution Room of the self-expanded Intercultural Research Model, which integrates cultural considerations. It uses a multimethod, user-centered design thinking approach, focusing on extensive human involvement for the open web-based application. This includes gathering self-assessed textual user feedback, conducting a System Usability Scale (SUS) analysis, and conducting 4 face-to-face semistructured expert interviews, following COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. RESULTS: Based on the identified limitations of the low-fidelity prototype, She!Masomo (SUS score 67), which were highlighted through textual user feedback (63/77) and prototype feature comparisons, iterative development and improvement were implemented. This process led to the creation of an enhanced high-fidelity prototype (We!Masomo). The improved effectiveness of the enhanced prototype was evaluated using the qualitative SUS analysis (82/90), resulting in a favorable score of 77.3, compared with the previous SUS score of 67 for the low-fidelity prototype. Highlighting the importance of accessible digital educational tools, this study conducted 4 expert interviews (4/4) and reported e-survey results following the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guideline. The digital educational platform, We!Masomo, is specifically designed to promote universal and inclusive free access to information. Therefore, the developed high-fidelity prototype was implemented in Kenya. CONCLUSIONS: The primary outcome of this research provides a comprehensive exploration of utilizing a case study methodology to advance the development of digital educational web tools, particularly focusing on cultural sensitivity and sensitive educational subjects. It offers critical insights for effectively introducing such tools in regions with limited resources. Nonetheless, it is crucial to emphasize that the findings underscore the importance of integrating culture-specific components during the design phase. This highlights the necessity of conducting a thorough requirement engineering analysis and developing a low-fidelity prototype, followed by an SUS analysis. These measures are particularly critical when disseminating sensitive information, such as sexual health, through digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12905-023-02839-6.

A qualitative study on Chinese primary school EFL teachers' beliefs about incorporating intercultural competence into foreign language teaching.

Intercultural competence has become one of the important goals of foreign language education. The potential and value of foreign language education on students' intercultural competence (IC) has been widely recognized by academia. Currently, most of the research on intercultural foreign language teachers in China focuses on university teachers, with little attention paid to primary school EFL teachers. However, the cultivation of IC is a staged and continuous process which cannot be achieved in one stroke. Therefore, it is necessary to include primary school EFL teachers in the study of IC cultivation. This paper presents data on Chinese primary school EFL teachers' beliefs about incorporating IC into foreign language teaching. Specifically, their understanding of culture, IC, and intercultural teaching practices are investigated through interviews. The interview transcriptions were analyzed using thematic analysis. The research found: 1. Chinese primary school EFL teachers generally hold an essentialist view of culture; 2. Teachers emphasize the attitudinal dimension of IC; however, they also exhibit a tendency to oversimplify IC or perceive it as a higher-order skill than language proficiency, hence deeming it unsuitable for cultivation at the primary school level; 3. Most cultural teaching practices are teacher-centered, focusing on background knowledge-style introduction. In general, teachers' intercultural teaching practices align with their cultural outlook. At last, the study explores two suggestions for promoting intercultural foreign language teaching: 1. Supporting primary school EFL teachers in updating their language and culture concepts system; 2. Encouraging teachers to reflect on their daily teaching practices as a major opportunity to promote the development of intercultural foreign language teaching.