Exploring racial microaggression experiences among ethnic minority nursing students: A descriptive phenomenological study.

BACKGROUND: The increasing pursuit of enhanced educational opportunities has led to a significant rise in international student enrollment in various fields, including nursing. Nursing is currently in its early stages and faces challenges related to racial microaggression. Understanding the dynamics of racial microaggression is crucial in countries like Turkey, where students from diverse ethnic backgrounds are accommodated. OBJECTIVE: To explore and achieve a more profound insight into the lived encounters of ethnic minority nursing students confronting racial microaggression. METHOD: The study employed a descriptive phenomenological approach. Data collection involved conducting in-depth interviews from February 1, 2023, to June 1, 2023. Analysis was performed utilizing Colaizzi's analysis method. RESULTS: Each participant in the study encountered at least one type of microaggression. The analysis identified three clear themes: "challenges in social interactions," "unfavorable learning atmosphere," and "aspirations for the future." CONCLUSION: This study highlights the crucial need to establish secure and inclusive environments that foster authentic discussions within academic settings. Faculty and educators should strengthen their ability to consider diverse perspectives in various scenarios. Moreover, integrating an up-to-date and comprehensive curriculum, along with the adoption of inclusive language, into the nursing program is essential for effectively addressing these concerns.

Exploring the mechanisms underlying increased risk of depressive disorder in ethnic minority populations in Europe: A causal loop diagram.

BACKGROUND: Multiple ethnic minority populations in Europe show high risk of major depressive disorder (MDD), with ethnic discrimination and low socioeconomic position (SEP) as established risk factors. How this risk is shaped by the interactions between these, and other social factors, remains to be elucidated. We aimed to develop a causal-loop diagram (CLD) to gain a better understanding of how factors at the intersection of ethnic discrimination and SEP dynamically interact to drive MDD risk. METHODS: We iteratively mapped the interactions and feedback loops between factors at the intersection of ethnic discrimination and SEP, drawing input from (i) a series of two interviews with a range of MDD domain experts, (ii) an existing CLD mapping the onset of MDD across psychological, biological, and social dimensions at the level of the individual, and (iii) other relevant literature. RESULTS: Through tracing the feedback loops in the resulting CLD, we identified ten driving mechanisms for MDD onset in ethnic minorities (two related to ethnic discrimination, SEP, social network and support, and acculturation, as well as one relating to the living environment and self-stigma towards MDD); and four factors that modulate these mechanisms (recent migration, religious affiliation, neighborhood social environment, and public stigma towards MDD). The intersecting nature of ethnic discrimination and SEP, combined with the reinforcing dynamics of the identified driving mechanisms across time- and spatial scales, underscores the excess exposure to circumstances that increase MDD risk in ethnic minorities. CONCLUSIONS: While this CLD requires validation through future studies, the intersecting and reinforcing nature of the identified driving mechanisms highlights that tackling the high risk of MDD in ethnic minorities may require intervening at multiple targets, from the individual (e.g., psychological interventions targeting negative beliefs or reducing stress) to the societal level (e.g., addressing labor market discrimination).

Impostor Phenomenon in Racially/Ethnically Minoritized Groups: Current Knowledge and Future Directions.

In recent years there has been a surge of research conducted on the impostor phenomenon, with approximately half of all impostor phenomenon articles being published between 2020 and 2022 and growing interest in understanding how the impostor phenomenon affects racially and ethnically minoritized individuals. Questions around intersectionality remain about how to apply the impostor phenomenon to the experiences of minoritized individuals. In this review, we revisit the historical context of the impostor phenomenon. We address issues of nomenclature and current controversies regarding whether the impostor phenomenon (a) blames the victim, (b) should be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and (c) is beneficial for individuals. In addition, we address the limitations of current research on racially and ethnically minoritized individuals, especially women of color. Finally, we conclude by discussing the need for a reconceptualized racialized impostor phenomenon as well as the need to establish new impostor phenomenon measures, conduct more quantitative research with diverse samples, and create culturally tailored interventions.

From triple quandary to talent quest: The past, present, and future of A. Wade Boykin's contributions to psychology.

A. Wade Boykin's scholarship has provided key insights into the psychological realities of racially minoritized people and catalyzed revolutionary changes in psychology and education. Combining insights from personal and research experiences, Boykin authored the foundational triple quandary (TQ), a framework describing how Black Americans must navigate the often conflicting values and priorities of dominant mainstream society, the heritage culture of Black communities, and dynamics associated with being racially minoritized. TQ describes the unique developmental challenges faced by Black children, for whom misalignment between home cultural socialization and U.S. schooling often leads to pathologizing mischaracterizations of their attitudes and behaviors, resulting in chronic academic opportunity gaps. Boykin used his training as an experimental psychologist to empirically test the validity and explanatory utility of the TQ framework and to determine whether Black cultural values could be leveraged to improve student learning. Focusing on cultural values such as expressive movement, verve, and communalism, studies with his collaborators consistently supported Boykin's framework and predictions for improving Black student achievement-related outcomes. Beginning in the early 2000s, Boykin and his colleagues began to scale the lessons of decades of empirical work into the talent quest model for school reform. The TQ and talent quest continue to evolve in their application, as scholars and practitioners have found them relevant to a diverse range of minoritized populations in American society and beyond. Boykin's work continues to bear on the scholarship, career outcomes, and day-to-day lives of many scholars, administrators, practitioners and students across disciplines and institutions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

COVID-19-Related Discrimination Among Racial/Ethnic Minorities and Other Marginalized Communities in the United States.

Objectives. To determine the prevalence of COVID-19-related discrimination among major US racial/ethnic groups and estimate associations between discrimination, race/ethnicity, and other sociodemographic characteristics. Methods. We conducted a nationally representative online survey of 5500 American Indian/Alaska Native, Asian, Black/African American, Hawaiian/Pacific Islander, Latino (English and Spanish speaking), White, and multiracial adults from December 2020 to February 2021. Associations between sociodemographic characteristics and COVID-19-related discrimination were estimated via multinomial logistic regression. Results. A total of 22.1% of the participants reported experiencing discriminatory behaviors, and 42.7% reported that people acted afraid of them. All racial/ethnic minorities were more likely than White adults to experience COVID-19-related discrimination, with Asian and American Indian/Alaska Native adults being most likely to experience such discrimination (discriminatory behaviors: adjusted odd ratio [AOR] = 2.59; 95% confidence interval [CI] = 1.73, 3.89; and AOR = 2.67; 95% CI = 1.76, 4.04; people acting afraid: AOR = 1.54; 95% CI = 1.15, 2.07; and AOR = 1.84; 95% CI = 1.34, 2.51). Limited English proficiency, lower education, lower income, and residing in a big city or the East South Central census division also increased the prevalence of discrimination. Conclusions. COVID-19-related discrimination is common, and it appears that the pandemic has exacerbated preexisting resentment against racial/ethnic minorities and marginalized communities. Efforts are needed to minimize and discredit racially driven language and discrimination around COVID-19 and future epidemics. (Am J Public Health. 2022;112(3):453-466. https://doi.org/10.2105/AJPH.2021.306594).

Validation of the 5-D Itch Scale in Three Ethnic Groups and Exploring Optimal Cutoff Values Using the Itch Numerical Rating Scale.

BACKGROUND: Chronic pruritus is a common and distressing condition that has serious emotional and psychosocial consequences. Due to its subjective nature, self-report questionnaires are widely implemented as cost-effective measures to gauge the severity of chronic pruritus. The current study is aimed at validating the 5-D itch scale in three ethnic groups-Black, Asian, and Hispanic-with the well-validated Itch Numerical Rating Scale (NRS) and Worst Itch NRS (WI-NRS) and developing its cutoff value using receiver operating characteristics (ROC) and inspection of the area under the curve (AUC) across ethnic groups. At the same time, it is aimed at comparing the concurrent prevalence of itch and depression in these populations, who often form ethnic minorities in many countries. The current study addresses the knowledge gap of cultural adaptation of the 5-D pruritus scale for greater usage. METHODS: Community samples of three ethnic groups were recruited from an online platform of Qualtrics and administered the self-report questionnaires of Itch-NRS, 5-D itch scale, and Patient Health Questionnaire-9 (PHQ-9) to measure their pruritus domains, itch intensity, depression screening, and its severity. Informed consent was obtained from all participants. Subgroup analysis was conducted, including concurrent validity and cutoff values compared between each ethnic group. Concurrent prevalence of itch and depression was evaluated using the cutoff value of Itch-NRS and PHQ-9. RESULT: A total of 2323 participants were included in the study. A significant positive correlation (p < 0.001) was found between the Itch-NRS, WI-NRS, and 5-D itch scale. The cutoff value of the 5-D itch scale was established for the three ethnic groups using ROC, with a cutoff value of Itch-NRS as a reference. CONCLUSIONS: The 5-D itch scale has demonstrated sound psychometric properties in three ethnic groups and is closely related to Itch-NRS. The analysis of the cutoff value of the 5-D itch scale suggests that different cutoff values should be considered to reduce the inflation of pruritus severity.

Perceptions of physical activity and technology enabled exercise interventions among people with advanced chronic kidney disease: a qualitative study.

BACKGROUND: Exercise improves health outcomes and quality of life in persons with chronic kidney disease (CKD). The numbers of persons with advanced CKD meeting physical activity guidelines however is low. We undertook a qualitative study of men and women aged 36-74 from various race/ethnic populations with advanced CKD not requiring dialysis to describe their experiences and opinions around prior physical activity, motivating factors for and barriers to exercise, and perceptions of exercise-promoting technology and group-based programming designed to improve physical activity levels. METHODS: Nineteen persons with advanced CKD not requiring dialysis were interviewed at two high volume nephrology clinics enriched with racial/ethnic minority patients (Emory University and Santa Clara Valley Medical Center). We used thematic analysis to identify dominant themes (n = 4) and subthemes (n = 19) around exercise experience, barriers, motivators, views, and preferences. RESULTS: Four dominant themes and 19 subthemes were identified. The most common motivators to exercise included physical and mental health benefits, appearance, improvement in energy levels, and potential social interaction in group-based programs. Common barriers included health concerns, particularly complications related to other co-morbidities, as well as time and transportation constraints. Participants were skeptical of exercise programs solely reliant on technology. CONCLUSIONS: The use of group-based exercise programs may motivate persons with CKD to increase exercise levels, while programs entirely based on technology may be less effective.

Mistreatment, discrimination and burn-out in Neurosurgery.

OBJECTIVE: Issues concerning harassment, bullying and discrimination are not unknown to medical specialties and are likely to be present in neurosurgery as well. The aim of this study was to estimate the extent to which neurosurgeons are faced with issues pertaining to this mistreatment. METHODS: A survey consisting of fourteen questions was distributed among members of the Congress of Neurological Surgeons (CNS). The survey consisted of three parts: 1) demographics; 2) exposure to mistreatment; 3) experienced burnout symptoms. RESULTS: In total 503 out of the 5665 approached CNS members filled in a survey (response rate 8.9 %). Respondents consisted for 85.9 % out of neurosurgeons and for 13.9 % out of residents. Overall, 61.4 % of the respondents was a victim of form of abusive behavior, while 47.9 % was a victim of at least one form of discrimination. Most reported sources of these mistreatments were other neurosurgeons or (family of) patients. Overall, 49.9 % of the respondents experienced burnout symptoms. Multivariable logistic regression analysis showed that female respondents had higher odds of being a victim of abuse (OR 2.5, 95 % CI 1.4-4.6). Female respondents (OR 19.8, 95 % CI 8.9-43.9) and ethnic minorities (OR 3.8, 95 % CI 2.3-6.2) had higher odds of being a victim of discrimination. Furthermore, victims of abuse were at higher odds (OR 1.7, 95 % CI 1.1-2.6) of having burnout symptoms. CONCLUSIONS: Mistreatment and experiencing burnout symptoms frequently occurs among neurosurgeons and residents.

Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions.

OBJECTIVES: Although disparities in maternal vaccine acceptance among racial/ethnic groups are well documented, the reasons for these disparities are unclear. The objective of this study was to describe differences in pregnant women's knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines by race/ethnicity. METHODS: We collected survey data from 1862 pregnant women from diverse prenatal care practices in Georgia and Colorado from June 2017 through July 2018. We performed multiple logistic regressions to determine differences in intentions, knowledge, attitudes, beliefs, and trust by race/ethnicity and calculated odds ratios (ORs) and 95% CIs. RESULTS: Compared with White women, Black and Hispanic women were less confident in vaccine safety and efficacy and less likely to perceive risk of acquiring vaccine-preventable diseases, report provaccine social norms, indicate having enough vaccine knowledge, and trust vaccine information from health care providers and public health authorities. Black women were the least confident in the safety of the maternal influenza vaccine (OR = 0.37; 95% CI, 0.27-0.49); maternal tetanus, diphtheria, and acellular pertussis vaccine (OR = 0.37; 95% CI, 0.27-0.52); and infant vaccines overall (OR = 0.40; 95% CI, 0.28-0.58), and were least likely to intend to receive both maternal vaccines (OR = 0.35; 95% CI, 0.27-0.47) or all infant vaccines on time (OR = 0.45; 95% CI, 0.34-0.61) as compared with White women. CONCLUSIONS: Understanding differences in behavioral constructs integral to vaccine decision making among women of different races/ethnicities can lead to tailored interventions to improve vaccine acceptance.

Quality of life in at-risk school-aged children with asthma.

INTRODUCTION: Asthma is the most common chronic condition of childhood. Urban, minority children from families of lower socioeconomic status have disproportionately higher rates of asthma and worse outcomes. We investigated the association between the presence of asthma and asthma severity among American, urban, minority children and reported quality of life (QOL) of children and their families. METHODS: We performed a prospective, cross-sectional study comparing QOL of urban, minority elementary school-age children with and without asthma. A convenience sample of children was enrolled from the pediatric emergency department (ED) and a specialized asthma clinic, at a large urban children's hospital. We measured child and parent QOL using the Pediatric Quality of Life Inventory Version 4 (PEDSQL4), and evaluated associations with asthma, parental educational attainment, and frequency of ED visits. RESULTS: We enrolled 66 children, 76% were African American, and 61% were female. Overall child QOL was higher for those without asthma (p = 0.017, d = 0.59). Children with asthma also visited the ED almost twice as frequently (t [64] = -3.505, p < 0.001, d = 0.8), and parents of children with asthma reported a lower overall QOL (p = 0.04, d = 0.53) than those without asthma. Among children with asthma, a higher overall child QOL was associated with decreased asthma severity, more ED visits, and higher parental educational attainment. CONCLUSIONS: Urban, minority elementary school-age children with asthma report a lower QOL than those children without asthma, and decreased asthma severity was associated with higher QOL.

Social disadvantage, linguistic distance, ethnic minority status and first-episode psychosis: results from the EU-GEI case-control study.

BACKGROUND: Ethnic minority groups in Western countries face an increased risk of psychotic disorders. Causes of this long-standing public health inequality remain poorly understood. We investigated whether social disadvantage, linguistic distance and discrimination contributed to these patterns. METHODS: We used case-control data from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, carried out in 16 centres in six countries. We recruited 1130 cases and 1497 population-based controls. Our main outcome measure was first-episode ICD-10 psychotic disorder (F20-F33), and exposures were ethnicity (white majority, black, mixed, Asian, North-African, white minority and other), generational status, social disadvantage, linguistic distance and discrimination. Age, sex, paternal age, cannabis use, childhood trauma and parental history of psychosis were included as a priori confounders. Exposures and confounders were added sequentially to multivariable logistic models, following multiple imputation for missing data. RESULTS: Participants from any ethnic minority background had crude excess odds of psychosis [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.69-2.43], which remained after adjustment for confounders (OR 1.61, 95% CI 1.31-1.98). This was progressively attenuated following further adjustment for social disadvantage (OR 1.52, 95% CI 1.22-1.89) and linguistic distance (OR 1.22, 95% CI 0.95-1.57), a pattern mirrored in several specific ethnic groups. Linguistic distance and social disadvantage had stronger effects for first- and later-generation groups, respectively. CONCLUSION: Social disadvantage and linguistic distance, two potential markers of sociocultural exclusion, were associated with increased odds of psychotic disorder, and adjusting for these led to equivocal risk between several ethnic minority groups and the white majority.

Saúde, currículo, formação: experiências sobre raça, etnia e gênero / Salud, currículum, educación: experiencias sobre raza, etnia y género / Health, curriculum and education: experiences about race, ethnicity and gender

O racismo gera iniquidades na saúde, caracterizando-se como importante fator de violação de direitos. As políticas curriculares de ação afirmativa e a Política Nacional de Saúde Integral da População Negra (PNSIPN) apontam que a formação dos profissionais de saúde é um campo estratégico para a alteração desse quadro. Este texto apresenta um relato sobre a experiência exitosa de um Grupo Temático (GT) 28 - Saúde, currículo, formação, composto por integrantes do GT Racismo e Saúde, da Associação Brasileira de Saúde Coletiva (Abrasco). Ao pautar a formação de profissionais da saúde, a política de saúde da população negra e a educação das relações étnico-raciais, o GT mobilizou esforços para promover formação, levantamento de propostas formativas e divulgação de experiências, que resultaram na organização e na publicação de um dossiê. O relato revela uma metodologia de trabalho colaborativo e expressa desafios e possibilidades para a formação em saúde da população negra. (AU)

El racismo genera iniquidades en la salud, caracterizándose como importante factor de violación de derechos. Las políticas curriculares de acción afirmativa y la Política Nacional de Salud Integral de la Población Negra señalan que la formación de los profesionales de salud es un campo estratégico para la alteración de este cuadro. Este texto presenta un relato sobre la experiencia exitosa de un grupo temático (GT 28 - Salud, currículum, formación) compuesto por integrantes del GT Racismo y Salud, de la Asociación Brasileña de Salud Colectiva (Abrasco). Al pautar la formación de profesionales de la salud, la política de salud de la población negra y la educación de las relaciones étnico-raciales, el GT movilizó esfuerzos para promover formación, levantamiento de propuestas formativas y divulgación de experiencias, que resultaron en la organización y publicación de un dosier. El relato revela una metodología de trabajo colaborativo y expresa desafíos y posibilidades para la formación en salud de la población negra. (AU)

Racism creates inequities in health and a major reason for the violation of rights. Curriculum policies that cover affirmative actions and the Brazilian National Policy for Integral Health of the Black Population stress that the education of health professionals is a strategic field for changing this situation. This article reports the successful experience of a working group (WG 28 - Health, Curriculum, Education) composed of members of the Abrasco Racism and Health Working Group. By discussing the education of health professionals, health policies for the black population, and the education on ethnic-racial relations, the WG mobilized efforts to promote education, survey educational proposals, and disseminate experiences that resulted in the organization and publication of a dossier. This report reveals a collaborative work methodology and presents the challenges and possibilities for Health Education of the black population. (AU)

Escalas de aculturación para minorias étnicas: una revisión de literatura / Scales of acculturation for ethnic minorities: a literature review

La aculturación proceso multidimensional que afecta a grupos étnicos que se enfrentan a una cultura distinta a la originaria, ha sido estudiada en su relación con la salud, encontrándose inconsistencia en diversos estudios, pudiendo deberse a los distintos instrumentos utilizados para medir este proceso. El objetivo de esta revisión de literatura es analizar las características y propiedades psicométricas de los instrumentos que miden la aculturaciónen minorías étnicas en ciertos procesos de salud. Revisión bibliográfica narrativa, cuyo propósito fue revisar investigaciones relacionadas a la medición de aculturación asociada a la salud en grupos étnicos, en las bases de datos de CINAHAL y PubMed, seleccionándolos de acuerdo al cumplimiento de criterios de inclusión y exclusión en los últimos 10 años. Son 13 los instrumentos de aculturación encontrados en la revisión, respecto a las características de los instrumentos de aculturación el 77% de ellos tiene un enfoque bidimensional, la medición del lenguaje y/o idioma es el dominio más utilizado,el 38% de estos instrumentospresentan un nivel de fiabilidad sobre lo aceptable (0,7). Las dimensiones consideradas en los instrumentos de aculturación son distintas entre un instrumento y otro, o no consideran todas las dimensiones involucradas en el proceso de aculturación. La fiabilidad y validez no es conocida en todos los instrumentos de aculturación utilizados pudiendo afectar la correcta comprensión e interpretación de los resultados obtenidos en estudio realizados en grupo étnicos.

The multidimensional acculturation process that affects ethnic groups that face a culture different from their original has been studied in their relationship with health, finding inconsistency in various studies. These inconsistencies may be due to the different instruments used to measure this process. The objective of this literature review is to analyze the characteristics and psychometric properties of the instruments that measure acculturation in ethnic minorities in particular health processes. Narrative bibliographic review, whose purpose was to review research related to the measurement of acculturation associated with health in ethnic groups, in the CINAHAL and PubMed databases, selecting them according to compliance with inclusion and exclusion criteria in the last 10 years. There are 13 acculturation instruments found in the review, regarding the characteristics of acculturation instruments 77% of them have a two-dimensional approach, the measurement of language or dialect is the most used domain, 38% of these instruments have a level of reliability over the acceptable (0.7). Acculturation instruments do not consider all the dimensions involved in the acculturation process, being also different between one instrument and another. Reliability and validity are not known in all acculturation instruments used and may affect the correct understanding and interpretation of the results obtained in ethnic group studies