Attitudes of Public Hospital Nurses in Greece Toward Cultural Diversity and Their Association with Empathy
DOI:
https://doi.org/10.14738/bjhmr.112.16700Keywords:
Multiculturalism, intercultural empathy, hospital nurses, cultural skills, management of cultural situationsAbstract
This study aimed to investigate the attitudes of public hospital nurses in Greece toward cultural diversity and explore the relationship between these attitudes and empathy. A 4-month cross-sectional quantitative study was conducted from October 2022 to January 2023. The questionnaires were distributed using the Google Forms platform, and the sample comprised 179 nurses (n=179) employed in public hospitals. The questionnaire encompassed demographic and work-related inquiries, along with sections on cross-cultural health education and the Clinical Culture Competency Questionnaire (CCCQ) and Toronto Empathy Questionnaire (TEQ). Data analysis was carried out using SPSS software, version 28. The results indicated that nurses exhibit a moderate to fairly high level of positive attitudes toward ethnic minority patients, alongside a low level of empathy. Additionally, a positive weak correlation was observed between cultural skills and empathy (r=.223, p<.001), as well as between management of cultural situations and empathy (r=.162, p<.005). Significant differences in nurses' attitudes toward cultural diversity and empathy were identified based on specific demographic characteristics and their training experiences in intercultural health. In conclusion, this study underscores the importance of nurturing more positive attitudes among nurses toward patients from ethnic minorities. This necessitates a concerted effort to enhance both empathy and training in intercultural health. By fostering these qualities, healthcare professionals can better address the diverse needs of patients, thereby promoting more inclusive and effective healthcare delivery.
References
Flowers, D. L. Culturally Competent Nursing Care A Challenge for the 21st Century. Critical Care Nurse, 2004.24(4): p.48-52.
International Council of Nurses. Cultural and linguistic competence. 2013. Available from: https://www.icn.ch/sites/default/files/inline-files/B03_Cultural_Linguistic_Competence.pdf.
Repo, H., Vahlberg, T., Salminen, L., Papadopoulos, I., &Leino-Kilpi, H. The Cultural Competence of Graduating Nursing Students. Journal of Transcultural Nursing, 2017. 28(1): p.98–107.
Henderson, S., & Barker, M. Developing nurses' intercultural/intraprofessional communication skills using the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps. Journal Of Clinical Nursing, 2018. 27(17-18): p.3276–3286.
Liu, T-T., Chen, M-Y., Chang, Y-M., & Lin, M-H. A Preliminary Study on the Cultural Competence of Nurse Practitioners and Its Affecting Factors. Healthcare.2022; 10. Available from:
Almutairi, A. F., Adlan, A. A., & Nasim, M. Perceptions of the critical cultural competence of registered nurses in Canada. BMC Nursing, 2017. 16(4): p.1-9.
Papadopoulos, Ι., et al. Developing tools to promote culturally competent compassion, courage, and intercultural communication in healthcare. Journal of Compassionate Health Care, 2016. 3(2): p.1-10.
Deegan J & Smith K. Expert to novice: experiences of professional adaptation reported by non-English speaking nurses in Australia. Australian Journal of Advanced Nursing, 2010. 27: p.31-37.
Okougha M &Tilki M. Experiences of overseas nurses: the potential for misunderstanding. British Journal of Nursing, 2010.19: p.102-106.
Yakar, H. K., & Alpar, S. E. Intercultural Communication Competence of Nurses Providing Care for Patients from Different Cultures. International Journal of Caring Sciences, 2018. 11(3): p.1743-1755.
Suk, M. H., Oh, W. O., & Im, Y. Factors affecting the cultural competence of visiting nurses for rural multicultural family support in South Korea. BMC Nursing, 2018. 17(1): p. 1-9.
Zarei, B., Salmabadi, M., Amirabadizadeh, A., & Vagharseyyedin, S. A. Empathy and cultural competence in clinical nurses: A structural equation modeling approach. Nursing Ethics, 2019. 26(7-8): p.2113-2123.
DeZulueta, P. C. Developing compassionate leadership in health care: an integrative review. Journal of Healthcare Leadership, 2016.
Sinclair, S., et al. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliative Medicine, 2017. 31(5): p.437-447.
Levenson, R. W., & Ruef, A. M. Empathy: A Physiological Substrate. Journal of Personality and Social Psychology, 1992. 63(2): p.234-246. 107
Cuff, B. P. M., Brown, S. J., Taylor, L., & Howat, D. J. Empathy: A Review of the Concept. Emotion Review, 2014. 8(2): p. 144-153.
Powell, P. A., & Roberts, J. Situational determinants of cognitive, affective, and compassionate empathy in naturalistic digital interactions. Computers In Human Behavior, 2017. 68: p.137-148.
Jeffrey, D. Empathy, sympathy and compassion in healthcare: Is there a problem? Is there a difference? Does it matter? Journal Of the Royal Society of Medicine, 2016. 109(12): p.446-452.
Ioannidou, F., & Konstantikaki, V. Empathy and emotional intelligence: What is it really about? International Journal of Caring Sciences, 2008. 1(3): p.118-123.
Mercer, S. W., & Reynolds, W. J. Empathy and quality of care. The British journal of general practice: the journal of the Royal College of General Practitioners, 2002. 52: p.S9–S12.
Hojat, M., Louis, D. Z., Maio, V., & Gonnella, J. S. Empathy and health care quality. American Journal of Medical Quality: the official journal of the American College of Medical Quality, 2013. 28(1): p. 6–7.
Schulz, A. A., & Wirtz, M. A. Midwives' empathy and shared decision making from women's perspective -sensitivity of an assessment to compare quality of care in prenatal and obstetric care. BMC Pregnancy and Childbirth, 2022. 22(1): p. 717.
Moreno-Poyato, A. R., Rodríguez-Nogueira, Ó., & MiRTCIME CAT working group. The association between empathy and the nurse-patient therapeutic relationship in mental health units: a cross-sectional study. Journal Of Psychiatric and Mental Health Nursing, 2021. 28(3): p. 335–343.
Rodríguez-Nogueira, Ó., et al. The association between empathy and the physiotherapy-patient therapeutic alliance: A cross-sectional study. Musculoskeletal Science & Practice, 2022. 59: p.102557.
Dyche, L., & Zayas, L. H. Cross-cultural empathy and training the contemporary psychotherapist. Clinical Social Work Journal, 2001. 29(3): p. 245-258.
Drewelow, I. A Socio-Constructivitist Approach to Developing Intercultural Empathy. In: S. Dubreil, S. L. Thorne & S. K. Bourns (Eds.), AAUSC Volume - Issues in Language Program Direction: Social Pedagogies and Entwining Language with the World. Boston: Cengage Learning, 2017: p. 255-265.
Xiaoni, L. Cultivation of cultural empathy in intercultural communication under the background of One Belt and One Road. 2019 5th International Conference on Education Technology, Management, and Humanities Science, 2019: p.1384-1388.
Like R, Fulcomer M, Kairys J, Wathington K, Crosson J. Final report. Aetna 2001 Quality Care Research Fund. Assessing the impact of cultural competency training using participatory quality improvement methods. Piscataway (NJ): Center for Healthy Families and Cultural Diversity, Department of Family Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School.2004.
Apostolara et. al. Reliability and validity of the Clinical Cultural Competency Questionnaire-Greek version (CCCQ-G). Balkan Military Medical Review, 2016. 19 (2): p. 46-54.
Spreng, Nathan R., Margaret McKinnon, Raymond A. Mar, and Brian Levine. The Toronto Empathy Questionnaire: Scale development and initial validation of a factor-analytic solution to multiple empathy. Journal of Personality Assessment, 2009. 91(1): p. 62-71.
Kourmousi, N., et al. The Toronto Empathy Questionnaire: Reliability and Validity in a Nationwide Sample of Greek Teachers. Social Sciences, 2017. 6(2): p.62.
Stanley, M. J., Hayes, J., & Silverman, F. L. Examining student nurses’ perceptions of diverse populations: Are student nurses prepared to care for culturally diverse patients? Journal of Nursing Education and Practice, 2014. 4(7): p. 148-155.
Alpers, L. M., & Hanssen, I. Caring for ethnic minority patients: a mixed method study of nurses' selfassessment of cultural competency. Nurse Education Today, 2014. 34(6): p.999–1004.
Benedict, J. L. The Angry Amish Grandfather: Cultural Competence and Empathy: A Case Commentary. The Journal of Clinical Ethics, 2017. 28(3): p. 236–238.
Markey, K., Tilki, M., & Taylor, G. Understanding nurses' concerns when caring for patients from diverse cultural and ethnic backgrounds. Journal of Clinical Nursing, 2018. 27(1-2): p. e259–e268.
Cai, D., He, W., & Klug, D. Cultural competence among nurses and its influencing factors: A cross-sectional study. Nursing & health sciences, 2021. 23(2): p. 411–418.
Shahzad, S., Ali, N., Younas, A., & Tayaben, J. L. Challenges and approaches to transcultural care: An integrative review of nurses' and nursing students' experiences. Journal of professional nursing: official journal of the American Association of Colleges of Nursing, 2021. 37(6): p. 1119–1131.
Aydogdu, A. L. F. Cultural Competence of Turkish Nurses and Nursing Students: An Integrative Literature Review. Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society, 2022. 33(4): p. 529–541.
Antón-Solanas, I., et al. Qualified Nurses' Perceptions of Cultural Competence and Experiences of Caring for Culturally Diverse Patients: A Qualitative Study in Four European Countries. Nursing reports (Pavia, Italy), 2022. 12(2): p. 348–364.
Médecins du monde. Access to health care for vulnerable groups in the European Union in 2012. An overview of the condition of persons excluded from healthcare systems in the EU. 2013. Available from: http://www.europarl.europa.eu/document/activities/cont/201302/20130208ATT60776/20130208ATT60776EN.pdf
Graham, I. Globalisation and multiculturalism: what do they mean for healthcare? Diversity in Health and Social Care, 2005. 2: p. 79-80.
Diaz, E., & Kumar, B. N. Health care curricula in multicultural societies. International Journal of Medical Education, 2018. 9: p. 42-44.
Bernhardt, B. C., & Singer, T. The Neural Basis of Empathy. Annual Review of Neuroscience, 2012. 35: p. 1-23.
Fuller, M., Kamans, E., van Vuuren, M., Wolfensberger, M., & de Jong, M. T. D. Conceptualizing Empathy Competence: A Professional Communication Perspective. Journal of Business and Technical Communication, 2021. 35(3): p. 333-368.
Wesołowska, K., et al. Psychosocial work environment and cross-cultural competence among native and foreign-born registered nurses. Research in nursing & health, 2019. 42(5): p. 349–357.
Patel, S., et al. Curricula for empathy and compassion training in medical education: A systematic review. PloS one. 2019. 14(8), e0221412. Available from: https://doi.org/10.1371/journal.pone.0221412.
Krishnasamy, C., Ong, S. Y., Loo, M. E., & Thistlethwaite, J. How does medical education affect empathy and compassion in medical students? A meta-ethnography: BEME Guide No. 57. Medical teacher, 2019. 41(11): p. 1220–1231. 109
Putrino, N., Tabullo, Á., Mesurado, B., & de Minzi, M. C. R. Are there differences in health professionals’ empathy due to academic and clinical experience? Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues, 2021. 40(2): p. 647–654.
Barker, M. E., Crowfoot, G., & King, J. Empathy development and volunteering for undergraduate healthcare students: A scoping review. Nurse Education Today, 2022. 116: p. 105441.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Georgia Gazi, George Alexias, Sofia Triantafillidou , Constantinos Togas
This work is licensed under a Creative Commons Attribution 4.0 International License.
