The Current Situation And Influencing Factors Of Cross-cultural Care Encounter Between Nurses And Patients In Lhasa,Tibet

Objectives:To increase the level of medical and nursing care in Tibet and meet people's the health and its need in Tibetan areas,recent years,under the care and policy of the party and the state,the number of major medical professionals from the mainland have gradually imported more medical and health professionals.when the clinical nursing greatly promoted in Tibet,the problem of cross-cultural care encounters would inevitably arise.Therefore,the purpose of this study is to understand the status quo of the cross-cultural care encounters between nursing staff and Tibetan patients in Lhasa City,Tibet,analyze the causes and influencing factors of the status quo,and provide strategies for the improvement of the management and training of cross-cultural care encounters among the nurses and patients in Tibet.Methods:We conducted surveys on 300 cases in two upper first-class hospitals and 255 in two upper second-class hospitals in Lhasa that met the criteria for this study from July to November in 2017.A convenient sampling method was adopted.(1)Nurses' survey tools:general data questionnaires,cross-cultural care capacity measurement questionnaires,cross-cultural care encounter questionnaires are used.(2)The patient survey tools were: general data questionnaires,cross-cultural care encounter questionnaires,and cross-cultural care needs questionnaires.Our study used EpiData3.1 software to establish a database and SPSS21.0 software for data analysis.The average data,standard deviation,and composition ratio were used to describe the general data of nurses and patients,cross-cultural care encounters,cultural care capabilities,and cultural care needs;t-test,rank sum test,one-way Kruskal-wallis,and multiple stepwise regression analysis were used to analyze the factors affecting the intercultural care situation among patients.The Pearson correlation analysis was usedto explore the relationship between nurses' cross-cultural care situations and cultural care abilities and the patient's cross-cultural care situation and cultural care needs.Results:1.The average score of the cultural care competence of the nursing staff in Lhasa City was(218±31.09),and the items were all divided into(3.64±0.52)points.The scores of each dimension were: culturally sensitive dimensions(25.93±4.56)points,cultural understanding dimensions(32.59±5.35)points,health-related sociocultural knowledge dimensions(32.59 ± 5.35)points,cultural assessment and diagnosis dimensions(48.35 ± 6.82)points,and cultural care plans(6.97 ± 1.61)points The implementation and evaluation of cultural care was(48.42 ± 7.49)points,among which the score of cultural care plan and the dimension of health-related Cross-cultural knowledge were low.2.The scores of cross-cultural care situations for the care recruits in Lhasa City were(61.73±11.86)and the average score was(3.09±0.59)points.The scores in each dimension: language communication problems(15.17 ± 3.41)points,eating habits problems(7.10±1.80)points,different religious beliefs(7.10±1.82)points,different folk etiquette(6.24±1.59)points,different health-related social knowledge(6.15±1.42)points,different ward environment(5.14±1.73)points,(8.35±2.51)points for different folk taboos,and(6.49±1.52)points for ethnic discrimination and prejudice.Among them,the dimension score of language communication disorder,the dimension of different dietary habits,and the dimension of different religious beliefs have higher scores.3.Single factor and regression analysis showed that Tibetan language ability,age,marital status,education level,technical title,and whether or not they participated in Tibetan language and humanities training were the main factors affecting the cross-cultural care situation of the caregivers.4.The total cross-cultural situation of Tibetan patients during the hospitalization process was(37.49±10.6),with an average score of(1.79±0.50).The descending order of scores in each dimension was: language communication impairment(2.126±0.55),folk discrimination or prejudice(1.97±0.44),social etiquette(1.80±0.54),and non-hidden ward(1.73 ± 0.59).There are not enough points for privacy protection(1.57 ± 0.50),respect for religious beliefs(1.48 ± 0.45),and respect for customs taboos(1.28±0.47).5.The single factor and multiple regression analysis results of patients' cross-cultural circumstances showed that Chinese ability,different occupations,and home areas were the main influencing factors for Tibetans' cross-cultural experience(P<0.05).6.The patient's cultural care needs score range was(59.60±13.73)points,and the average score was(3.03 ± 0.80).The scores from highest to lowest for each dimension were Tibetan communication needs(3.90±0.22)points,privacy protection(3.87±0.25)points,respect for eating habits(3.81±0.11)points,respect for customs taboos(3.57±0.10)points,religion Belief(3.51±0.14)points,social etiquette needs(3.21±0.18)points,Tibetan wards(3.50±0.80)points.7.The single factor and regression analysis of the patient group showed that there were differences in the scores of different Chinese language abilities,ages,occupation types,and religious beliefs in patients' cross-cultural care needs(P<0.05).8.The correlation analysis found that there was a positive correlation between the cross-cultural care situation and cross-cultural care needs of Tibetans in Lhasa City with(r=0.298).and the correlation analysis found that there was a correlation between nurses' cross-cultural care situation and cross-cultural care ability(r=0.121).Conclusion:1.The scores of the cross-cultural care experience of the nursing and recruitment staff in Lhasa City are higher.Different Tibetan language skills,age,marital status,education level,technical title,participation in Tibetan language,and humanistic education and training are the main influencing factors.2.Tibetans in Lhasa City have experienced high scores in cross-cultural encounters in seeking medical treatment.Different occupations,home areas and Chinese abilities are the main factors.3.Nurses' cultural competence is at a medium level,and patients have higherscores for cross-cultural care needs.4.Nurses' cultural care capacity is negatively correlated with cross-cultural care encourages;patient care needs are positively correlated with cross-cultural care encourages.