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  • 1.
    Bäcklund, Kajsa
    et al.
    Blekinge County Hospital, Sweden.
    Persson, Karoline
    Blekinge County Hospital, Sweden.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Intensive care nurses’ experiences of caring for intubated patients under light sedation: a qualitative study2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 7, p. 473-484Article in journal (Refereed)
    Abstract [en]

    Introduction: Previous studies have shown that a light sedation level is beneficial for intubated patients in the Intensive care unit (ICU). 

    Aim: This study aimed to describe intensive care nurses’ experiences of caring for intubated patients under light sedation. 

    Methods: This study was an explorative descriptive qualitative study. Data were collected from 12 intensive care nurses by three focus group interviews and analyzed using qualitative content analysis. 

    Findings: Five categories emerged from the data: 1) the importance of verbal communication and the nurses’ presence, 2) feelings of frustration and heavy workload, 3) assessment of patients’ pain and anxiety, 4) the nurses’ desire for the development of guidelines, and 5) being inspired by the care. 

    Conclusion: The study found that intensive care nurses were positive towards light sedation care but the organization of care did not support them as the patients cared for with light sedation treatments demanded their physical presence at patients’ bed site.

  • 2.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    PROBLEMS AND IMPLICATION OF THE USE OF INTERPRETERS IN PRIMARY HEALTHCARE2013Conference paper (Refereed)
  • 3.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    The use of interpreter in healthcare: Perspectives of individuals, healthcare staff and families2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis focuses on the use of interpreters in Swedish healthcare. The overall aim was to explore how individuals, healthcare professionals and family members experience and perceive the use of interpreters in healthcare.

    The study design was explorative and descriptive. The thesis included Serbo-Croatian(Bosnian/Croatian/Serbian)speaking individuals(n=17), healthcare professionals(n=24), official documents(n=60)and family members(n=10)of individuals using interpreters in healthcare. Individual interviews, written descriptions, review of official documents in the form of incident reports from a single case study and focus group interviews were used to collect data. Data were analyzed using phenomenography, qualitative content analysis and qualitative data analysis of focus group interviews.

    The overall finding from all perspectives was the wish to have a qualified interpreter whose role was as a communication aid but also as a practical and informative guide in healthcare. The perception of a qualified interpreter was someone highly skilled in medical terminology, Swedish and individuals’ native language with ability to adapt to different dialects, wearing non-provocative and neutral clothes, of the same gender, with a professional attitude and preferably in personal contact through face-to-face interaction. Besides being a communication aid, the interpreter was perceived as having an important role in helping individuals to find the right way to and within the healthcare system because foreign-born individuals were unable to understand information in healthcare. Another aspect was to have a well-developed organization with good cooperation between the parties involved in the interpretation situation, such as patients, interpreter, interpreter agency, family members and healthcare professionals to offer a good interpretation situation.

    In conclusion, the use of an interpreter was determined by individual and healthcare situational factors. Individualized holistic healthcare can be achieved by offering and using high-quality interpreters and cooperation within a well-developed interpreter organization.

     

    Keywords: communication, healthcare service, patient-safe quality care, qualitative data collection, qualitative data analysis, users’ perceptions/experiences, utilization of interpreters.

  • 4.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ukrainian-speaking migrants’ concerning the use of interpreters in healthcare service: a pilot study2016In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 10, p. 1-7Article in journal (Refereed)
    Abstract [en]

    The aim of this pilot study was to investigate Ukrainian-speaking migrants’ attitudes to the use of interpreters in healthcare service in order to test a developed questionnaire and recruitment strategy. A descriptive survey using a 51-item structured selfadministered questionnaire of 12 Ukrainian-speaking migrants’ and analyzed by the descriptive statistics. The findings were to have an interpreter as an objective communication and practical aid with personal qualities such as a good knowledge of languages and translation ability. In contrast, the clothes worn by the interpreter and the interpreter’s religion were not viewed as important aspects. The findings support the method of a developed questionnaire and recruitment strategy, which in turn can be used in a larger planned investigation of the same topic in order to arrange a good interpretation situation in accordance with persons’ desire irrespective of countries’ different rules in healthcare policies regarding interpretation. © 2016, Emina Hadziabdic; Licensee Bentham Open.

  • 5.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Family members’ experiences of the use of interpreters in healthcare2014In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 15, no 2, p. 156-169Article in journal (Refereed)
    Abstract [en]

    Aim The aim was to explore adults’ experiences of their family members’ use of interpreters in health-care encounters.

    Background Language barriers are a major hindrance for migrants to receive appropriate healthcare. In a foreign country, family members often need support in care of migrant patients. No previous studies focusing on adult family members’ experiences of the use of interpreters in healthcare have been found.

    Method A purposive sample of 10 adult family members with experiences of the use of interpreters in health-care encounters. Data were collected between May and September 2009 by focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.

    Findings Three categories emerged from the analysis: (1) Experiences of the use of professional interpreters, (2) Experiences of being used as an interpreter and (3) Experiences of what needs to be improved when using interpreters. The main findings showed no agreement in family members’ experiences; interpretation should be individually and situationally adapted. However, when family members acted as interpreters, their role was to give both practical and emotional support, and this led to both positive and negative emotions. Use of simple language, better collaboration in the health-care organization and developing the interpreters’ professional attitude could improve the use of professional interpreters. The type of interpreter, mode of interpretation and patient's preferences should be considered in the interpretation situation. In order to achieve high-quality healthcare, health-care professionals need to organize a good interpretation situation case-by-case, choose the appropriate interpreters with the patient in focus and cooperate with members of the patient's social network.

  • 6.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Healthcare staffs perceptions of using interpreters:  a qualitative study2010In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 11, no 3, p. 260-270Article in journal (Refereed)
    Abstract [en]

    Aim: To describe how healthcare professionals experience and perceive the use of interpreters in their contacts with patients with whom they do not share a common language.

    Methods: An explorative descriptive study. The study was conducted in different healthcare settings in Sweden and included 24 healthcare staff, of whom 11 were physicians, 9 nurses, 2 physiotherapists and 2 assistant nurses. Data were generated through written descriptions of the use of interpreters in healthcare and  analysed using qualitative content analysis.

    Findings: Two main categories emerged: 1) aspects related to the interpreter and 2) organizational aspects. It was shown that having a face-to-face, professional, trained interpreter, with a good knowledge of both languages and of medical terminology, translating literally and objectively, was perceived positively. The organizational aspects that affected the perception were functioning or non-functioning technical equipment, calm in the interpretation environment, documentation of the patients’ language ability, respect for the appointed time, and the level of availability and service provided by the interpreter agency.

    Conclusion: It is important to develop a well-functioning interpreter organization that offers trained interpreters with a professional attitude to improve and ensure cost-effective and high-quality encounters and care.

  • 7.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Arabic-speaking migrants’ attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare: a postal cross-sectional survey2014In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 7, article id 71Article in journal (Refereed)
    Abstract [en]

    Background

    Good communication is an important prerequisite for equal treatment in a healthcare encounter. One way to overcome language barriers when patients and healthcare staff do not share the same language is to use a professional interpreter. Few previous studies have been found investigating the use of interpreters, and just one previous study from the perspective of European migrants, which showed that they perceived interpreters as a communication aid and a guide in the healthcare system as regards information and practical matters. No previous study has gathered quantitative information to focus on non-European migrants’ attitudes to the use of interpreters in healthcare encounters. Thus, the aim of this study was to investigate Arabic-speaking individuals’ attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare in order to: (i) understand how persons’ expectations and concerns regarding interpreters may vary, both within and across cultural/linguistic populations; (ii) understand the consequences of diverse opinions/expectations for planning responsive services; and (iii) confirm findings from previous qualitative studies.

    Method

    A postal cross-sectional study using a structured self-administered 51-item questionnaire was used to describe and document aspects of Arabic-speaking individuals’ attitudes to the use of interpreters in healthcare. The sample of 53 Arabic-speaking migrants was recruited from three different places. Participants were mostly born in Iraq and had a high level of education and were almost equally divided between genders. Data were analysed with descriptive statistics.

    Results

    The main findings were that most of the participants perceived the interpreter’s role as being a communication aid and a practical aid, interpreting literally and objectively. Trust in the professional interpreter was related to qualification as an interpreter and personal contact with face-to-face interaction. The qualities of the desired professional interpreter were: a good knowledge of languages and medical terminology, translation ability, and sharing the same origin, dialect and gender as the patient.

    Conclusion

    This study confirmed previous qualitative findings from European migrant groups with a different cultural and linguistic background. The study supports the importance of planning a good interpretation situation in accordance with individuals’ desire, irrespective of the migrant’s linguistic and cultural background, and using interpreters who interpret literally and objectively, who are highly trained with language skills in medical terminology, and with a professional attitude to promote communication, thus increasing cost-effective, high-quality individualized healthcare.

  • 8.
    Hadziabdic, Emina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Heikkilä, Kristiina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Albin, Björn
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Migrants' perceptions of using interpreters in health care2009In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 56, no 4, p. 461-469Article in journal (Refereed)
  • 9.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Problems and consequences in the use of professional interpreters: qualitative analysis of incidents from primary healthcare.2011In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 18, no 3, p. 253-261Article in journal (Refereed)
    Abstract [en]

    The aim was to explore what probklems were reported by healthcare straff in primary healthcare concerning the use of interpreters and what consequences that might lead to. A single-case study of a real life situation was implemented by analysing 60 incident reports written by different health care professionals. Qualitative content analysis was applied. The results showed that the main problems were related to language in terms of lack of available interpreters in a particular language, and to organisational routines with difficulties in availability of interpreters and access to the interpreter agency. The consequences reported were incorrect use of time and resources, with increased workload and thus delayed treatment. Other consequences were limited possibilities to communicate and consultations carried out without a professional interpreter and instead using family members.

  • 10.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Arabic-speaking migrants' experiences of the use of interpreters in healthcare: a qualitative explorative study2014In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 13, article id 49Article in journal (Refereed)
    Abstract [en]

    Introduction: Arabic-speaking migrants have constituted a growing population in recent years. This entails major challenges to ensure good communication in the healthcare encounter in order to provide individual and holistic healthcare. One of the solutions to ensure good communication between patient and healthcare staff who do not share the same language is to use a professional interpreter. To our knowledge, no previous qualitative studies have been found concerning Arabic-speaking migrants and the use of interpreters. This study aims to ascertain their individual experiences which can help extend our understanding of the studied area. Method: A purposive sample of 13 Arabic-speaking persons with experience of using interpreters in healthcare encounters. Data were collected between November 2012 and March 2013 by four focus-group interviews and analysed with qualitative analysis according to a method described for focus groups. Results: Four categories appeared from the analysis: 1) The professional interpreter as spokesperson; 2) Different types of interpreters and modes of interpretation adapting to the healthcare encounter; 3) The professional interpreter's task and personal properties affected the use of professional interpreters in a healthcare encounter; 4) Future planning of the use of professional interpreters in a healthcare encounter. The main findings were that the use of interpreters was experienced both as a possibility and as a problem. The preferred type of interpreters depended on the interpreter's dialect and ability to interpret correctly. Besides the professional interpreter's qualities of good skill in language and medical terminology, translation ability, neutrality and objectivity, Arabic-speakingparticipants stated that professional interpreters need to share the same origin, religion, dialect, gender and political views as the patient in order to facilitate the interpreter use and avoid inappropriate treatment. Conclusion: The study showed that the personal qualities of a good interpreter not only cover language ability but also origin, religion, dialect, gender and political views. Thus, there is need to develop strategies for personalized healthcare in order to avoid inappropriate communication, to satisfy the preferences of the person in need of interpreters and improve the impact of interpretation on the quality of healthcare.

  • 11.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linköping University;Uppsala University.
    Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: a case study2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 2, p. 210-216Article in journal (Refereed)
    Abstract [en]

    Aim

    The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden.

    Design

    A descriptive qualitative study.

    Methods

    A descriptive case study based on a review of 14 public documents and individual interviews with two experts in the area, analysed with qualitative content analysis.

    Results

    This study found that shared language, preservation of customs and habits and collaboration between the representatives of the municipality, Finnish-speaking migrant associations and staff at the nursing home influenced the development of the culturally specific nursing home for older Finnish-speaking people intended to avoid loneliness, isolation and misunderstandings among older Finnish-speaking. Collaboration between healthcare service for older persons and minority people resulted in an optimal culturally specific nursing home, simultaneously encountering the majority culture. Nursing and healthcare services need to be aware of positive effects of collaboration with stakeholders to achieve optimal culturally specific nursing homes.

  • 12.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linköping University.
    Perspectives of professional interpreters regarding their role and attitude in the healthcare encounter2016In: Diversity and equality in health and care, ISSN 2049-5471, E-ISSN 2049-548X, Vol. 13, no 3, p. 221-229Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore how professional interpreters experience their role in a healthcare encounter. An explorative study with semi-structured individual interviews and written descriptions was conducted with a purposeful sample of nine professional interpreters who represented the migrant population in Sweden. Qualitative content analysis was used to analyse data. The findings showed that the professional interpreters viewed their role as to transfer information accurately, to keep confidentiality, to remain impartial and to perform the duties related to their work assignments. However, the study also found a number of factors and challenges that influenced this role. These were: 1) the form of interpretation, 2) the interpretation environment, 3) the employment conditions and personal characteristics of the interpreters, and 4) the behaviour of the patient and healthcare staff during the interpretation session. The study found that professional interpreters experienced their role as aligning with the existing guidelines regarding an interpreter’s role and ethical attitude. Healthcare service providers, policymakers and interpreter agencies should focus on improving training and support and development opportunities in order to increase the impact of interpretation on equality and quality of healthcare.

  • 13.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Uppsala University, Sweden.
    Register-based study concerning the problematic situation of using interpreting service in a region in Sweden2019In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, p. 1-8, article id 727Article in journal (Refereed)
    Abstract [en]

    Background Due to increasing international migration, Sweden has become a multicultural and multilingual society, with about 19% of the population born abroad, which imposes high demands on the healthcare sector and interpreting services. The aim was to investigate problems in the use of interpreters as recorded by healthcare staff and the interpreter service in a region in Sweden. Methods Cross-sectional register-based study. The study focused on a geographically well-defined region in Sweden including (a) specialized care at three hospitals; (b) local healthcare, including out-patient clinics at hospital and emergency healthcare and primary healthcare; and (c) dental care. The study was based on 726 existing incident reports on the interpreting service and information from the interpreter agency from 2012 and the first quarter of 2016 during a period of a massive influx of refugees. Results The highest number of adverse advents was reported in local healthcare and mainly concerned the absence of an interpreter at the appointed time. Non-authorized in-person interpreters performed most interpretation assignments and Arabic was the most requested language. Conclusions This study highlights the significance of good cooperation between healthcare and the interpreter service in order to guarantee safe and high-quality healthcare for patients in need of interpreters to be able to communicate in healthcare.

  • 14.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Working with interpreters: practical advice for use of an interpreter in healthcare2013In: International Journal of Evidence-Based Healthcare, ISSN 1744-1595, E-ISSN 1744-1609, Vol. 11, no 1, p. 69-76Article in journal (Refereed)
    Abstract [en]

    The aim of this descriptive commentary is to improve communication in healthcare when an interpreter is used by providing practical advice to healthcare staff when they consider using interpreters. This descriptive commentary considered the issues of preparation and implementation of interpretation sessions to reveal the complexities and dilemmas of an effective healthcare encounter with interpreters. Using the design of a discursive paper, this article seeks to explore and position of what is published in the literature on the topic studied and on the basis of previous studies to provide practical advice on the use of interpreters. The descriptive commentary showed that the interpreter should be used not only as a communication aid but also as a practical and informative guide in the healthcare system. In preparing the interpretation session, it is important to consider the type (trained professional interpreter, family member or bilingual healthcare staff as interpreters) and mode (face to face and telephone) of interpreting. Furthermore, it is important to consider the interpreter's ethnic origin, religious background, gender, language or dialect, social group, clothes, appearance and attitude. During the healthcare encounter, the interpreter should follow the recommendations given in guidelines for interpreters. Healthcare staff should choose an appropriate room and be aware of their own behaviour, appearance and attitude during the healthcare encounter. Good planning is needed, with carefully considered choices concerning the right kind of interpreter, mode of interpretation and individual preferences for the interpretation in order to deliver high-quality and cost-effective healthcare. Depending on the nature of the healthcare encounter, healthcare staff need to plan interpreting carefully and in accordance with the individuals' desires and choose the type of interpreter and mode of interpreting that best suits the need in the actual healthcare situation in order to deliver high-quality healthcare.

  • 15.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Lundin, Christina
    Linköping University.
    Hjelm, Katarina
    Linköping University.
    Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare2015In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, p. 1-13, article id 458Article in journal (Refereed)
    Abstract [en]

    Background

    Elderly migrants who do not speak the official language of their host country have increased due to extensive international migration, and will further increase in the future. This entails major challenges to ensure good communication and avoid communication barriers that can be overcome by the use of adequate interpreter services. To our knowledge, there are no previous investigations on interpreting practices in multilingual elderly healthcare from different healthcare professionals’ perspectives. This study examines issues concerning communication and healthcare through a particular focus on interpretation between health professionals and patients of different ethnic and linguistic backgrounds. The central aim of the project is to explore interpretation practices in multilingual elderly healthcare.

    Methods

    A purposive sample of 33 healthcare professionals with experience of using interpreters in community multilingual elderly healthcare. Data were collected between October 2013 and March 2014 by 18 individual and four focus group interviews and analysed with qualitative content analysis.

    Results

    The main results showed that interpreting practice in multilingual elderly healthcare was closely linked to institutional, interpersonal and individual levels. On the organizational level, however, guidelines for arranging the use of interpreters at workplaces were lacking. Professional interpreters were used on predictable occasions planned long in advance, and bilingual healthcare staff and family members acting as interpreters were used at short notice in everyday caring situations on unpredictable occasions. The professional interpreter was perceived as a person who should interpret spoken language word-for-word and who should translate written information. Furthermore, the use of a professional interpreter was not adapted to the context of multilingual elderly healthcare.

    Conclusion

    This study found that interpreter practice in multilingual elderly healthcare is embedded in the organizational environment and closely related to the individual’s language skills, cultural beliefs and socio-economic factors. In order to formulate interpreter practice in the context of multilingual elderly healthcare it is important to consider organizational framework and cultural competence, cultural health knowledge, beliefs and customs.

  • 16.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Safipour, Jalal
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bachrach-Lindström, Margareta
    Linköping University.
    Hultsjö, Sally
    Linköping University.
    Swedish version of measuring cultural awareness in nursing students: validity and reliability test2016In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 15, article id 25Article in journal (Refereed)
    Abstract [en]

    Background

    Nearly 20 % of the Swedish population is foreign-born. Increased exposure of patients from diverse cultures means there is an urgent need to address their unique requirements and provide optimal health care to a diverse population. Nursing schools thus have an important goal of educating nurses to ensure they are culturally competent. Culturally competent care improves safety and equity for patients. To measure cultural awareness among nursing students in Sweden, the aim of this study was to translate, adapt and test the validity and reliability of the Swedish version of a cultural awareness scale which has not previously been tested.

    Methods

    A total of 158 nursing students from three universities in Sweden completed the 36-item questionnaire on cultural awareness. Verification of face and content validity and a translation/reverse translation process were first carried out.

    Results

    The results indicate that one item (no 13) caused weak reliability and validity, and therefore it was removed. The reliability test result (with 35 items) showed Cronbach’s Alpha ranged from 0.60 to 0.87. The Model ChiSq group fit for five factors was 50.44 (31.27–77.06; Df = 5; p < 0.001), and the RMSEA was 0.24 (C.I 95 % = 0.18–0.30).

    Conclusion

    The findings of the validity and reliability tests revealed that the CAS-scale for the 35 items is valid and reliable for use with Swedish nursing students. However, the CAS should be further tested in larger and more diverse samples of nursing students before being used in different socio-cultural settings.

  • 17.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Thelin, Angelika
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Social Work.
    Tankestilar om kritiskt tänkande i sjuksköterskeutbildning2011In: Vård i Fokus, ISSN 0781-495X, Vol. 28, no 4, p. 4-8Article in journal (Other (popular science, discussion, etc.))
  • 18.
    Higginbottom, Gina M.A
    et al.
    Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
    Hadziabdic, Emina
    Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
    Yohani, Sophie
    Paton, Patricia
    Immigrant women's experience of maternity services in Canada: A meta-ethnography2014In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, no 5, p. 544-559Article in journal (Refereed)
    Abstract [en]

    Objective

    to synthesise data on immigrant women's experiences of maternity services in Canada.

    Design

    a qualitative systematic literature review using a meta-ethnographic approach

    Methods

    a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings.

    Findings

    the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings.

    Key conclusions and implications for practice

    in order to implement woman-centered care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care.

  • 19.
    Hultsjö, Sally
    et al.
    Ryhov County Council, Sweden;Linköping University, Sweden.
    Bachrach-Lindström, Margareta
    Linköping University, Sweden.
    Safipour, Jalal
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    “Cultural awareness requires more than theoretical education”: nursing students’ experiences2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 39, p. 73-79Article in journal (Refereed)
    Abstract [en]

    Cultural awareness in healthcare providers is considered one of the most important factors in improving the efficiency and quality of care in a diverse population. Thus, education in cultural awareness needs to be an essential component in nursing education. This study, which uses a qualitative design, aimed to investigate cultural awareness in nursing students in Sweden. Focus groups were used to collect data from 12 students. Three categories were identified as follows after qualitative data analysis of the interviews: 1) desire to learn, 2) learning by doing and 3) caring beyond boundaries. The result clearly indicates that students are willing to learn more about how to care for people with different cultural backgrounds. However, this learning is not always available in official lecture-based education. In fact, most awareness about cultural aspects of healthcare is developed from practice and informal education.

    Finally, the result also revealed the importance of nurses being able to see the individual beyond the culture, and being aware of their own prejudice. In conclusion, education offers limited opportunities for nursing students to become culturally aware. Nursing education can be improved by strengthening both theoretical and practical tasks involving cultural awareness.

  • 20.
    Lundin, Christina
    et al.
    Linköping university.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping university.
    Hjelm, Katarina
    Linköping university;Uppsala University.
    Language interpretation conditions and boundaries in multilingual and multicultural emergency healthcare2018In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 18, article id 23Article in journal (Refereed)
    Abstract [en]

    Background: With an increasing migrant population globally the need to organize interpreting service arises in emergency healthcare to deliver equitable high-quality care. The aims of this study were to describe interpretation practices in multilingual emergency health service institutions and to explore the impact of the organizational and institutional context and possible consequences of different approaches to interpretation. No previous studies on these issues in multilingual emergency care have been found. Methods: A qualitative descriptive study was used. Forty-six healthcare professionals were purposively recruited from different organizational levels in ambulance service and psychiatric and somatic emergency care units. Data were collected between December 2014 and April 2015 through focus-group and individual interviews, and analyzed by qualitative content analysis. Results: Organization of interpreters was based on patients' health status, context of emergency care, and access to interpreter service. Differences existed between workplaces regarding the use of interpreters: in somatic emergency care bilingual healthcare staff and family members were used to a limited extent; in psychiatric emergency care the norm was to use professional interpreters on the spot; and in ambulance service persons available at the time, e.g. family and friends were used. Similarities were found in: procuring a professional interpreter, mainly based on informal workplace routines, sometimes on formal guidelines and national laws, but knowledge of existing laws was limited; the ideal was a linguistically competent interpreter with a professional attitude, and organizational aspects such as appropriate time, technical and social environment; and wishes for development of better procedures for prompt access to professional interpreters at the workplace, regardless of organizational context, and education of interpreters and users. Conclusion: Use of interpreters was determined by health professionals, based on the patients' health status, striving to deliver as fast and individualized care as possible based on humanistic values. Defects in organizational routines need to be rectified and transcultural awareness is needed to achieve the aim of person-centered and equal healthcare. Clear formal guidelines for the use of interpreters in emergency healthcare need to be developed and it is important to fulfill health professionals' wishes for future development of prompt access to interpreters and education of interpreters and users.

  • 21.
    Pettersson, Sara
    et al.
    Linköping University, Sweden.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University, Sweden.
    Marklund, Helén
    Linköping University, Sweden.
    Hjelm, Katarina
    Linköping University, Sweden;Uppsala University, Sweden.
    Lower knowledge about diabetes among foreign-born compared to Swedish-born persons with diabetes: a descriptive study2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 367-376Article in journal (Refereed)
    Abstract [en]

    Aim To compare foreign‐ and Swedish‐born persons, diagnosed with type 2 diabetes, to study whether there are dissimilarities in knowledge about diabetes and to study determinants of knowledge.

    Design A cross‐sectional descriptive study was conducted.

    Method Data were collected between September 2014 and March 2016, using the standardized Diabetes Knowledge Test (DKT), statistically analysed.

    Results The results showed dissimilarities in knowledge between foreign‐ and Swedish‐born persons, supporting the hypothesis that foreign‐born persons had lower knowledge about diabetes than Swedish‐born persons. There was a relationship between poor knowledge and country of birth, marital status and employment status. Country of birth was the strongest independent determinant of knowledge about diabetes. The risk of poor knowledge was ten times higher among persons born in the Middle East or in another country outside Europe compared with Swedish‐born persons. Other influencing factors for poor knowledge about diabetes were being not gainfully employed and living alone.

  • 22.
    Safipour, Jalal
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hultsjö, Sally
    Region Jönköpings län ; Jönköping University.
    Bachrach-Lindström, Margareta
    Linköping University.
    Measuring nursing students’ cultural awareness: a cross-sectional study among three universities in southern Sweden2017In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 7, no 1, p. 107-113Article in journal (Refereed)
    Abstract [en]

    Background/Objective: Cultural awareness refers to when someone is aware of his/her own and other people’s cultural values. Academic nursing education should promote students’ ability to analyze, understand, and respect people’s cultural backgrounds and their values to be able provide equitable care in a multicultural society. This essential competence for nursing students can be obtained through learning and practicing to prioritize people’s greatest needs. The aim of this study was to explore students’ cultural awareness related to their nursing education by considering their socio-demographic background.

    Methods: This quantitative study was conducted by means of a pre-designed Cultural Awareness Scale. In total, 215 students participated in this study. Descriptive statistics were used to report the distribution of the data, and regression analysis was carried out to assess the statistical significance of the association between the variables.

    Results: The results indicated moderately high cultural awareness among nursing students related to their general education, cognitive awareness, comfort with interaction, and clinical practice/patient care. Nevertheless, no statistically significant correlation was identified between the socio-demographic factors (sex, age, and experience of living abroad). However, being a first generation immigrant was significantly associated with better cultural awareness in terms of Patient Care/Clinical Issue.

    Conclusions: In Sweden, universities are free to design their educational programs since there is no universal curriculum that applies to all the universities; nonetheless, the relatively high level of cultural awareness remained the same for the universities under investigation. This finding suggests that the importance of cultural awareness in nursing education is recognized in this context.

  • 23.
    Safipour, Jalal
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Wenneberg, Stig
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Experience of Education in the International Classroom: A Systematic Literature Review2017In: Journal of International Students, ISSN 2162-3104, Vol. 7, no 3, p. 806-824Article in journal (Refereed)
    Abstract [en]

    In this essay, we investigate the learning and teaching experiences in the international classroom from both the teachers and the students’ perspectives. The findings of this study showed that language barriers are one of the difficulties, but academic cultural differences seem to play a more important role that can impact on the learning outcomes in the international classroom. This can also lead to negative experiences and the forming of stereotypical views of international students solely based on their educational background. 

  • 24.
    Vallianatos, Helen
    et al.
    University of Alberta, Canada.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Higginbottom, Gina
    University of Alberta, Canada.
    Designing Participatory Research Projects2015In: Participatory Qualitative Research Methodologies in Health / [ed] Gina Higginbottom, Pranee Liamputtong, London: Sage Publications, 2015Chapter in book (Other academic)
  • 25.
    Wärdig, Rickard
    et al.
    Linköping university, Sweden.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Uppsala university, Sweden.
    Healthcare staff’s evaluation of a walk-in centre at a healthcare centre in an immigrant-dense area2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 9-10, p. 1473-1481Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To evaluate a walk-in centre at a healthcare centre in an immigrant-dense area where a high proportion of the patients have limited language ability in Swedish, from the perspective of healthcare personnel. Background: Increased global migration results in higher vulnerability in migrants, with the risk of increased morbidity and mortality. Migrants’ health often deteriorates, which can be attributed to an increased level of stress and adaptation to a new lifestyle. Therefore, immigrants are at higher risk of being affected by, for example, cardiovascular diseases and diabetes. This requires access to good health care. Design: A qualitative exploratory study was conducted, using semi-structured interviews. Content analysis was used in the analysis process. Methods: Semi-structured interviews were held with 15 purposively sampled doctors and nurses, working at a healthcare centre in Sweden. Data were collected during autumn 2017. The study was performed in accordance with COREQ. Results: Working at the walk-in centre involved caring for everything from basic to advanced health problems and meant a high pace that required stress-resistant personnel. The walk-in centre was described as both promoting and threatening patient safety. The personnel had several ideas on how to develop the walk-in centre. Conclusions: A walk-in centre can be seen as a necessity related to issues of ensuring patient safety and delivering care for everyone in an immigrant-dense area. However, it cannot be the only form of care offered, as it seems not be adapted to certain groups, such as people with disabilities and the elderly. Relevance to clinical practice: The findings emphasise that a walk-in centre is a way to increase accessibility for the entire population and offer equal care for all, even if it involves challenges that need to be addressed.

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