Conectar
To explore the influence of broader cultural and social factors on clinicians' care delivery to patients from culturally and linguistically diverse backgrounds in the emergency department.
A qualitative exploratory study.
A social ecological perspective drawn from a Social Ecological Model was used to guide the study. Clinicians from two public hospital emergency departments in Southeast Queensland, Australia were recruited with purposive and snowballing sampling strategies. Semi-structured interviews were undertaken between October 2022 and September 2023. Data were analysed using a content analysis approach.
Seventeen clinicians participated in the interviews: nine nurses and eight doctors. Nine participants were born in a country outside of Australia. Three main themes were generated from the interview data: (i) cultural and religious diversity and challenges in care delivery; (ii) social interactions and communication in clinical care; and (iii) perception about care delivery, services and supports.
Findings from this study offer insight into clinicians' experiences and perspectives regarding the influence of cultural and religious diversity as well as cross-cultural communication and prejudice in care delivery. Social interactions and communication in clinical care were found to facilitate care delivery process and navigate challenges. Cultural competency training and multicultural services and resources can help support clinicians in providing culturally appropriate care in the emergency department.
The findings of this study may help inform the development of practical guidelines and strategies to support clinicians in care delivery. Appropriate training regarding cultural competency is essential to promote culturally appropriate care. Developing a tailored multicultural service and targeted resources in the emergency department is recommended in clinical practice.
The consolidated criteria for reporting qualitative research checklist was used.
A health consumer representative was involved to provide advice on the study conceptualization and data interpretation.
by Mohammad K. Siddiqui, Shagufta Khan, Rinchenla Bhutia, Vivek Nair, Ashok Rai, Nirmal Gurung, Tseten Yamphel, Peggy K. Dadul, Debya S. Kerongi, Karma Doma Bhutia, Jagat Pradhan, Kabita Khati, Sreenivas A. Nair, Shamim Mannan, Kiran K. Rade, Dinesh Gupta, Pawan Malhotra, L. Masae Kawamura, Shikha Dhawan, Asif Mohmmed
BackgroundMonasteries in India house individuals from childhood to advanced age. These congregate settings amplify tuberculosis (TB) transmission and exposure when the disease is present, especially in the high burden areas like Sikkim, India. However, the prevalence of active-TB disease (ATB), tuberculosis infection (TBI), and their associated risk factors have not been studied. The diagnosis and treatment of TBI remain a major bottleneck in eradicating TB. ATB and TBI risk among residents living in the congregate setting of monasteries in Sikkim, India, a high-TB burden area, may be high due to high-density living quarters, public interaction and their frequent travel history but has never been illustrated.
MethodA cross-sectional screening of the monks and residents of Rumtek Monastery (Sikkim, India) was carried out to assess extent of ATB and TBI in a congregate setting. TrueNat MTB and GeneXpert MTB/Rif systems were utilized for ATB diagnosis, whereas QuantiFERON-TB Gold Plus (QFT-plus) Interferon-gamma release assay (IGRA) analysis was used for TBI detection. Follow-up sputum testing by TrueNat MTB was performed on IGRA-positive individuals to exclude ATB.
ResultsAmong the 350 inhabitants of the monastery, 7% (25/350) were found to be symptomatic for TB, whereas 93% (325/350) were asymptomatic. Out of them, 189 participants, including symptomatic cases, agreed to participate in the study and were screened for TBI; however, 15 participants were excluded from the study due to result discrepancies. None of the participant were diagnosed with active tuberculosis (ATB), although, 44.2% (77/174) were found to be positive for TBI; however, none of those with TBI progressed to ATB during one year follow-up. Risk factors for TBI included: advancing age, frequent travel history, family history of TB or having contacts with TB patients and abnormal Body Mass Index (BMI) ≤18.5- ≥ 25.
ConclusionThis study confirms the high prevalence of TBI among residents in the congregate setting of monasteries, and justify TB prevention strategies by targeted screening, TBI testing and preventive treatment in congregate settings of high TB burden areas.
To determine the independent predictors of full immunisation coverage (FIC) among children aged 12–23 months along with the parental awareness and attitudes (of children aged ≤23 months) regarding routine childhood vaccinations in Perambalur district of Tamil Nadu, South India.
A community-based cross-sectional analysis.
Perambalur district situated in the central region of Tamil Nadu state, South India.
Parents of children aged ≤23 months.
The primary outcome measured was the FIC and FIC plus in the district along with the parental awareness and attitudes regarding routine childhood vaccinations. The independent predictors of FIC and FIC plus were determined using multivariable logistic regression models.
The study included 652 children, with a mean (±SD) age of 16.47 (±6.37) months and a male-to-female ratio of 60:40. The FIC and FIC plus of children aged 12–23 months were 91.3% (95% CI 88.64 to 93.33) and 79.7% (95% CI 76.15 to 82.80), respectively. The immunisation card retention was 97.9% among the parents of children aged 12–23 months. The independent predictors of FIC included below poverty line families (adjusted OR (AOR) 0.11; 95% CI 0.02 to 0.64), illiteracy among mothers (AOR 0.67; 95% CI 0.32 to 0.87), lack of immunisation card (AOR 0.14; 95% CI 0.03 to 0.55), lack of frequent home visits by healthcare worker (AOR 0.38; 95% CI 0.18 to 0.79) and hesitancy of parents towards vaccination (AOR 0.26; 95% CI 0.12 to 0.87).
This study revealed a high FIC in this specific district. However, achieving full coverage is influenced by factors like socioeconomic status, maternal education and parental attitudes. Understanding these factors is essential for improving immunisation rates and ensuring all children are protected.
FreshRSS 