NURSES’ CULTURE COMPETENCE AND THE USERS’ PERSPECTIVE

OBJECTIVES
The central guideline of this research is based on the cultural analysis since its central focus is to question the association between being, thinking and doing which occurs in a very specific symbolic universe, jointly built by the socio-professional group of OB/GYN nurses. The general objectives of this study were: (i) To understand Nurses’ professional culture in the social interaction with other social actors in the process of care; (ii) To comprehend cultural care expression in the perspective of parturients as users of the care they provide and, as a specific object; (iii) to formulate an instrument that allows to know parturients attitudes regarding to their personal experience during child-birth.

METHODS
This a quali-quantitative, ethno-sociologic study, completed in two steps: the first is of ethnographic nature, using participant observation, comprehensive interview and sociologic analysis model for professional cultures. The second step was performed under a quantitative and exploratory study. The sample was not probabilistic and was constituted of 506 parturients from two hospitals (central and district) from the Northern part of Portugal. Likert scale was applied. It consists in 58 items and was built from dimensions and indicators obtained from empirical verification in a previous study. The basis was the cultural competence model of Giger e Davidhizar (1994). Structural analysis of the inquiry’s concept was made using exploratory factorial analysis with extraction of factors through the principal components method.

RESULTS
The results of the factorial analysis forced to eight factors with Varimax rotation and Kaiser normalization explain the 60.05% of total variance. The obtained factors and the explained variance for each one were: nurse/parturient Communication, 0.80; lack of information and respect, 0.82, negative feelings and sensations, 0.84; time, 0.94; Social organization, 0.85; Space 0.84; Environment 0.81 and Feelings caused by use of devices and appliances, 0.83. Analysis of internal consistence and reliability of the inquiry was done and a total Cronbach Alfa of 0.89 was obtained. The Cronbach Alfa of the sub-scales range from 0.96 for Space and 0.62 for Feelings caused by the use of devices and appliances.

DISCUSSION
The emergent conclusions of the second step show that applied models are distant from de cultural competence models. Nurses apply other strategies as a mean to overcome constrains that standardized models recommended by Organizations place. These results can impact teaching, research and hospital practice since this is a transition phase from parenthood, where the dichotomy of health and sickness cross in a transition. The use of a model that evidences the nurses’ cultural competence is extremely useful, so that the philosophical principles of cultural care are put to work and the respect for culture equity and differences is acknowledged. It would ultimately permit gains in the health system and reinforce professional autonomy.