Culture and Communication Skills for Long Term Care

描述(申请人提供)：在2010年年满65岁的人中，约有三分之一的人将在有生之年进入养老院短期或长期居住。尽管老年人口越来越多样化，但目前养老院居民中86%是白人，62%是女性。越来越多样化的工作人员正在照顾相对同质的长期护理(LTC)常驻人口。在LTC工作的护士中有16%是外国出生的，他们可能正在学习如何在一个新的系统中合作和沟通，同时照顾大多数和少数族裔患者。土生土长于美国医疗体系的护士发现，与外国出生的同事和多样化的常住人口一起有效地工作是一项挑战。无论出身如何，护士都负责管理直接护理人员，其中50%是种族或少数民族。具体来说，30%是非洲裔美国人，15%是拉丁裔，23%是外国出生的。直接护理人员可能在几个重要方面与监督他们的护士和他们照顾的居民不同，包括原籍国、种族、民族、主要语言、教育和收入能力。如果照顾者不理解和解决这些偏好，有关护理的文化偏好可能会成为成功互动的障碍。此外，文化偏好很容易对来自不同文化背景的工人产生偏见，这也可能阻碍护理的有效性。这项申请建议为长期护理中心的护士和直接护理人员开发一门基于网络的文化和沟通技能课程。文化能力需要对人们的所想、所说以及他们所经历的事情感兴趣，也就是说，对“人的故事”感兴趣。拟议课程的目标是提高沟通技能，以便在护理工作中融入文化差异，并在各级工作人员之间建立有效的工作关系。课程内容将通过互动视频案例研究呈现，其中要求学习者从住院医生、直接护理人员和护士的角度出发。在整个课程中，将通过视频模拟住院医生或同事的录音来教授和练习沟通和解决问题的技能。学习的目的是在整个课程中积累，最终将由八个独立但综合的模块组成，这些模块涉及整个长期培训课程的相关主题。在第一阶段，将开发两个30分钟的模块，其中包括互动案例研究、长期护理之路和团队沟通基础知识，以及针对课程内容的知识测试和技能量表。这些模块和新措施将接受30个目标用户的可用性和试点测试，以确定概念验证。 公共卫生相关性：大约160万65岁或以上的人生活在16,500多个联邦医疗保险和医疗补助熟练护理机构中，约300万直接护理人员提供70%至80%的有偿、亲自操作的长期护理。50%的直接护理人员是种族/民族多样性或外国出生的，而监督他们的护士通常是白人。拟议的网络课程“文化与沟通技能”将向护士和直接护理人员传授沟通技能，以便在护理工作中运用文化差异，并在各级工作人员之间建立有效的工作关系。拟议的课程与不断增长和复杂的长期护理领域相关。

DESCRIPTION (provided by applicant): Approximately one-third of those who turned 65 in 2010 will enter a nursing home for short or long-term stay in their lifetime. Although the older adult population is growing more diverse, the current population of nursing home residents is 86% White and 62% female. An increasingly diverse staff is caring for the comparatively homogeneous long term care (LTC) resident population. Sixteen percent of nurses working in LTC are foreign born and may be learning how to collaborate and communicate in a new system, while caring for both majority and minority patients. Nurses who are native to the U.S. healthcare system find themselves challenged to work effectively with foreign-born colleagues and a diversifying resident population. Regardless of origin, nurses are charged with managing direct care workers, 50% of whom are racial or ethnic minorities. Specifically, 30% are African American, 15% are Latino, and 23% are foreign born. Direct care workers are likely to differ from the nurses who supervise them and the residents for whom they care on several important dimensions, including country of origin, race, ethnicity, primary language, education, and earning power. Cultural preferences regarding care can be obstacles to successful interactions if the caregiver does not understand and address those preferences. Moreover, cultural preferences can easily shade into prejudice against workers from a different cultural background, which can also impede the effectiveness of care. This application proposes to develop a web-based Cultural and Communication Skills course for nurses and direct care workers in LTC. Cultural competence requires taking an interest in what people think and say and what they have experienced, that is, in "the story of the person." The objectives of the proposed course are to improve communication skills for engaging cultural difference in care giving and in building effective working relationships among staff at every level. The course content will be presented via interactive video case studies in which learners are asked to take the perspectives of residents, direct care workers, and nurses. Throughout the course, communication and problem solving skills will be taught and practiced via audio recordings in response to video simulated residents or coworkers. Learning is intended to be cumulative throughout the course, which ultimately will consist of eight free standing but integrated modules on topics relevant across the full continuum of LTC. In Phase I, two 30-minute modules with interactive case studies will be developed, Pathways to Long Term Care and Team Communication Basics, along with a knowledge test and a skills scale specific to the course content. The modules and new measures will be subjected to usability and pilot testing with 30 target users to establish proof of concept. PUBLIC HEALTH RELEVANCE: Approximately 1.6 million people 65 or older live in more than 16,500 Medicare and Medicaid skilled nursing facilities where some 3 million direct care workers provide 70 percent to 80 percent of the paid, hands-on, long-term care. Fifty percent of the direct care workforce is racially/ethnically diverse or foreign born, while the nurses who supervise them are typically White. The proposed web-based course, Culture & Communication Skills, will teach nurses and direct care workers communication skills for engaging cultural difference in care giving and in building effective working relationships among staff at every level. The proposed course is relevant to the growing and complex field of long-term care.