Culture and Communication Skills for Long Term Care

描述（由申请人提供）：2010年，大约三分之一的65岁老人将在其一生中短期或长期住在养老院。尽管老年人口越来越多样化，但目前养老院的居民中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）居民人口。在长期护理中心工作的护士中有16%是外国出生的，她们可能正在学习如何在一个新的系统中进行协作和沟通，同时照顾多数和少数患者。美国本土医疗保健系统的护士发现自己面临着与外国出生的同事和多样化的居民群体有效合作的挑战。不论出身如何，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。直接护理工作者可能在几个重要方面与监督他们的护士和他们所照顾的居民不同，包括原籍国、种族、民族、主要语言、教育程度和收入能力。如果护理者不理解和处理这些偏好，有关护理的文化偏好可能成为成功互动的障碍。此外，文化偏好很容易变成对来自不同文化背景的员工的偏见，这也会阻碍护理的有效性。本申请旨在为LTC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巧课程。文化能力要求对人们的想法、言论和经历感兴趣，也就是说，对“这个人的故事”感兴趣。拟议课程的目标是提高沟通技巧，使文化差异参与护理工作，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，学习者被要求从住院医生、直接护理人员和护士的角度出发。在整个课程中，沟通和解决问题的技能将通过录音来教授和练习，以回应视频中的模拟居民或同事。学习旨在在整个课程中累积，最终将包括八个独立但集成的模块，涉及与LTC完整连续体相关的主题。在第一阶段，将开发两个30分钟的互动案例研究模块，即长期护理之路和团队沟通基础，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在30个目标用户中进行可用性和试点测试，以确定概念的证明。

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.