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Cultural Competence in Israel . Dr. Anita Noble Henrietta Szold/Hadassah – Hebrew University School of Nursing. Background. Israel is a country full of cultural diversity Population Religion Religious Identity Religious Observance Ethnicity Language.
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CulturalCompetence in Israel Dr. Anita Noble Henrietta Szold/Hadassah – Hebrew University School of Nursing
Background • Israel is a country full of cultural diversity • Population • Religion • Religious Identity • Religious Observance • Ethnicity • Language
Population by Religion& Population Group Central Bureau of Statistics, 2006
Israel - 2006 • Immigrants – 19,000 • 43% - FSU • 17% - Ethiopia • 13% - France & other • Central Bureau of Statistics, 2006
Instruments • The Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals –Revised (IAPCC-R) (Campinha-Bacote, J. 2003) • Copyrighted by Campinha-Bacote (2003). Printed with permission from • Transcultural C.A.R.E. Associates
Instruments IAPCC-R • Appropriate for initial assessment of general cultural competence of all HCP’s • Self administered questionnaire • 25 items • 5 constructs • 4 point Likert scale • Scoring 25-100 • 25-50 culturally incompetent • 51-74 culturally aware • 75-90 culturally competent • 91-100 culturally proficient
Level Cultural Competence of Israeli Midwives? IAPCC-R Note: Possible score 25-100. A score of 25-50 = culturally incompetent; 51-74 = culturally aware; 75-90 = culturally competent; 91-100 = culturally proficient
New York City 153 HCP’s 69 Nurses 18 Physicians 41 Allied Health Professionals 25 Pediatric Residents Testing
% Culturally Competent p=.003 Entire group 23%
Sample • 146 first year nursing students enrolled in the Introduction to Nursing course • 2 Control groups • Control group 1: n = 51 • Control group 2: n = 37 • 1 Intervention group • n = 58
Israeli Nursing Students p=.000
Meeting Regulatory Requirements • No mandated legislation • Efforts are being directed to decrease health inequalities and promote legislation • Initiatives undertaken by individuals and institutions without a regulatory requirement
It begins with the staff • Most cultures are represented among Israel’s HCP’s who are multilingual • Nursing programs designed for immigrant nurses and those with a BA wanting to change profession • Immigrant physicians employed after passing medical boards
Cultural competence initiatives • Nursing initiatives • Core curriculum will include cultural diversity • Individual nursing schools have already included cultural diversity/cultural competence into courses • Ziv School of Nursing –Safed • Hadassah School of Nursing - Jerusalem • Kaplan School of Nursing - Rechovot • Recanati School of Nursing – Beer Sheva
Language Access • Bar Ilan University • Prof. Miriam Shlesinger & Michal Shuster • Course for Translator’s –currently in pilot project • Telephone translation for Amharic speaking patients • List of employees who are bilingual
Language • Patient handouts available in Hebrew & English • Translators hired for specific areas ie Cystic Fibrosis department • Clowns – Hebrew & Arabic speaking
Physical Plant • Synagogues • Moslem prayer • Kosher food • Appropriate for both Jewish and Moslem patients • “Mehadrin” supervision at Hadassah • Ramadan - after-fast meals served • Sabbath elevator • Interfaith group for healthcare professionals
Community Outreach • Clinic for Down Syndrome includes bilingual staff that work specifically with Arab families • Hospital works together with B’Terem on projects tailored for Jewish and Arab communities • Community organizations distribute strictly kosher snacks to ALL patients and families daily • Sabbath meals for patients & families provided free of charge • Clergy of different faiths
Cultural competence initiatives • Hadassah Medical Center – continuing education courses/workshops include a lecture on cultural competence • More conferences focus on cultural competence
Continuing Education • 2005 • Israel Association for Nursing Research, Recanati School of Nursing, Beer Sheva Dr. Rena Papadopoulos –guest lecturer Dr. Ilana Margalit - Founder • 2006 • Henrietta Szold/Hadassah-Hebrew University School of Nursing, Jerusalem Cultural competence workshop for nursing faculty Dr. Rachel Spector (Lady Davis Fellow) Dr. Anita Noble
Continuing Education • 2006 • Mind the Language Gap: Access to Health Care for Language Minorities, Bar Ilan University Prof. Miriam Shlesinger, Michal Shuster • Health Promotion & Cultural Diversity, Ministry of Health – Public Health, Jerusalem Dr. Karen Glantz Prof. Ronny Shtarkshall Ruti Weinstein, conference chairperson
Continuing Education • “A Tool Chest for Cultural Tailoring” Hebrew University Faculty of Medicine & School of Public Health Prof. Ronny Shtarkshall • “Connecting Bridges” Association for Nursing Faculty in Israel Ziv School of Nursing • Intercultural Center for Human Sexuality & Family Life