After several decades of slow progress, researchers are beginning to make advances in linking constructs based on the multicultural competencies tradition-especially those focused on qualities of the therapist-to therapy outcomes. The multicultural orientation framework was developed in response to several trends within the multicultural competencies tradition, with a particular emphasis on integrating the multicultural competencies tradition into research on psychotherapy process. We provide a narrative review of studies that include one of the three constructs (i.e., cultural humility, cultural opportunities, and cultural comfort) articulated by the multicultural orientation framework. Results indicate initial evidence linking multicultural orientation constructs to therapy outcomes (e.g., perceived improvement, racial/ethnic disparities in termination, and therapy alliance). Results also supported the social bond and social oil hypotheses from theorizing on humility. Implications for future research and therapy practice are discussed. (PsycINFO Database Record

The multicultural orientation framework: A narrative review.

Concept Development In Nursing Foundations Techniques And Applications

Therapists and mental health professionals strive to provide competent treatment to increasingly diverse populations, but can struggle to effectively engage with clients from different cultural backgrounds. Cultural humility is an approach and process that can help facilitate strong working alliances between therapists and diverse clients, leading to better therapy outcomes. In this article, we first consolidate definitions of cultural humility and work to better operationalize the construct. Next, we provide a brief review of empirical studies examining the role of cultural humility in therapy. Then, we offer a 4-part framework for applying cultural humility in therapy by (a) engaging in critical self-examination and self-awareness, (b) building the therapeutic alliance, (c) repairing cultural ruptures, and (d) navigating value differences. Finally, we illustrate what cultural humility looks like in the therapy room with two case studies.

Cultural humility: A therapeutic framework for engaging diverse clients.

Healthcare Simulation Standards of Best PracticeTM Simulation Design

In recent years, the study of psychedelic science has resurfaced as scientists and therapists are again exploring its potential to treat an array of psychiatric conditions, such as depression, post...

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The psychedelic renaissance and the limitations of a White-dominant medical framework: A call for indigenous and ethnic minority inclusion

Diversity is being increasingly recognized as an area of emphasis in health care. The term cultural humility is used frequently but society's understanding of the term is unclear. The aim of this article was to provide a concept analysis and a current definition for the term cultural humility. Cultural humility was used in a variety of contexts from individuals having ethnic and racial differences, to differences in sexual preference, social status, interprofessional roles, to health care provider/patient relationships. The attributes were openness, self-awareness, egoless, supportive interactions, and self-reflection and critique. The antecedents were diversity and power imbalance. The consequences were mutual empowerment, partnerships, respect, optimal care, and lifelong learning. Cultural humility was described as a lifelong process. With a firm understanding of the term, individuals and communities will be better equipped to understand and accomplish an inclusive environment with mutual benefit and optimal care.

Cultural Humility: A Concept Analysis

Correspondence to Dr Rudi Coninx; rudiconinx@ hotmail. com © Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Interlinkages between conflict, health and peace are well known. The 1986 Ottawa Charter for Health Promotion, which enumerates the fundamental conditions and resources needed for health, lists peace as the first on the list of prerequisites for health. There cannot be health without peace. Violence in general, and armed conflicts in particular, have a direct impact on health. Conflicts cause violent deaths not only among combatants, but also among civilians, and lead to physical and mental injuries that will have lasting effects long after the conflict has ended. Conflicts also lead to the disruption of health systems, collapse of essential medical supply chains, and breakdown of social and economic systems, making it difficult to achieve Universal Health Coverage (UHC), one of the main objectives of WHO. It also leads to an exodus of healthcare workers, attacks on healthcare, upsurges in epidemics, increased infant mortality rates, sexual violence, and mental disorders such as depression, anxiety, and posttraumatic stress. While there cannot be health without peace, there cannot be peace without health either: lack of access to basic social services, such as healthcare, for specific population groups, often on ethnic or religious grounds, leads to feelings of exclusion, sentiments of unfair treatment by the government and perceptions of unequal treatment vis-à-vis other groups. These inequities lead to grievances, which in turn, often boil over into protests and later violence.

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How health can make a contribution to peace in Africa: WHO’s Global Health for Peace Initiative (GHPI)

Strategy to mitigate various Ebola virus disease (EVD) outbreaks are focusing on Infection Prevention and Control (IPC) capacity building, supportive supervision and IPC supply donation. This study was conducted to assess the impact of a Pay for Performance Strategy (PPS) in improving IPC performance in healthcare facilities (HF) in context of the 2018-2019 Nord Kivu/ Democratic Republic of the Congo EVD outbreak.A quasi-experimental study was conducted analysing the impact of a PPS on the IPC performance. HF were selected following the inclusion criteria upon informed consent from the facility manager and the National Department of Health. Initial and process assessment of IPC performance was conducted by integrating response teams using a validated IPC assessment tool for HF. A bundle of interventions was then implemented in the different HF including training of health workers, donation of IPC kits, supportive supervision during the implementation of IPC activities, and monetary reward. IPC practices in HF were assessment every two weeks during the intervention period to measure the impact. The IPC assessment tool had 34 questions aggregated in 8 different thematic areas: triage and isolation capacity, IPC committee in HF, hand hygiene, PPE, decontamination and sterilization, linen management, hospital environment and Waste management. Data were analysed using descriptive statistics and analytical approaches according to assumptions. R software (version 4.0.3) was used for all the analyses and a p-value of 0.05 was considered as the threshold for statistically significant results.Among 69 HF involved in this study, 48 were private facilities and 21 state facilities. The median baseline IPC score was 44% (IQR: 21-65%); this IPC median score reached respectively after 2, 4, 6 and 8 weeks 68% (IQR: 59-76%), 79% (71-84%), 76% (68-85%) and 79% (74-85%). The improvement of IPC score was statistically significative. Spearman's rank-order correlation revealed the associated between proportion of trained HW and IPC score performance after 8 weeks of interventions (rs = .280, p-value = 0.02).Pay for Performance Strategy was proved effective in improving healthcare facilities capacity in infection prevention and control practice in context of 2018 EVD outbreak in Nord Kivu. However, the strategy for long-term sustainability of IPC needs further provision. More studies are warranted on the HW and patients' perceptions toward IPC program implementation in context of Nord Kivu Province. 

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Impact of multimodal strategies including a pay for performance strategy in the improvement of infection prevention and control practices in healthcare facilities during an Ebola virus disease outbreak

The Democratic Republic of Congo declared their tenth outbreak of Ebola in North Kivu in 2018, which was the second-largest in the world and took place in an active conflict zone. Transmission of Ebola occurs by direct contact with infected bodily fluids and can occur within facilities when infection prevention and control (IPC) precautions are not strictly practised. To develop infection prevention and control (IPC) standards in health facilities, 45 medical students were trained and placed in 101 health facilities to mentor healthcare workers and support IPC practices between February and October 2019. A mixed-methods retrospective evaluation of quality improvement in North Kivu was conducted in October and November 2019 to capture key lessons from such a pilot IPC project. Five focus groups (N=49) and 42 key-informant interviews were conducted in addition to a secondary analysis of surveillance and programmatic data collected during the intervention. The intervention contributed 1.83 times (95% confidence interval, CI=1.10-3.06) to increased the likelihood of health facilities achieving an IPC score of 80% or above compared with facilities that did not receive the intervention. Overall, we found the odds of Ebola cases declining three times more likely in Butembo and Katwa (odds ratio, OR=3.00, 95% CI=1.87-5.62) relative to ten health zones in the region that were not reached by the intervention. The results are difficult to attribute to any one type of intervention, given the number of other interventions implemented concurrently during the outbreak response. Further evaluations should be conducted to assess the cost-effectiveness of using medical students in conflict resolution and IPC, and to assess the suitability of scaling these approaches to other settings and diseases.

Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo

Kevin Ousman

Papers

Cultural Humility: A Concept Analysis

How health can make a contribution to peace in Africa: WHO’s Global Health for Peace Initiative (GHPI)

Impact of multimodal strategies including a pay for performance strategy in the improvement of infection prevention and control practices in healthcare facilities during an Ebola virus disease outbreak

Evaluation of a health systems strengthening intervention to improve Ebola Virus Disease infection prevention and control in the Democratic Republic of the Congo