Evaluating the utility of the FamCHAT ethnocultural nursing assessment tool at a Canadian tertiary care hospital: A pilot study with recommendations for hospital management

Abstract

Objectives: The multicultural nature of Canadian society and the decline in health of immigrants after relocation to Canada prioritizes a commitment to ensure equity in health care access and outcomes. An important feature shaping health care access and outcomes is the reception of culturally safe and competent care. Partnering with senior management at a tertiary care hospital, this pilot study aimed to investigate whether an identified cultural assessment tool, the Family Cultural Heritage Assessment Tool (FamCHAT), validated for use in a rural primary care setting, was suitable for use in tertiary care. The objectives were to investigate: 1) whether using the FamCHAT enabled the nurses to elicit assessment information from their patients who represent diverse ethnocultural groups, and 2) the nurses' perspectives on the practical use of this form in their clinical practice.Methods: Nurses purposively selected from the Women's, Surgery and Medicine units were asked to complete the FamCHAT form with all patients admitted during a three-month period in 2009. Focus group interviews were then held to learn the nurses' perspectives related to the form's constructs and its use in their practice. The data from the completed FamCHAT forms were tabulated and analyzed using descriptive statistics to determine the extent of completion and accuracy, and the sample characteristics. The interview data was analyzed using qualitative analytical software (ATLAS.ti Scientific Software Development, GmbH, Germany) and Roper and Shapira's framework for analysis of ethnographic data. Results:The nurses filled out forty-four FamCHAT forms with patients having a diverse ethnocultural profile. In many forms, several questions were either left blank or answered incorrectly with regard to the guidance notes containing categorical answers for the variables of family size and language. Nine nurses participated in two focus groups (n = 4 and n = 5) and one in an individual interview. Five themes emerged from the qualitative data analysis: feasibility of using the FamCHAT in acute care practice; ethnocultural awareness needs of the participating nurses; perspectives of nurses about patient concerns; potential for enhancement to nursing care assessments; and suggestions for enhancing and facilitating a new tool or approach. Nurses participating in the interviews thought that the constructs within FamCHAT could be usefulwww.sciedu.ca/jnep Journal of Nursing Education and Practice, May 2012, Vol. 2, No. 2 Published by Sciedu Press 25for enhancing nursing assessments in their practice, but thought the tool was too long, was repetitive to some of their current assessment data, and had questions many patients were uncomfortable answering. One option suggested in both focus groups was to embed the most useful constructs into existing assessment frameworks. Some of the variables were thought to be of limited relevancy for some nursing specialties. Conclusions:The findings provided valuable information for the hospital management in their eff...

An ethnographic investigation of the maternity healthcare experience of immigrants in rural and urban Alberta, Canada

“…This finding is supported by previous studies about immigrant health communication [ 15 , 18 , 67 , 68 ]. A language barrier not only hinders communication but also limits access to the information resources about availability of services [ 15 , 23 ]. Immigrant women who do not have information and knowledge about the availability of the services simply are not accessing these services.…”

“…Many of the women continued to follow their healthcare beliefs and some experienced cultural shock when confronted with different healthcare practices such as the types of food served in maternity wards and less focused postnatal care. In a pluralistic multicultural society such as Canada, cultural competency of healthcare providers plays an important role in providing sufficient healthcare services with reduced risk of misunderstandings [ 23 , 29 ].…”

“…Maternity care that is adapted poorly to serve diverse cultural populations can result in low birth weight and preterm birth, which can impact the short or long-term health of women and children [ 12 , 19 , 21 , 22 ]. Inadequate health assessment and communication issues between care givers and their clients may encourage unnecessary interventions, thereby wasting precious resources [ 23 ]. More information about the diversity of experience and the factors that shape the experiences of immigrant women in the Canadian healthcare system will help us to improve maternity health in Canada [ 24 , 25 ].…”

What is Participatory Research? Why do it?

“…They had identified a clear need to enhance the quality of care for their increasingly diverse patient population. After the research team identified a potentially suitable tool (Higginbottom et al, 2011), we partnered with the senior management to conduct a pilot study aimed at investigating the suitability and acceptability of the identified cultural assessment tool -the Family Cultural Heritage Assessment Tool (FamCHAT) -in their setting (Higginbottom et al, 2012). The findings provided valuable information for the hospital management in their efforts to revise nursing assessment tools.…”