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Abstract

The increasing cultural diversity of British Columbia is affecting the delivery of health care. Although there is extensive literature outlining the knowledge and skills required by nurses to provide culturally sensitive care, little is known about the perspective of nurses providing this care. The purpose of this study was to identify and describe the main issues for nurses who cared for culturally diverse clients and families in a paediatric inpatient setting. The second focus of this study was to describe the resources and supports nurses utilized and needed in order to provide this care. Kleinman's (1978) conceptualization of the three domains in which health is experienced and reacted to provided direction for examining the effects of conflicting explanatory models of health and illness from the nurse's perspective. A descriptive approach was used to address the following two research questions : 1) What issues do nurses identify as influencing their ability to provide culturally sensitive care in a paediatric setting? and 2) What agency-based resources facilitate or hinder the nurses' ability to provide culturally sensitive care? The investigator used a convenience sampling approach to recruit 42 respondents from a paediatric inpatient setting. A questionnaire developed and piloted by Lynam, Sauro et.al (1990) was adapted and used for this study. Content analysis was used to analyze openended responses, and descriptive statistics were calculated for the fixed-response questions. Communication was the overriding issue paediatric nurses faced. The communication barrier influenced the nurses' ability to assess clients and to provide care. When nurses were unable to provide optimal care, they experienced frustration and moral and ethical dilemmas. Nurses reported their ability to provide care was dependent upon the resources available. Difficulties were overcome when the nurse's personal philosophy valued client differences, and enabled her to negotiate with the client. Availability of interpreter services and resources to assist communication also affected the nurse's ability to provide care. Implications arising from this study for nursing education, practice and research are discussed.