title: Working conditions and cultural competence when interacting with children and parents of foreign origin--Primary Child Health Nurses' opinions.
abstract: BACKGROUND
  Interaction with children and parents of foreign origin is an important part of Primary Child Health Care (PCHC) services. Cultural competence among Primary Child Health Nurses' (PCHNurses') must therefore be regarded as essential. Cultural competence has been described as a process with different steps through which an individual must proceed.
  
  
  OBJECTIVE
  The present study investigates PCHNurses' opinions regarding their working conditions and cultural competence. The focus will be placed on their interaction with children and parents of foreign origin.
  
  
  METHODS
  A total of 270 PCHNurses working in the PCHC services in Stockholm County responded to a questionnaire (response rate 70%). The association between experiences of difficulties and nine explanatory variables were analysed with logistic regression.
  
  
  RESULTS
  Many of the PCHNurses reported inadequate working conditions and dissatisfaction with the quality of their healthcare work and said that they lacked written guidelines, support and help. A majority (84%) experienced difficulties in their interactions with children and parents of foreign origin, although to different degrees. The odds of experiencing difficulties were increased when nurses were responsible for a high proportion of children of foreign origin, when nurses had long professional experience and when they worked more than 50% on child-health-services assignments. Many nurses had no formal training in cultural competence and the majority felt that their formal and clinical cultural competence was insufficient.
  
  
  CONCLUSIONS
  Deficiencies were found regarding the PCHNurses' working conditions and cultural competence when interacting with children and parents of foreign origin. Improvements are needed to facilitate the nurses' healthcare work and to enable high quality health care on equal terms for all children and parents visiting the PCHC services.
authors.affiliation: Neurotec Department, Family Medicine Stockholm, Karolinska Institute, Huddinge, Sweden. anita.berlin@slpo.sll.se
authors.forename: Anita
authors.initials: A
authors.lastname: Berlin
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Johansson
authors.forename: Lena
authors.initials: L
authors.lastname: Törnkvist
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services; D002983:Clinical Competence / Q000592:standards*; D018864:Cultural Diversity; D004641:Emigration and Immigration; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D020380:Needs Assessment; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000523:psychology*; D009745:Nursing, Supervisory; D010371:Pediatric Nursing / Q000193:education / Q000458:organization & administration*; D011320:Primary Health Care; D011368:Professional-Family Relations; D012111:Residence Characteristics; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013548:Sweden; D016746:Transcultural Nursing / Q000193:education / Q000458:organization & administration*; D017132:Workplace / Q000458:organization & administration / Q000523:psychology