Moving towards culturally competent dementia care: have we been barking up the wrong tree?

2005 ◽  
Vol 15 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Jenny Mackenzie ◽  
Ruth Bartlett ◽  
Murna Downs
Keyword(s):  
Service Providers ◽  
Evidence Base ◽  
Culturally Competent ◽  
Ethnic Communities ◽  
Cultural Groups ◽  
Care Services ◽  
People With Dementia ◽  
Health And Social Care ◽  
The Uk ◽  
Minority Ethnic

In the UK it is established that health and social care services for people with dementia from black and minority ethnic communities need to move towards providing evidence-based culturally appropriate care. At present, however, the evidence base available to guide professionals working with people with dementia from diverse ethnic and cultural groups is limited, and beliefs about dementia and the type of treatment and support needed have received little attention. Consequently this creates problems for service providers faced with appropriately supporting people with dementia and their families from black and minority ethnic communities.

scholarly journals Autism in black, Asian and minority ethnic communities: a report on the first Autism Voice UK Symposium

2020 ◽  
Vol 6 (2) ◽  
pp. 165-175
Author(s):  
Mariama Seray Kandeh ◽  
Mariama Korrca Kandeh ◽  
Nicola Martin ◽  
Joanna Krupa
Keyword(s):  
Public Awareness ◽  
Action Plan ◽  
Cultural Perspective ◽  
Ethnic Communities ◽  
Cultural Groups ◽  
Content Type ◽  
Autistic People ◽  
The Uk ◽  
Autism Education ◽  
Minority Ethnic

Purpose Little is known about the way autism is interpreted and accepted among the black, Asian and minority ethnic (BAME) populations in the UK. This report summarises a Symposium on autism in the UK-BAME community in 2018, organised by Autism Voice UK, Participatory Autism Research Collective and the Critical Autism and Disabilities Studies Research Group at London South Bank University. Design/methodology/approach The stance a family or community takes about a condition such as autism is influenced by their cultural background. The aims of the Symposium were to highlight different perspectives about autism in BAME communities and to preserve the cultural dignity of the community in supporting autistic members. Beliefs about autism, its diagnosis and acceptance of and support for autistic people from a specific cultural perspective of BAME communities must be cautiously interpreted by autism professionals because beliefs vary among different cultural groups. Findings Thematic analysis of feedback from participants yielded the following foci. Firstly, cultural, ethnic and religious sensitivities were important to participants who felt that these were often ignored by non-BAME professionals. Secondly, the need for collaboration to improve autism awareness within the community and understanding by professionals of the intersectionality between autism and identity in BAME families was prioritised. Thirdly, issues around feelings of stigma were common, but delegates felt that these were not well understood beyond people identifying as BAME. Originality/value An action plan was created which highlighted raising public awareness through community engagement, improvement of access to information for parents and culturally aware autism education for professionals and BAME communities.

scholarly journals O23 Testing the waters: COVID-19 first wave and shielding among Black, Asian and Minority Ethnic patients with rheumatological conditions in the UK

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Shirish Dubey ◽  
Kanta Kumar ◽  
Helen Bunting ◽  
Tom Sheeran ◽  
Barbara Douglas ◽  
...  
Keyword(s):  
Culturally Competent ◽  
Ethnic Communities ◽  
Asian Patients ◽  
Vulnerable Patients ◽  
Significant Difference ◽  
Minority Ethnic Community ◽  
Risk Scoring ◽  
Caucasian Patients ◽  
The Uk ◽  
Minority Ethnic

Abstract Background/Aims  COVID-19 has created numerous challenges for people globally. In the UK, few studies have reported poorer outcomes for certain ethnic populations. UK government introduced shielding guidance to protect the most vulnerable patients and this was in force for a number of months. However, shielding guidance was initially released only in English, which resulted in further disenfranchisement of the Black, Asian and Minority Ethnic community (BAME). We undertook an audit to understand experiences of shielding particularly in rheumatological BAME patients in multi-ethnic communities in 3 centres - Wolverhampton, Leicester and Oxford. Methods  This study was approved in all three sites as an audit. Patients contacting rheumatology helpline or having routine consultations were included. Each centre aimed to recruit at least 20 patients. A questionnaire was developed to capture important data on shielding. The study was conducted between May and June 2020 during the peak of the first wave of Covid 19. Results  We recruited 79 patients into this audit, of these 54 were of BAME and 25 of Caucasian ethnicity with 17 males and 62 females. Rheumatoid Arthritis (RA) was the commonest diagnosis in 49 of these patients (62%) and these patients were older (median ages 56 vs. 46 years, p = 0.14). BSR risk scoring algorithm was used to determine need for shielding (BSR score of 3 or more) - 38 patients fell into this category. The remaining patients had scored lower and had the option of shielding or enhanced social distancing. Of the 13 Caucasian patients who should have been shielding, 11 were (85%). Of the 25 BAME patients who should have been shielding: 17 were, and 8 were not (68%, p = 0.26; 65% looking at South Asian patients alone). Understanding of reasons for shielding was clear for 21 out of 25 Caucasian patients (84%). In contrast, 33 of 54 patients from BAME backgrounds (61%) were clear on this (p = 0.10). Within Wolverhampton and Leicester, the numbers are starker with 20 out of 37 (54%) being clear on this. Very few Caucasian patients made changes to their existing medications with 84% carrying on their medications as they were before the onset of COVID 19. However, of 54 BAME patients, 14 patients had stopped medications - either by themselves or as per advice of health professionals (74%, p = 0.16). There was a significant difference between centres in patients stopping medications with patients from Leicester much more likely (p < 0.001). Conclusion  Despite the small numbers, the data clearly suggest that BAME patients were less likely to understand the reasons for shielding, to follow shielding advice, and more likely to change their medications, thereby risking a flare. Addressing culturally competent educational needs and health equality for BAME rheumatology patients continues to remain a challenge. Disclosure  S. Dubey: None. K. Kumar: None. H. Bunting: None. T. Sheeran: None. B. Douglas: None. J. Sabu: None. M. Attwal: None. A. Moorthy: Honoraria; UCB, MSD, AbbVie.

Ethnic Differences in Self-Poisoning Across South London

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 268-272
Author(s):  
Sean Cross ◽  
Dinesh Bhugra ◽  
Paul I. Dargan ◽  
David M. Wood ◽  
Shaun L. Greene ◽  
...  
Keyword(s):  
Black Women ◽  
Data Collection ◽  
White Women ◽  
Population Based ◽  
Care Services ◽  
Self Harm ◽  
Managing Risk ◽  
The Uk ◽  
Incident Cases ◽  
Minority Ethnic

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.

scholarly journals Older Carers and Carers of People with Dementia: Improving and Developing Effective Support

2020 ◽  
pp. 1-15
Author(s):  
Mary Larkin ◽  
Melanie Henwood ◽  
Alisoun Milne
Keyword(s):  
Third Sector ◽  
Evidence Base ◽  
Service Evaluation ◽  
People With Dementia ◽  
Carer Support ◽  
Tailored Approach ◽  
The Uk ◽  
Similar Stage

The policy drive to support carers is a longstanding national and international priority. Research about the design and delivery of support for carers is critical to the underpinning evidence base. Through a timely exploration of a third sector perspective, the UK-based study discussed in this article provides insights into approaches to, and the commissioning of, support for older carers and carers of people with dementia. The study highlights the importance of: embedding carers’ perspectives in service developments; the provision of both generic and targeted support which adopts a nuanced and tailored approach; titrating the delivery of information and advice at a pace to match carers’ needs; capturing quantitative and qualitative dimensions in service evaluation; and increased quantity and longevity of funding. Such insights not only complement existing research but are also generalisable to other countries at a similar stage in the development of carer support.

Identity

2018 ◽  
Author(s):  
Zanib Rasool
Keyword(s):  
Young People ◽  
Young Women ◽  
Social Cohesion ◽  
National Narrative ◽  
Ethnic Communities ◽  
Writing Group ◽  
Sociocultural Practices ◽  
Parallel Lives ◽  
The Uk ◽  
Minority Ethnic

This chapter focuses on the identities of British Muslim young women from a writing group, and shares some of the themes that emerged during these writing sessions. Three specific themes related to identity came out of the girls' writing group: place and globalisation; religion; and language. In the UK, there is an increased focus on social cohesion and integration. Young people from minority ethnic communities experience a great deal of pressure in order to fit in with the national narrative of ‘Britishness’, and often feel that they should conform outwardly in their dress and physical appearance, and adopt British sociocultural practices. Those individuals who maintain their faith, language, and cultural identity are seen as segregating themselves and living parallel lives.

scholarly journals Better data, better knowledge, better society: Developing an ideal homelessness data system drawing on lessons from global practice

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Ian Thomas ◽  
Peter Mackie
Keyword(s):  
Data Collection ◽  
Central Government ◽  
Service Providers ◽  
Data Access ◽  
Evidence Base ◽  
Data System ◽  
Policy And Practice ◽  
Good Data ◽  
Ideal System ◽  
Health And Social Care

The aim of this paper is to set out the principles of an ideal data system. Good data is crucial to effective policy and practice development in all social policy spheres and this is a particular challenge in the context of homelessness policy. Policy makers, practitioners and researchers have been highly critical of the current state of homelessness data across the globe, with concerns largely focused on the incompleteness of the data. Most research has narrowly focused on the strengths and weaknesses of different data collection techniques, such as Point-In-Time counts. However, good data does not only derive from the data collection method - consideration must also be given to the wider data system, including how data are generated, reported, analysed, and crucially, how they are made accessible and to who. The evidence base for the paper is a desk-based review of 49 data collection systems from 8 countries, including systems in health and social care settings—where data are being increasingly used to drive more effective care. The different systems are synthesised to generate 8 areas of design, being: data architecture, governance, data quality, ethical and legal, privacy/security, data access, and importantly, purpose. Drawing these elements together, the paper concludes that data collection should adopt a common data standard shared across the sector, enabling inter-organisational information sharing and improving collaboration; reporting to local and central government must not be one-sided, instead data providers should receive some tangible benefit for their engagement; the focus of analysis needs to shift from statistics toward evaluation into the effectiveness of interventions; and access must be available to a range of sector actors, including service providers and academia. Importantly, the paper also concludes that in delivering the ideal system, care must be taken not to interrupt the delivery of effective homelessness interventions.

scholarly journals Systematic Review Investigating Multi-disciplinary Team Approaches to Screening and Early Diagnosis of Dementia in Primary Care – What are the Positive and Negative Effects and Who Should Deliver It?

2017 ◽  
Vol 15 (1) ◽  
pp. 5-17 ◽  
Author(s):  
Toby Smith ◽  
Jane Cross ◽  
Fiona Poland ◽  
Felix Clay ◽  
Abbey Brookes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Early Diagnosis ◽  
Service Providers ◽  
Care Practice ◽  
Initial Contact ◽  
Negative Effects ◽  
People With Dementia ◽  
Health And Social Care ◽  
Early Diagnostic

Background: Primary care services frequently provide the initial contact between people with dementia and health service providers. Early diagnosis and screening programmes have been suggested as a possible strategy to improve the identification of such individuals and treatment and planning health and social care support. Objective: To determine what early diagnostic and screening programmes have been adopted in primary care practice, to explore who should deliver these and to determine the possible positive and negative effects of an early diagnostic and screening programme for people with dementia in primary care. Methods: A systematic review of the literature was undertaken using published and unpublished research databases. All papers answering our research objectives were included. A narrative analysis of the literature was undertaken, with the CASP tools used appropriately to assess study quality. Results: Thirty-three papers were identified of moderate to high quality. The limited therapeutic options for those diagnosed with dementia means that even if such a programme was instigated, the clinical value remains questionable. Furthermore, accuracy of the diagnosis remains difficult to assess due to poor evidence and this raises questions regarding whether people could be over- or under-diagnosed. Given the negative social and psychological consequences of such a diagnosis, this could be devastating for individuals. Conclusion: Early diagnostic and screening programmes have not been widely adopted into primary care. Until there is rigorous evidence assessing the clinical and cost-effectiveness of such programmes, there remains insufficient evidence to support the adoption of these programmes in practice.

Managing radicalised patients in healthcare: raising questions for future service development

2019 ◽  
Vol 25 (5) ◽  
pp. 196-204 ◽  
Author(s):  
Feryad A Hussain ◽  
Lindsay Royan
Keyword(s):  
Therapeutic Interventions ◽  
Service Development ◽  
Police Departments ◽  
Care Services ◽  
Professional Challenges ◽  
Health And Social Care ◽  
Working Together ◽  
The Uk ◽  
Models Of Service Delivery ◽  
Specific Project

Today, there are an ‘increasing number of radicalised ‘returnees’ coming home after being involved in fighting abroad. While the issue of radicalisation has existed for a number of decades, the UK faces a growing problem of managing people who have been exposed to radical beliefs. The literature has identified a number of common, contributory factors that are rooted in psychosocial issues. To this effect, health and social care services are being asked to offer therapeutic interventions and support, while working together with legal teams and police departments in order to develop a suitable preventative/management strategy. This article has been borne out of a specific project of one such team. It considers the professional challenges that teams face in applying existing models of service delivery to a new and emerging area of healthcare. An alternative working model is suggested for the development of future services.

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