Mel Stewart

Cultural Competence in Undergraduate Healthcare Education: Review of the issues

Summary People who are clinically competent are also often assumed to be culturally competent. Whereas clinical competence is increasingly judged on the outcome measures and standards issued by the professional organisations and government, similar guidelines for the assessment of cultural competence are lacking. This paper suggests that the components of cultural competence may be derived from previous research and appropriate literature, and discusses ways in which these components could make a contribution to developing cultural competence in healthcare undergraduates.

Reaching the ‘hard to reach’: strategies to recruit black and minority ethnic service users with rare long-term neurological conditions

Little is known about health and social care experiences of patients with rare long-term neurological conditions. Furthermore, black and minority ethnic (BME) service users are often perceived to be under-represented in health services research. BME service users have been described as ‘hard to reach’ in the past. However, evidence suggests that a variety of recruitment methods need to be used in order to increase recruitment. We employed a range of recruitment strategies shown to be effective in recruiting BME patients, to recruit patients to participate in one-to-one interviews to establish experiences of health and social care. Strategies included community and clinically based strategies. In total we recruited 15 participants through these recruitment methods, with all recruits ultimately coming from neurology clinics and disease-specific charities. Despite community-based strategies generating interest and a willingness to be involved, the rare nature of these conditions resulted in a lack of recruits from these strategies. Consequently we conclude that researchers need to plan and prioritise strategies carefully in order to maximise recruitment and utilise resources efficiently dependent on the nature of the research.

Researches into the effectiveness of physiotherapy in rheumatoid arthritis of the hand

Summary People presenting with rheumatoid arthritis affecting the hands are often referred for physiotherapy. There is little research which shows that physiotherapy is effective in managing this condition. This paper reviews some of the modalities which have been investigated and the contribution they have made to the treatment of the hands of patients with rheumatoid arthritis. Some of the limitations and omissions in these researches are discussed. Suggestions are forwarded which take account of the need for a balance between the qualitative and quantitative methods employed in the investigation of physiotherapy, especially when exercises are administered in the management programme. It is suggested that research methods which take heed of the science as well as the art of physiotherapy may facilitate a more accurate evaluation of the effectiveness of physiotherapy in practice.

Sickle Cell Disorders and Physiotherapy

Sickle cell disorders affect a wider group of people than is commonly realised. Screening is not universal and this, with a general lack of awareness about the condition, means that many people are inadequately treated. Physiotherapy is noticeably absent from the general medical literature and from the current health education programmes which relate to the disease. Its appropriateness has rarely been addressed, and yet some of the manifestations and potential problems are similar to other conditions which are commonly treated. The case for physiotherapy management to include stroke and pulmonary rehabilitation, preventive care, joint protection, back care, pain control, leg ulcer management and exercise is outlined. Finally, serious concerns are raised about the lack of awareness and knowledge of health professionals including physiotherapists regarding the condition.