Student nurse perceptions of Gypsy Roma Travellers; A European qualitative study

de Diego Cordero, Rocío

doi:10.1016/j.enfcle.2019.08.001

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Facultad de Enfermería, Fisioterapia y Podología. Universidad de Sevilla" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Percepciones de los estudiantes de Enfermería sobre los gitanos itinerantes: un estudio cualitativo europeo" ] ] "textoCompleto" => "<elsevierMultimedia ident="tb1005"></elsevierMultimedia>Introduction: the Roma community to this day remains a great unknown to non-Roma people, and is subject to prejudice and stereotypes so commonly entrenched that the discriminatory situations it experiences are routinely normalised or kept invisible by most of society and therefore, by health professionals.Aim: The aim of this article was to explore nursing student's understanding, knowledge and perceptions of working with itinerant Roma people.Method: 23 nursing students from four European countries (United Kingdom, Spain, Belgium, Turkey) between 19 and 32 years of age, male (N=4) and female (N=19), participated in the study. Focus groups and individual interviews were conducted.Results: the results of the study revealed four main themes: exposure to Roma communities of Roma travellers, perceptions of nomadic Roma culture, unhealthy lifestyles and culture, and the role of nurses with regard to the itinerant Roma community.Conclusions: The conclusions of this study show that most of the students’ perceptions regarding these communities were negative.Training in nurses’ study plans should include how the Roma community should be approached to deliver culturally competent care. In addition there is evidence of a lack of research into the attitudes of health professionals towards this community, which needs to be addressed through more research.CommentaryThe manuscript reports the experience of an intervention to explore the knowledge and perceptions of nursing students in relation to working with itinerant Roma people. The study was conducted with 23 nursing students from universities in four European countries (Belgium, Turkey, Spain and the United Kingdom) attending a cross-cultural summer school and invited to participate in the research study. The participating students received an information sheet that indicated both the voluntary nature of their participation and the confidential nature of their responses.An intervention was carried out using two qualitative techniques: focus groups and individual interviews of between 30 and 45min. Most of the data were gathered through closed-door focus groups in a classroom or meeting room in the participants’ universities. These were supplemented by individual and/or group interviews for those unable to attend the groups.All the data were audio-recorded and transcribed. They were then translated into English, the results were analysed and categories of analysis established, namely: exposure to Roma communities of Roma travellers, perceptions of the nomadic Roma culture, unhealthy lifestyles and culture, and the role of nursing vis-à-vis the itinerant Roma community.As mentioned, the authors state in the manuscript that they adopted a qualitative design based on focus groups and interviews, but they do not mention anything about the instrument used to undertake these techniques, which makes it impossible to assess how they were approached; appending the script of questions used by the researchers would have enabled the reader a better understanding of the participants’ answers, and made it possible to use in other research studies. There is no mention either of the background on which the design of the questions for the groups and interviews was based or which aspects were most emphasised.We would also highlight the sample size since, although it is accepted that in phenomenology-based studies 23 participants can be sufficient, this is a very specific sample of a very specific group undergoing very specific training. It is advisable to extend it, for example, with the rest of the countries included in the European initiative “Decade of Roma Inclusion 2005-2015” to improve the socio-economic status and social inclusion of the (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Slovakia, Spain, Hungary, Northern Macedonia, Romania, Serbia and Montenegro), or at least with the seven European countries (Spain, Bulgaria, Slovakia, Greece, Portugal, Czech Republic and Romania) that participated in 2010 in the meeting “Health and the Roma community. Analysis of the situation in Europe”, on the health of the Roma population in relation to that of the general population.However, the contribution of this study to the field of health must be valued, since, although there are some other previous experiences in the literature, research into Roma health and population in Europe has principally focussed on communicable diseases, genetic studies and congenital anomalies.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>The social situation of the Roma population in Europe led the European Commission to approve, in the context of the abovementioned “Decade of Roma Inclusion 2005-2015”, the European framework of national strategies for Roma inclusion until 2020<a class="elsevierStyleCrossRef" href="#bib0010">2</a> in which they consider it imperative for member countries to improve the situation of Roma people in Europe. This communication established four large areas for intervention: education, employment, housing and health. In the latter area, the objective is to “reduce health inequalities between Roma people and the rest of the population”. Nevertheless, the European literature continues to note lower life expectancy in this community (around 10 years), and higher fertility rates and infant mortality.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>In the specific case of Spain, transposing this initiative resulted in the approval of framework documents for the development and inclusion of the Roma population, in particular the National Strategy for the Social Inclusion of the Roma Population 2012-2020.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> Thus, the government of Spain undertook to reduce health inequalities in key indicators such as preventive gynaecological visits, child health, cardiovascular diseases, mental and oral health, accidents, access to health services and the development of research. But as in the case of Europe, the data indicate that there remains a significant inequality gap with the rest of the population and the percentage of health exclusion is 3 times greater in the Roma population.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>For this reason this article's proposal is worth mentioning; previous initiatives have measured attitudes towards Roma people, such as the study by Navas and Cuadrado <a class="elsevierStyleCrossRef" href="#bib0030">6</a> who sought to determine the attitudes of the native population of a municipality of Almeria towards three ethnic groups with a high presence in the area: Maghrebian immigrants, sub-Saharan immigrants and Roma. One hundred and five respondents answered a questionnaire that measured the affective and cognitive component of attitudes, the perceived social consideration of these groups, the allocation of the differences among the group itself and exogroups and the perception of the number of members of exogroups present in the area. The results showed that the most poorly assessed collective was that of the Maghrebian immigrants, followed by the Roma and the sub-Saharan immigrants.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> But little has been done with health personnel specifically, and there is little literature on this subject in the field of Nursing.In order to provide culturally congruent and competent care, nurses must respect cultural differences and similarities. Attitudes towards illness and strategies to combat it vary from culture to culture. In their work with individuals and the community, nurses must preserve the actions they undertake to maintain their wellbeing, according to their culture and beliefs and must adapt their interventions to their patients’ culture for them to be effective. In short, actions carried out must be culturally congruent for people to change their behaviour. <a class="elsevierStyleCrossRef" href="#bib0035">7</a> Hence the importance of nurses’ knowledge about the Roma population and contributions such as that of this research study.Therefore, the abovementioned paper opens up an opportunity for research in this field, given the scarcity of papers on this subject and the importance of approaching it. It is now only a question of uniting efforts at a scientific level to implement this proposal." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Commentary" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-29" "fechaAceptado" => "2019-08-30" "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "tb1005" "tipo" => "MULTIMEDIATEXTO" "mostrarFloat" => false "mostrarDisplay" => true "texto" => array:1 [ "textoCompleto" => "Heaslip V, Vanceulebroeck V, Kalkan I, Kömürcü N, Solanas IA.Student nurse perceptions of Gypsy Roma Travellers; A Euro-pean qualitative study. Nurse Educ Today. 2019;82:1–7. doi:10.1016/j.nedt.2019.07.011." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The health of the Roma people: a review of the published literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Hajioff" 1 => "M. McKee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jech.54.11.864" "Revista" => array:6 [ "tituloSerie" => "J Epidemiol Community Health." "fecha" => "2000" "volumen" => "54" "paginaInicial" => "864" "paginaFinal" => "869" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11027202" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Comunicación de la Comisión al Parlamento Europeo, al Consejo, al Comité Económico y Social y al Comité de las Regiones. Un Marco Europeo de Estrategias Nacionales de Inclusión de los Gitanos hasta 2020. COM(2011) 173 final. Disponible en: https://eur-lex.europa.eu/legal-content/ES/TXT/?uri=celex%3A52011DC0173." ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "the Roma Population Working Group Incidence of infectious diseases and survival among the Roma population: a longitudinal cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Casals" 1 => "P. Pila" 2 => "K. Langohr" 3 => "J.-P. Millet" 4 => "J.A. Caylà" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurpub/ckq204" "Revista" => array:7 [ "tituloSerie" => "Eur J Public Health." 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Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nurses from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. Its objectives are to promote the dissemination of knowledge, promote the development of evidence in care and contribute to the integration of research in clinical practice. These objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Reviews, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes two kinds of articles: comments about original articles of special interest written by experts, and evidence synthesis articles based on bibliographic reviews. The journal is included in National Library of Medicine/Pubmed/Medline, Scopus/SCImago Journal Rank(SJR), Emerging Sources Citation Index (ESCI) (Clarivate Analytics), CINHAL, Elsevier Bibliographic Databases, EBSCO Publishing, Biblioteca Nacional de Ciencias de la Salud, CSIC/IME, IBECS, Latindex, CUIDEN, Dialnet, Google Scholar Metrics.

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Vol. 29. Issue 5.

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