Family change theory: A preliminary evaluation on the basis of recent cross-cultural studies

Family change theory (Kagitcibasi, 1996, 2007) is an approach which can be used to explain how modernisation and globalisation processes affect the family. The most important assumption of the theory is that when traditional interdependent cultures modernise, they need not necessarily develop in the direction of the independent family model typical of Western individualistic societies. Instead, they may develop towards a family model of emotional interdependence that combines continuing emotional interdependencies in the family with declining material interdependencies and with rising personal autonomy. In this chapter a preliminary evaluation of the empirical status of family change theory is given based on a review of recent cross-cultural studies. It will be shown to what extent the few studies that have been systematically conducted in this respect have found results either supporting or not supporting aspects ofthe theory, and where the strengths and problems of this research lie.

A cross-cultural examination of social and sexual behaviour in High Functioning Autism and Down Syndrome

The focus of this research was to obtain an understanding of the social and sexual behaviour of adolescents with High Functioning Autism (HFA) or Down Syndrome (DS) in comparison to Typically Developing (TD) adolescents across cultures. The findings highlight the importance of cross-cultural research and indicate the need for sex education. The portfolio presents four case studies which support the proposition that insecure attachment is only likely to lead to depression in the presence of socially-related and other psychological difficulties, since not all insecurely attached children develop depressive symptoms.

Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants : Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies

This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms “cross cultural comparison” and “menopause.” Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction.

Exploring the concept of learner autonomy in cross-cultural research

This research explores how the concept of learner autonomy is understood and used in Vietnamese higher educational settings. Data were collected through interviews in Vietnamese with four university lecturers in Hanoi, Vietnam and then reported in an English language thesis. The problems confronted by the lecturers were in understanding the concept of learner autonomy, the complexities of translation equivalence for the concept from one language to another, and the impact of culture in interpreting the concept of learner autonomy. The paper concludes with recommendations for educators to be sensitive to cultural and linguistic considerations when transferring concepts from one culture to another.

Critical ethnography of the cross-cultural adaptation of HRQoL instruments

The thesis examines current approaches to the adaptation of health-related quality of life (HRQoL) instruments for cross-cultural research. The major conclusion is that nearly all existing HRQoL adaptation is based on simplistic processes that ignore relevant underlying disciplines including cognitive psychology, sociolinguistics, cultural anthropology, translation theory and survey research.

Communities constructing knowledge

The research consisted of narrative writing and reflective practice to promote the construction of new understandings between the Indigenous and non-Indigenous peoples of Australia. The research findings propose exemplars of knowledge and practice and approaches to learning that are community centred, immersed in social practices and which include systematic narrative formation.

Cross cultural perspectives of teachers : a study in three countries

In a shrinking world where globalization has blurred the boundaries across nation states and cultural divides, limitations on intercultural communication can readily give rise to glib generalizations and lack of understanding of diversity. Acknowledging the key role of teachers in shaping the views of future generations, this paper reports on the first stage of a research study on the intercultural understanding of teachers in Australia, Japan, and Thailand. Overall, the teacher participants had diverse cross-cultural experience, differing both in extent and nature of the contact. The methodology used a common survey instrument, except for its language of presentation. However, instead of using a traditional comparative approach to contrast responses of the three target groups, the study asked teachers to provide their perceptions of prevailing world views of people in their own AND the other two countries. The reciprocal nature of the observations provides a powerful methodology to explore perceived intercultural similarities and differences. The article also considers problems associated with response set in investigations of this kind. Three scales are considered — change through intervention, symbolic inner self, and independent thought and action — and the data reveal some similarities but also some striking differences in perceptions across countries. The differences signal a lack of intercultural understanding which is being explored further in a second, qualitative stage of the research. The findings indicate the need for increasing shared programs, exchanges and other opportunities for reciprocal relations that foster genuine dialogue, partnership and intercultural understanding between countries.

Cross-cultural learning and international collaboration: evaluation of a study tour to Thailand

Purpose:
To evaluate cross-cultural learning among Thai staff and host students from the Faculty of Nursing, Mahidol University (MU) and Australian guest students from the School of Nursing and Midwifery, Deakin University (DU), who participated in a study tour.

Design:
Descriptive exploratory evaluation.

Methods:
Key stakeholders were invited to participate resulting in a convenience sample of seven MU staff, five MU and 22 DU students. Data were collected using mixed methods. Qualitative data were theme analysed and quantitative data were analysed using descriptive statistics.

Main findings:
The semi-structured interviews with MU staff, focus group with MU students and free response questions in the online survey with DU students indicated the themes of enhanced and valuable cross-cultural learning and relationship building, the challenges of different social behaviours and the importance of tolerance and acceptance. In the online survey, over 77% (n = 17) of DU students reported high satisfaction with their cross-cultural learning on the study tour. The online survey included the validated Miville-Guzman Universality-Diversity scale short form (M-GUD-S). All Australian students reported seeking diversity of contact (X ± SD = 23.1 ± 4.4), relativistic appreciation (X ± SD = 24.7 ± 3.9), and comfort with differences (X ± SD = 26.2 ± 3.0), indicating high levels of openness to cultural diversity and similarity on the M-GUD-S. 

Conclusion and recommendations:
This study provides an example of an evaluated study tour emphasising cross-cultural relationship building. Findings indicate that nursing education should include opportunities for intercultural exchange among nursing students. Nurses require excellent skills in cross-cultural nursing and relating to meet the future global challenges to health care over the next millennium.

Development and evaluation of a teaching and learning approach in cross-cultural care and antidiscrimination in university nursing students

Background:
Cross-cultural care and antidiscrimination are vital to ethical effective health systems. Nurses require quality educational preparation in cross-cultural care and antidiscrimination. Limited evidence-based research is available to guide teachers.

Objectives:
To develop, implement and evaluate an evidence-based teaching and learning approach in cross-cultural care and antidiscrimination for undergraduate nursing students.

Design:
A quantitative design using pre- and post-survey measures was used to evaluate the teaching and learning approach.

Settings:
The Bachelor of Nursing program in an Australian university.

Participants:
Academics and second year undergraduate nursing students.

Methods:
A literature review and consultation with academics informed the development of the teaching and learning approach. Thirty-three students completed a survey at pre-measures and following participation in the teaching and learning approach at post-measures about their confidence to practice cross-cultural nursing (Transcultural Self-efficacy Tool) and about their discriminatory attitudes (Quick Discrimination Index).

Results:
The literature review found that educational approaches that solely focus on culture might not be sufficient in addressing discrimination and racism. During consultation, academics emphasised the importance of situating cross-cultural nursing and antidiscrimination as social determinants of health. Therefore, cross-cultural nursing was contextualised within primary health care and emphasised care for culturally diverse communities. Survey findings supported the effectiveness of this strategy in promoting students' confidence regarding knowledge about cross-cultural nursing. There was no reported change in discriminatory attitudes. The teaching and learning approach was modified to include stronger experiential learning and role playing.

Conclusions:
Nursing education should emphasise cross-cultural nursing and antidiscrimination. The study describes an evaluated teaching and learning approach and demonstrates how evaluation research can be used to develop cross-cultural nursing education interventions.

Methods used in cross-cultural comparisons of psychological symptoms and their determinants

This paper is the second in a series of reviews of cross-cultural studies of menopausal symptoms. The goal of this review is to compare and contrast methods which have been previously utilized in Cross-Cultural Midlife Women's Health Studies with a view to (1) identifying the challenges in measurement across cultures in psychological symptoms and (2) suggesting a set of unified questions and tools that can be used in future research in this area. This review also aims to examine the determinants of psychological symptoms and how those determinants were measured. The review included eight studies that explicitly compared symptoms in different countries or different ethnic groups in the same country and included: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and the Women's International Study of Health and Sexuality (WISHeS). This review concludes that mental morbidity does affect vasomotor symptom prevalence across cultures and therefore should be measured. Based on the review of these eight studies it is recommended that the following items be included when measuring psychological symptoms across cultures, feeling tense or nervous, sleeping difficulty, difficulty in concentrating, depressed and irritability along with the CES-D Scale, and the Perceived Stress Scale. The measurement of these symptoms will provide an evidence based approach when forming any future menopause symptom list and allow for comparisons across studies.

Methods used in cross-cultural comparisons of sexual symptoms and their determinants

This is the fourth in a series of reviews of cross-cultural studies of menopausal symptoms. The purpose of this review is to examine methods used in cross-cultural comparisons of sexual symptoms among women at midlife, and to examine the determinants of sexual symptoms and how those determinants were measured. The goal of this review is to make recommendations that will improve cross-cultural comparisons in the future. The review included nine studies that explicitly examined symptoms in different countries or different ethnic groups in the same country and included: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). Although methods used for assessing sexual symptoms across cultures differed between studies, statistically significant differences were reported. Cross-cultural differences in sexual symptoms exist, and should be measured by including the following symptoms: loss of interest in sex, vaginal dryness, and the Females Sexual Function Index which covers desire, arousal, lubrication, orgasm, satisfaction, and pain on intercourse. The measurement of these symptoms will provide an evidence-based approach when forming any future menopause symptom list and allow for comparisons across studies.