Literature Collection

INTRODUCTION: Purnell's Model for Cultural Competence outlines that cultural competence is essential for bridging the gap between health care providers and patients from diverse cultural backgrounds.' METHODOLOGY: This study followed PRISMA-ScR guidelines, focusing on studies involving nurses, nursing students, and educators using Purnell's Model. Literature was searched across six databases up to July 2024. RESULTS: From 834 records, 20 studies met the inclusion criteria. The primary themes identified were "Cultural competence in health care" and "Nursing interventions and patient relationships." Subtopics included Cultural health care practices, Patient-centric nursing, holistic and culturally sensitive care, and integrated care and education. These subtopics provide a nuanced understanding of cultural competence application across various settings. DISCUSSION: Findings highlight the importance of integrating cultural competence training to reduce health care disparities, improve patient-provider communication, and enhance the efficacy of nursing interventions in diverse populations. Incorporating these aspects into education and practice is crucial for achieving cultural competence in nursing.

Digital cognitive behavioural therapy for insomnia has been developed to increase capacity and scalability for patients with insomnia, but implementation in primary care remains limited. The aim of the trial was to evaluate the implementation of digital insomnia therapy into primary care practice for patients with insomnia. We conducted a single-arm feasibility trial of digital behavioural therapy for insomnia (SleepFix) providing sleep restriction therapy with insomnia patients in primary care. Healthcare professionals (comprising General Practitioners, community pharmacists and nurses) were enrolled into the trial and, when deemed clinically appropriate, prescribed SleepFix to patients with insomnia. The primary outcome was uptake assessed by the number of downloads of SleepFix. Interviews with primary care healthcare professionals explored their attitudes towards implementing/using insomnia digital therapeutics in clinical practice, and patients about their experiences with SleepFix. Insomnia symptoms, mood and sleep quality were measured before and after the trial. This trial was prospectively registered (ACTRN12620000055909). Thirty healthcare professionals and 105 patients were enrolled into the trial. Fourteen healthcare professionals administered at least one insomnia digital therapeutic prescription between November 2021 and March 2022. Fifty patients downloaded and used SleepFix (47.6% uptake). In post-trial interviews, healthcare professionals felt they could incorporate digital sleep health into clinical practice and patients found SleepFix acceptable. There were significant improvements in insomnia symptoms, mood and sleep quality at week 6 (all p < 0.05). This trial shows a real-world implementation of a digital insomnia therapy into primary care that could provide a framework for prescribing digital sleep interventions.