Contact and Attitudes in Nursing Students: Immigrants and Cultural Intelligence

Migration is a population movement in which people relocate individually or collectively, regardless of the cause, structure, or duration. These movements can be voluntary or forced, driven by natural disasters, armed conflicts, or political and economic reasons. According to the Glossary of Migration Terms, a migrant is someone who moves to a different country or region to improve the material and social conditions of themselves and their family, and to enhance their life expectations, without being influenced by coercive external factors.

The Syrian Civil War led to the migration of more than five million Syrians to Turkey, Lebanon, Jordan, and other countries. In Turkey alone, there are 3.6 million Syrian migrants. This influx has highlighted the need to develop migration and migrant health policies for Syrian migrants in the country. Although Syrian migrants have been in Turkey for an extended period, they face significant challenges, particularly due to the language barrier, which hinders their ability to express themselves and communicate effectively. While some communication is possible in border provinces where there are shared cultural and linguistic characteristics, difficulties increase as migrants move towards the western regions of the country.

Migrants in Turkey face challenges in various areas, including accommodation, education, employment, and access to health services, in addition to language barriers. To address these issues, Migrant Health Centres (MHCs) were established as part of the SIHHAT project. The Ministry of Health has been setting up MHCs across the country since 2015. These centers provide free primary healthcare services to unregistered migrants without temporary protection identity documents and non-Syrian migrants. MHCs are designed to offer primary health care services to migrants under temporary protection in Turkey, with one unit serving every 4,000 people, in line with the standards of family medicine in the country. By employing Turkish and Syrian healthcare personnel and Arabic- and Turkish-speaking patient guidance personnel, these centers aim to overcome the challenges posed by language and cultural barriers and deliver effective healthcare services.

In Turkey, the formation of multicultural societies due to migration, driven initially by war and later by economic, political, and sociological factors, has impacted the provision of services, including healthcare. This has underscored the importance of intercultural sensitivity. Intercultural care plays a crucial role in nursing. Nursing philosophy emphasizes the necessity of providing individual-centered care to all ethnic groups in a globalizing world. Leininger's Cultural Care Theory highlights the importance of nurses developing their knowledge and skills related to cultural differences and being aware of their patients\' values, beliefs, and lifestyles. Nursing practices involve providing holistic care to patients, which requires cultural competence and consideration of cultural differences. Nurses develop intercultural sensitivity when they acknowledge that the individuals they care for are culturally different from themselves and when they respect and appreciate these cultural characteristics.

Although providing individual-centered intercultural care is a nurse's responsibility, there are instances where nurses may exhibit ethnocentric attitudes due to a lack of knowledge, understanding, awareness, education, cultural competence, or beliefs about culture. Ethnocentrism, defined as the belief in the superiority of one's own culture and the tendency to judge other cultures by one's own cultural values, can lead to patient alienation, inadequate treatment, misdiagnosis, and culturally inappropriate healthcare services. However, a culturally sensitive approach can improve the quality of care, increase patient satisfaction, enhance health outcomes, and reduce stress and burnout. In this context, acquiring intercultural sensitivity also implies a reduction in ethnocentrism. Nurses, as healthcare professionals, are responsible for providing care to individuals with diverse cultural backgrounds. Therefore, it is essential to assess the levels of intercultural sensitivity and ethnocentrism during their training period to enhance the cultural competence of future nurses. It is believed that the levels of cultural sensitivity and ethnocentrism among nursing students working with migrants in MHCs are shaped through direct contact and interaction with migrant individuals during their practical training.