Showing papers in "Journal of Transcultural Nursing in 2017"
TL;DR: To improve cultural competence in students, nursing education should provide continuous opportunities for students to interact with different cultures, develop linguistic skills, and provide possibilities for internationalization both at home and abroad.
Abstract: Purpose: Cultural competence is an essential component in nursing. The purpose of this study was to evaluate the level of cultural competence of graduating nursing students, to identify associated ...
101 citations
TL;DR: It is found that the most effective recruitment strategies reflect the common cultural values of personalismo, simpátia, confianza, respeto, and familismo.
Abstract: People from non-White racial groups and other underserved populations, including Latinos, are frequently reluctant to participate in research. Yet their participation into research is foundational to producing information that researchers and health care providers need to address health disparities. The purpose of this article is to describe challenges we have encountered along with culturally relevant strategies we used in five research studies to recruit Mexican American participants from community settings, some of whom were also of low socioeconomic status. We found that the most effective recruitment strategies reflect the common cultural values of personalismo, simpatia, confianza, respeto, and familismo.
51 citations
Middlesex University1, Metropolitan State University of Denver2, Istanbul Sabahattin Zaim University3, National and Kapodistrian University of Athens4, Bataan Peninsula State University5, Charles Sturt University6, Autonomous University of Madrid7, Western Sussex Hospitals NHS Foundation Trust8, Cyprus University of Technology9, Oslo University Hospital10, Rzeszów University11, Oslo and Akershus University College of Applied Sciences12, University of Debrecen13, Max Stern Academic College of Emek Yezreel14, Sewanee: The University of the South15
TL;DR: The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care and the impact of sociopolitical influences on perceptions of compassion and the conscious and intentional nature of compassion.
Abstract: Purpose: In recent years, there has been much focus on compassion in nursing care, and concern has been raised in a number of reports and media stories regarding decreased compassion. The aim of this study was to explore similarities and differences in the understanding and demonstration of compassion in nursing practice across 15 countries.
Design: A total of 1,323 nurses from 15 countries responded to questions in relation to compassion, via an international online survey.
Results: The data revealed the impact of sociopolitical influences on perceptions of compassion, and the conscious and intentional nature of compassion.
Discussion and Conclusion: The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care. The differences reported were not as significant as had been expected.
Implications for Practice: Further research is needed to explore the country and culture differences in the enactment of compassion.
45 citations
TL;DR: It is indicated that culturally tailored cervical cancer education is needed to promote Pap test uptake and HPV vaccination in this underserved population of young Korean immigrant women.
Abstract: This study aimed to identify major barriers to Papanicolaou (Pap) test uptake and human papillomavirus (HPV) vaccine acceptability. Three focus groups with 16 young Korean immigrant women residing in a community in the Midwest were conducted. Braun and Clarke's six phases of thematic analysis were used to develop themes. Three major themes emerged as barriers: (a) limited knowledge about cervical cancer and preventive behaviors, (b) culture-specific barriers, and (c) low accessibility to health care services. These themes were multifactorial and interrelated barriers to Pap test uptake and HPV vaccine acceptability among young Korean immigrant women. These findings indicate that culturally tailored cervical cancer education is needed to promote Pap test uptake and HPV vaccination in this underserved population.
41 citations
TL;DR: Minority patients had more adverse events, less improvement in functional outcomes, and worse patient experiences when compared with majority patients, and efforts should be made to provide culturally and linguistically appropriate care to all patients.
Abstract: Introduction: Though extensive evidence demonstrates that U.S. minority patients suffer health care disparities, the incidence of disparities among the 3.3 million adult patients receiving skilled ...
35 citations
TL;DR: By focusing more on biases and assumptions brought forth from the dominant culture, health care providers may experience less moral distress and convey increased caring in the context of intercultural interactions and nondisclosure of prognosis of a terminal illness.
Abstract: Purpose: Nondisclosure of terminal prognosis in the context of intercultural interactions can cause moral distress among health care providers guided exclusively by informed consent. However, cultu...
34 citations
TL;DR: Higher mutuality and stronger filial attitudes were significantly associated with less caregiver depression after the covariates were controlled and Mutuality and filial attitude may be protective factors against caregIVER depression.
Abstract: Purpose. Caregiving to parent stroke survivors in China is increasing and adult child–parent relationships are being challenged. The purpose of this study was to explore whether mutuality and filia...
34 citations
TL;DR: The personal journey of reflective development that a non-Aboriginal White researcher and health professional underwent to be “fully positioned” in the everyday lives of a rural Australian Aboriginal community in Western Australia is highlighted.
Abstract: This article highlights the personal journey of reflective development that a non-Aboriginal White researcher and health professional underwent to be "fully positioned" in the everyday lives of a rural Australian Aboriginal community in Western Australia. The article explains the researcher's personal development in areas important to building respect, building relationships, and ensuring reciprocity while undertaking Aboriginal research. The researcher reports on the reflective evaluation of her worldview. Understanding that judgment is a natural tendency, the researcher used reflexivity as a tool to examine and contextualize her judgments, presumptions, and preconceptions, which positioned her to be open to differing viewpoints and actively explore alternate perspectives. The researcher explores her evolutionary understanding that cultural competence is not a destination but a continual journey, and she details her knowledge development regarding the Aboriginal research paradigm, which requires that all the learning, sharing, and growth taking place is reciprocal and engages all parties actively.
32 citations
TL;DR: Results exemplify the need to improve culturally competent work environments and mentoring programs and suggest that better communication and proper respect from students, colleagues, and administrators are necessary.
Abstract: Purpose: This study explored the experiences of Black nurse faculty employed in predominantly White schools of nursing. High attrition rates of this group were noted in previous literature. Understanding their experiences is important to increase nurse diversity. Design: Hermeneutic phenomenology was used to explore the experiences of 15 Black nurse faculty using interviews. Findings: Four themes were extracted as the following: cultural norms of the workplace, coping with improper assets, life as a “Lone Ranger,” and surviving the workplace environment. Discussion: The study provided insight to understand the meaning that Black faculty members give to their experiences working in predominantly White schools of nursing. Findings exemplify the need to improve culturally competent work environments and mentoring programs. Implications for Practice: Results suggest that better communication and proper respect from students, colleagues, and administrators are necessary. The limited research on this topic illu...
31 citations
TL;DR: Examination of prevalence, nutrition and activity, and overweight and obesity prevention and management in Saudi Arabia found the eastern region had the highest prevalence of overweight and Obesity.
Abstract: Purpose: To examine prevalence, nutrition and activity, and overweight and obesity prevention and management in Saudi Arabia. Design: Using the Preferred Reporting Items for Systematic Reviews and ...
27 citations
TL;DR: The majority of selected health associations in Canada include cultural safety within position statements or organizational policies; however, comparable U.S. organizations focused on cultural sensitivity and cultural competence are not included.
Abstract: Purpose: This article examines the concept and use of the term cultural safety in Canada and the United States. Design: To examine the uptake of cultural awareness, cultural sensitivity, cultural c...
TL;DR: The study demonstrated that symptom reporting and identification of symptom clusters might be influenced by cultural factors.
Abstract: An understanding of symptoms in heart failure (HF) among different cultural groups has become increasingly important The purpose of this study was to compare symptom reporting and symptom clusters in HF patients between a Western (the United States) and an Eastern Asian sample (China and Taiwan) A secondary analysis of a cross-sectional observational study was conducted The data were obtained from a matched HF patient sample from the United States and China/Taiwan ( N = 240 in each) Eight selective items related to HF symptoms from the Minnesota Living with Heart Failure Questionnaire were analyzed Compared with the US sample, HF patients from China/Taiwan reported a lower level of symptom distress Analysis of two different regional groups did not result in the same number of clusters using latent class approach: the United States (four classes) and China/Taiwan (three classes) The study demonstrated that symptom reporting and identification of symptom clusters might be influenced by cultural factors
TL;DR: Diabetes education for the Chinese may be enhanced by building on traditional Confucian education strategies, which did not translate well culturally and did not appear to meet Chinese patients’ needs.
Abstract: Purpose: To explore the range of teaching approaches and cultural-tailoring elements used in diabetes educations directed at Chinese patients and to determine the strategies that appeared to best a...
TL;DR: Two universal themes of were found of respect and faith in God and family that influenced parental care, along with differences in feelings of isolation and dependence on supports were found among single- and two-parent families.
Abstract: Purpose: Parents are the most significant contributor to care of children with autism spectrum disorder (ASD), and as such research on African American parenting in ASD is conspicuously absent. Findings relevant to parenting are discussed from a study with urban African American families caring for children with ASD. Design: An ethnonursing study was conducted with 24 African American family members of children with ASD and 28 professionals. Data were analyzed and reported as themes. Findings: Two universal themes of were found of respect and faith in God and family that influenced parental care. Two diverse themes of mother’s watchful care and father’s protective care, along with differences in feelings of isolation and dependence on supports were found among single- and two-parent families. Discussion and Practice Implications: When health care professionals increase their knowledge and understanding of cultural practices in the parental care of children with ASD, they provide health care that is cultur...
TL;DR: A significant gain from pre- to postmeasure in students’ overall transcultural self-efficacy was demonstrated and may be influenced by formal education and learning experiences of DNP students.
Abstract: Purpose: The Doctor of Nursing Practice (DNP) degree is the most advanced clinical leadership role in nursing. Curricula prepare these students to design, implement, evaluate, and continuously impr...
TL;DR: Interventions addressing the barriers peculiar to this population may alleviate these barriers and improve Pap screening use in this population.
Abstract: Purpose: Papanicolau (Pap) screenings disparities exist for immigrant women in the United States. This study sought to have an understanding of factors influencing Pap screening among sub-Saharan African immigrant women. Method: This is a qualitative descriptive study. Women were recruited from the community and by word of mouth following institutional review board approval. Data were gathered through in-depth focus group and demographic questionnaires. Interview sessions were digitally recorded and transcribed verbatim. Transcripts were analyzed for themes. Findings: Twenty-two women aged 24 to 65 years were interviewed. Barriers to screening included low knowledge of screening, cost, cultural beliefs, fear and communication issues. Motivators to improve Pap use include provider’s recommendations, enlightenment, and family support. Discussion: Interventions addressing the barriers peculiar to this population may alleviate these barriers and improve Pap screening use in this population. Providers have the...
TL;DR: A large-effect size was observed in reducing maternal body mass index, waist circumference, and improving maternal eating style and self-efficacy for promoting healthy eating in short-term maternal behaviors changes related to diet and exercise.
Abstract: Introduction: Nearly a quarter of preschool-aged Chinese American children are overweight or obese. Children of overweight mothers are at higher risk for obesity. Efforts to prevent obesity among l...
TL;DR: Assessing the impact of a home health care (HHC) pilot project on meeting the needs of older adult refugee patients indicated that HHC has great potential to improve the health of vulnerable refugee populations and assist the families involved in their care.
Abstract: The United States resettles close to 70,000 refugees each year more than any other country in the world. Adult refugees are at risk for negative health outcomes and inefficient health resource use, and meeting the multiple health needs of this vulnerable population is a challenge. The purpose of this study was to assess the impact of a home health care (HHC) pilot project on meeting the needs of older adult refugee patients. A retrospective chart review of 40 refugee adult patients who participated in an HHC pilot was done to analyze their health outcomes using OASIS-C data. Participants' pain level, anxiety level, medication management, and activities of daily living management all significantly improved over the course of their HHC episode. Results of this study indicate that HHC has great potential to improve the health of vulnerable refugee populations and assist the families involved in their care.
TL;DR: Female gender, the presence of anemia, and low levels of physical activity were associated with poor sleep quality, and better understanding of risk factors associated withpoor sleep quality may contribute to more effective interventions to improve health and well-being.
Abstract: Purpose: The purpose of this study was to evaluate sleep quality and to explore its associations with participant characteristics, anemia, excessive daytime sleepiness, and physical activity in older Turkish adults with hypertension. Method: This cross-sectional study included 128 adults aged 60 years or older with hypertension. Data were collected by using a personal information form, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the International Physical Activity Questionnaire. Anemia was assessed by hemoglobin levels. Results: Eighty-one patients (63.3%) reported poor sleep quality. Anemia was present in 35.2% of the patients (defined as hemoglobin <13 g/dL for males and <12 g/dL for females). Female gender, the presence of anemia, and low levels of physical activity were associated with poor sleep quality. Conclusion/Implication: The majority of the participants had poor sleep quality. Better understanding of risk factors associated with poor sleep quality may contribute to mo...
TL;DR: KARNs who were aged ≥50, married, hospital-employed, had longer nursing experience, and experienced turnover at least once were more likely to report higher job satisfaction compared with other nurses, and organizational commitment, culture, marital status, and workplace were significant predictors of and explained 76.8% of the variance in job satisfaction.
Abstract: Purpose: This study aimed to describe the perceived level of organizational commitment and organizational culture of Korean American Registered Nurses (KARNs) and to investigate predictors of job s...
TL;DR: Hispanic women are less physically active and have higher rates of type 2 diabetes (DM2) when compared with other population groups, and DM2 programs should place a greater emphasis on PA intervention strategies.
Abstract: Hispanic women are less physically active and have higher rates of type 2 diabetes (DM2) when compared with other population groups This review uses the social ecological model as a framework to identify the individual and social environmental factors associated with successful physical activity (PA) interventions for Hispanic women with DM2 Research questions include (a) Which social ecological levels have been applied to PA interventions? (b) Which individual and social environmental intervention strategies are associated with successful PA outcomes? Database searches using CINAHL, PubMed, and Scopus for the years 2000 to 2015 identified 10 studies; with 6 using quasi-experimental study designs and 4 using randomized controlled designs Inclusion criteria were Hispanic/Latina women with DM2, ≥70% women, PA interventions, measures of PA, and quantitative designs Future research should focus on a combination of intervention levels, and DM2 programs should place a greater emphasis on PA intervention strategies
TL;DR: Use of the cultural distress model to guide research offers an innovative framework by which researchers may identify potential interventions such that patients never reach a level of cultural distress.
Abstract: Although cultural competence in practice is a common goal within the health care professions, little is known about the consequences of a lack of such competence in health and healing. We propose a novel theoretical framework of cultural distress to describe patient experiences of and reactions to care that does not incorporate attention to cultural needs. Use of the cultural distress model to guide research offers an innovative framework by which researchers may identify potential interventions such that patients never reach a level of cultural distress.
TL;DR: Results showed that text messaging was a feasible and acceptable strategy to promote PA in overweight and obese AA women in a university setting.
Abstract: The purpose of this study was to develop a participant-informed technology-based physical activity (PA) promotion tool for young overweight and obese African American (AA) women. A mixed-method 3-phase study protocol design was used to develop text messages to promote PA in AA women attending the University of Alabama at Birmingham during the Spring of 2013. Nominal focus groups and a 2-week pilot were used to generate and test participant-developed messages. Participants ( n = 14) had a mean age of 19.79 years ( SD = 1.4) and mean body mass index of 35.9 ( SD = 5.926). Focus group data identified key themes associated with the use of text messages to promote PA including message frequency, length, tone, and time of day. Participants preferred text messages that were brief, specific, and time sensitive. Results showed that text messaging was a feasible and acceptable strategy to promote PA in overweight and obese AA women in a university setting.
TL;DR: Data support the feasibility of adapting an established health-enhancing approach for promoting self-management of T2D to a low health literacy Spanish-speaking population.
Abstract: Purpose: This study assessed the feasibility of adapting a patient-centered educational intervention for type 2 diabetes (T2D) self-management for a Hispanic population with low health literacy skills. Design: A descriptive qualitative study design and phenomenological analyses were used. Nine Hispanic adults with T2D recruited from a rural community health center participated in an educational program that instructed on low glycemic food choices, meaningful glucose self-monitoring, and physical activity to decrease blood glucose spikes. Participants’ feedback was recorded during four 2-hour focus group sessions. Findings/Results: Participants’ feedback clustered around four themes: information and knowledge, motivation and barriers to change, experiences with new behaviors, and personal responsibility. Discussion/Conclusions: Data support the feasibility of adapting an established health-enhancing approach for promoting self-management of T2D to a low health literacy Spanish-speaking population. Implicat...
TL;DR: Commonalities are presented from the experiences of U.S. nurse researchers who conducted studies in India, Jordan, Aotearoa/New Zealand, and Trinidad and Tobago, and recommendations are offered to support investigators planning research in a culture that is not their own.
Abstract: Commonalities are presented from the experiences of U.S. nurse researchers who conducted studies in India, Jordan, Aotearoa/New Zealand, and Trinidad and Tobago. While planning research, it is important to engage collaborators who are members of the culture to be studied to understand what are culturally appropriate aims and methods. It is also vital to observe cultural etiquette, especially while gaining entree and collecting data. Issues related to data collection include timing it around local holidays and events, and adapting individualist methods for obtaining consent and data to be more respectful for those in a collectivist culture. Care must be taken to give back, to sharing findings, and insure sustainability for future research in the host culture. Based on these and other reflections, recommendations are offered to support investigators planning research in a culture that is not their own.
TL;DR: Having mentors, knowing family histories, and connecting with healthy Aboriginal communities fostered positive First Nation identities for participants and there is potential to advance nursing practice by enacting creative means that may support client’s positive First Nations identity and well-being.
Abstract: Purpose: Dominant discourse contains negative stereotypical images of First Nations males that are steeped in colonialism. These racialized images can influence First Nations men’s sense of self as well as the care that nurses deliver. The objective was to (a) explore practices that support positive First Nations identity and (b) provide suggestions for practicing culturally safe care. Design: The theory of Two-Eyed Seeing guided this study. Data were collected via two semistructured interviews and Anishnaabe Symbol–Based Reflection from three First Nations men living in Toronto, Canada. Findings: Having mentors, knowing family histories, and connecting with healthy Aboriginal communities fostered positive First Nations identities for participants. Implications: There is potential to advance nursing practice by enacting creative means that may support client’s positive First Nations identity and well-being. Nursing education that focuses on strength-based and decolonizing frameworks, as well as reflexive ...
TL;DR: The reasons 88 Latinas with breast cancer selected specific supportive others to participate in an 8-week psychosocial intervention were described to provide support for including the supportive person identified by the patient during a health crisis rather than the provider suggesting who that should be.
Abstract: The purpose of this study is to describe the reasons 88 Latinas with breast cancer selected specific supportive others to participate in an 8-week psychosocial intervention. Participants were asked one open-ended question during the baseline assessment for a larger clinical trial: "Could you tell me more about why you selected [insert name] to participate in the study with you?" A content analysis of the responses found three thematic categories: source of informational or emotional support, concern for the informal caregiver's welfare, and special characteristics or qualities of the informal caregiver. These findings reflected both the cultural value of familism, the woman's role as caregiver to the family ( marianismo), and the man's role of provider ( machismo). Findings provide support for including the supportive person identified by the patient during a health crisis rather than the provider suggesting who that should be. Psychosocial services designed and implemented through such a cultural lens are more likely to be successful.
TL;DR: The Giger and Davidhizar transcultural assessment model is utilized to explore veteran culture and self-stigma and the impact of self-Stigma.
Abstract: Self-stigma is a salient concept in mental health care. Consequences of self-stigma include increased morbidity and decreased engagement with the health care system. Cultural factors may affect self-stigma and its consequences. This article utilizes the Giger and Davidhizar transcultural assessment model to explore veteran culture and self-stigma. Veterans have their own cultural values that can affect nursing care. Operation Iraqi Freedom and Operation Enduring Freedom veterans are seeking care in community settings more often than within the VA system; therefore, all nurses should be aware of the cultural needs of veterans including the impact of self-stigma.
TL;DR: This article focuses on methodological issues related to conducting ethnographic research among the author's own people, including examining the issues of anthropological reflexivity as a native ethnographer and highlighting the author’s experiences embodying multiple identities.
Abstract: There are benefits and challenges associated with conducting research in a familiar setting, especially when the researcher is more an insider than an outsider. The aim of this article is to explore the author's experience as a native scholar conducting ethnographic research among the Swahili peoples of Lamu, Kenya. This article focuses on methodological issues related to conducting ethnographic research among the author's own people, including examining the issues of anthropological reflexivity as a native ethnographer and highlighting the author's experiences embodying multiple identities. Native ethnographers must consider the challenges associated with negotiating multiple roles in the research setting, especially in the presence of sociocultural factors such as gender stratification, complex kinship networks, socioeconomic hierarchies, illiteracy, and poverty. Embracing rather than being confused by the multiple levels of understanding native researchers bring to studies of their communities opens up new avenues of research and possibilities.
TL;DR: Results suggest that educating family units on the dietary management of diabetes may be more effective than individual education and that educating women being responsible for preparing food, while men typically manage money for purchasing food yet do not provide input on what food is purchased.
Abstract: The purpose of this study was to identify cultural enablers and barriers to dietary management of type 2 diabetes in M’Bour, Senegal. This qualitative study used the PEN-3 cultural model to explore diabetes dietary management within a cultural framework. Content analysis identified emergent themes based on the PEN-3 model. Forty-one individuals completed interviews. Themes reflecting ways that culture affects adherence to the diabetic diet included (a) having a different diet or eating separately from the communal family plate creates feelings of social isolation; (b) forgoing the diabetic diet sometimes occurs so that family members have enough food; (c) reducing servings of traditional foods feels like abandoning culture; and (d) women being responsible for preparing food, while men typically manage money for purchasing food yet do not provide input on what food is purchased. Results suggest that educating family units on the dietary management of diabetes may be more effective than individual education.