Provision of culturally competent health care: an interim status review and report.

This review reports on the current nursing literature as it relates to the progress the nursing community has made in the field of transcultural nursing. This review also reports on the current status of the nursing professions' initiative to integrate multi-cultural, diversity training into its educational programs and on the degree to which nurses' report on their preparedness to provide exemplary, culturally competent care following their educational training. The literature reveals we are still only beginning to understand how nursing's educators and employers can provide critical learning environments and workplaces for students, faculty and practitioners to grasp the concepts of transcultural nursing and to evaluate the effectiveness of our actions following training. This status report provides the nursing profession with opportunities to be creative in designing cultural immersion experiences, faculty workshops, educational programs, certification programs, and qualitative and quantitative evaluation tools to measure the effectiveness of our cultural competence programs and experiences. Further opportunities include the dissemination of important concepts and findings through research, conferences, scholarly journals, nursing publications, staff development programs, and continuing education programs.

[Ethnography and fieldwork: the crisis of representation and beyond]. / Ethnografie und Forschen im Feld: diesseits und jenseits der Krise der Repräsentation.

Writing as a nursing researcher about the subjects that comprise the nursing profession means writing about oneself. Conducting ethnographic research on subjects within one's own professional culture and interacting with these subjects in the field poses a challenge. Ethnographic research analyses and opens out the horizon of one's own professional culture for the benefit of the potential reader. However, at the same time, the researcher's self within an ethnographic framework is called into question. In anthropology the researcher-subject relationship is deemed a special relationship, and in this article both authors reveal the precarious status of their research object. In this article an attempt is made to let the nursing subjects speak for themselves, while at the same time the authors write about their subjects' social practices an communication processes. To date there has hardly been any German research work within nursing dealing with this critical area of interest. The authors seek to provide an introduction to the constitutive parts of ethnography and the crisis of representation and beyond. In addition, they present two reflexive accounts.

Global health for nursing...and nursing for global health.

This article draws on the literature to present a conceptualization of global health (GH) that corresponds with the discipline of nursing and defines the contributions of nursing to GH. The author's perspective is that "health" should be defined and considered holistically to reflect the fact that GH involves more than the eradication of disease and that health as a fundamental right of every human being must be made explicit. "Global" refers to the supraterritorial links among the social determinants of health located at points anywhere on earth within a whole-world context. The focus of GH is the supraterritorial determinants and its ultimate objective is health equity for all nations and all people. The contributions of nurses are advocacy, healing and alleviating suffering through caring, and increasing nursing capacity globally. To truly advance the GH agenda, a new world order is needed, one in which political decision-making is guided by our shared humanity.

Globalisation, localisation and implications of a transforming nursing workforce in New Zealand: opportunities and challenges.

Severe staff and skill shortages within the health systems of developed countries have contributed to increased migration by health professionals. New Zealand stands out among countries in the Organisation for Economic Co-operation and Development in terms of the high level of movements in and out of the country of skilled professionals, including nurses. In New Zealand, much attention has been given to increasing the number of Maori and Pacific nurses as one mechanism for improving Maori and Pacific health. Against a backdrop of the changing characteristics of the New Zealand nursing workforce, this study demonstrates that the globalisation of the nursing workforce is increasing at a faster rate than its localisation (as measured by the growth of the Maori and New Zealand-born Pacific workforces in New Zealand). This challenges the implementation of culturally appropriate nursing programmes based on the matching of nurse and client ethnicities.

Cultural safety and its importance for Australian midwifery practice.

Cultural safety is an important concept in health care that originated in Aotearoa (New Zealand) to address Maori consumer dissatisfaction with health care. In Australia and internationally, midwives are now expected to provide culturally safe midwifery care to all women. Historically, Australia has received large numbers of immigrants from the United Kingdom, European countries and the Middle East. There have also been refugees and immigrants from South-East Asia, and most recently, from Africa. Australia continues to become more culturally diverse and yet to date no studies have explored the application of cultural safety in Australian midwifery practice. This paper explores how cultural safety has evolved from cultural awareness and cultural sensitivity. It examines the importance of cultural safety in nursing and midwifery practice. Finally, it explores the literature to determine how midwives can apply the concept of cultural safety to ensure safe and woman centred care.

Practice of breastfeeding in quilombola communities in the light of transcultural theory.

OBJECTIVES: to identify factors that interfere with the practice of exclusive breastfeeding in quilombola communities. METHODS: qualitative research based on the Transcultural Theory proposed by Madeleine Leininger, performed with quilombola mothers. For data collection, we used the semi-structured interview, conducted from June 2018 to January 2019. Content analysis was guided by the interactive model of Miles and Huberman. RESULTS: it was revealed that intergenerational cultural myths and customs interfere with breastfeeding practice, and identified the influence of professional nurses on best breastfeeding practices. FINAL CONSIDERATIONS: cultural and intergenerational factors favor early weaning and expose the child to illness.

Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care.

AIMS AND OBJECTIVES: The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. BACKGROUND: Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. DESIGN: Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. METHODS: Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. RESULTS: The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. CONCLUSIONS: This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. Relevance to clinical practice. It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

The Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model.

The goals of the Andrews/Boyle Transcultural Interprofessional Practice (TIP) model are to provide a patient- or client-centered systematic, logical, orderly, scientific process for delivering safe, culturally congruent and competent, affordable, accessible, evidence-based, and quality care for people from diverse backgrounds across the life span. Key components of the TIP model include the context from which people's health-related values, attitudes, beliefs, and practices emerge; the interprofessional health care team; effective verbal and nonverbal communication among all team members; and a five-step systematic, scientific problem-solving process-assessment, mutual goal setting, and planning, implementing, and evaluating the effectiveness of therapeutic interventions and care. The model is applicable wherever nurses practice, teach, learn, lead, consult, and conduct research domestically and globally.

Policy makers' perceptions and attitudes regarding incorporation of traditional healers into the national health care delivery system.

Based on mixed perceptions which were both negative and positive the policy makers have not been vocal about the process to incorporate traditional healers into the National Health Care Delivery System of South Africa. Negative views were related to the denial that traditional healing does provide a cure and the positive views were identified in the passing of policies from 1994. These policies passed initiated recognition of the existence of traditional healers, but failed to address the important aspect of incorporating the traditional healers into the National Health Care Delivery System. It is these mixed perceptions as well as lack of appropriate policy to facilitate incorporation of traditional healers that urged the researcher to explore the perceptions and attitudes of policy makers regarding this incorporation process, as well as their views on how it should be achieved. An exploratory, descriptive and contextual qualitative research design was followed. Participants were selected by non-probable, purposive voluntary sample. Data was collected by means of conducting semi-structured interviews, as well as taking field notes. Data analysis was achieved by analysing transcriptions through open coding involving a co-coder until consensus was achieved. Results reflect that policy makers are in favour of incorporation. In conclusion incorporation was seen as a process that needs to be undertaken by both traditional healers and biomedical personnel through communication. That government should be responsible for this process by policy formulation, which should clarify terms and conditions for incorporation.

Transcultural Nursing: Current Trends in Theoretical Works.

PURPOSE: To explore the current trends in theoretical works related to transcultural nursing through an integrated literature review. METHODS: The literature on theoretical works related to transcultural nursing during the past 10 years was searched through multiple databases and reviewed to determine themes reflecting the current trends in theoretical works related to transcultural nursing. RESULTS: Through the review and analysis process, four themes reflecting the current trends in theoretical works related to transcultural nursing were found: (a) purposes of exploring, defining and clarifying, and reflecting; (b) various theorizing methods; (c) multiple sources of theorizing; and (d) clear linkages to nursing practice and research. CONCLUSION: Continuous efforts need to be made to further develop the theoretical works related to transcultural nursing to reflect changes in this ever-changing nursing world.