Transcultural Adaptation of Tibetan Nursing Trainees: A Case Study of "9+3" Vocational Technical Students in Sichuan Province, China.

BACKGROUND Nursing education is an important part of the "9+3" vocational education program led by Sichuan Province. In the internship stage, nursing students of Tibetan ethnicity may have problems of intercultural adaptation in the process of getting along with patients, which may affect the effective nursing outcome. The purpose of this study was to clarify the current situation of transcultural adaptation of Tibetan trainee nurses and to provide more theoretical support and guidance. MATERIAL AND METHODS We collected 237 valid survey questionnaires, based on Ward's acculturation process model, from a total of 363 Tibetan trainee nurses in the "9+3" free vocational education program in Chengdu, Luzhou, and Nanchong of Sichuan Province. The SPSSAU project (2020), an online application software retrieved from https://www.spssau.com, was used for data coding and archiving. RESULTS The results of questionnaire and data analysis showed that the overall level of transcultural adaptation of Tibetan trainee nurses was that the number of people with poor adaptation was slightly higher than those with good adaptation, and most Tibetan trainee nurses were in the middle level. Meanwhile, sociocultural adaptation was better than psychological adaptation. There were no statistically significant differences among the 4 grouping variables: gender, student home region, the city where the internship hospital was located, and whether they were from a single-child family or not. CONCLUSIONS The results revealed that there was still transcultural maladjustment among Tibetan nurses in the internship stage, and the psychological maladjustment was more obvious than the sociocultural maladjustment. We provide countermeasures and suggestions to solve the problems of transcultural adaptation reflected in the research.

The transcultural adaptation and the validity and reliability of the Turkish Version of Perroca's Patient Classification Instrument.

AIM: This study examines the transcultural adaptation and the reliability and validity of the Turkish version of Perroca's Patient Classification Instrument. BACKGROUND: Nurse managers need valid and reliable patient classification tools for determining patients' acuity or dependency levels on nursing care for measuring nursing workloads. METHODS: This study was conducted in two stages in a private hospital in Istanbul, Turkey. First, the instrument was translated, and its content validation was analysed. In the second stage, data were gathered from 300 hospitalized patients and were analysed by factor analyses, Cronbach's alpha and Cohen's kappa. RESULTS: Validity testing with ten experts revealed a scale-content validity index of 0.93. Exploratory factor analysis revealed a two-dimensional instrument with distinct factor loadings and a variance of 66.97%. The confirmatory factor analysis revealed that the fit indices were satisfactory. This instrument had an overall Cronbach's alpha coefficient of .86 and Cohen's kappa coefficient of .826. CONCLUSION: The study provides evidence that the Turkish version of Perroca's Patient Classification Instrument is a valid and reliable tool to determine patients' acuity levels on nursing care. IMPLICATIONS FOR NURSING MANAGEMENT: This instrument may be used by nurse managers to determine acuity levels of patients and measure nursing workload.

Diversity, Inclusion, and Storying: Connecting Across Cultures to Give Meaning to Patients' Whole Health.

Transcultural nursing inspires us for humanness. The breadth of a culture is handed down through stories. Storytelling creates understanding and mutuality within a culture and between cultures. Deeper understanding can lead to better patient outcomes across variances in health, wellness, and social standing. The intentional use of storying by six nurses in a project called Story Care led to more appreciative understanding of the other's culture and raised awareness of self in interaction with another. The nurses, patients, and their families had deliberate opportunities to learn more about another who was culturally different, to understand how historical perspectives influence the dynamics of interactions, and to explore a sense of commonality and mutuality in nurse-patient engagements. As we strive for cultural intelligence, diversity, and inclusion in our organizations, transcultural nursing helps nurses connect to and be mindful of cultural ways in which we understand a patient's or population's vulnerability, determination, spirit, and strengths that give meaning to their whole health.

Cervical cancer prevention among quilombola women in the light of Leininger's theory. / Prevenção do câncer do colo uterino de quilombolas à luz da teoria de Leininger.

OBJECTIVE Our purpose was to discuss practices of cervical cancer prevention among Quilombola Women. METHOD This study used, in 2014, a qualitative research approach aiming twenty women from a quilombola community (people who live in quilombos, descendants of Afro-Brazilian slaves), which is located in Bahia. A semi-structured interview was developed by researchers in order to collect data. The Ethno-nursing Research method was used to analyze the data. RESULTS The use of cultural care through medicinal plants, and the nursing professional care (Pap Smear exam procedure) were stated by Quilombola women as serving as prevention practices against cervical cancer. However, most women stated that they did not use any prevention practices. CONCLUSION Social, cultural and health access issues are practices that are linked to the cervical cancer prevention among Quilombola Women. Therefore, it is indispensable to create an appropriate care plan for Quilombola women's reality.

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

Transcultural nursing strategies for carers of people with dementia.

Caring for a family member with dementia is stressful, and carers from all backgrounds often feel overwhelmed and under-supported. Professional and family carers' perceptions of the challenges and satisfactions of caring are influenced by culturally derived expectations. However, experiences of caring often differ from stereotypical norms. Experiences of carer stress and beliefs about the nature and extent of support that can be expected from social networks and statutory services may differ between cultural groups in the UK, but sensitive advice, information, and emotional and practical support are universally required. Transcultural comparisons reveal similarities between carers' needs and enable identification of values-based culturally congruent recommendations that nurses can use to promote black and Asian minority ethnic carers' confidence and wellbeing. This article, based on practice experience and a literature review, explores the effect of caring among different cultural groups and offers recommendations for culturally congruent interventions to support carers. It provides evidence-based guidance to enable nurses to meet their responsibilities for transcultural working, as laid out in the Care Act 2014. A scenario illustrates recommendations for practice.

[Towards a transcultural approach to eating disorders]. / Pour une approche transculturelle des troubles du comportement alimentaire.

Anorexia must not be considered as a syndrome specific to a culture but as being linked to fast-moving sociocultural changes. Its occurrence can be favoured by certain transcultural phenomena, such as globalisation and the process of acculturation. The analysis of a clinical case of a young migrant with anorexia illustrates the complexity and need for complementary transcultural psychotherapy, to improve understanding and the future.

Supporting women after genital mutilation.

Female genital mutilation is a common practice in many cultures, and has a range of complications. Many women in the UK have undergone the procedure and many girls are at risk. This article discusses the types of FGM and its complications, and explains how nurses can identify those who have had or are at risk of FGM and either offer support or specialist referral.

Measures of cultural competence in nurses: an integrative review.

BACKGROUND: There is limited literature available identifying and describing the instruments that measure cultural competence in nursing students and nursing professionals. DESIGN: An integrative review was undertaken to identify the characteristics common to these instruments, examine their psychometric properties, and identify the concepts these instruments are designed to measure. METHOD: There were eleven instruments identified that measure cultural competence in nursing. Of these eleven instruments, four had been thoroughly tested in either initial development or in subsequent testing, with developers providing extensive details of the testing. RESULTS: The current literature identifies that the instruments to assess cultural competence in nurses and nursing students are self-administered and based on individuals' perceptions. The instruments are commonly utilized to test the effectiveness of educational programs designed to increase cultural competence. CONCLUSIONS: The reviewed instruments measure nurses' self-perceptions or self-reported level of cultural competence but offer no objective measure of culturally competent care from a patient's perspective which can be problematic. Comparison of instruments reveals that they are based on a variety of conceptual frameworks and that multiple factors should be considered when deciding which instrument to use.

Two-eyed seeing: a framework for understanding indigenous and non-indigenous approaches to indigenous health research.

This article presents two-eyed seeing as a theoretical framework that embraces the contributions of both Indigenous and Western "ways of knowing" (world-views). It presents key characteristics and principles of these different perspectives and suggests ways in which they might be used together to answer our most pressing questions about the health of Indigenous people and communities. Presenting a critique of positivism, which has historically undermined and/or dismissed Indigenous ways of knowing as "unscientific," it discusses the origins of both Western and Indigenous approaches to understanding health; the importance of giving equal consideration to diverse Indigenous and non-Indigenous worldviews such that one worldview does not dominate or undermine the contributions of others; and how balanced consideration of contributions from diverse worldviews, embraced within a two-eyed seeing framework, can reshape the nature of the questions we ask in the realm of Indigenous health research.

Our land, our language: connecting dispossession and health equity in an indigenous context.

For contemporary Indigenous people, colonial relations (past and present) intersect with neoliberal policies and practices to create subtle forms of dispossession.These undermine the health of Indigenous peoples and create barriers restricting access to appropriate health services. Integrating insights from the critical geographer David Harvey, the authors demonstrate how the dispossession of land and language threaten health and well-being and worsen existing illness conditions. Drawing on the qualitative findings from a program of community-based research with the 'Namgis First Nation in the Canadian province of British Columbia, the authors argue for an account of how neoliberal mechanisms operate to further the "accumulation by dispossession" associated with historical and ongoing colonialism. Specifically, they show how neoliberal ideologies operate to sustain medical colonialism and health inequities for Indigenous peoples. The authors discuss the implications for nursing actions to achieve health equity in rural First Nations communities.

Tensions in anti-colonial research: lessons learned by collaborating with a mining-affected indigenous community.

Community-based nurse researchers strive to develop collaborative partnerships that are meaningful to the health priorities of participants and relevant to their sociopolitical realities. Within the context of global inequity, intersecting forces of privilege and oppression inevitably shape the research process, resulting in tensions, contradictions, and challenges that must be addressed. This article has 3 purposes: to examine the political context of mining corporations, to describe common health threats and challenges faced by mining-affected communities, and to reflect on research with a mining-affected Indigenous community in Guatemala whose health and capacity for self-advocacy are impacted by a legacy of colonialism. Using an anti-colonial lens, the authors discuss 3 central tensions: community agency and community victimhood, common ground and distinct identities, and commitment to outcomes and awareness of limitations. They conclude by offering methodological suggestions for nurse researchers whose work is grounded in anti-colonial perspectives.

Indigenous life stories as narratives of health and resistance: a dialogical narrative analysis.

The Sami people have historically been exposed to severe assimilation processes. The objective of this study was to explore elderly Samis' experiences of health. A total of 19 elderly Sami individuals in Norway were interviewed.This article is a dialogical narrative analysis of the life stories of 3 Sami women. The life stories are perceived as narratives of health and resistance. Postcolonial theory provides a framework for understanding the impact of historical and socioeconomic factors in people's lives and health. Narratives of resistance demonstrate that people are not passive victims of the legacy of colonialism. Resistance is not a passive state but an active process, as is health. Resistance is a resource that should be appreciated by health services, both at a systemic level--for example, through partnership with Indigenous elderly in the planning and shaping of services--and in individual encounters between patients and healthcare providers.

A culturally targeted self-management program for African Americans with type 2 diabetes mellitus.

Inadequate knowledge of the influence of lifestyle on clinical outcomes contributes to the difficulties many African Americans experience with type 2 diabetes mellitus (T2DM). This pilot study examined a 12-week church-based culturally targeted diabetes self-management education (DSME) intervention for middle-aged and older African Americans with T2DM. Quantitative data were collected at baseline and at 12 weeks and included questionnaires and anthropometric measures. There were significant increases in medication adherence (p = .006), healthy eating (p = .009), and foot care adherence (p = .003). The intervention had a clinically significant effect on systolic blood pressure, blood lipids, physical activity, and waist circumference. Church-based culturally targeted DSME interventions may result in improved outcomes for African-American adults with T2DM. The authors discuss the value of community-based interventions that target behavioural changes in populations of chronically ill patients, particularly those who historically have been disenfranchised and/or underserved.

Intellectual disability nursing and transcultural care.

In today's healthcare environment, nurses are urged to use up-to-date research evidence to ensure better patient outcomes and inform nursing decisions, actions and interactions with patients. Within the practice setting, there is an increasing challenge to provide care to patients from minority ethnic groups. In order to deliver care to different cultural groups, nurses need to recognize and empathize with patients' belief systems, being mindful of their diverse cultural needs. This article presents the concept of transcultural care and identifies issues within intellectual disability nursing through a focus on the components identified by Campinha-Bacote (2002; 2003) and Cortis (2003): cultural awareness, cultural skill, cultural knowledge, cultural encounter and cultural desire. It highlights the issues which are relevant to nursing practice, cultural care and service provision for persons with intellectual disability from ethnic minorities in Ireland.

The importance of transcultural nursing in cancer care.

All patients around the time of cancer diagnosis are emotionally vulnerable. This sense of anxiety is further heightened for patients who are not fully integrated into the society in which they are receiving care because of the cultural shock and language barriers they may face. This article explores the author's experience of caring for a patient from China who was studying in the UK and was admitted with acute promyelocytic leukaemia. The patient had a limited grasp of English and was used to very different cultural norms. Bridging the cultural gap as outlined by Narayanasamy in the ACCESS model (2002) enabled the author to provide the important holistic nursing care that could be easily overlooked in these situations. There is a need for nurses to actively seek to understand cultural differences and take the opportunity to experience transcultural nursing.

South Asian cultural concepts in diabetes.

BACKGROUND: Type 2 diabetes is a significant health problem in the South Asian community. AIM: To extract messages from primary research reports to improve nurses' cultural understanding so they are better able to promote self-management among people of South Asian origin with type 2 diabetes. METHOD: A review was conducted of studies describing people from this group, cultural concepts of their diabetes management and the impact of culturally sensitive care. RESULTS: Eight studies involved adults of South Asian origin, with three focused solely on the Bangladeshi community. They all explored cultural perceptions of diabetes and self-management. CONCLUSION: Cultural beliefs play an important role in attitudes towards diabetes among people of South Asian origin. Understanding their beliefs improves the care provided to this community.

Best practices guidelines for nurse practitioners regarding smoking cessation in American Indian and Alaskan Native youth.

The greatest prevalence of tobacco use in the United States occurs with the American Indian and Alaskan Native (AI/AN). A critical need exists for a culturally specific tobacco cessation option for AI/AN youth. The nurse practitioner is positioned to provide a culturally specific commercial tobacco cessation option by incorporating the transcultural nursing theory into the development of a decision tree to expand understanding of culturally appropriate best practices regarding screening and management of tobacco smoking cessation in AI/AN youth. Presented is the Nurse Practitioner Culturally Specific American Indian and Alaskan Native Youth Decision Tree for Smoking Cessation with supporting evidence-based best practices.