Understanding Obesity in African American Women Using Leininger's Theory.

In the United States, African American (AA) women suffer from higher rates of obesity as compared with Caucasians or Asians. Unfortunately, most weight management interventions have been unsuccessful in maintaining weight loss. Prior research has revealed that AA women face unique barriers in managing obesity; therefore, more research is warranted to address this problem. Leininger's theory is used to understand obesity through a cultural lens. The constructs of the sunrise model are defined as a means to intervene when providing nursing care through cultural preservation, accommodation, and repatterning. We conclude that culture care theory offers a theoretical framework to assist nurses in providing culturally sensitive care to Black women with obesity. Nurses caring for this population can utilize this theory to tailor interventions specific to the cultural needs of women to improve outcomes in the management of obesity. In this article, we use AA and Black interchangeably to represent Americans whose ancestors originate from Africa.

Effect of a transcultural nursing course on improving the cultural competency of nursing graduate students in Korea: a before-andafter study

PURPOSE: This study aimed to evaluate the impact of a transcultural nursing course on enhancing the cultural competency of graduate nursing students in Korea. We hypothesized that participants' cultural competency would significantly improve in areas such as communication, biocultural ecology and family, dietary habits, death rituals, spirituality, equity, and empowerment and intermediation after completing the course. Furthermore, we assessed the participants' overall satisfaction with the course. METHODS: A before-and-after study was conducted with graduate nursing students at Hallym University, Chuncheon, Korea, from March to June 2023. A transcultural nursing course was developed based on Giger & Haddad's transcultural nursing model and Purnell's theoretical model of cultural competence. Data was collected using a cultural competence scale for registered nurses developed by Kim and his colleagues. A total of 18 students participated, and the paired t-test was employed to compare pre-and post-intervention scores. RESULTS: The study revealed significant improvements in all 7 categories of cultural nursing competence (P<0.01). Specifically, the mean differences in scores (pre­post) ranged from 0.74 to 1.09 across the categories. Additionally, participants expressed high satisfaction with the course, with an average score of 4.72 out of a maximum of 5.0. CONCLUSION: The transcultural nursing course effectively enhanced the cultural competency of graduate nursing students. Such courses are imperative to ensure quality care for the increasing multicultural population in Korea.

Social representation of spiritual surgeries in Umbanda: culture, religion and contributions of nursing theory.

OBJECTIVE: to analyze the social representation of spiritual surgeries in Umbanda for Bantu-Amerindian ritual mediums and their contributions to the cross-cultural care proposed by Madeleine Leininger. METHODS: a descriptive-exploratory, qualitative study, supported by the procedural approach of Social Representation Theory and Transcultural Nursing Theory, carried out with 30 Umbanda mediums of the Bantu-Amerindian ritual through interviews, submitted to the Iramuteq software for lexical analysis. RESULTS: mostly women, white, with an average of 46 years old and approximately 14 years of practice in Umbanda participated. The social representation of spiritual surgeries in Umbanda is objectified and anchored through a biomedical vision of care, encompassing a set of beliefs, values and practices as religious treatments, through faith, whose main objective is healing. FINAL CONSIDERATIONS: spiritual surgeries are a form of transcultural care, according to Madeleine Leininger's propositions, as they integrate the culture of a group through health care in Umbanda.

The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study.

BACKGROUND: Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia. METHODS: A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05. RESULTS: The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge. CONCLUSIONS: The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.

Enfermagem transcultural no cuidado de Famílias ciganas: olhar do enfermeiro de família / Transcultural nursing in the care of Gypsy families: the family nurse's perspective

O presente relatório enquadra o Curso de Mestrado de Saúde Familiar conducente à atribuição do título de Enfermeiro Especialista em Saúde Comunitária na área de Saúde Familiar. A cultura é um fenómeno universal, com impacto na sociedade moderna, que impõe reajustes nomeadamente ao nível dos cuidados de enfermagem às famílias, considerando-as unidades sistémicas e em desenvolvimento. As famílias de cultura cigana são consideradas uma minoria étnica, com padrões culturais distintos; nem sempre compreendidas e aceites pela sociedade considerada maioritária. Os cuidados de enfermagem culturais às famílias ciganas assumem expressões e significados, que podem ser significativos na relação terapêutica enfermeiro-utente, fundamentada no respeito pela diferença, valores e crenças. Os enfermeiros de família têm a perceção de que precisam melhorar os cuidados e identificam determinantes que influenciam e promovem os cuidados culturalmente competentes. A Revisão Integrativa (II Parte) constitui uma estratégia de pesquisa subjacente à questão de investigação: quais os determinantes aos cuidados culturalmente competentes a desenvolver pelo enfermeiro de família, junto de famílias de cultura diversa, em especial cigana? Cujo objetivo configura da seguinte forma: identificar os determinantes da prática de enfermagem transcultural pelos enfermeiros de família, junto de famílias de cultura diversa, em especial cigana. A Revisão integra quatro estudos, publicados entre 2016 e 2022. Os resultados revelam que existem determinantes que condicionam os cuidados de enfermagem culturalmente competentes, uns que os condicionam outros que os promovem, conduzindo à discussão com base no Modelo de Sunrise de Madeleine Leininger. O Modelo de Sunrise relaciona-se com os determinantes promotores dos cuidados culturais e permite descobrir, conhecer e explicar a interdependência dos fenómenos culturais com os cuidados de enfermagem, conferindo satisfação das famílias, numa base de preservação, negociação e/ou RE padronização.

This report frames the Master's Degree in Family Health leading to the award of the title of Specialist Nurse in Community Health in the area of ​​Family Health. Culture is a universal phenomenon, with an impact on modern society, which imposes readjustments particularly in terms of nursing care for families, considering them to be systemic and developing units. Gypsy families are considered an ethnic minority, with distinct cultural patterns; not always understood and accepted by society considered the majority. Cultural nursing care for gypsy families takes on expressions and meanings, which can be significant in the nurse-user therapeutic relationship, based on respect for difference, values ​​and beliefs. Family nurses realize that they need to improve care and identify determinants that influence and promote culturally competent care. The Integrative Review (II Part) constitutes a research strategy underlying the research question: what are the determinants of culturally competent care to be developed by family nurses, with families from different cultures, especially Roma? The objective of which is as follows: to identify the determinants of transcultural nursing practice by family nurses, with families from different cultures, especially gypsies. The Review includes four studies, published between 2016 and 2022. The results reveal that there are determinants that condition culturally competent nursing care, some that condition it and others that promote it, leading to the discussion based on Madeleine Leininger's Sunrise Model. The Sunrise Model relates to the determinants that promote cultural care and allows discovering, knowing and explaining the interdependence of cultural phenomena with nursing care, providing family satisfaction, on a basis of preservation, negotiation and/or RE standardization.

Transcultural Nursing in Italy: An Explorative Study.

The health profile of foreigners in Italy is affected by multiple factors and events, including environmental, microbiological, cultural, and behavioral. To explore nurses' basic cross-cultural knowledge, and their perceptions of problems that arise in encounters with clients from outside the country, and to suggest solution strategies, we enrolled 327 nurses in an observational, cross-sectional, multicenter study. The findings suggested a need to improve sociocultural skills related to working in a multiethnic society, as early as the first level courses and possibly continue with appropriate master's degrees and research projects.

Cultural competence of nursing educators at medical universities of 2nd regional planning in Iran.

BACKGROUND: One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals' health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran. METHODS: The current research was a descriptive and survey study framed within Campinha-Bacote's cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software. RESULTS: The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates' interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants' responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants' responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73. CONCLUSIONS: The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran.

Examination of individualised care behaviours and ethnocentrism of nurses caring for refugees: A descriptive and exploratory study.

BACKGROUND: Qualified individualised nursing care should be provided to all communities and ethnic groups with free of ethnocentrism. AIMS: To evaluate nurses' individualised care behaviours and ethnocentric attitudes and predict the relationship between their individualised care behaviours and ethnocentric attitudes. DESIGN: A descriptive and exploratory study. METHODS: This study was conducted with 250 nurses working in a public and two private hospitals in a city, an area with many refugees. Data were collected using the Ethnocentrism Scale and Individualised Care Behaviours Scale. Structural equation model analysis to test hypothetical model and descriptive statistics were used. RESULTS: Nurses working in the private hospitals had a higher individualised care decision control mean score. Those nurses who enjoyed spending time with people from different cultures had lower mean ethnocentrism scale scores, higher individualised care clinical status, personal life and decision control status subscales mean scores compared to other nurses. Mean scores of the individualised care personal life and decision control status subscales of the nurses who followed the literature on transcultural nursing was higher. A significant relationship between the ethnocentrism levels and individualised care behaviours was identified. Accordingly, the ethnocentric attitudes of the nurses negatively affected their individualised care behaviours, and the model established between the two concepts is statistically appropriate. CONCLUSIONS: Nurses who work in private hospitals, receive intercultural nursing education and enjoy spending time with different cultures have higher individualised care behaviours and lower ethnocentrism levels. Ethnocentric attitudes of the nurses negatively affected their individualised care behaviours. Care strategies should be developed that consider the factors that will maximize individualised care practices that minimize ethnocentric behaviours among nurses. IMPLICATIONS FOR THE PROFESSION: Increasing awareness on individualised care behaviours, ethnocentric attitudes and effected factors will contribute to improve of nursing care quality of nurses while giving care to individuals from different cultures.

Crenças e Práticas culturais dos casais nepaleses, durante a gravidez, parto e pós parto: Um estudo em Portugal / Cultural beliefs and practices of Nepalese couples during pregnancy, childbirth and postpartum: A study in Portugal

Este trabalho visa explanar as competências adquiridas ao longo do 2º Ano do Curso de Mestrado em Enfermagem de Saúde Materna e Obstétrica, desenvolvidas ao longo dos diversos estágios, como também o desenvolvimento de um estudo de investigação, resultante de inquietudes surgidas no decorrer dos estágios. Estas prenderam-se essencialmente com a dificuldade sentida na prestação de cuidados de enfermagem especializados a casais grávidos migrantes, nomeadamente casais nepaleses. A migração tem sido uma constante ao longo dos tempos, mantendo-se até aos dias de hoje. A maternidade é um dos aspetos que mais é afetado com a migração. O conhecimento das crenças tradicionais, associadas a uma cultura diferente e durante um período específico, neste caso durante a gravidez, parto e pós-parto, torna-se essencial para uma melhoria significativa dos cuidados de enfermagem, através do desenvolvimento da competência cultural dos enfermeiros, nomeadamente dos Enfermeiros Especialistas de Saúde Materna e Obstétrica (Santiago, 2020). Este trabalho de investigação, desenvolvido na parte II, tem como objetivo principal identificar as crenças e práticas culturais subjacentes aos comportamentos dos casais nepaleses, durante a gravidez, parto e pós-parto, com filhos e inscritos numa unidade de saúde. Outros objetivos foram delineados, tais como: caracterização sociodemográfica dos participantes no estudo e caracterização obstétrica das participantes. Recorri à metodologia qualitativa, tipo I, exploratória e descritiva, amostra intencional ou não probabilística de casais nepaleses com filhos, inscritos na unidade de saúde. O instrumento de recolha de dados escolhido foi a entrevista semiestruturada, elaborada pela investigadora, tendo por base o documento ?SER MÃE HINDU Práticas e Rituais Relativos à Maternidade e aos Cuidados à Criança na Cultura Hindu em Contexto de Imigração? (Monteiro, 2007). A entrevista foi de carater anónimo e de participação voluntária, estruturada em 3 partes, a primeira relativa à caracterização sociodemográfica da amostra em estudo, a segunda caracterização obstétrica e por fim a terceira parte, no que concerne, às perceções da gravidez e crenças e práticas culturais durante a gravidez, parto e pós-parto, da população em estudo. Na primeira parte deste relatório descrevo as experiências que me proporcionaram o desenvolvimento das competências comuns e especificas de natureza científica, técnica e humana, regulamentadas para o exercício profissional do enfermeiro especialista em Saúde Materna e Obstétrica. Na segunda parte apresento o estudo de investigação, desenvolvido sobre ?Crenças e Práticas Culturais, dos casais nepaleses, durante a Gravidez, Parto e Pós-parto: um estudo em Portugal?. Deste modo, este estudo contribuirá para o conhecimento das crenças e práticas culturais dos casais nepaleses, durante a gravidez, parto e pós-parto. De forma a aperfeiçoar as competências culturais dos Enfermeiros Especialistas em Enfermagem de Saúde Materna e Obstétrica (EEESMO) e consequentemente prestar cuidados de enfermagem culturalmente mais eficazes e com ganhos em saúde.

Integration of Population Health, Social Determinants, and Social Justice in Transcultural Nursing and Culturally Competent Care: White Paper by the Scholars Education Interest Group.

INTRODUCTION: As part of its mission to advance Transcultural Nursing worldwide, the Transcultural Nursing Society Scholars upholds the central role of the discipline and cultural competence in advocacy, empowerment, and transformation of the life conditions of disadvantaged populations. This White Paper affirms the Scholars' core belief in the value of Transcultural Nursing and culturally competent care in addressing social determinants to promote health equity. METHODS: The Scholars Education Interest Group proposes recommendations for changes in education, practice, and research undergirding the discipline and expand cultural competence to directly address social structural and historical forces that perpetuate health vulnerability in diverse populations. RESULTS: Collaborative leadership between the TCNS Scholars, Board of Trustess and members should develop initiatives to foster implementation of the recommendations and promote global dissemination of exemplars in education, research and practice. DISCUSSION: Collaborative implementation of recommendations will generate evidence of health equity outcomes through TCN and culturally competent care.

Teaching cultural competence to undergraduate pharmacy students using vignettes (case scenarios) as an innovative teaching intervention.

OBJECTIVE: Cultural competence is instrumental in reducing health equities. Addressing cultural competence at higher education level in healthcare students lays a solid cultural competence foundation for professional practice. The use of vignettes as a teaching intervention was effective because it allowed the use of role-modelling in real-life situations.The study aimed to enhance cultural competence in undergraduate pharmacy students using a self-directed online interactive cultural competence module embedded with three vignettes (case scenarios). METHOD: This study was an exploratory longitudinal mixed method (survey and written feedback) study and used a convenience sample of 90 pharmacy students at an Australian University. Students' self-perceived transcultural self-efficacy was evaluated pre- and post-intervention using Jeffreys' Transcultural Self-Efficacy Tool (TSET) which is a validated outcome measure. KEY FINDINGS: Vignettes were effective in teaching cultural competence as shown by significant (P < 0.0005) changes pre- to post-intervention in cognitive, practical and affective domains scores using TSET. The affective domain had the least positive mean score change. There was no significant association between any of the demographic factors such as age, gender or birthplace/parents' birthplace and changes in any of the three domains. Cronbach's alpha of >0.90 in all domains confirmed the test's internal consistency and reliability. CONCLUSIONS: The findings were indicative of the students' positive receptivity to learning cultural competence and that they had a well-developed understanding of cultural competence. Further research is needed to determine why most cultural competence teaching methods produce little or no meaningful change in enhancing the affective domain.

Interrelações das Epistemologias do Sul e o cuidado transcultural nas práticas em saúde e Enfermagem / Interrelaciones de Epistemologías del Sur y cuidado transcultural en salud y prácticas de enfermería / Interrelationships of Epistemologies of the South and cross-cultural care in health and Nursing practices

Resumo Objetivo refletir sobre as interrelações do cuidado transcultural e as Epistemologias do Sul nas práticas em saúde e Enfermagem. Método trata-se um de estudo reflexivo, com base em uma revisão narrativa da literatura, destacando os conceitos da linha abissal, ecologia dos saberes e descolonização do saber do referencial das Epistemologias do Sul. Resultados após a análise reflexiva do material emergiram três eixos reflexivos, a saber: Populações ao Sul da linha abissal; Ecologia dos saberes e a interculturalidade; e Descolonização do saber nas práticas em saúde e Enfermagem: cuidado culturalmente congruente. Considerações finais e implicações para a prática a valorização da cultura de autocuidado de grupos populacionais vulneráveis ao sul da linha abissal é fundamental para oportunizar a visibilidade e a voz, retirados pelo processo de colonização no campo da saúde, fruto da supervalorização do saber biomédico. Observa-se a necessidade do diálogo entre os conhecimentos para a construção de um ambiente de aprendizagem mútua, caracterizado como ecologia dos saberes. Para isso, é preciso o processo de descolonização na perspectiva do pensamento pós-abissal, com a valorização do saber popular, em prol de um cuidado culturalmente congruente. Por fim, na Enfermagem, o referencial da Teoria da Universalidade e Diversidade do Cuidado Cultural instrumentaliza o enfermeiro para planejar e implementar o cuidado transcultural sensível.

Resumen Objetivo reflexionar sobre las interrelaciones del cuidado transcultural y las Epistemologías del Sur en las prácticas de salud y Enfermería. Método se trata de un estudio reflexivo, a partir de una revisión narrativa de la literatura, destacando los conceptos de la línea abisal, ecología del saber y descolonización del saber en el marco de las Epistemologías del Sur. Resultados luego del análisis reflexivo del material surgieron tres ejes reflexivos, a saber: Poblaciones al sur de la línea abisal; Ecología del conocimiento e interculturalidad; y Descolonización del saber en salud y prácticas de Enfermería: cuidado culturalmente congruente. Consideraciones finales e implicaciones para la práctica la valorización de la cultura del autocuidado de los grupos poblacionales vulnerables al sur de la línea abisal es fundamental para generar espacios de visibilidad y voz sustraídos por el proceso de colonización en el campo de la salud, producto de la sobrevaloración de la biomedicina conocimiento. Hay una necesidad de diálogo entre saberes para construir un ambiente de aprendizaje mutuo, caracterizado como la ecología del saber. Para ello, se necesita el proceso de descolonización desde la perspectiva del pensamiento postabismal, con la valorización del saber popular, en pro del cuidado culturalmente congruente. Finalmente, en Enfermería, el marco de la Teoría de la Universalidad y Diversidad del Cuidado Cultural equipa a los enfermeros para planificar e implementar un cuidado transcultural sensible.

Abstract Objective to reflect on the interrelationships of transcultural care and the Epistemologies of the South of health and Nursing practices. Method this is a reflective study, based on a narrative review of the literature, highlighting the concepts of abyssal line, ecology of knowledge, and decolonization of knowledge from the framework of the Epistemologies of the South. Results after the reflective analysis of the material, three reflexive axes emerged, namely: Populations south of the abyssal line; Ecology of knowledge and interculturality; and Decolonization of knowledge in health and nursing practices: culturally congruent care. Final considerations and implications for practice the appreciation of the self-care culture of vulnerable population groups south of the abyssal line is essential to create opportunities for visibility and voice removed by the colonization process in the health field, as a result of the overvaluation of biomedical knowledge. There is a need for dialogue between knowledge to build an environment of mutual learning, characterized as the ecology of knowledge. For this, the decolonization process is needed from the perspective of post-abyssal thinking, with the appreciation of popular knowledge, in favor of culturally congruent care. Finally, in nursing, the framework of the Theory of Universality and Diversity of Cultural Care equips nurses to plan and implement sensitive transcultural care.