Journal of Transcultural Nursing

The purpose of this research was to examine the experience of HIV-positive Ghanaian women and to identify factors that influenced their vulnerability to infection. The study was carried out in Ghana from January to May 1999 using participatory action research. In-depth interviews and focus groups with 31 HIV-positive women, 5 HIV-positive men, 8 nurses, 10 professionals, and 2 traditional healers were used to collect the data. The need for secrecy in "breaking the news" emerged as an important theme. Secrecy affected the women's access to treatment and to financial and emotional support from families. The secrecy surrounding breaking the news of HIV infection is one manifestation of AIDS stigma in Ghana. Encouraging disclosure within a trusting and supportive environment may be one strategy to diffuse AIDS stigma in Ghana. Educational interventions to eliminate AIDS stigma among health care professionals, including nurses, are required in Ghana.

Advance directives are a way to communicate the kind of care that people desire at the end of life. Recent research shows that ethnic minorities have been found to complete advance directives significantly less often than Caucasians, and no information was available regarding advance directives in the Asian Indian population. To address this shortcoming, this descriptive exploratory design sampled a community sample of 45 Asian Indian Hindus. Being female and having an individualistic decision-making style were significantly positively correlated with advance directive completion. Having strong religious affiliation and a family decision-making style were significantly negatively correlated with advance directive completion. The results of this study provide needed information regarding the Asian Indian population and how Hinduism affects advance directives.

The purpose of this study is to describe how home care nurses orient to and manage cultural issues during patient visits. Fourteen home care nurse-patient dyads were observed. Interviews were then conducted with nurses. Nurses and the home care agencies for which they worked engaged in practices aimed at minimizing patients' cultural practices and beliefs. A correspondence with how nurses oriented to patients' cultures and how cultural issues were managed during encounters was observed. Overwhelmingly, nurses and home care agencies used strategies to avoid dealing with patients' "different" cultural backgrounds. Work needs to be done to begin integrating theory and practice regarding culturally competent health care.

Through qualitative ethnographic methods, the researcher explored gendered nursing education and practice among Iranian nursing students and faculty. Interaction with nursing students and faculty occurred in a familiar turf using the native language in interviews and on field observations. Settings included classrooms, skills laboratory, faculty offices, clinical areas, and informants' homes. Formal and informal interviews, observations, and printed materials provided useful data to reach consistent common patterns. Thematic analysis and triangulation of data identified gender variations in care and compassion, spirituality, economic motives, and practice preference. Integrated experiences of pre-Islamic period were used to describe the current developments of gendered nursing education and practice in the Islamic Republic of Iran. Study of gendered nursing education and practice brings attention to the cultural significance of gender issues. This body of knowledge will benefit American nurses and educators by increasing their cultural understanding of gender.

The purpose of this pilot study was to describe the perspectives of 4 Yaqui Native Americans with diabetes regarding biomedical and traditional methods for healing foot ulcers. Leininger's sunrise model provided the conceptual framework for this study. Analysis of ethnographic data produced four cultural themes: (a) Belief in God is expressed in prayers for healing, (b) the way to keep healthy is to take care of oneself, (c) foot ulcer is a modern illness that takes time to heal, and (d) support is important to survive a difficult journey. Understanding cultural beliefs, perceptions, and healing practices of Yaqui individuals with foot ulcers may provide health care providers with a broader scope for providing culturally competent care.

Traditionally, many literacy and health education programs have had difficulty in significantly affecting vulnerable priority populations. The materials used were largely generalized for one language, one level of literacy, and one culture. A multidiscipline review of literature discusses the relationship between literacy, health, and culture and provides rationale for the interdisciplinary literacy for health model. The model's synthesis of anthropology, linguistics, literacy, nursing, and community partnership guides development of culturally and linguistically appropriate materials for successful adoption and diffusion within a priority population. In Nepal, the model is being used in the Mugom first-language literacy project among a group of remote Tibetan Buddhist peoples.

As Sweden changes toward a multicultural society, scientific knowledge of transcultural nursing care becomes increasingly important. Earlier studies in Swedish nursing education have demonstrated a lack of knowledge base in transcultural nursing. Through an extensive review of the literature, a didactic model was developed to help facilitate the establishment of this body of knowledge in transcultural nursing. The article demonstrates how the model applies the content and structure of Leininger's theory of culture care diversity and universality and ethnonursing method in a 3-year nursing program in theory as well as clinical education. The model includes a written guide for faculty members, with references to scientific articles and documents to be used.

Humor is a ubiquitous element in human interactions. It smoothes relationships, enhances communication, and assists with management of emotions. It plays a significant role in health care relationships. Humor is an important feature of Native American culture. If non-Native nurses and caregivers are to deliver culturally competent care, they would do well to familiarize themselves with the benefits that humor has to offer as well as the pitfalls they may encounter.

As set forth by the United States Department of Health and Human Services in Healthy People 2010, the primary goal of the national health promotion and disease prevention plan is to eliminate the health care disparities among racial and ethnic groups. This disparity is due, in part, to unequal health access. However, equal access to health care alone would not eliminate the difference. The health care provided must be culturally competent to be effective. Before providers can effectively begin strategizing ways to provide culturally sensitive health care for the people they serve, they first need to identify the groups of people in their service areas. A clinical example will be used to demonstrate public health nursing's role in accessing and advocating for uncounted populations as a fundamental beginning for eliminating disparity in health care delivery.