Journal of Transcultural Nursing

The Swahili of Lamu, Kenya, understand illness as the result of a spiritual imbalance caused by personal transgression or an attack by harmful forces directed by an envious person. Another underlying component of the Swahili concept of illness is that each person’s physical body operates in conjunction with personal attributes that are fixed at birth and determine moral character, behavior, and predisposition to ailments. When physical symptoms occur, the Swahili focus on identifying the human or supernatural entity that caused the illness in consultation with a range of healers who specialize in a variety of curing strategies. Two case studies illustrate how culturally congruent nursing care can be achieved when health care providers understand the Swahili framework of diagnosing and treating illness.

Incarcerated women are a highly vulnerable population, most of whom have had extremely adverse life experiences. Nurses who work in corrections have significant challenges as they attempt to care in a setting that is focused on punishment. This article focuses on the unique culture of incarceration as it applies to women, along with the common challenges nurses face when caring for these women. Leininger’s Theory of Culture Care and the Sunrise Enabler are discussed as useful tools to assist nurses in providing culture care within the confines of the prison, as well as a means of understanding these women as cultural beings apart from the prison setting. Despite the many security restrictions that exist within the correctional environment, “care” can be provided regardless of the setting. A model case has been developed to show the enormous impact that culture care can have on the lives of many women who face incarceration.

Purpose: To translate and test the psychometric properties of the Turkish version of the Infertility Self-Efficacy Scale–Short Form (TISE-SF). Methods: The convenience sample consisted of 120 infertile women. A psychometric research design was used with content and construct validity and reliability. Results: Cronbach’s alpha of .78 showed moderate reliability, whereas item–total correlations ranged from .30 to .54. Factor analysis extracted a single component, explaining 40.3% of the variance. Kendall W showed agreement with each expert regarding the appropriateness of the items, confirming the content validity of the translated TISE-SF. Conclusion: The results supported the construct validity and reliability of the TISE-SF for measuring infertility self-efficacy in a population of Turkish women. Implications: Evaluating infertile women’s perception of self-efficacy with the TISE-SF may be useful in clinical studies in Turkey. TISE-SF can be used by professionals as a counseling tool to help guide women in managing their treatments at infertility centers.

Purpose: The purpose of this study was to evaluate the attitudes of nursing and medical students toward older people in Turkey. Method: This was a cross-sectional and comparative descriptive study. The Turkish version of Kogan’s Old People Scale was used to evaluate attitudes toward older people among 618 students. Results: Medical students showed more positive attitudes toward older people than nursing students. Students who were females, whose economic income was less than expenditure, and who were not interested in working with older people after graduation showed less positive attitudes. Conclusion: The results suggested that positive attitudes toward older people exist; despite this, it is obvious that more efforts are required to enhance these attitudes. Implications for Practice: Revision and improvement in curricula are needed to enhance the attitudes of students toward older people, and lecturers in schools should further consider the need to prepare students for their roles as caregivers for this particular group.

Type 2 diabetes mellitus (T2DM) is a steadily growing epidemic in the United States, especially for overweight Latino youth who are among the highest at-risk for T2DM development. Although dietary interventions are not often inferred to patients prior to T2DM diagnosis, they may be implicated in risk reduction. The purpose of this review is to examine the use of dietary fiber in reducing the risk of T2DM in Latino youth. The main results of this examination found that a wide variation in use of dietary fiber intake or supplementation resulted in an overall inverse relationship and association with visceral adipose tissue, metabolic syndrome, and insulin resistance. However, due to inconsistencies in fiber definition and/or implementation, dietary and supplemental fiber intake must be further explored in randomized controlled trials so that more agreement may be reached on fiber recommendations, especially in populations at high risk for T2DM such as Latino youth.

Purpose: The aim of this study was to evaluate the reliability and validity of the Turkish version of the Beliefs about Dietary Compliance Scale (BDCS-T). Methods: This methodological study enrolled a sample of 140 patients. Data were collected by using a questionnaire form, the BDCS-T, and the Dialysis Diet and Fluid Restrictions Nonadherence Questionnaire. Descriptive statistics, the one-sample Kolmogorov-Smirnov test, Mann–Whitney U test, correlation coefficients, and psychometric tests were used for the analysis of data. Results: The factor analysis confirmed that the BDCS-T had a two-factor structure (perceived benefits and perceived barriers) explaining 58.7% of the total variance. The BDCS-T had acceptable internal consistency (Cronbach’s alpha coefficients: perceived benefits = .91; perceived barriers = .66), test–retest reliability (intraclass correlation coefficients: perceived benefits = .93; perceived barriers = .79), concurrent validity with the Dialysis Diet and Fluid Restrictions Nonadherence Questionnaire scores, and known group validity with intensity of diet nonadherence. Conclusions: The BDCS-T was found to be a reliable and valid tool for assessing the beliefs related to salt-restricted diet in patients on hemodialysis. Implications for Practice: Nurses are recommended to make tailored interventions by taking the benefits and barriers that the patients perceive toward low-salt dietary adherence into account.

Purpose: This study demonstrates preliminary evidence of the utility of an optimality index as a simple tool for monitoring complications across the perinatal period. Method: The medical records of 147 Latina women participating in a preventive randomized controlled trial for perinatal depression were reviewed for outcomes across the perinatal period. Results: Application of the optimality index found optimality scores ranging from 77.3% to 97.7% in a Latina immigrant population known to have low rates of low–birthweight infants and preterm birth. Optimality scores were significantly lower among women who had a preterm birth or low–birthweight infant. Discussion: The ability of optimality indices to capture within-group variability will allow for a more nuanced understanding of the antecedents and sequelae of negative birth outcomes. Implications for Practice: Increasing reliance on electronic medical records will facilitate the calculation of optimality scores that can be used to track patterns of perinatal health disparities.

Increasing cultural diversity in the United States and significant health disparities among immigrant populations make acculturation an important concept to measure in health research. The purpose of this cross-sectional, descriptive study was to examine acculturation and health of Korean American adults. A convenience sample of 517 Korean American adults in a Midwestern city completed a survey in either English or Korean. All four groups of Berry’s acculturation model were identified using cluster analysis with Lee’s Acculturation Scale. Assimilation, integration, and separation were found in the English survey sample, whereas integration, separation, and marginalization were found in the Korean survey sample. Moreover, the findings revealed that acculturation is a bidimensional process, and the unique nature of samples may determine acculturation groups. Physical health and mental health were significantly related to acculturation in the English survey sample. However, there was not a significant relationship between health and acculturation in the Korean survey sample.

Purpose: This qualitative study was conducted with 14 South Asian women in Hong Kong to explore their perception and experiences of domestic violence by an intimate partner. Design: All interviews were transcribed and then coded based on the process of coding suggested by Strauss and Corbin, including both open and axial coding. Results: Data analysis resulted in two main core categories, “Women’s perception of domestic violence” and “Cultural factors that influence their help-seeking behavior,” denoting that the context in which domestic violence is experienced influences women’s perception and understanding of domestic violence. Participants also drew on the discourse of culture to explain its role in their experiences of domestic violence. Conclusion: Domestic violence is a concern among this group of South Asian women. Culturally appropriate domestic violence services and public education on domestic violence are needed for this community.

Purpose: This article seeks to review and discuss the evidence linking depression, coronary heart disease (CHD), and culture. Method: PsychInfo, CINAHL, PubMed, and Google were searched for pertinent evidence linking depression, culture, and CHD, and retrieved articles were analyzed using thematic content analysis. Findings: Identified themes were the followings: depression is a factor in development and prognosis of CHD and affects the capacity to self-manage and adhere to treatment recommendations; culture mediates mental health/illness representations and treatment-seeking behaviors; screening and assessment of depression can be affected by cultural factors; and there is a need for culturally appropriate screening and therapeutic strategies. Discussion and Conclusions: As depression is a predictor and moderating variable in the genesis and progression of CHD, understanding how factors such as culture affect screening and management of the disease is important to inform the development of culturally and linguistically competent strategies that ensure accurate screening, detection, and treatment of depression in cardiac patients in clinical practice.

Purpose: Two tools were created to help international students to better understand culture by becoming more astute observers of nonverbal behaviors, particularly behaviors depicting emotions among Norwegian students. Design/Method: The two tools were a trilingual list of words illustrating emotions and an exercise with images to practice verbalizing their observations of emotional expression. Findings: Students compared the subdued behaviors of Norwegians to the Israelis’ very vivid behaviors. The intense emotional expression of Israelis influenced their interpretations. By making comparisons and through the experiences with Israelis, they learned more about culture and their own emotional expression. Discussions and Conclusions: Creative strategies can contribute to students understanding and reflection of patients in a different culture. Implications for Practice: Encouraging students to grasp the nuances of emotional expression is part of understanding a different culture. Students, like faculty, learn that self-exploration is an evolving process that requires checking out one’s assumptions and interpretations.

Rupture of the hymen before marriage is a significant problem for a woman and her family. The purpose of this article is to present a case report where hymen membrane perforation was required for vaginal agenesis in a 13-year-old adolescent, identify psychosocial issues related to the torn hymen in the Turkish culture, discuss gender inequality affecting health care of women with a torn hymen, identify the impact of a torn hymen on a Turkish woman’s social status, and discuss health care implications for the woman and her family. The girl could not understand the situation and experienced feelings of guilt. The parents displayed an intense reaction of shock and denial after being informed about the disorder and treatment process and felt a sense of hopelessness about the future of their daughter. Nurses are expected to fulfill their training, counseling, and advocacy roles about this issue.

As HIV incidence rises globally, Asian and Pacific Islander communities are increasingly affected. While often overlooked, Asian and Pacific Islander American women have shown the greatest percentage increase in HIV diagnosis rates. The development of a multilevel and multistrategy approach to HIV/AIDS education, prevention, and treatment among Asian and Pacific Islander females requires health care providers to identify personal and cultural barriers to prevention and treatment and implement culturally sensitive and specific measures. The purpose of this article is to illuminate barriers to HIV-related prevention, treatment, and care among Asian and Pacific Islander American females and provide practical application-based suggestions for providers, which may enhance Asian and Pacific Islander female inclusion in comprehensive HIV prevention.