Journal of Transcultural Nursing

Latinos/Hispanics are the largest and fastest growing ethnic minority group in the United States. By mid-century, older Hispanics may account for almost 20% of the older cohort. Yet while health disparities have garnered increased attention, little is known about older Hispanics and their overall health, social, and economic needs. This article presents an innovative Ethnocultural Gerontological Nursing Model that can serve as an overarching framework for exploring various salient macro- and micro-level factors that affect the lives of Latino elders, their families, and the communities that support them. By utilizing a life span perspective, the Ethnocultural Gerontological Nursing Model and attached questionnaire can assist nurses and other health providers in gaining a fuller assessment of older Latinos in order that we may improve our understanding and development of health service, program, and policy changes that address the needs of older Latinos and the nurses who care for them and their families.

Background: Surgical nursing within humanitarian contexts is complex, sporadically described in literature and little understood. Aim: To achieve a deeper understanding of the lived experience of New Zealand nurses providing humanitarian aid within surgical settings and war zones in developing countries. Method: In-depth conversational interviews were undertaken with four New Zealand nurses whose humanitarian experience lay in general surgical, military, and intensive care settings. A qualitative descriptive method as described by Sandelowski, informed by van Manen’s phenomenology in terms of analysis, was used. Results: Specialized knowledge and nursing expertise are recognized to be essential but not sufficient for humanitarian work. Understanding local cultures contributes to positive feelings about work effectiveness. Themes included feeling anxious and misunderstood, practicing differently, and adjusting to life back home. Discussion: This study highlights the need to better prepare nurses who volunteer for humanitarian work, with implications for recruiting organizations, educators, and clinicians.

Purpose: Poor sexual health is a significant contributor to morbidity in young African American women. Knowing how sexual knowledge is transmitted to Black girls is needed to develop effective preventive interventions. The purpose of this study was to explore the ways in which Black mothers transmit sexual values and knowledge to their daughters. Design: Interviews were conducted with 14 mothers, aged 25 to 34 years, with daughters aged 8 to 16 years. Data were analyzed using constant comparative analysis. Findings: The themes derived were (a) truth telling, (b) building strength through self-esteem, and (c) spirituality as helper. The overarching cultural theme was “Growing Strong Black Women.” Discussion/Conclusions: Mothers’ discussions with their daughters were infused with cultural meaning derived from their experiences. Black girls’ behavioral responses to their mothers’ strategies need to be studied. Implications: The findings will help nurses develop effective interventions that take into account the cultural realities of Black mothers.

Purpose: This study explored Latino migrant/seasonal farmworkers’ (MSFWs’) adherence to hypertension treatment. Design: A cross-sectional correlational study was conducted. Method: Forty-five Latino MSFWs from two farmworker health clinics completed Spanish versions of the Morisky Medication Adherence Scale, the Blood Pressure Knowledge Scale and Blood Pressure Self-Care Scale, the Perceived Stress Scale, the Acculturation Rating Scale for Mexican Americans–II, the Short Assessment of Health Literacy for Spanish-Speaking Adults, health care access questions, and blood pressure measurements. Results: MSFWs had poor medication adherence (51%). Blood pressure knowledge, perceived stress, acculturation, health literacy, and health care access accounted for 49% of the variance in blood pressure self-care. Higher acculturation level and health literacy were associated with better blood pressure control (p = .01). Discussion: MSFWs had poor medication adherence and blood pressure control. Blood pressure knowledge and acculturation played a role in blood pressure self-care. Implications: Culturally appropriate educational programs are needed to help MSFWs’ adherence to hypertension treatment.

Breast and cervical cancers continue to contribute to high cancer mortality rates in American Indian/Alaska Native women; culturally appropriate interventions are needed to influence screening behaviors and to reduce delays in obtaining care. In a pilot feasibility study designed to influence Pacific Northwest American Indian/Alaska Native women’s health screening knowledge and behaviors (breast and cervical), we employed a community-based participatory research approach. Data from interviews with study participants, those involved in implementation of the study and observations were included in the analysis. Study questions focused on training of staff, recruitment of participants, and implementation of the protocol and data management. The complexities of translational, transcultural research and the importance of reporting pilot feasibility studies to the advancement of transcultural research are highlighted in the findings of this research effort.

Purpose: The objective of this study was to explore the maternal health risk factors and sentinel events among women in the Solomon Islands, from the viewpoints of health care providers in the Solomon Islands. Design and Method: Three focus group interviews were conducted in July and August 2011 at a secondary referral hospital in an urban area. The study consisted of 10 registered nurses and 11 skilled birth assistants. Thematic analysis was used for this qualitative data analysis. Findings: Six major themes were emerged from the data: (a) environmental hazard: malaria, (b) malnutrition: iron deficiency anemia, (c) adolescent pregnancy, (d) betel nut chewing, (e) cultural beliefs influencing women’s health, and (f) difficulty accessing health care services. Conclusions and Implications for Practice: The results of this study provide a useful first step toward identifying specific maternal health risks among women in the Solomon Islands. The findings may assist the health sector and midwives/antenatal educators to better understand the health risks and reduce the disease burden among pregnant women in South Pacific countries. The results may also contribute to the development of policies to improve maternal health and to accelerate progress toward the fifth target goal of UNICEF’s Millennium Development Goals.

Purpose: The aim of this study was to examine the relationship between acculturation, medication adherence, lifestyle behaviors (e.g., physical activity, nutrition, weight control), and blood pressure control among hypertensive Arab Americans. Design: The study utilized a cross-sectional descriptive design. A convenience sample of 126 participants completed questionnaires and had measures of blood pressure, weight, and height. Forty-six participants were hypertensive and were included in the analysis. Results: Only 29.2% of participants reported high medication adherence. High medication adherence was associated with lower diastolic blood pressure, eating a healthy diet, and following lifestyle modifications. Acculturation was significantly associated with physical activity and body mass index. Conclusion: Our study found that acculturated participants were more adherent to medications and physical activity and had better blood pressure control. Further studies are needed to explore how acculturation improves adherence and what factors contribute to better adherence in order to design culturally sensitive interventions.

Purpose: To translate and examine the psychometric properties of the Arabic version of the Summary of Diabetes Self-Care Activities. Design: An instrument translation and validation study. Settings: A total of 243 participants (33 first sample and 210 second sample) diagnosed with type 2 diabetes mellitus were recruited from four primary health care centers in Saudi Arabia. Methods: The study was guided by the World Health Organization guidelines for translation and validation of instrument. Results: Translation indicators showed satisfactory outcomes for each included process in the forward-translation, an expert panel, and back-translation stages. Reliability and validity outcomes were as follows: test–retest, r = .912 and p < .001; split-half = .9; and Cronbach’s alpha (α) = .76. The alpha scores for the subscales were as follows: diet, .89; exercise, .83; blood glucose testing, .92; and foot care, .77. Principal component analysis revealed the presence of four components with eigenvalues greater than 1.0, explaining 34.4, 16.4, 15.4, and 11.2% of the variance in everyday practices for these items, respectively (accumulated = 77.1%). Conclusions: The translation and validation processes revealed acceptable psychometric properties. The instrument could evaluate diabetes self-care in Saudi Arabia and has the potential to be used in other Arabic-speaking populations.

Purpose: The purpose of this systematic review is to explore the perceptions of acute, persistent, and disease-specific pain and treatment options held by adult African Americans. Underassessment and undermanagement of pain in African Americans has been well documented; however, the cultural continuum of pain perceptions and their influence on pain assessment and management has not been synthesized. Design: Electronic database searches of the Cumulative Index for Nursing and Allied Health Literature and PubMed, Web-based searches of the pain-specific journals plus a manual search of reference lists identified 41 relevant articles addressing perceptions of pain and/or pain management. Findings: Analysis of the literature revealed six themes: (a) meaning of pain, (b) description of pain, (c) coping with pain, (d) impact of pain, (e) patient–provider relationship, and (f) treatment approaches. Conclusion: These findings warrant further research and indicate the need for more precise evaluation of pain in African Americans, highlighting an imperative to incorporate cultural patterns into pain management practice and education.

Canada is among the most diverse countries in the world. To provide meaningful health care, the Canadian health care system requires nursing health care teams reflecting this diversity. Meeting this demand should be a specific goal of Canadian nursing schools. Nursing students with English as an Additional Language (EALs) are graduating and passing national licencing exams at a lower rate than nursing students whose first language is English. It is the premise of the article that EALs require both academic and nonacademic forms of support during their years of nursing education. A literature review reveals that EALs facing academic crisis benefit from individual and group English language support, aimed at improving their understanding and use of English in an academic environment. Studies also suggest that group sessions help improve EALs’ psychosocial functioning. This article provides an overview of the establishment and implementation of a proactive nursing support program, purposely designed to address the challenges faced by EALs.