Journal of Transcultural Nursing

Introduction: Asian cultures reflect patriarchal cultural values and attitudes, which likely have influenced women leaders in their countries differently from women in Western cultures. However, virtually no leadership theories have been developed to reflect the experiences and development of nursing leaders from Asian cultures. The purpose of this article is to present an emerging integrated middle-range theory on Asian women’s leadership in nursing. Methodology: Using an integrative approach, the theory was developed based on three major sources: the leadership frames of Bolman and Deal, literature reviews, and exemplars/cases from five different countries. Results: The theory includes two main domains (leadership frames and leadership contexts). The domain of leadership frames includes human resources/networks, structure/organization, national/international politics, and symbols. The domain of leadership contexts includes cultural contexts, sociopolitical contexts, and gendered contexts. Discussion: This theory will help understand nursing leadership in Asian cultures and provide directions for future nurse leaders in this ever-changing globalized world.

Introduction: Heart failure (HF) accounts for 30% of all global deaths and Asians are likely to suffer from HF 10 years earlier than their Western counterparts. Low self-efficacy and poor health-related quality of life (HRQoL) have been reported in patients with HF. Methodology: A descriptive correlational design was adopted to investigate the associations between self-efficacy and HRQoL in 91 patients with HF in Singapore. Results: Patients with HF demonstrated moderately good self-efficacy (M = 3.05, SD = 0.61) and HRQoL (M = 22.48, SD = 18.99). Significant differences were found between total self-efficacy scores and education levels (p = .05), and between overall HRQoL and smoking status (p < .05). Self-efficacy was not significantly correlated to HRQoL. Smoking status, HF classification, and self-efficacy in maintaining function predicted HRQoL. Discussion: Health care professionals should assess each patient’s demographics, smoking status, and clinical condition before delivering individualized education to enhance their self-efficacy and, in turn, overall HRQoL.

Introduction: Almost half (47.8%) of adult Latinas report they never engage in any leisure time physical activity (PA) which is an independent risk factor for the development of cardiovascular disease and other chronic illnesses. There is a pressing need to develop and test PA interventions among Latinas. Therefore, the purpose of this study was to evaluate the effects of a PA Intervention for Latinas, a culturally tailored, promotora-facilitated 12-week PA intervention. It was hypothesized that at the completion of the intervention, participants would have (a) higher daily PA levels; (b) improved aerobic fitness, muscle strength, and flexibility; and (c) lower body mass index and percentage of body fat. Methodology: A partially randomized patient preference trial design with lag group was used to test the intervention. Participants (N = 76) attended twice weekly, low-impact aerobic/Latin dance PA classes taught by laywomen trained as promotoras. Results: Significant improvements were measured in aerobic fitness, muscle strength and flexibility, and daily PA levels (p < .001). Sixty percent of the participants attended at least 60% of the PA sessions. Discussion: Findings suggest laywomen trained as promotoras can successfully facilitate the delivery of an intervention to increase PA among immigrant Latinas.

Purpose: This preliminary pilot effort assessed the effect of group counseling using A-B-C technique on irrational beliefs and self-efficacy for women health volunteers (WHVs) in breast self-awareness. Design: In this randomized controlled trial, 40 WHVs from three health centers (Abhar, Iran) were randomly allocated into two groups. Method: Seven weekly group counseling sessions were held for the intervention group. Data about cancer fatalism belief, dissatisfaction of body, anxiety, and self-efficacy were collected through validated questionnaires 1 month before and 2 weeks after the intervention. Results: Mean scores of anxiety (p = .036), body dissatisfaction (p = .002), cancer fatalism belief (p ≤ .0001), and self-efficacy (p ≤ .0001) were improved in the intervention group compared with control group. Discussion/Conclusion: Group counseling using A-B-C technique was effective in improving irrational beliefs and self-efficacy of the WHVs about breast self-awareness. Implications for Practice: The findings may help in further development of strategies and cultural programs to improve health-related irrational beliefs.

Introduction/Importance: Given the promise of integrating traditional healing practices into primary care, we sought to examine the influence of primary care providers’ racial concordance and Indigenous patients’ ethnic salience on traditional healing treatment decisions. Method: Using a descriptive comparative design with an online clinical case vignette, we measured provider decision making via a 5-point Provider Acceptance of Traditional Healing–Referral and Consult questionnaire. Aggregated results of the main effects and interactional effects were analyzed using a 2 × 2 analysis of variance between-subjects design. Results: The main effect for patient racial concordance on the dependent variable was significant, F(1, 89) = 5.71, p = .02. Conclusions: Provider–patient racial concordance does increase the providers’ likelihood of consulting with and referring patients to traditional healing practices, regardless of the patient’s ethnic salience. Implications for Practice: All health care providers require training in traditional healing practices for Indigenous persons as guided by the cultural safety framework.

Introduction: Alarming increases in childhood disease outbreaks present particular threats to children of immigrants in the United States. The researcher explores issues Latino immigrants experience when vaccinating their children in U.S. health care system. Methodology: A purposive sample of 11 Latino immigrants who sought immunizations for their foreign-born children during their first 5 years in the United States was obtained. Interview questions, probes, and data collection methods were based on interpretive phenomenology. Results: Trust issues emerged as the main theme from the Latino immigrants’ perspective based on interactions with the health care system: trusting themselves as parents to vaccinate children, trusting/mistrusting the U.S. health care providers/facilities, and mistrusting the U.S. health care system. Discussion: The researcher reports disparities in access to health care within a family unit. Parental distress results when Latino immigrants experience health care disparities between U.S.-born and foreign-born children. This can be mitigated by making vaccination practices and health care policies consistent.

Background: Studies have indicated that one of the key factors in relieving depression in older people is social network support, especially from the family. In Chinese society, the traditional value of filial piety strongly influences daily interactions and behavior. The purpose of this study was to examine older people’s perceptions of filial piety and to explore the correlation between filial piety and depression in older people. Method: In this systematic literature review of seven databases (CEPS, Cochrane, PubMed/Medicine, OVID, CINAHL, ProQuest, and PsycINFO), eight studies on the correlation between filial piety and depression in older people were selected, six of which were included in the present meta-analysis. Results: The studies included in this review lacked consistency regarding the screening and measurement instruments used. Two groups of meta-analyses (four studies) illustrated that filial piety was negatively correlated with depression in older people (r = −0.196,p < .001, 95% confidence interval [CI] [−0.283, −0.106] and r = −0.139, p = .006, 95% CI [−0.235, −0.041]), suggesting that an increase in older people’s perception of their children’s filial piety was correlated with a reduction in their depression. Conclusions: Filial piety was correlated with depression in older people. Future studies should focus on clarifying the concept of filial piety to aid in the application of appropriate measurement tools and the development of intervention measures that could enhance the care provided for depression in older people.

Background: As foreigners live in and visit Turkey for various reasons, it is essential to provide culturally appropriate health care. Purpose: This study was conducted to determine the relationship between cultural sensitivity and assertiveness in university nursing students. Method: This descriptive, cross-sectional study was conducted at two universities in the cities of Kilis and Elazığ, Turkey. The study sample consisted of 444 nursing students. Data collection tools included a questionnaire about participant sociodemographic characteristics, Chen and Starosta’s Intercultural Sensitivity Scale, and the Rathus Assertiveness Scale. Results: The mean age of participants was 21.09 years. Most students (71.6%) were female and 34.7% of the students stayed at the hostel. Of the students, 44.4%, 27.5%, and 28.2% attended were the second-, third-, and fourth-year students, respectively. Participants were asked about problems related to caring for patients who speak different languages. The mean score for the Intercultural Sensitivity Scale was 89.42 ± 13.55 and the total score for all students for the Assertiveness Scale was 112.64 ± 15.61. We identified a positive relationship between total scores for the Intercultural Sensitivity Scale and the Assertiveness Scale (p < .001). There was relationship between cultural sensitivity and gender and want to work overseas; assertiveness and year of nursing education and want to work overseas. Conclusions: Nursing students at both schools had a moderate level of cultural sensitivity and assertiveness. It has been determined that as assertiveness level of the students increased, intercultural sensitivity of them also increased. Implications for Practice: Consequently, it is concluded that training as assertive and self-confident individuals during the nursing education of students has a contribution to making patient-specific and culture-sensitive care.

Introduction: Cultural competency is an integral component in undergraduate nursing education to provide patient-centered care and addressing patients’ cultural differences. Students need to consider the prevalence of alcohol and other drug use/misuse in patients from all cultures. This project combines cultural competency education, simulation, and educating students to use screening, brief intervention, and referral to treatment for alcohol and other drug use. Method: Culturally diverse simulation scenarios were developed and used in the simulation lab with students to reduce stigma surrounding other cultures while learning an evidence-based practice to screen and intervene with patients who use/misuse substances. Results: Results show students value simulation and 91% of the students felt that they were able to apply culturally competent knowledge after the simulation experience. Discussion: Cultural competency principles can be embedded in teaching the broader evidence-based practice of screening, brief intervention, and referral to treatment with undergraduate students. This is a replicable teaching methodology that could be adapted in other schools of nursing.