Uso da adaptação transcultural nos cursos de pós-graduação em Enfermagem / Use of cross-cultural adaptation in Postgraduate Nursing courses / Uso de la adaptación transcultural en las carreras de grado en Enfermería

Objetivo: analisar a produção científica brasileira, na Pós-Graduação em Enfermagem, que utilizou o método de adaptação transcultural. Método: estudo documental, com busca realizada na Biblioteca Digital de Teses e Dissertações, que resultou em 140 dissertações e 72 teses para análise, oriundas de Programas de Pós-Graduação da região Sudeste, seguida das regiões Nordeste, Sul e Centro-Oeste, sem representação da região Norte. Resultados: os instrumentos adaptados foram, em sua maioria, procedentes do idioma inglês. Prevaleceram as pesquisas na área/campo Assistencial, destacando-se a linha de pesquisa Processo de Cuidar em Saúde e Enfermagem. Identificou-se descompasso entre o que é produzido na área e o que é recomendado internacionalmente. Conclusão: verificou-se aumento na utilização da adaptação transcultural como método de pesquisa, com persistência das assimetrias acadêmicas regionais e sem consenso sobre o referencial metodológico.

Objective: to analyze the Brazilian scientific production in Postgraduate Nursing education using the cross-cultural adaptation method. Method: documentary study with searches carried out in the Digital Library of Theses and Dissertations resulting in 140 Master's theses and 72 Doctoral dissertations for analysis originated from Postgraduate Programs carried out in the Southeast region of Brazil, followed by the Northeast, South and Midwest regions ­ there was no representation of the North region. Results: the adapted instruments were, mostly, originally written in English. Research in the Care area/field prevailed, highlighting the line of research called Health and Nursing Care Process. A gap between what is produced in the area and what is recommended internationally was identified. Conclusion: an increase in the use of cross-cultural adaptation as a research method was noticed, with the persistence of regional academic asymmetries and lack of consensus on the methodological framework.

Objetivo: analizar la producción científica brasileña, en el Postgrado en Enfermería, que utilizó el método de adaptación transcultural. Método: estudio documental, la búsqueda se realizó en la Biblioteca Digital de Tesis y Disertaciones, se obtuvieron 140 tesis de maestría y 72 tesis de doctorado para análisis, provenientes de Programas de Posgrado de la región Sudeste, seguida de las regiones Nordeste, Sur y Centro-Oeste, no se encontraron documentos de la región Norte. Resultados: los instrumentos adaptados fueron, en su mayoría, del idioma inglés. Predominaron las investigaciones en el área/campo Asistencial, se destacó la línea de investigación Proceso de Atención en Salud y Enfermería. Se identificó que lo que se produce en el área no coincide con lo que se recomienda a nivel internacional. Conclusión: se comprobó que aumentó el uso de la adaptación transcultural como método de investigación, que persisten las disparidades académicas regionales y que no hay consenso sobre el marco metodológico.

Disruption, transformation and silos: medical humanities and the management gurus.

To disrupt, to transform and to break through silos are common sense aims for the medical humanities and other interdisciplinary endeavours. These keywords arise because of the influence upon the academy of management and business gurus, reputed experts who arose in response to the economic crises of the 1980s. Despite the noted analytic deficiencies in the concept of disruption, and its association with product innovation, the term has been extended to academic research, where it connotes radical novelty in research practice, typically accompanied by profound organisational and managerial change. 'Disruption' has become wedded to the word 'transformation' as national funders seek to support more radically innovative research that will maintain Western economic hegemony. A distorted version of Kuhn's model of scientific revolutions underpins the discourse of transformation, which fits humanities research to a template in which revolutionary, transformative shifts can be instrumentally favoured by funders, at the expense of inferior 'incremental' progress. Disruptive and transformative research are, according to funders, more readily produced in organisations that have broken through silos between disciplines. The silo metaphor misleadingly models academic disciplines as if they were essentially unitary entities, akin to the functionally specialised units of a business organisation. The discourse of silos arises from the guru doctrine of the learning organisation. This theory supposes that the organisation-including the university-is literally a living organism, and thereby susceptible to corporate sickness, mortality, infection and disability. Medical humanity researchers should be aware of, and reject, this vitalist metaphysic in which the optimal organisation is a culturally homogeneous supra-personal organism whose immense capacities are harnessed by visionary leaders. Moreover, a new vocabulary should be developed for research evaluation, superseding the supposed hierarchical opposition between transformative and incremental research.

Federal field nurses and Indigenous births.

Beginning in 1924, the US Office of Indian Affairs sent public health or 'field' nurses to Native nations to provide preventative healthcare and education. The field nurse programme began under the US policy of assimilating Native Americans. To that end, field nurses championed 'modern' institutionalised medicine and opposed Indigenous health traditions. They taught an ethnocentric form of health education to Native mothers, and their work was complicit in the genocidal policy of removing Native children to federal boarding schools. However, Indigenous women resisted many of the interventions of the field nurse programme. They also exercised medical pluralism and sought other field nurse services relating to childbirth, prenatal and postpartum health, sometimes in defiance of the nursing programme's professional boundaries. The history of the field nurse programme reveals the ways in which professionalised public health nursing served settler colonial policy, yet it also showcases Native women's self-determination as pregnant patients and as nurses themselves.

Assessment of Suicide Risk and Cultural Considerations in Forcibly Displaced Migrant Youth.

Migrant youth who face forced displacement from their home countries have an emergent mental health burden, placing them at increased suicide risk. As such, it is crucial for pediatric providers to include suicide screening and assessment in their care for this population. Migrant families seek safety but, in many cases, encounter adverse events and psychosocial inequities in the migration journey and in the host community. Factors such as trauma, acculturative stress, and intersectionality influence suicide risk in migrants. Summative traumatic events contribute to the mental health load and worsen suicidal outcomes in migrant youth. Acculturative stress can lead to social marginalization in the host country, further adding to the existing mental health burden. Finally, intersectionality encompasses complex sociocultural influences, which shape the development of cultural identity in migrant youth and influence suicide risk. By examining these factors, the author advances cultural considerations in screening and assessment for suicide risk in migrant youth through evidence-based tools in pediatric clinical practice. Barriers to access to mental health services, stigma, and distrust of the health care system within the host community are also addressed. The author establishes recommendations for early suicide screening and prevention within this population through trauma-informed care, active advocacy, and cultural sensitivity.

Partnering With Immigrant Patients and Families to Move Beyond Cultural Competence: A Role for Clinicians and Health Care Organizations.

The delivery of culturally competent health care is recognized as critical to providing quality, equitable care for marginalized groups. This includes immigrant patients and families who experience significant barriers to health care and poor health outcomes. However, operationalization of cultural competence challenges health care delivery. Complementary concepts have also emerged such as cultural humility, cultural safety, and structural competence, recognizing the need for multi-level approaches involving patients, families, clinicians, health care organizations, the larger community, and policymakers. In this review, we define cultural competency and related frameworks and their applicability to immigrant patients and families. The evolution in terminology reflects an increasingly more comprehensive approach to understanding culture as multidimensional and shaped by social and structural factors. We then highlight strategies at each level, focusing on clinicians and organizations to leverage loci of control most directly within clinicians' reach. Community-level strategies include community engagement (ie, vis-à-vis community health workers or community advisory boards) for clinical and research practice. Organization-level strategies include "immigrant-friendly," or "immigration-informed" policies aimed at reducing immigration-related stressors, like limiting cooperation with immigration enforcement agencies or developing medical-legal partnerships to assist with patients' legal needs. Lastly, policy-level strategies seek to change local and federal policies to address needs beyond health care (eg, education, housing, other social services), taking a "Health in All" policies approach that articulates health considerations into policymaking across sectors. Finally, we conclude with suggestions for future directions that center the experiences of immigrants, with the ultimate goal of sustainably meeting the complex needs of immigrant patients and families.

Culturally Local Perspectives Are Imperative to Scientific Excellence and Health Equity in Eating Disorders Research: Commentary on Monocello et al. (2024).

This commentary discusses a principal contribution of Monocello et al.'s paper presenting a cultural models approach to body fatness perceptions, which provides a rigorous and systematic means of identifying analytic categories that are locally meaningful, in contrast to categories derived from a solely universalizing perspective. In situating their work within an underrepresented population in eating disorders research-young men in South Korea-the authors step beyond the constraints of a universalizing, or etic, framework for probing how body dissatisfaction relates to eating disorder risk. The value of an alternative analytic framework, based on a culturally local, or emic, perspective on how bodies are perceived is demonstrated through the use of a cultural models approach exploring the relationship between culturally defined conceptualizations of body image and eating disorder risk. Understanding such relationships and the meanings attributed to the myriad aspects of body image through locally grounded frameworks provides an essential tool for investigators and clinicians to better understand the lived experience of body dissatisfaction and disordered eating, and also to inform more culturally salient approaches to diagnosis, treatment, and prevention. An emic approach that centers local perspectives and priorities also facilitates participation of communities underrepresented in research in knowledge production.

The place for people in rewilding.

Rewilding, although controversial, is increasingly presented as humanity's best hope of addressing the global biodiversity crisis, but it remains unclear how restoring nonhuman autonomy affects people's relationships with nature. We conceptualized 3 human-nature relationships (HNRs) that could occur when restoring nonhuman autonomy: human-nature dichotomy, human-nature compromise, and human-nature mutualism. Through 51 interviews, we then empirically tested the occurrence of these HNRs across diverse actors living and working in 2 longstanding British rewilding initiatives to better understand the place for people in rewilding. Actors' HNRs aligned with the 3 conceptual framings, but these relationships were complex. Individuals often demonstrated multiple perspectives that transcended conventional actor categorization. The tripartite framing also revealed conflicting values across and within individuals, resulting in pluralistic HNRs. Our work adds to the theory and practice surrounding the place for people in rewilding by cautioning against a single preferred HNR when restoring nonhuman autonomy and advocating that a diversity of human interactions with nature should be integrated into the global rewilding movement.

El lugar de las personas en la renaturalización Resumen Aunque la renaturalización es controversial, se presenta cada vez más como la mejor esperanza para que la humanidad aborde la crisis mundial de biodiversidad, aunque todavía no está claro el efecto de la restauración de la autonomía no humana sobre las relaciones entre las personas y la naturaleza. Conceptualizamos tres relaciones humanidad­naturaleza (RHN) que podrían ocurrir al restaurar la autonomía no humana: dicotomía, equilibrio y mutualismo, todas entre los humanos y la naturaleza. Realizamos 51 entrevistas para probar de forma empírica la ocurrencia de estas RHN con varios actores que viven y trabajan dentro de las dos iniciativas británicas de renaturalización más antiguas y así entender mejor el lugar de las personas en la renaturalización. Las HNR de los actores se alinearon con los tres marcos conceptuales, aunque estas relaciones fueron complejas. Los individuos frecuentemente mostraron tener varias perspectivas que trascendían la categoría de los actores. El marco tripartito también reveló valores conflictivos entre y en los individuos, lo que resultó en RHN pluralistas. Nuestro trabajo suma a la teoría y práctica en torno al lugar de la gente en la renaturalización con la prevención de una sola relación humanidad­naturaleza preferida cuando se restaura la autonomía no humana y con la recomendación de que la diversidad de interacciones humanas con la naturaleza debería integrarse al movimiento mundial de renaturalización.

Deciphering dynamic interactions among multidimensional psychological motivations, academic performance, and sociocultural adjustment: The critical influence of excessive WeChat use.

As the preeminent mobile social media platform in Mainland China, WeChat's meteoric expansion has revolutionized the dynamics of interpersonal communication and the modalities of mutual interaction among individuals. Despite the escalating significance of mobile social media in the cross-cultural adaptation of international students, existing scholarly works have largely neglected the underlying relationship between psychological motivations, excessive WeChat use, academic performance, and sociocultural adaptation of these students. Anchored in uses and gratifications theory and cross-cultural adaptation paradigm, the primary objectives of this study are to devise a theoretical model and to scrutinize differential psychological motivations propelling international students' WeChat usage, its association with excessive WeChat use, and impacts on academic performance and sociocultural adjustment. The proposed model undergoes meticulous evaluation through data amassed online from 598 Chinese international students studying in Germany. Sequential analytical techniques, especially Confirmatory Factor Analysis and Structural Equation Modeling, were employed to elucidate the dynamic interplay among key variables. The final results validate the path effect suggesting that both hedonic and social motivations are positive predictors of excessive WeChat use. Moreover, excessive WeChat use is negatively correlated with academic performance and sociocultural adjustment. However, utilitarian motivation is not significantly related to excessive WeChat use. By demystifying the driving factors and consequences of excessive WeChat use, these findings not only accentuate the pivotal role of mobile social media in the cross-cultural adaptation of international students but also enrich the theoretical landscape and enhance the strategic approaches for educators and academic institutions.

Multidimensional impact of sport types on the psychological well-being of student athletes: A multivariate investigation.

The correlation between sports participation and psychological well-being is well-documented, revealing a complex interplay influenced by competition level and cultural context. This is particularly relevant in Korea, where the university sports culture significantly impacts student life. This study evaluates how competitive versus non-competitive sports affect Korean university students' psychological well-being using a quantitative approach with SmartPLS 4 for multi-group analysis. Findings reveal that competitive sports significantly enhance mental toughness and stress management through structured coping mechanisms and robust social support, improving coping strategy effectiveness by 34 % compared to non-competitive sports. Conversely, participants in non-competitive sports experience greater general well-being with a 40 % higher use of informal support. These insights suggest that university sports programs could benefit from targeted interventions incorporating specific coping strategies and social support frameworks tailored to the competitive context. This research underscores the need for precise stress management techniques and resilience-building exercises in sports curricula to optimize psychological well-being across different sports environments in Korean universities.

The Cultural Evolution and Social Pressures of Liposuction Among Iraqi Women: Navigating Modern Beauty Standards Amidst Conservative Traditions.

This editorial explores the impact of societal transformation on Iraqi women's lives, particularly concerning beauty standards and cosmetic procedures like liposuction. It examines the influences of modernization, social media, and social pressures juxtaposed with traditional conservative values. The transition from repressive regimes to more open, albeit unstable, political landscapes has led to significant shifts in women's roles, with increased conservatism contrasting with emerging modernist influences. The role of social media in amplifying modern beauty ideals creates internal conflicts for women striving to balance these with traditional expectations. The growing acceptance of cosmetic procedures indicates a shift toward integrating modern beauty standards within Iraqi society.

The role of social media in public health awareness during times of war in Sudan: snakebites and scorpion stings.

BACKGROUND: Snakebite envenomation (SBE) and scorpion sting envenomation (SSE) are significant neglected tropical diseases that primarily affect impoverished communities in rural areas of developing nations. A lack of understanding about snake and scorpion species and their distribution exacerbates the disabilities and fatalities caused by SBE and SSE. In Sudan, particularly in regions affected by ongoing conflicts where healthcare resources are scarce, social media platforms offer a cost-effective approach to addressing public health challenges. Our aim in this study is to highlight the benefits of using social media for data collection and health promotion in such environments. METHODS: We present a cost-effective communication and data collection strategy implemented at the Toxic Organisms Research Centre (TORC) of the University of Khartoum, focusing on a Facebook group, "Scorpions and Snakes of Sudan", as our primary social media platform. Additionally, we discuss the lessons learned and the initial impact of this strategy on enhancing population health literacy. RESULTS: The group community is composed of ~ 5000 members from 14 countries. During the period from January 2023 to January 2024, we received 417 enquiries about snakes and scorpions belonging to 11 families and composed of 55 species. In addition, 53 other enquiries covered a range of organisms and their tracks (e.g., spiders, skinks, chameleons, foxes, sun spiders, centipedes, lizards, moth larvae, and insect tracks). The first photographic evidence of Malpolon monspessulanus in Sudan was via the group activities. The rare species Telescopus gezirae, the Blue Nile cat snake, is also documented via the group member's queries. Recognizing the evolving nature of social media use in public health, we also address the current limitations and evidence gaps that need to be addressed to effectively translate best practices into policy. CONCLUSION: In conclusion, utilizing Facebook as an institutional platform to share scientific information in simple Arabic language underscores the proactive roles that citizens, scientists, and public health stakeholders can play in leveraging social media for eHealth, eAwareness, and public health initiatives. This approach highlights the potential for collaborative efforts, particularly during crises, to maximize the benefits of social media in advancing public health.

The darkness of reacculturation: examining factors influencing depression among Chinese international student returnees in the post-COVID-19 era.

Introduction: In the aftermath of the COVID-19 pandemic, the reintegration of Chinese international student returnees intersects with China's critical effort to combat a significant brain drain of highly skilled talents, highlighting an unprecedented psychological battleground. This convergence underscores the urgent need for nuanced research to navigate the uncharted territory of their mental health. Methods: Employing Bayesian analysis supported by Markov Chain Monte Carlo (MCMC) algorithms, this study examined depression prevalence and associated factors among 1,014 Chinese returnees. The sample comprised 44.87% male participants (455), 51.58% female participants (523), and 3.55% identifying as "Others" (36), with an age distribution of 61.74% aged 18-30 (626), 28.80% aged 31-40 (292), and 9.47% aged 41-50 (96). The mean age of participants was 29.6 years, ranging from 18 to 50 years. PHQ-9 diagnoses revealed alarming levels of depression, with 47.9% exhibiting a moderately severe degree of depressive disorder. Results: Our findings highlight the intricate interplay between identity clusters- "homestayers" (those leaning towards a Chinese cultural identity), "navigators" (those with a bicultural identity), and "wayfarers" (those leaning towards a foreign cultural identity)-and the likelihood of depression. Specifically, homestayers showed a clear and strong negative association, navigators demonstrated a positive association, and wayfarers had a positive yet unclear correlation with depression levels. Furthermore, acculturation, age, and gender showed no significant effects, whereas education mildly mitigated depression. Discussion: Based on these findings, we suggest the implementation of better-tailored mental health support and policies to facilitate smoother reintegration.

Patient perceptions of nurses' cultural competence in public sector hospitals in Gauteng.

Background: Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses' cultural competence are largely unexplored in South Africa. Aim: This study explored how the concept of cultural competence is perceived by patients. Setting: Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals - district (level one), regional (level two), and academic (tertiary, level three). Methods: This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch's eight steps of data analysis. Results: Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses' level of cultural competence. Conclusion: Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients. Contribution: Patients' perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

Cultural adaptation of a self-review tool for health promoting universities in Bulgaria.

Introduction: The Health Promoting University initiative is unknown in Bulgaria, and the health promotion potential of Bulgarian universities has not been studied. In order to examine it, a suitable instrument is needed. The UK Healthy Universities Network provides an accessible Self-Review-Tool (SRT). Aim: To present the process of cultural adaptation of the SRT in Bulgarian language. Methods: The standardized WHO methodology for cultural adaptation of instruments was followed in four stages: (1) Two language translations of the instrument into Bulgarian were made; (2) An expert Delphi discussion reached a consensus on specific health promoting (HP) terms, followed by a backward translation; (3) Pilot testing of the tool among university community representatives was conducted through a survey among a small sample, with independent responses to the SRT questionnaire followed by cognitive interviews; (4) Final revision of the instrument. Results: Ten public health experts reached a consensus on the name of the initiative and various HP terms. Ten other respondents pre-tested the tool. Difficulties in responding the SRT concerned the meaning of some HP terms, complex words, the system of answers, limited applicability of some statements. Changes were made to 61 of the total 68 elements in the SRT. Conclusion: All stages of the cultural adaptation were important for the final result. The adapted Bulgarian version of the SRT would be useful to Bulgarian universities that want to make a clear commitment to improving the health of their university community and the wider society.

Measuring electronic health literacy in the context of diabetes care: psychometric evaluation of a Persian version of the condition-specific eHealth literacy scale for diabetes.

BACKGROUND: The rise of the internet and social media has led to increased interest among diabetes patients in using technology for information gathering and disease management. However, adequate eHealth literacy is crucial for protecting patients from unreliable diabetes-related information online. OBJECTIVE: To examine the psychometric characteristics and explore the preliminary validity of the Persian version of the Condition-specific eHealth Literacy Scale for Diabetes (Persian CeHLS-D) to assess eHealth literacy in the context of diabetes care. METHODS: After adapting, translating, examining content validity, and pilot testing the questionnaire, it was administered to 300 patients with type 2 diabetes mellitus (T2DM). Construct validity was assessed through confirmatory factor analysis, convergent and known-groups validity. The internal consistency (Cronbach's alpha), composite reliability and maximum reliability, and test-retest correlation were assessed. RESULTS: Factor analysis supported the hypothesized two-factor model with 10 items, and the standardized factor loadings ranged from 0.44 to 0.86 (P-values < 0.001). Cronbach's alpha and test-retest correlation were good for each factor. Convergent validity was confirmed by significant correlations of Persian CeHLS-D with diabetes health literacy, perceived usefulness and importance of using the internet for health information, internet anxiety, and perceived physical and mental health. Know-groups validity determined using groups with different internet-use frequencies, and different attitudes towards providing online healthcare services, were satisfied. CONCLUSION: This study demonstrated the Persian CeHLS-D as a reliable and valid measure of eHealth literacy among patients with T2DM in Iran. Its satisfactory psychometric properties support its use in research and clinical settings to assess eHealth literacy and inform interventions.

A Brief Overview of the Development and Significance of Modern Scientific Medicine in China: Take Chinese Academy of Medical Science and Peking Union Medical College as an example.

Since the early 20th century, China has gradually established a clinical, educational, and research system centered around modern scientific medicine, which has now become the dominant force in China's medical and health system and services, with the construction and development of the Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) as the most prominent symbol. The scientific medicine in the new era require close cooperation across multiple disciplines and fields to build a high-quality and efficient medical and health service system. It also involves combining the excellent traditional Chinese culture with Western modern medicine to explore a unique path of modern scientific medicine with Chinese characteristics.

4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis.

Background Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4 DSP) into Spanish. Methods A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4 DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. Results The S-4DSP was fully completed by 108 participants (mean age 34 ± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. Conclusions The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.