[Developing cultural competence in nursing schools]. / Le développement de la compétence culturelle en institut de formation en soins infirmiers.

Cultural competence is not mentioned as such in the training standards for future nurses, but it is essential for appropriate, personalized and effective care. Learning about and reflecting on one's own history and culture enable an open relationship with patients from other cultures.

Dominant Worldviews, Institutional, and Contextual Factors Affecting Cancer Care: Evidence From an Institutional Ethnonursing Study in Nigeria.

INTRODUCTION: Cancer remains a significant health burden in Nigeria and requires the efforts of all stakeholders to address it. Little is known about how the worldviews of Nigerian patients with cancer and other institutional factors affect cancer management in Nigeria. This paper draws evidence from an ethnonursing study conducted in a Nigerian cancer care setting. METHOD: This study adopted a qualitative design using an ethnonursing approach. The study was conducted in one of the primary cancer treatment centers owned by the federal government of Nigeria. Data collection was conducted using participant observation, interviews, and field notes. Data collected were analyzed using NVivo 12 and presented as categories and sub-categories. RESULTS: Analysis yielded two themes and seven sub-themes. The major themes included (1) dominant worldview and (2) institutional/contextual factors. Participants attributed life, living, and death as being controlled by a supreme being. Cancer care was constrained by unfavorable institutional factors such as lack of equipment, staffing, and intensified workload. DISCUSSION: Cancer institutions should provide more cancer care infrastructure that will facilitate the work of nurses and other health care workers. There should be an enabling environment that would attract and retain nurses in the cancer wards. The hospital environment should be made conducive for the cancer care providers, patients with cancer, and their relatives.

Cultural care needs of Spanish speaking parents with limited English proficiency whose children are hospitalized: An ethnonursing study.

PURPOSE: Parents' inability to speak English proficiently is associated with communication barriers in the care process of their children, social determinants of health, and poor child health outcomes. Research exploring perspectives of Spanish speaking parents with limited English proficiency (SSP-LEP) whose children are hospitalized in the context of culture is lacking in the literature. The purpose of this study was to explore the cultural experiences, values, and beliefs of SSP-LEP, of Mexican origin, whose children were hospitalized and to understand nurses' roles in providing culturally congruent care. DESIGN AND METHODS: Leininger's qualitative, ethnonursing method was used for this study. The Theory of Culture Care Diversity and Universality provided a guiding framework. Eleven SSP-LEP, of Mexican origin, participated in interviews conducted in-person and via Zoom. Data was analyzed using Leininger's four phases of qualitative analysis. RESULTS: Three themes emerged: 1. role of the mother as an ever-present manager of care for the hospitalized child and family, 2. parents' difficult, fearful, stressful, and unknowing experiences in the presence of a language barrier, and 3. expected nursing care that was kind, respectful, compassionate, and attentive. CONCLUSIONS: Lack of knowledge creates hardships for parents who desire to be involved, informed caregivers. Communication in Spanish language is integral to parents' understanding and expected nursing care. SSP-LEP may have negative feelings; yet describe a positive care experience. PRACTICE IMPLICATIONS: Culturally congruent care should incorporate language services for information sharing that facilitates parent participation and decision-making; be kind, respectful, compassionate, and attentive; and promote maternal role maintenance.

Ethonursing Study of Pain Management in Neonates in Indonesia.

PURPOSE: Even though Indonesia is comprised of at least 1,300 ethnic groups, no specific traditional method for reducing pain, especially in neonates, has been elaborated. AIM: This study aimed to investigate the traditional methods used by the Sundanese people in Indonesia to manage pain in neonates. METHODS: This ethnonursing study was conducted in the Pangandaran District, West Java Province, Indonesia. Thirty informants including health cadres, midwives, and community leaders in the health sector, such as trained traditional birth attendants and female elders, participated in this study. Data were collected through interviews and focus group discussions, as well as from field notes. Data were analyzed using the four phases of qualitative analysis based on Leininger's theory. RESULTS: Six themes were identified in this study: (1) Preference for the use of traditional methods to treat pain in neonates and infants, (2) Desire to obtain information on the safe use of traditional medicine, (3) Desire to use practical pain management methods, (4) Easy to get modern medicine, (5) Use of medicinal plants, (6) Physical methods. CONCLUSIONS: This study demonstrates the need for better harmonization between the use of traditional and modern medicines, in both research and practice, to determine the most appropriate mix that combines the strengths of each method based on accurate scientific evidence.

Health-Seeking Behaviors in Mozambique: A Mini-Study of Ethnonursing.

In settings where traditional medicine is a crucial part of the healthcare system, providing culturally competent healthcare services is vital to improving patient satisfaction and health outcomes. Therefore, this study sought to gain insight into how cultural beliefs influence health-seeking behaviors (HSBs) among Mozambicans. Participant observation and in-depth interviews (IDIs) were undertaken using the ethnonursing method to investigate beliefs and views that Mozambicans (living in Pemba City) often take into account to meet their health needs. Data were analyzed in accordance with Leininger's ethnonursing guidelines. Twenty-seven IDIs were carried out with 12 informants from the Makonde and Makuwa tribes. The choice of health service was influenced by perceptions of health and illness through a spiritual lens, belief in supernatural forces, dissatisfaction with and dislike of the public medical system on grounds of having received poor-quality treatment, perceived poor communication skills of health professionals, and trust in the indigenous medical system. This study confirmed the need for health professionals to carefully take cultural influences into consideration when providing care for their patients. We recommend an educational intervention that emphasizes communication skills training for healthcare workers to ensure successful physician/nurse-patient relationships.

Culturally Congruent Health Activities for the Prevention of Functional Disabilities Among Older Adults in Japan's Forest Communities.

INTRODUCTION: In Japan's forest areas, cultural capital and older adults play key roles in helping to sustain the community. The purpose was to explore cultural values/beliefs related to culturally congruent health activities among older adults in forest communities. METHOD: The qualitative ethnonursing research method was used. Data were collected through fieldwork and key informants' interviews (n = 14) over 1 year. The setting was a traditional village with 80% forest cover. RESULTS: Findings included two universal cultural values/beliefs, which were "community identity as a community member" and "our cohesion and connection as community members." Additionally, two diverse cultural values/beliefs were found: "gender-based differences" and "differences between those having experience working outside the forest community and those without this experience." These were related to community-based health activities. DISCUSSION: These values/beliefs were suggested to develop a multilayered network around health activities in order to prevent functional disabilities among older adults.

Cultural, Belief, And Lifeway Factors in Diabetes Patients: An Ethnonursing Study

@#Introduction: The people of Sumba prefer traditional medication from shamans as they believe that diabetes they suffer from the Marapu, hence uncurable by modern medical means. This study aimed to derive a picture regarding diabetes patients’ cultural values, beliefs, and lifeways in the East Sumba ethnic of Indonesia. Methods: This study uses a qualitative design with an ethnographic approach which was conducted in 2018. The main participants in the study were seven diabetic patients, were determined purposively. Focused discussions were held with the person in charge of the non-communicable disease program from seven Public Health Centers. Data were collected from interviews, focus group discussions, field notes and observation sheets. All data were analyzed by content analysis method corresponding to the 4 phases in ethnonursing. Results: Five themes were generated in this study with details of three themes describing the cultural values of diabetic patients (subthemes traditional ceremonies, chewing happa, and traditional medicine), one theme describing the beliefs of diabetic patients (subthemes perceptions about diabetes) and one theme describing the lifestyle of diabetic patients (subthemes eating/drinking patterns, spiritual values, rest/sleep habits, and daily activities). The culture of diabetics depicted in adat ceremonies, happa or betel nut chewing, and traditional medication, which is still thick in East Sumba and their beliefs on the disease they suffer from, exert influence on their daily lives, including their eating or drinking patterns, spiritual values, resting or sleeping patterns, and daily activities. Conclusion: This finding can be helpful for the effort to improve nursing for diabetes patients by cultural approaches.

An Ethnohistory of the Transcultural Nursing Scholars and Their Contributions to the Field.

Introduction: The Transcultural Nursing Society (TCNS) recognizes transcultural nursing (TCN) scholars for creative leadership and advancing education, practice, research, and administration. The purpose of this study was to discover the historical context of scholars' professional growth and development and their contributions to and future vision for transcultural nursing. Method: Leininger's Ethnonursing Research Method was used to develop an ethnohistorical qualitative approach that included a semistructured, open-ended interview guide and data analysis plan. Data were analyzed using NVivo software and Leininger's Phases of Ethnonursing Data Analysis Enabler for Qualitative Data. Results: Analysis resulted in the discovery of five themes and 15 patterns related to the sources of scholars' interest in TCN; professional development strategies; contributions to TCN theory development, education, research, practice, service, and consultation; the responsibilities of being a TCN scholar; and their future vision for TCN. Discussion: These findings could inspire and guide TCN scholars as they pursue the study and practice of TCN.

Cultural Aspects of End-of-Life Advance Care Planning for African Americans: An Ethnonursing Study.

INTRODUCTION: Advance directive completion rates among the general population are low, with even lower completion rates among African Americans (AAs). This study's purpose was to identify culturally based meanings, expressions, and traditions of end-of-life (EOL) advance care planning (ACP) and decision making in order to promote culturally congruent nursing care among African Americans. METHODOLOGY: Leininger's Culture Care Theory and Ethnonursing Research Method guided the study. A convenience sample of 21 informants were interviewed in community settings. Data analysis was guided using Leininger's phases of ethnonursing data analysis for qualitative data. RESULTS: Three themes emerged that affect EOL decision making: (a) faith in God and belief in life after death, (b) a strong matriarchal family structure, and (c) fear of talking about death and mistrust of the U.S. health care system. DISCUSSION: AA culture, beliefs, and traditions influence EOL ACP and practices, and must be considered while providing culturally congruent care.

Contextualizing the Cultural Factors Associated With Cancer Care in Nigeria: An Ethnonursing Study.

Introduction: Culture and care are two important phenomena of particular concern to transcultural nursing. Cancer care is generally affected by certain cultural factors that influence how cancer patients experience diseases and seek and utilize care services. This study aimed to explore the cultural factors that affect cancer care in a Nigerian cancer care institution. Method: This study adopted an ethnonursing method involving participant observation and individual interviews. The study was conducted in the oncology unit of University College Hospital, Nigeria. Seven nurses and six patients were key participants, while four physicians, three ward assistants, and six patients' relatives constituted the general participants. Result: Two themes and five patterns were identified. Participants described how the interplay of several cultural factors influenced or inhibited cancer care. Findings revealed significant influence of kinship, family, and social structure as well as the roles played by cultural beliefs, values, and practices in cancer care in Nigeria. Discussion: Cultural factors need to be considered broadly for the efforts toward prevention, early diagnosis, and treatment of cancer to be effective in Nigeria.

Caring for Adolescents Based on the Wisdom of Indonesian Pandalungan Culture: An Ethnonursing Pilot Study.

PURPOSE: This study aimed to explore the caring of families with adolescents based on the local wisdom values in Pandalungan families in the Eastern region of Java Island, Indonesia. DESIGN AND METHOD: A pilot study with ethnonursing design was performed to identify the domain of inquiry of Pandalungan local wisdom deeply related to how cultural aspects influence families caring for adolescents. The data collection involved 4 months of participants observation in the community and in-depth interviews with the key informants. Then, focus group discussion was performed until data saturation with 92 informants (consisting of key informants, adolescents, and parents). We used Leininger's four phases of analysis for qualitative data to develop a thematic structure of this study. RESULTS: Fourteen patterns generated four themes through the analysis of all data. The local wisdom of Pandalungan was integrated into spiritual value in their family. The spiritual value was used to structure their family lives. Then, local wisdom was internalized to functionalize their family function to care for adolescents. Family structuring and functionalizing based on local wisdom of Pandalungan were used to achieve family life cycle development with adolescents. CONCLUSIONS: The local wisdom values were internalized in the family spirituality, structure, function, and task development in Pandalungan families caring of their adolescents children in Indonesia. PRACTICE IMPLICATIONS: A cross-cultural approach with an emphasis on cultural sensitivity issues can be used to identify the family as a whole system regarding the local wisdom of Indonesia.

Leininger's Ethnonursing Research Method: Historical Retrospective and Overview.

A historical overview and evolution of Leininger's ethnonursing research method (ERM) is presented along with descriptions of the method's purpose, goal, terminology, and enablers. A succinct guide to using ERM is provided to assist novice and seasoned researchers, as well as mentors and educators, in teaching, mentoring, advising, and/or conducting ethnonursing research studies. Criteria for evaluation of qualitative research studies, such as the ERM, are highlighted.

Atividade educativa para o desenvolvimento de competências culturais de enfermeiras(os) que atuam na saúde indígena na Amazônia paraense / Educational activity for the development of cultural competencies in nurses who work on indigenous health in the Amazon region of Pará

Introdução: A diversidade sociocultural na Amazônia brasileira requer dos profissionais da saúde competências culturais. No entanto, a assistência de enfermagem não difere entre os povos indígenas e não indígenas, a formação profissional e permanente é verticalizada e centrada na operacionalização dos serviços e as competências exigidas na saúde indígena são de natureza técnico-assistencial. Objetivo geral: Desenvolver, implementar e avaliar uma atividade educativa mediada pelos Círculos de Cultura para o desenvolvimento de competências culturais críticas com enfermeiras(os) que atuam na saúde indígena do DSEI Guatoc no estado do Pará. Método: Estudo de intervenção, de enfoque qualitativo com triangulação na obtenção, análise e avaliação dos dados. Utilizou-se os Círculos de Cultura como itinerário de pesquisa no desenvolvimento da atividade educativa. Realizaram-se cinco encontros na CASAI Icoaraci, CASAI e Polo de Marabá e sete encontros na CASAI e Polo Paragominas. Participaram dezenove enfermeiras(os) que atuavam mais de um ano nos serviços e não estavam afastadas do trabalho por qualquer motivo. A investigação iniciou após aprovação pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da USP. Os resultados do perfil das(os) participantes e do instrumento de autoavaliação foram lançados no programa Microsoft Excel, versão 2007, para análise descritiva. Os dados qualitativos foram organizados pela versão livre do software Atlas Ti e analisados segundo a hermenêutica-dialética. Resultados: A maioria das(os) participantes era constituída por mulheres, nortistas, negras e pardas, casadas; formada(o) em Instituições de Ensino Superior privadas; tinha especialização em Saúde Indígena e vínculo empregatício celetista. A autoavaliação não mostrou resultados tendenciosos a respostas socialmente aceitáveis, o que demonstra possível autoavaliação crítica e reflexiva. Emergiu na atividade educativa, mediada pelos círculos de cultura, na investigação temática, o tema gerador dificuldade de comunicação; na tematização, a interculturalidade funcional; e na problematização percebeu-se que ao analisar das situações-problemas as(os) participantes desenvolveram uma transitividade de consciência e produziu-se uma cartilha idiomática. Discussão: O conhecimento regulação é norteador da atuação das(os) participantes, mas durante os Círculos de cultura apresentaram uma transitividade de consciência, especialmente no domínio cognitivo dos atributos sensibilização/consciência e conhecimento cultural, pois manifestaram reflexão, crítica e mobilização no sentido de interconhecimento, reconhecimento e autoconhecimento, apontando para uma aproximação com a Ecologia de saberes e do conhecimento emancipação. Conclusão: Por meio da atividade educativa, mediada pelos círculos de cultura, apreendeu-se que o desenvolvimento de competências culturais na perspectiva crítica é um processo educativo dialogado, coletivo, colaborativo, insurgente e permanente que considera os domínios afetivo, cognitivo e comportamental, que interseccionam aos atributos do desejo, sensibilização/consciência, conhecimento, habilidades e encontros culturais, mas que também compreende a dimensão política da atuação da(o) enfermeira(o) que lê, codifica e interpreta o contexto histórico, social e cultural em que está inserida(o), ressignificando seus saberes, práticas e cuidado do outro e de si. Potencial de impacto da pesquisa: Ressignificar o cuidado e a atuação da(o) enfermeira(o) na saúde de povos tradicionais; contribuir para a teoria de enfermagem transcultural ao abordar as competências culturais a partir do paradigma crítico; impactar na educação permanente de enfermagem ao articular a dimensão profissional com a dimensão sociopolítica como proposta de processo educativo que considera as zonas de conflitos culturais do cotidiano de enfermeiras(os) que atuam em contexto de diversidade sociocultural; produzir um instrumento inédito de autoavaliação das competências culturais de enfermeiras(os) que atuam na saúde indígena. E por fim, produzir inovação por meio de uma tecnologia assistencial que possibilitou o exercício do trabalho coletivo e colaborativo e promoveu a interlocução idiomática do universo cultural indígena com os profissionais de saúde.

Introduction: The sociocultural diversity in the Brazilian Amazon demands cultural competences from the health professionals. Despite this fact, the nursing care provided to indigenous and non-indigenous people does not differ. The professional and permanent training is verticalized and centered around the operation of services. The competences required by the indigenous health have a technical-care nature. General goal: Develop, implement and evaluate an educational activity mediated by Culture Circles focused on the development of critical cultural competences alongside nurses who work on indigenous health at DSEI Guatoc in the state of Pará. Method: Qualitative intervention study approached through the triangulation of data acquisition, analysis and assessment. Culture Circles were used as research itinerary in the development of the educational activity. Five meetings were held at the CASAI Icoaraci, CASAI and Polo de Marabá, and seven meetings were held at CASAI and Polo Paragominas. Among the participants, there were 19 nurses who were working in these services for more than a year continuously without taking a work leave. The investigation started after the approval from the Research Ethics Committee of the University of São Paulo Nursing School. The results of the participants profile and the self-evaluation instrument were collected using Microsoft Excel, version 2007, for descriptive analysis. The qualitative results were organized using the free version of Atlas Ti and analyzed according to the dialectical hermeneutics method. Results: Most of the participants were women, northerner, black and colored, married; alumni from private universities; specialized in indigenous health and in a work contract under the general labor law, known as CLT. The self-evaluation did not show biased results towards socially accepted responses, which can demonstrate critical and reflective self-evaluation. During inquiry stage of the educational activity, mediated by culture circles, communication issues emerged as generative theme; in the thematization stage, the functional interculturality; and in the problematization, it became evident that the participants developed transitive consciousness owing to the analysis of the problem-posing situations, which resulted in the production of a idiomatic booklet. Discussion: The knowledge-regulation is the guiding principle for the work of the participants, yet they presented transitive consciousness during the culture circles. The cognitive domain brought out sensibleness/consciousness and cultural knowledge due to the manifestation of reflection, critical thinking and mobilization towards inter-knowledge, acknowledgement and self-knowledge. These pointed to a closeness to the ecology of knowledge and the knowledge emancipation. Conclusion: Through the educational activity, mediated by the culture circles, it was possible to understand that the cultural competences from a critical perspective is an educational process based on dialogue which can be described as collective, collaborative, insurgent and permanent. It takes into account the domains of affection, cognition and behavior, and intersects with the attributes of desire, sensibleness/consciousness, knowledge, abilities and cultural encounters. Furthermore, it comprehends the political dimension of a nurses work who reads, codes and interprets his or her social, cultural and historical context, changing the meaning of his or her knowledge, practice and care of others and him or herself. Research impact: Changing the meaning of the care and the work of a nurse regarding the health of traditional people; contributing to the transcultural nursing theory through the discussion of cultural competences from a critical paradigm; impacting the permanent nursing education as a result of articulating the professional dimension with the sociopolitical dimension, proposing it as an educational process that considers the cultural-conflicting zones in the daily life of a nurse who works in the context of sociocultural diversity; producing an unprecedented instrument of self-evaluation regarding cultural competences of nurses working on indigenous health; producing innovation by means of a care technology which allowed for collective and collaborative work, and promoted the idiomatic dialogue between the universe of the indigenous culture and the health professionals.

Prácticas de cuidado cultural en gestantes del sector rural del municipio de Combita Boyacá / Cultural care practices in pregnant women in the rural sector of the municipality of Combita Boyacá

INTRODUCCIÓN: Las mujeres en gestación del municipio de Combita que residen en el sector rural representan un grupo poblacional enriquecido con los saberes culturales propios del altiplano Cundiboyacense es por ello que, describir las prácticas de cuidado cultural en un proceso de creación de saberes conjuntos con las gestantes, aporta conocimientos desde y para la disciplina de enfermería, en pro de mejorar la salud materno perinatal. OBJETIVO: Describir las prácticas de cuidado cultural que tienen las mujeres gestantes del sector rural del municipio de Cómbita, Boyacá, que permitan orientar el cuidado desde el primer nivel de atención. MÉTODO: Esta investigación es cualitativa, etnográfica y el método usado fue la etnoenfermería. La muestra está compuesta por diecinueve mujeres gestantes y dos participantes generales. El análisis se hizo con el facilitador de "Guía de fases de análisis de datos de la etnoenfermería" de Leininger. RESULTADOS: Surgieron dos temas: "Significados de la gestación" con cinco patrones, y "Prácticas de cuidado" con diez. CONCLUSIONES: Las mujeres se enfrentan con diferentes barreras para obtener los servicios de salud, dentro de ellas se encuentran los factores económicos, la canalización inadecuada hacia los servicios de salud y el uso de un lenguaje impositivo sobre el cuidado, lo que conlleva a la pérdida de confianza en los profesionales para expresar el cuidado del emic. Es importante promover la actualización y la capacitación de los profesionales de la salud orientados a la empatía para poder progresar hacia la sensibilidad y la conciencia cultural, y de este modo garantizar una mayor calidad en la atención de la salud

INTRODUCTION: The pregnant women of the Combita municipality that reside in the rural area represent a population group enriched with the cultural knowledges typical of the Altiplano Cundiboyacense is therefore that, to describe the practices of cultural care in a process of creation of joint knowledges with the pregnant women, provide understanding since and for the nursing discipline, in support of improve the maternal perinatal health. OBJECTIVE: To describe the cultural care practices that have the pregnant women of the rural area of the Combita municipality, Boyacá, that permit orient the care of the first level of attention. METHOD: This investigation is qualitative, ethnographic, the Ethno nursing was the method used. The sample were nineteen pregnant women and two general participants. The analysis was made with the facilitator "Ethnonursing datums analysis Guide" of Leininger. RESULTS: Arose two themes: "pregnancy meanings" with five patterns and "care practices" with ten. CONCLUSION: The women are dealing with different barriers to get the health services, in these are the economic factors, the unsuitable channeling to the health services and the use of an imposing language over the care, that involves the loss of the confidence on the professionals to express the emic care. Is important to promote the update and the training of the health professionals oriented to empathy to be able to progress to the sensitivity and the cultural conscience, and by this guarantee a biggest quality in the health attention

Leininger's Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future.

An historical overview of Leininger's Theory of Culture Care Diversity and Universality also known as the Culture Care Theory (CCT) and evolution of the Sunrise Enabler are presented along with descriptions of the theory purpose, goal, tenets, basic assumptions, major core constructs, and orientational definitions. Recent articles, books, and book chapters provide relevant exemplars to enhance scholarly understanding and application of theory constructs. Proposed future directions encompass using the CCT to guide research of discovery and translational research projects for evidenced-based nursing practice; develop nursing courses and curricula to prepare culturally competent nurses; guide future culturally competent administrative and leadership policies and procedures; inform public policy related to cultural diversity and underserved populations; promote grant writing initiatives to enhance cultural diversity in hiring nursing staff, supervisors, and faculty; and promote admission of nursing students from underserved and/or diverse backgrounds.

Culture Care Beliefs and Practices of Ethiopian Immigrants.

INTRODUCTION: The purposes of this mini study were to identify and describe the culture care beliefs and practices of Ethiopian immigrants in the mid-Atlantic region of the United States and to advance the science of transcultural nursing. METHODOLOGY: Leininger's theory of culture care diversity and universality guided the research and was the framework for the design of this qualitative ethnonursing mini study. Data were collected from 15 participants through in-depth interviews. RESULTS: Five themes and 14 care patterns merged from the data, including preserving cultural heritage, supporting family and friends, importance of religion and prayer, valuing freedom, cultural caring, and therapeutic communication. DISCUSSION: Participants valued health care and medical technology in the United States. They wanted nurses to inquire about their culture, language preference, food and dietary practices, and family dynamics. Perceived lack of caring by nurses and unavailability of interpreters in health care settings negatively affected access to care.

Community-Informed Health Promotion to Improve Health Behaviors in Honduras.

BACKGROUND: Honduras is the second poorest country in Central America. The already high burden of disease is disproportionately worse among individuals with less education and limited access to health care. Community engagement is needed to bridge the gap in health care resources with the need for health promotion and education. Culturally relevant health promotion activities can foster transcultural partnerships. PURPOSE: The purpose of this study was to partner nursing students with village leaders to assess a community's health needs and implement health promotion activities in Honduras. DESIGN: Participatory action research was used in the study. METHOD: U.S. nursing students ( n = 4) partnered with a nonprofit organization and community partners in Villa Soleada to interview mothers in Villa Soleada, a Honduran village of 44 families, and implement health promotion activities targeted to the health priorities of their families. RESULTS: Structured interviews with 24 mothers identified gastrointestinal issues, health care access and quality, and malaria as the top three priorities. Ninety-two percent of respondents were interested in nurse-led health promotion. Activities engaged new community partners. DISCUSSION: This partnership and learning model was well received and sustainable. The U.S. nurses involved in the partnership gained exposure to Honduran health issues and led locally tailored health promotions in Villa Soleada. The community's response to health promotion were positive and future activities were planned. IMPLICATIONS: Nursing student's immersion experiences to support population-based health activities in low-resource settings are a replicable model that can help build healthier communities with a sustainable local infrastructure. Transcultural nursing experiences enhance students' perspectives, increase personal and professional development, strengthen nursing students' critical thinking skills, and for some students, confirm their desire to practice in an international arena.

Experiencing Leininger's stranger to trusted friend enabler as a novice ethnonursing researcher

@#<p style="text-align: justify;">Leininger espoused that when studying cultures, researchers are likely to discover authentic and credible data when they are viewed by the participants as trusted friends. The Stranger to Trusted Friend Enabler was formulated to guide researchers in identifying indicators that a researcher has become the participants' trusted friend. This article presents my reflections on using Leininger's Stanger to Trusted Friend Enabler as a novice ethnonursing researcher. From my own experience, I have identified four hallmarks of a trusting relationship during fieldwork that correspond with the indicators of a trusting relationship identified by Leininger: (1) participants voluntarily share information about their culture and their personal experiences; (2) participants express concern for the researcher's welfare through their words and actions; (3) participants give the researcher a sense of community identity, such as a native name; and (4) participants suggest steps to further improve the trustworthiness of the study.</p><p style="text-align: justify;">One of the limitations of the Stranger to Trusted Friend Enabler, however, is the fact that it only focuses on assessing the participants' trust towards the researcher. A successful ethnographic research requires mutual trust between the researcher and participants. From my experience in conducting an ethnonursing research, I have noted that aside from the participants' trust towards me, my trust towards them was also essential in obtaining rich and accurate data. Furthermore, the transition from being a stranger to a trusted friend is not a linear process in ethnonursing and in other types of ethnographic research. As a researcher transitions to become a trusted friend, he or she does not totally abandon his or her sense of alienation to the researched. The scientific nature of ethnography requires researchers to be a stranger and a trusted friend at the same time.</p>

Beliefs and practices of cultural care of women with severe maternal morbidity / Creencias y prácticas de cuidado cultural de mujeres con morbilidad materna severa

The present study aimed to describe the beliefs and practices of cultural care in women who had major causes of severe maternal morbidity, not in the prenatal control and attended at an institution of III level of health care in the city of Medellín. It was a research of a qualitative, ethnographic type, a method used was the ethno-infertility proposed by Leininger, the sample composed of 17 women with severe maternal morbidity, not in control of prenatal, who were interviewed several times until data saturation was achieved; Then, they were collected and analyzed through the ethnographic analysis proposed by Spradley. Results: 5 general themes and 2 taxonomies were found. The study concluded that women with severe maternal morbidity, unresponsive to prenatal care, have their own modes of care for themselves and the unborn child when they are ill, because access to maternal health services is deficient. Similarly, the nursing care offered to these women should be based on the knowledge of cross-cultural nursing proposed by Leininger.

El presente estudio tuvo como objetivo describir las creencias y prácticas de cuidado desde lo cultural en mujeres que tuvieron causas principales de morbilidad materna extrema, inasistentes al control prenatal y atendidas en una institución de III nivel de atención en salud de la ciudad de Medellín. Fue una investigación de tipo cualitativo, etnográfico, método utilizado fue la etnoenfermería propuesto por Leininger, la muestra compuesta por 17 mujeres con morbilidad materna extrema, inasistentes a control prenatal, éstas fueron entrevistadas varias veces hasta lograr la saturación de datos; luego, se recolectaron y analizaron mediante el análisis etnográfico propuesto por Spradley. Resultados: Se encontró 5 temas generales y 2 taxonomías. El estudio concluyó que la mujer con morbilidad materna extrema, inasistente al control prenatal tiene sus propios modos de cuidado a sí misma y al hijo por nacer cuando está enferma, porque el acceso a los servicios en salud materna es deficiente. De igual forma, el cuidado de enfermería que se ofrece a estas mujeres debe hacerse con base al conocimiento de la enfermería transcultural propuesto por Leininger.

Parenting African American Children With Autism: The Influence of Respect and Faith in Mother, Father, Single-, and Two-Parent Care.

PURPOSE: Parents are the most significant contributor to care of children with autism spectrum disorder (ASD), and as such research on African American parenting in ASD is conspicuously absent. Findings relevant to parenting are discussed from a study with urban African American families caring for children with ASD. DESIGN: An ethnonursing study was conducted with 24 African American family members of children with ASD and 28 professionals. Data were analyzed and reported as themes. FINDINGS: Two universal themes of were found of respect and faith in God and family that influenced parental care. Two diverse themes of mother's watchful care and father's protective care, along with differences in feelings of isolation and dependence on supports were found among single- and two-parent families. Discussion and Practice Implications: When health care professionals increase their knowledge and understanding of cultural practices in the parental care of children with ASD, they provide health care that is culturally congruent.