Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model.

BACKGROUND AND PURPOSE: The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice. PURPOSE: To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger's Sunrise Model. METHODS: Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care. RESULTS: Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company). IMPLICATIONS FOR PRACTICE: The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman.

Exploring the experiences of cultural competence among clinical nurses in Taiwan.

AIMS: To generate a descriptive theory framework regarding the experiences of the cultural competencies among clinical nurses in Taiwan. BACKGROUND: With the advances in, and the easy accessibility to health care services, frontline nurses require a higher cultural competence to perceive and satisfy the needs of the culturally diverse patients. METHODS: A qualitative approach using a grounded theory was applied. There were 30 nurses recruited by purposive sampling. RESULTS: 'Unprepared when encountering different cultures' was the core theme for describing and guiding the process of examining the nurses' experiences with a cultural competence. 'Awareness of value differences' was identified as the antecedent condition. The nurses revealed that they have had difficulty implementing their nursing work and seeking resources that represented situations in which interactive behavioral characteristics appeared to improve their cultural competencies. The nurses managing different cultural situations ultimately learned to tolerate the different cultures and to give patients culturally appropriate care, which thereby enhanced the care quality. CONCLUSIONS: This study highlights the multiple layers of cultural competence experienced by the nurses and the understanding of cultural diversity among patients and caregivers. These results will assist the healthcare providers by offering references for clinical healthcare based on the patients' subjectively different cultural perspectives. Medical organizations should design an in-service educational program/instructions concerning culture to help strengthen the nursing specialists' relevant cultural competencies, to meet the individual patients' cultural care needs, and thereby boost the clinical care quality.

Are You Culturally Competent?

The practice of nursing today demands that the nurse identify and meet the cultural needs of diverse groups, understand the social and cultural reality of the client, family, and community, develop expertise to implement culturally acceptable strategies to provide nursing care, and identify and use resources acceptable to the client (Andrews and Boyle 2002).

[Community health and interculturality]. / Santé communautaire et interculturalité.

An interventional research study in public health was carried out with populations originating from sub-Saharan Africa living in France. With the aim of acting on health inequalities through health education, the researchers focused notably on the links between intercultural relationships and the improvement of health promotion actions.

Las enfermeras ante el cuidado de base cultural. Actividad investigadora en iberoamérica / Nurses facing cultural care: research activity in Latin América

Objetivo. Analizar la actividad investigadora llevada a cabo por enfermeras iberoamericanas sobre los cuidados en salud de base cultural. Metodología. Revisión bibliográfica en la que fueron analizados 27 artículos originales: 14 en español y 13 en portugués, entre los años 1996-2014. Límites de búsqueda: medicina tradicional, cuidados culturales, en las bases de datos CUIDEN y SciELO como hemeroteca virtual. Resultados principales. El tipo de terapia predominante se enmarca dentro del plano natural. Los problemas de salud que se tratan con este tipo de terapias están relacionados principalmente con la mujer y el recién nacido. Asimismo, el rol de la mujer es fundamental como promotora, transmisora y protagonista del mantenimiento de las tradiciones. Conclusión. Es imprescindible que el personal sanitario, principalmente las enfermeras, se involucren en el cuidado cultural del ser humano, aceptando y respaldando estos saberes, no solo por el riesgo que algunos remedios suponen para la salud en caso de su mal uso, sino para poder así prestar unos cuidados congruentes y romper con la barrera cultural, a fin de favorecer la comunicación con el paciente (AU)

Objective. To analyze research activities carried out by Latin American nurses on cultural based healthcare. Methodology. Literature review based on the analysis of 27 original articles, 14 in Spanish and 13 in Portuguese, published between 1996-2014. Search limits: traditional medicine and cultural care in CUIDEN database and SciELO virtual library. Results. The predominant type of therapy discussed falls within the natural plane. Health problems treated are primarily related to women and newborns. Likewise, women’s role is crucial in maintaining tradition, promoting, transmitting and being its undisputable protagonists. Conclusion. It is essential that health professionals, especially nurses, get involved in the cultural care of patients, accepting and supporting this kind of knowledge, not only because of the risks that its misuse may pose, but also to provide consistent care, breaking through cultural barriers and favoring communication with patients (AU)

El cuidado espiritual: una propuesta con base en las prácticas tradicionales de una comunidad indígena Nahua / Cuidado espirituais: proposta com base nas práticas tradicionais de uma comunidade Nahua / Spiritual Care: a traditional practices based proposal from nahua Indian Community

El presente artículo se genera a partir de los resultados de la investigación "Prácticas de cuidado tradicional y espiritual en una comunidad indígena nahua" (García, 2015; García Piña, Cardoso Gómez, Serrano Sánchez & Ostiguín Meléndez, 2015), donde se identificaron elementos de carácter espiritual como recurso para el afrontamiento del proceso salud-enfermedad y muerte. Dichos resultados se complementaron con un análisis documental. Objetivo: Reivindicar las estrategias de cuidado en el contexto social, cultural e histórico, de la comunidad estudiada, con la finalidad contribuir a mejorar la práctica del cuidado de enfermería en el contexto mexicano. Método: Análisis documental teórico-inductivo. Resultados: Las comunidades se van construyendo a partir de objetivos y fines comunes, y son éstas mismas quienes generan respuestas a los procesos de salud-enfermedad y muerte desde su perspectiva particular. Conclusiones: La enfermería tiene como función primordial rescatar las respuestas que las personas generan individual y colectivamente, para afrontar situaciones de la vida; y permitir que el cuidado sea un ejercicio de retroalimentación mutua (AU)

This paper outlines the findings from research named "Traditional and spiritual care practices in a Nahua, indigenous community" (García, 2015; García Piña, Cardoso Gómez, Serrano Sánchez & Ostiguín Meléndez, 2015), in which spirituality elements were identified as coping strategies for the health-diseasedeath processes. Those results were complemented with a documental review. Objective: to claim on the caring strategies, on a specific social, cultural and historical context, that promotes the improvement of the nursing practice in the Mexican context. Method: theoretical-inductive documentary analysis. Results: communities are built from common goals and objectives, which arise as health-disease-death processes in its own particular perspective. Conclusion: nursing has as one of its main functions, to rescue people's individual and collective response, for coping with every life situation; allowing that care itself, becomes a mutual feedback exercise (AU)

Este artigo tem sua origem no projeto de pesquisa intitulado "Práticas de cuidado espiritual e tradicional em uma comunidade indígena Nahua" (García, 2015; García Piña, Cardoso Gómez, Serrano Sánchez & Ostiguín Meléndez, 2015), no qual elementos de espiritualidade foram identificados como cópias de estratégias para o processo saúde-enfermidade-morte. Os resultados foram complementados com uma revisão documental. Objetivo: reivindicar as estratégias assistenciais, em um contexto social, cultural e histórico específico, que promova a melhoria da prática de enfermagem no contexto mexicano. Método: análise documental teórico-indutiva. Resultados: as comunidades são construí- das a partir de metas e objetivos comuns, que surgem como processos saúde-enfermidade- -morte em sua própria perspectiva particular. Conclusão: a enfermagem tem como uma de suas principais funções, resgatar a resposta individuais e coletivas das pessoas, com o objetivo de lidar com cada situação de vida; Permitindo, desse modo, que o cuidado torne-se uma mútua atividade de feedback (AU)

Validación facial de la escala Nursing Activities Score en tres unidades de cuidado intensivo en Bogotá, Colombia / Facial validation of Nursing Activities Score in three intensive care units in Bogota, Colombia

Introducción: La medición de cargas de trabajo en enfermería es fundamental para objetivizar la relación enfermera-paciente. Se asume que a mayor complejidad de los pacientes, es mayor el tiempo de dedicación de una enfermera a la provisión de cuidados directos Método: Se usará la adaptación transcultural de la escala Nursing Activities Score (NAS) al español, compuesta por 23 ítems que miden tareas clínicas y administrativas de enfermeras en UCI. Se someterá el instrumento a un juicio de expertos usando el método delphi de dos rondas para corroborar la validez de contenido del instrumento. Se aplicará la razón de validez de contenido (RVC) y el índice de validez de contenido (IVC) para establecer la utilidad de cada uno de los ítems. Posteriormente, se aplicará el instrumento a una muestra de profesionales de enfermería de tres unidades de cuidado intensivo polivalentes, aplicando los mismos estadísticos de prueba. Resultados: Se obtuvieron datos de RVC significativos para la mayoría de los ítems, tanto en la ronda de expertos como en el muestreo con profesionales. Aunque hay algunos ítems que no obtuvieron el puntaje mínimo para que se consideren válidos, el índice global IVC en la muestra de expertos y profesionales se considera satisfactorio, por lo que se considera que la escala puede ser válida con modificaciones (AU)

Introduction: The measurement of workloads in nursing is essential to objectify the nurse-patient relationship. It is assumed that the greater complexity of patients, the greater the time commitment of a nurse providing direct care. Method: Cross-cultural adaptation of the scale Nursing Activities Score (NAS) to Spanish, includes 23 items that measure clinical and administrative tasks of nurses in ICU use. The instrument to an expert opinion be submitted using the Delphi method two rounds to corroborate the content validity of the instrument. The ratio of content validity (RVC) and content validity index (CVI) to establish the usefulness of each item will apply. The ratio of content validity (RVC) and content validity index (CVI) to establish the usefulness of each item will apply. Subsequently, the device should be applied to a sample of nursing professionals three polyvalent intensive care units, applying the same statistical test. Results: significant RVC data were obtained for most items, in the round of experts and professionals sampling. Although there are some items that did not obtain the minimum score to be considered valid, the global index IVC in the sample of experts and professionals is considered satisfactory, so the scale is considered to be valid with amendments (AU)

The Cultural Competence of Graduating Nursing Students.

PURPOSE: Cultural competence is an essential component in nursing. The purpose of this study was to evaluate the level of cultural competence of graduating nursing students, to identify associated background factors to cultural competence, and furthermore to establish whether teaching multicultural nursing was implemented in nursing education. DESIGN: A structured Cultural Competence Assessment Tool was used in a correlational design with a sample of 295 nursing students in southern Finland. FINDINGS AND CONCLUSIONS: The level of cultural competence was moderate, and the majority of students had studied multicultural nursing. Minority background (p = .001), frequency of interacting with different cultures (p = .002), linguistic skills (p = .002), and exchange studies (p = .024) were positively associated to higher cultural competence. IMPLICATIONS FOR PRACTICE: To improve cultural competence in students, nursing education should provide continuous opportunities for students to interact with different cultures, develop linguistic skills, and provide possibilities for internationalization both at home and abroad.

Ethnocultural Gerontological Nursing: An Integrative Literature Review.

The aging population is growing increasingly more diverse, with one in four older adults from an ethnic minority group by 2050, while the nursing force will largely remain members of a single race White population. The purpose of this review is to appraise the state of nursing knowledge in relationship to meeting the needs of elders in unique racial/ethnic groups using two approaches: evaluating the efficacy of current knowledge and evaluating the state of nursing knowledge about ethnocultural gerontological nursing based on an integrative review of nursing literature. Thirty-four articles were reviewed. Most articles used qualitative methodology focused on a single ethnic group, with several articles focused on health promotion/prevention. Cultural perspectives were better addressed than aging concepts and few articles integrated ethnocultural and gerontological nursing concepts. This evaluation indicates many gaps in the knowledge base about ethnocultural gerontological nursing. Specific areas for future knowledge development are identified.

Female genital mutilation and transcultural nursing: adaptation of the Rising Sun Model.

BACKGROUND: Female genital mutilation (FGM) is a widespread practice mainly in Sub-Saharan Africa and is considered an affront on the dignity and health of women and young girls. OBJECTIVES: To establish a theoretical model, inspired by that of Madeleine Leininger, in order to examine the reasonings used to justify FGM. METHODS: Theorization through bibliographic review. Resuts and conclusions: The factors used to justify this act are diverse and convert the tradition into a form of cultural care. From this viewpoint, nurses might evaluate the supposed justifications via the Rising Sun Model in order to redirect such a practice through nursing interventions such as: research into propagating factors, sensitizing through hindering factors or health education, highlighting the contradictions existent in the justification of FGM.

Psychometric evaluation of the Cultural Capacity Scale Arabic version for nursing students.

BACKGROUND: With the rising influx of migrants into Saudi Arabia, it becomes necessary to develop a valid and reliable tool that can accurately measure the cultural competence of the Saudi nursing students. AIM: This study evaluated the psychometric properties of the Cultural Capacity Scale Arabic version (CCS-A) for nursing students. METHODS: A descriptive, cross-sectional study was conducted among 200 nursing students in Saudi Arabia. The scale reliability was assessed by internal consistency and stability reliability. Scale validity was established by content validity and construct validity. Exploratory factor analysis (EFA) was performed to extract the factors of the CCS-A. RESULTS: The computed Cronbach's α coefficient was 0.96 and the intra-class correlation was 0.88. The CCS-A exhibited excellent content validity and good construct validity. The EFA revealed a single factor with a cumulative contribution rate of 57.4%. CONCLUSION: The CCS-A exhibited acceptable reliability and validity, thus supporting its sound psychometric properties.

Nurses' performance on indigenous and African-Brazilian health care practices. / Atuação de enfermeiros sobre práticas de cuidados afrodescendentes e indígenas.

OBJECTIVE:: to analyze the performance of nurses from the Estratégia Saúde da Família (Family Health Strategy) on health care practices rooted in African and Indigenous cultures. METHODS:: Thematic Oral History was used and interviews were conducted with seven participants, who worked with Primary Health Care in Northeastern Brazil. The analysis was based on Leininger's Theory of Cultural Care and the intercultural concept of human rights, among others. RESULTS:: nurses are unaware of the religious and historical context of the ethnic groups cared for and do not appreciate their self-care practices in areas with a predominance of African and indigenous cultures. These practices coexist with the hegemonic biomedical model. CONCLUSION:: the debate on cultural competence in the context of professional qualification and exercise is required, aiming to promote the nursing work in the perspective of diversity and comprehensiveness of health care.

Prevalencia del Streptococcus agalactiae en la mujer embarazada en la ciudad autónoma de Melilla. ¿Es la cultura un factor determinante? / Prevalence of the Streptococus agalactiae in the pregnant woman from the autonomic city of Melilla: is culture a determinant factor?

Contexto. La infección neonatal por estreptococo grupo B es una de las principales causas de morbimortalidad neonatal. Por ello se realiza un cribado a todas las gestantes para detectar su presencia y, en tal caso, administrar un tratamiento antibiótico durante el trabajo de parto. El objetivo del estudio fue conocer la prevalencia de estreptococo en las gestantes de Melilla, así como sus diferencias en función de la cultura y la edad. Método. Estudio descriptivo trasversal con emplazamiento en el Hospital Comarcal de Melilla. Resultados. La muestra tomada está formada por 280 individuos; 194 son de cultura musulmana (69.3 %) y 68 son de cultura cristiana (24.3 %), con 18 individuos de cultura desconocida (6.4 %). Asimismo, se sabe que 78 tienen una edad menor o igual a 25 años (27.85 %), 158 individuos tienen una edad comprendida entre los 26 y 34 años (56.42 %) y 44 individuos tienen una edad igual o mayor a 35 años (15.71 %). Conclusiones. La prevalencia de colonización vagino-rectal por estreptococo grupo B en las gestantes de Melilla está dentro de las cifras estimadas a nivel nacional. Sin embargo, es diferente en función de si pertenecen a la cultura musulmana o cristiana, siendo mayor en la población musulmana. Ambas prevalencias se encuentran dentro de las estadísticas nacionales. Por otro lado, se observa que no existen diferencias en la prevalencia en función de la franja etárea (AU)

Background. The neonatal infection by Streptococcus group B is one of the main causes of neonatal morbi-mortality rate. For this reason a screening is made to each pregnant woman in order to detect its presence, and if it was the case, to apply an antibiotic treatment during labour. The aim of this study was to know the prevalence of this Streptococcus in the pregnant women from Melilla, as well as the differences according to culture and age. Method. A descriptive cross-sectional study located in the Hospital Comarcal from Melilla. Results. The sample is taken from 280 women: 194 are from Muslim culture (69.3 %), 68 are from Christian culture (24.3 %) and 18 women from unknown cultures (6.4 %). Also it is known that 78 of them are 25 years old or less (27.85 %), 158 are between 26 and 34 years old (56.42 %) and 44 are 35 years old or more (15.71 %). Conclusions. The prevalence of vagino-rectal colonization by Streptococcus group B in the pregnant women from Melilla is within the national estimated figures, however it is different if they are from Muslim or Christian culture, being higher in the Muslim population. On one hand both prevalences are within the national statistics, and on the other hand it is observed that there is not any difference according to age (AU)

Cultural Congruence and Infusion Nursing Practice.

The importance of cultural competence in every nursing practice setting in today's world cannot be understated. Unconscious bias can have detrimental effects on therapeutic relationships and health outcomes. Nursing models of cultural competence by Purnell, Leininger, and Campinha-Bacote are reviewed. The Kleinman Model and LEARN Model offer questions and guidelines to facilitate assessment of patients' understanding of illness and treatment. The Infusion Nursing Standards of Practice contains elements of diversity and cultural competence throughout. Self-reflection of one's own values, beliefs, biases, and practice as an infusion nurse will promote the development of cultural competence.

Samoan Philosophy of Nursing: a basis for culturally proficient care and policy.

AIM: To explore nurses' perspectives about the Samoan Philosophy of Nursing, and determine its feasibility for nursing care of Samoans internationally. BACKGROUND: This philosophy is the conceptual cultural framework for nursing law, practice, education and research in Samoa, and was developed by Samoan nurses who recognized the need for guidance to deliver quality, culturally competent and proficient health care. DESIGN: A mixed method study, employing a questionnaire and ethnographic methods. METHOD: The Samoan Philosophy of Nursing Questionnaire sought demographic data and aspects about the philosophy from 95 registered nurse clinicians, administrators and educators throughout Samoa during 2012. Descriptive statistics were used for data analysis. Additionally, 19 focus groups (5-6 participants each) and 19 in-depth interviews were held to further explore these aspects, as well as participant observations. Descriptive statistics were used to analyse quantitative data, and Spradley's ethnographic method was adopted for analysing the qualitative data. FINDINGS: Of 95 questionnaires analysed, 70% of participants reported using the philosophy all the time, and 30% most of the time. They placed a high satisfaction rate, value and importance on this philosophy. From the ethnography, six major themes emerged: valuable framework of learning; conceptual framework for holistic assessment; benchmark for regulating and monitoring practice improving interaction and culturally proficient practice; potential use for Samoans overseas; and maintaining quality health and the dignity of people. CONCLUSION: This first-time study evaluated the Samoan Philosophy of Nursing and adds to nursing knowledge. Findings confirmed its usefulness as a culturally based conceptual framework to facilitate, regulate and monitor education, research and practice for sustainable health outcomes in Samoa, and for Samoans living abroad. IMPLICATIONS FOR NURSING POLICY AND EDUCATION: It is important that Samoans living abroad receive culturally proficient care, but this requires the support of policymakers, nurse leaders and educators so that nurses internationally can access and competently utilize relevant aspects of this philosophy in practice.