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Introduction: Due to globalization, countries around the world are starting to notice diversity in their populations. It is crucial that midwives be able to communicate effectively with women from a variety of cultures to provide them with culturally effective health care. Method: This cross-sectional study was conducted with 394 midwives who work in seven different regions of Türkiye. Data on the intercultural effectiveness and intercultural communication competence of midwives were collected. Data analysis was performed using descriptive statistics, t -tests, analysis of variance, and regression analysis. Results: Midwives' intercultural effectiveness was influenced by their foreign language proficiency, experiences abroad, having friends from different cultures, following social media platforms in different languages and cultures, providing care to individuals from diverse cultures, and their willingness to do so. Discussion: Findings suggest that exposure to different cultures enhances the level of intercultural effectiveness. Consequently, it is recommended to make plans to support midwives to have positive experiences with different cultures. [ABSTRACT FROM AUTHOR]

Background: Culture is a fundamental concept in healthcare settings due to the reason that care provided to patients is holistic and encompasses their perspectives on health, which are greatly influenced by the patients' cultures. To prepare culturally competent nursing graduates, it is important to understand the experiences of students on transcultural nursing during clinical practice. However, there are limited studies that have explored experiences of students on transcultural nursing, specifically those located in multicultural societies. In addition, studies focus on experiences of international students who visit with student - exchange programme. Nevertheless, their experiences of transcultural nursing may differ since they are not residents and have limited exposure to transcultural nursing, and therefore cannot be generalized to undergraduate resident students. This study aimed to explore and describe transcultural nursing experiences of nursing students during clinical practice at an intermediate hospital in north-eastern Namibia. Methods: Descriptive and explorative qualitative designs were used, data were collected via individual interviews from 16 final year nursing students, who were sampled using maximum variation purposive and snowballing sampling. During data collection, an interview guide was used together with audiotape and field notes. Data analysis followed Tesch's eight steps in qualitative coding process. Trustworthiness was ensured using four principles of Lincoln and Guba, Moreover, ethical clearance and permission were granted by research ethics committees from two institutions. Findings: Four main themes emerged as findings of the study are: nursing students' exposure to different cultural practices and beliefs; personal feelings experienced by nursing students during transcultural nursing; challenges experienced by students during transcultural nursing; and nursing students coping mechanisms. Conclusions: Nursing students had mixed experiences on transcultural nursing which touch on aspects such as exposure to cultural aspects, personal feelings, challenges, and coping mechanisms. These findings are useful in helping nurse educators, clinical mentors, students, and future researchers to understand experiences of students on transcultural nursing. Consequently, assist in enriching transcultural nursing issues in curricula and for adequate preparation of graduates to become culturally competent when providing nursing care. [ABSTRACT FROM AUTHOR]

The objective of this study is to understand the practices of indigenous caregivers in the context of cultural change. Part of the idea of the need to build ethnographic bases that serve as inputs for the implementation of cross-cultural health and cross-cultural nursing approaches, as well as part of the evidence that facilitates health practices, based on competent descriptions that help to understand the cultural diversity of human populations. The methodological approach was carried out from qualitative research, with an ethnographic approach, combining documentary review and semi-structured interviews with 44 people. Codes were identified, grouped into subcategories and categories. Several types of caregivers were found, of which the traditional doctor and the midwife were considered relevant. Their practices are based on knowledge of the material and spiritual dimension, among which the use of medicinal plants, prayer, dream interpretation and collective ceremonies is highlighted. In addition, their work depends on social recognition, caregiver status and role in social organization. Intercultural models must consider caregivers, within the framework of strategies based on the dialogue of knowledge and participation. [ABSTRACT FROM AUTHOR]

Aim: Turkey is on the transit route of immigrants as it is located between countries where poverty and wars are intense and European countries. Therefore, there are countless immigrants from different countries in Turkey. Migrations affect every sector, especially the health sector. The aim of this study was to determine how cultural awareness of nurses, who are the cornerstone of the health system, affects brain drain and xenophobia. The problem of health care is not only on the agenda of immigrants, but also on the agenda of health service providers in their countries due to economic and working conditions. Design: This research was designed as descriptive and relationship‐seeking. Methods: The data of the research were collected through Google Forms between December 5 and 26, 2022. A total of 231 nurses working in a public hospital in south‐east Turkey participated in the study. Data were evaluated with descriptive statistics as well as reliability, t‐test, ANOVA, Pearson correlation and linear regression analysis. Results: It was determined that the attitudes of the participants towards brain drain were moderate, their cultural awareness was low and their xenophobic attitudes were high. In addition, it was determined that 44% of the change in the total score obtained from the intercultural awareness scale was explained by the scores obtained from the xenophobia and brain drain scales. Conclusions: In this context, it may be possible to reduce xenophobic attitudes by giving intercultural awareness trainings to nurses. In addition, it is important to provide working conditions and economic support by health policy makers to prevent the brain drain of nurses. Impact: Nurses may need to provide care for individuals from different cultures due to the regions in which they live. For this reason increasing their cultural awareness and reducing xenophobia may ensure that they provide improved care to their patients. [ABSTRACT FROM AUTHOR]

Background: Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. Methods: A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. Results: Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. Conclusions: Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking. Highlights: What is already known: Transcultural care promotes satisfaction among diverse populations. Cultural competence promotes an inclusive environment and mutual benefit. Cultural competence reduces biased decision making and promotes cultural awareness. What this paper adds: Transcultural learning in nursing is a complex learning process. Transcultural nursing learning is multifactorial and has an impact on students' personal and professional lives. Transcultural nursing learning experiences involve self-awareness, reflective thinking, cultural encounters, cultural skills, cultural desires and cultural knowledge. [ABSTRACT FROM AUTHOR]

Background: Globalization and population migration have led to increasingly culturally diverse societies, which has made nursing education in cultural competence and transcultural care a priority. This includes the ability to provide person-centered and culturally congruent care, even within one's own culture. However, this sort of training has been developed and implemented in practice comparatively more by English-speaking societies. Therefore, the aim of this study was to identify the existing educational initiatives for nurses and future ones in cultural competence and transcultural care in Spanish and explore their didactic characteristics in terms of teaching and learning formats, contents, skills, and evaluation methods at different academic levels. Methods: A scoping review was carried out by following the specific PRISMA recommendations and those of the Joanna Briggs Institute guidance throughout PudMed, Web of Science, Embase, Google Scholar, and Cinahl databases and also gray literature in the form of official documentation that later was complemented with a gap analysis including training programs published by Spanish and Latin-American educational institutions and the approaches of key academic informants. Results: The published evidence on nursing training in cultural competence or related topics in Spanish-speaking higher education for nurses is limited. Specific nursing programs in Spanish-speaking universities are primarily found in Spain, with fewer options available in Latin America. These contents are offered either as optional subjects or immersed in other courses and mainly taught in theoretical sessions. Practice in real contexts is supposed to be evaluated transversally under the cultural scope according to national educational recommendations though barely visible in students' evaluation reports. Even though postgraduate training dedicated to these issues exists, it is still limited, mixed with other contents, and generally depends on a few researchers investigating and publishing on the topic from very specific universities. Conclusions: It is essential to establish a common global strategy including Spanish-speaking countries in nurses' higher education and professional training on topics focused on cultural competence as well as the provision of nurses' social and cultural sensitivity towards their own culture and to define whether those that currently exist are effective. It is also crucial that this training was evaluated in practice in order to achieve enough impact on students, health organizations, and population health. [ABSTRACT FROM AUTHOR]

This study aimed to analyze Madeleine Leininger's Theory of Diversity and Universality of Cultural Care. It is a study of interpretive analysis based on the model of theory evaluation proposed by Johnson, carried out in the months of January and February 2022. It is confirmed that Leininger's theory has theoretical consistency and the ability to contribute to practical, scientific and nursing profession. The theory is presented as easy to understand, with accessible and clear language, and presents well-defined concepts that stimulate the formulation of propositions. It presents further variations and assumptions that contribute to the interpretation and understanding of the propositions, as well as theoretical knowledge that helps to explain and make predictions about two phenomena of interest in the disease. To analyze it is possible to show Leininger's theory to theoretical consistency and to the capacity to contribute to nursing practice. The relevance of the application of nursing hairs in various contexts of care is highlighted for the scope of care that is culturally and consistently guided by the context and the needs of two individuals. [ABSTRACT FROM AUTHOR]

Aim: The aim was to study medication use, effects of medication and perspective of participants involved in medication use among hospitalized older Buddhist monks. Design: An embedded mixed‐method study. Methods: This study included 71 hospitalized older Buddhist monks and 23 participants involved in medication use. Quantitative data were collected from medical and medication records. Meanwhile, qualitative data were collected by using in‐depth interviews. Data were analysed using descriptive statistics and content analysis. The study lasted from February to July 2021. Results: Over 77% of the monks had chronic diseases. The median of medicine use was seven medicines/person and 6 days of use. Effects of the medication were as expected (52.04%), not as expected (2.22%) and unmeasurable results (45.74%). Unexpected results were hypo‐hyperglycaemia, nausea/vomiting, high blood pressure and confusion. From the interview, participants perceived and did not perceive unique practices and medication use in Buddhist monks. In addition, the Buddhist monks received medication following standards and Buddhist doctrine. Finally, recommendations for medication use were adhering to the standard, following Buddhist doctrine and being flexible as deemed necessary. Conclusion: The results revealed medication use problems and medication effects among hospitalized older Buddhist monks. Impact: Older adults and Buddhist monks have specific needs and practices related to culture and religion, affecting typical treatment, especially medication use. Cultural diversity and sensitivity should be a concern for healthcare staff. The results can be utilized to promote an understanding of cultural diversity and increase the safety of medication administration for hospitalized older Buddhist monks. Patient and Public Contribution: Patient and public contributions were involved in this study. Participants involved in medication use were interviewed to answer the research objective. Moreover, a senior Buddhist monk at Wat Thai Washington D.C. reviewed content related to the Pali Canon for the final draft of the manuscript. Clinical Trial Registration Number: https://osf.io/b6p3e [ABSTRACT FROM AUTHOR]

The health profile of foreigners in Italy is affected by multiple factors and events, including environmental, microbiological, cultural, and behavioral. To explore nurses' basic cross-cultural knowledge, and their perceptions of problems that arise in encounters with clients from outside the country, and to suggest solution strategies, we enrolled 327 nurses in an observational, cross-sectional, multicenter study. The findings suggested a need to improve sociocultural skills related to working in a multiethnic society, as early as the first level courses and possibly continue with appropriate master's degrees and research projects. [ABSTRACT FROM AUTHOR]

Background: In an increasingly multicultural society, cultural competence and transcultural self-efficacy of public health nurses is important for providing culturally congruent care for client from diverse cultural background. To improv this, it is needed tailored and effective educational program based on the cultural competence educational needs. This study investigated the moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence. Methods: This cross-sectional study recruited 217 public health nurses in Korea using convenience sampling from August 2018 to January 2019. A direct questionnaire was used to collect data. Study variables were analyzed using descriptive statistics, correlation, and the Hayes PROCESS macro (Model 1) moderation model. Results: The mean scores for transcultural self-efficacy, cultural competence educational needs, and cultural competence were 62.33 ± 11.08, 58.19 ± 15.08, and 97.96 ± 17.09, respectively. Transcultural self-efficacy and cultural competence educational needs were positively associated with cultural competence. In the tested model, cultural competence educational needs had a conditional moderating effect on the relationship between transcultural self-efficacy and cultural competence. The positive association between transcultural self-efficacy and cultural competence was significant at low, medium, and high levels of cultural competence educational needs and stronger for those with high needs. Conclusions: Cultural competence educational needs may be an important determinant of cultural competence among public health nurses. To effectively increase cultural competence, transcultural self-efficacy should be increased by education programs tailored by cultural competence educational needs. [ABSTRACT FROM AUTHOR]

The article presents the discussion on impact of migrant policies on the health of involuntary migrant women being integrated into nursing education curriculum. Topics include providing nurses with ongoing education and support related to the integration of trauma and violence-informed care within practice being recommended; and higher rates of mental health concerns and forms of abuse and violence.

Because of globalization, immigration, and mass exodus from countries due to political conflicts, there is an ever-changing mix of people with diverse cultural backgrounds who require institutions to provide continuing education to ensure that effective services are provided to everyone. Part of the transcultural challenges involves religion, socioeconomic differences and languages, and ethnic backgrounds that differ. The objective of this study was to examine whether a transcultural training program for undergraduate nursing students in Israel could enhance students' cultural competence. In this study, 319 senior undergraduate nursing students were asked to complete the Transcultural Health Care Screening Questionnaire as a measure of their cultural competence. The students' cultural competence was satisfactory but less than it had been in previous years. The authors suggest that cultural competence needs to be considered as a contextual, developmental, and experiential process that requires ongoing attention and curricular revisions. [ABSTRACT FROM AUTHOR]

Background: Substantial mass migrations to the Scandinavian countries have made them heterogeneous and multicultural societies. Migration has also influenced the workforce, especially the healthcare system that has had to accommodate a culturally diverse population. This qualitative study aimed to explore nurses' experiences in caring for patients with an ethnic minority background. Methods: Focus group interviews with a total of 21 nurses were conducted. Thematic analysis was performed on the transcribed and translated interviews. Results: The findings of this study revealed three major themes: various experiences concerning language barriers and the use of interpreters, the impact of religious and cultural values, and caring for patients with an ethnic minority background is professionally interesting but demanding. Conclusions: Caring for culturally diverse patients offers both challenges and opportunities to enhance cultural competence and cultural sensitivity among nurses. Various culturally divergent needs of patients such as family visits, food preferences, expression of pain, and gender sensitivity are interlinked and depend on effective communication during encounters with nurses and the healthcare system at large. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed challenges to healthcare organizations across the world. This article describes an international joint venture between Mayo Clinic and Abu Dhabi to care for an increasing number of patients with COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Jack Goody and Edward Evans Evans-Pritchard have been two eminent Africanist anthropologists who have developed their works and research regarding Cognitive and Symbolic Anthropology and can contribute knowledge to Applied Anthropology. Objectives: to expose the personal reflections on the intersections in cognitive and symbolic anthropology of the works of Jack Goody (The Domestication of Savage Mind) and Evans-Pritchard (Theories of Primitive Religion) and to argue in a reflexive way the possible applications of both works to Applied Anthropology in Education and in Transcultural Nursing. Methodology: in-depth reading and subsequent reflective comparative analysis of both works to then propose possible applications to the aforementioned disciplines or professions. Development and results: Jack Goody converges with Evans-Pritchard at a cognitive and symbolic level. Both authors show that human beings, regardless of their ethnic or cultural origin, have different forms of cognitive organization of reality and different symbolic forms of expressing and to ritualize their beliefs. This does not mean that some human groups are inferior to others, even if they are from preliterate societies. Conclusion and final reflection: both authors and both works can serve as semiotic elements for an education in cultural diversity, in the prevention of violent behaviour against hatred and to empathy people in their concept of health/disease to further develop Transcultural Nursing and Cultural Competence. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to identify the nature of racism in the nurse–patient relationship and summarize international research findings about it. Design: A scoping review of the international literature. Data sources The search process encompassed three main online databases of PubMed (including MEDLINE), Scopus and Embase, from 2009 until 2021. Review methods: The scoping review was informed by the Levac et al.'s framework to map the research phenomenon and summarize current empirical research findings. Also, the review findings were reflected in the three‐dimensional puzzle model of culturally congruent care in the discussion section. Results: The search process led to retrieving 149 articles, of which 10 studies were entered into data analysis and reporting results. They had variations in the research methodology and the context of the nurse–patient relationship. The thematical analysis of the studies' findings led to the development of three categories as follows: bilateral ignition of racism, hidden and manifest consequences of racism and encountering strategies. Conclusion: Racism threatens patients' and nurses' dignity in the healthcare system. There is a need to develop a framework of action based on the principles of culturally congruent care to eradicate racism from the nurse–patient relationship in the globalized context of healthcare. Impact Racism in the nurse–patient relationship has remained a relatively unexplored area of the nursing literature. It hinders efforts to meet patients' and families' needs and increases their dissatisfaction with nursing care. Also, racism from patients towards nurses causes emotional trauma and enhances job‐related stress among nurses. Further research should be conducted on this culturally variant phenomenon. Also, the participation of patients and nurses should be sought to prohibit racism in healthcare settings. [ABSTRACT FROM AUTHOR]

Introduction: Culture-sensitive (CS) and patient-centered (PC) care are considered essential to achieve high-quality equitable care. The purpose of this study was to determine how expert nurses incorporate CS/PC care into their assessment and care planning practices, especially for culturally diverse and marginalized patients. Methodology: Using a qualitative, descriptive design, we conducted a focus group at the October 2019 Transcultural Nursing Society Conference. Participants (n = 9) discussed how they instilled cultural sensitivity and patient-centeredness into their assessment and care planning skills. Results: Participants revealed attitudes, knowledge, and skills associated with CS/PC assessment and care planning. They also identified specific strategies for translating CS/PC theory into assessment and care planning practices. Discussion: Three principles and many pragmatic strategies for incorporating CS/PC care into daily practice emerged from the data. Nurses may find these principles and strategies helpful in integrating CS/PC care into their daily care of patients in busy clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds. Materials and methods: A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5–7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal. Results: 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice. Conclusion: The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus pandemic has disproportionately negatively affected the ultraorthodox in Israel. Their unique characteristics and slow adoption of preventative health guidelines resulted in a significant increase in morbidity and mortality. To lower these rates, health and government authority figures employed methods to change the ultraorthodox community health behaviors. Methodology: This study utilizes the ACCESS model for transcultural nursing to analyze the response by authorities to high infection rates in the large ultraorthodox community in city of Beit Shemesh during the first wave of the outbreak (through early May). Results: The authorities employed all model components to varying degrees and found moderate success in changing health behaviors of the ultraorthodox. Discussion: Employing the ACCESS model as a response to the health care crisis among the ultraorthodox community in Beit Shemesh led to some success in increased compliance, thus lowering morbidity rates. However, not establishing strong respect and rapport hindered the process. [ABSTRACT FROM AUTHOR]

Aim: To identify and analyse the cultural attitudes, beliefs and practices of internationally educated nurses towards end‐of‐life care in the context of cancer. Background: Cultural heritage shape beliefs and practices about cancer and end of life, which complicates nursing care delivery. While previous studies centred on diverse patients' perspectives and cultural competence of healthcare professionals, little analysis available focusing on the cultural attitudes and beliefs of care providers from diverse backgrounds. Design: Mixed methods systematic review. Data sources: CINAHL, MEDLINE, Embase, PsychINFO and Scopus were searched between January and March 2020. No date limit was applied. Review methods: Quality appraisal was conducted using the mixed‐method appraisal tool. Convergent segregated synthesis was undertaken. Findings were thematically synthesised with the final synthesis presented narratively. Results: Seven studies were included: three qualitative, two quantitative and two mixed methods. None of the studies focused on the end‐of‐life care experiences of IENs in the context of cancer. One study reported views on cancer, with all studies analysing the cultural attitudes, beliefs and practices of internationally educated nurses towards end‐of‐life care. Three main themes were identified: the philosophy of care, approaches to care and perceptions of death and dying. Conclusion: The distinct gap in research on understanding the cultural attitudes and beliefs of internationally educated nurses in end‐of‐life care in the context of cancer demands further research. Several aspects of end‐of‐life care were in conflict with internationally educated nurses' cultural attitudes, beliefs and practices. As these nurses are integral in achieving culturally competent care, further understanding of this phenomenon is required to advance the delivery of culturally sensitive care to patients. Impact: Stakeholders, including the nursing workforce, need to play an active role in providing a culturally inclusive workplace. Support measures are necessary to reduce the impact of cultural conflicts experienced by internationally educated nurses. [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this article is to clarify the concept Of -cultural competence" contextually, thus providing clear conceptual foundation in nursing and in health care. Background. Other concepts have been used interchangeably in lieu of cultural competence; consequently, this elicited confusion and inconsistencies. Method. Rodgers' evolutionary method was used to clarify the concept of cultural competence. Results. Four attributes were identified. cultural awareness. cultural knowledge, cultural skills, and cultural humility which structured the pyramid of cultural competence. Conclusion. The four themes were echoed in nursing and in other disciplines. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 (coronavirus disease 2019) pandemic has radically changed the future of study abroad, yet students require the knowledge, skills, and attitudes to provide care for diverse cultures across geographical boundaries. The purpose of this article is to facilitate innovative learning opportunities in order to meet global health competencies in the physical or virtual classroom when study abroad is not feasible. Approach: Based on a review of published literature related to global health competencies and nursing over the last decade, a description of suggested global learning activities is provided. Results: Few research publications exist to describe activities for meeting global health competencies when travel abroad is restricted. The proposed activities provide a foundation to address the gap in literature and to establish a trajectory for future research. Discussion: The challenge is to demonstrate evidence of global health competency attainment when students are confined to their local community. [ABSTRACT FROM AUTHOR]

Introduction: Opening up to global migration processes has contributed to increasing the cultural diversity of Polish society. The diagnosis of nurses' attitudes toward cultural differences is important in the assessment of training needs and in providing professional care. Method: Cross-sectional studies, was carried out in 2018 among 1,271 nurses. In the research, the following scales and questionnaire were used: Bogardus Social Distance and Social Dominance Orientation Scales; Social Approbation Questionnaire and author's questionnaire. Results: The respondents showed the highest social distance toward Russians, Vietnamese, and Chechens. There was a significant dependence of the level of social distance of respondents from age, job seniority, place of residence, education, frequency of contact with representatives of other nationalities, living abroad, care for a person of other nationality, training on transcultural nursing, participation in cultural events regarding representatives of other nationalities. Conclusions: The results of the research indicate the need to train nurses in the field of transcultural nursing. [ABSTRACT FROM AUTHOR]

Introduction. The current globalized world expresses important challenges for nursing care, so that the suffering is recognized and relieved taking into account the patient’s culture. Objective. To describe the fin¬dings of research into experiences of hospital nurses about compassion and care to culturally diverse people. Method. Systematic review. The searches were conducted in: Web of Science, CINAHL, OVID Nursing, Evidence Based Medicine Reviews, Medline (PubMed), PsycARTICLES, Virtual Health Library, CUIDEN Plus, TripDatabase, Epistemonikos and Descubridor de la Universidad Nacional de Colombia. A total of 83 searches were conducted with MeSH, DeCS and natural language terms, including research or review articles with qualitative approaches, published in Spanish, English or Portuguese. Results. 42 papers were included, with a predominance of phenomenological, ethnographic and grounded theory designs. These reflect the link between compassion and care for culturally diverse people, developed through three themes, and 14 sub-themes. Conclusion. The experiences of nurses and patients are diverse, but the connection between compassion and cultural competence in nursing care in the clinical setting is visible. This systematization shows educational and training needs, demonstrates the tensions between personal, professional and institutional culture. [ABSTRACT FROM AUTHOR]

Aims: To identify (a) the challenges for multicultural aged care teams; (b) the opportunities to facilitate teamwork; and (c) the strategies to assist team members in a multicultural work environment. Background: High‐income countries have an increasingly culturally diverse aged care workforce. Fostering teamwork in such an environment is challenging. Methods: This systematic review of qualitative studies followed the Joanna Briggs Institute (JBI) meta‐aggregation approach. Six databases were searched. Retrieved articles were screened by two reviewers. This review identified 111 findings that were aggregated into 15 categories and five themes. Findings: Aged care workers' awareness of cultural diversity varies, and their knowledge of each other's cultural background is limited. However, cultural skills are demonstrated, contributing to teamwork. Their experience in cross‐cultural encounters is broad, and enhanced team cohesion is desired. Conclusions: The cultural competence of the aged care workforce shapes team building, peer support opportunities and positive cross‐cultural experiences. Implications for Nursing Management: Recommendations are provided for the adaptation of aged care workers to culturally diverse teams, fostering teamwork to enhance care outcomes for clients. Interventions for improvements in cross‐cultural leadership and management, and staff experience of cross‐cultural encounters are much needed. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, Italy has been exposed to significant migrant flows resulting from political and economic instability in neighbouring countries. As a result, there has been an increased amount of cultural and linguistic diversity (CALD) among nursing students. The aim of this study was to explore the experience of CALD nursing students as lived in the Italian nursing programmes. Method: A descriptive phenomenological method was used in 2017 with the involvement of a purposeful sample of 21 CALD nursing students in five Italian Bachelor of Nursing Science campuses. Data were collected using semistructured interviews; the subsequent content analysis was conducted by two independent researchers. Results: CALD nursing students reported having lived a transformative experience based on seven themes, from "living in the middle, between belonging and detachment" to "acquiring cultural awareness and cultural sensitivity." Discussion: Dealing with linguistic and cultural differences can affected CALD students' academic success, but also encourages them to develop awareness and cultural sensitivity by influencing their peers and the environment of the nursing programme. Therefore, having CALD students is a great value for nursing programmes. Nursing programmes should embody the values of cultural sensitivity and acceptance, including them as a nursing care value and as a concrete strategy to support CALD students. They should also develop strategies to promote the knowledge and responsibilities of nurses among CALD students and increase cultural sensitivity among faculty members at different levels. [ABSTRACT FROM AUTHOR]

Introduction: Nursing practice should promote the maintenance of wellbeing and life, through respect for culture against disease, through models of care in the evidence-based pluricultural context. The objective of this study was to reveal the rites of early childhood Pumé, and its impact on cultural reproduction and health care found such as protective collars, the placement of clinical names and the predisposition of the child: writing and painting skills attributed to maturity during its growth. Methodology: We frame the look in a focused ethnography exploring interculturality, rites of steps. The group of social actors subject to study was made up of seven key informants of the Pumé Ethnicity, with more than 5 years in the Community studied. Conclusions: Cultural care in Early Childhood will include activities aimed at preserving or maintaining, adapting or negotiating, reorienting or restructuring the care granted to children. That is why in the multicultural context in which we live, it is important to incorporate beliefs and values of people and thus provide effective, satisfactory and coherent nursing care with their culture and with evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Introduction: Leaders are realizing the importance of recognizing diversity and applying cultural humility for successful outcomes. When a difference in perspective is misunderstood or not adequately considered, the resulting conflict interferes with the accomplishment of goals and relationships. With the intent to advance mutual understanding and improve human interactions, a theory to guide nurses and other professions on how to appreciate diversity and apply cultural humility is presented. Method: Guided by Walker and Avant's strategies, the theory was developed from a synthesis of key concepts and constructs from research and scholarly works. Results: The theory of cultural humility is presented. Discussion: To foster a better understanding of the multiple considerations involved in being culturally humble, this theory provides clarity of the related concepts, influences, and outcomes. This theory may help learners recognize the multiple factors that lead to discordant perspectives and exude flexibility to foster positive outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Health care and culture are important to patient care. Theoretical frameworks, service delivery, and self-awareness are important to the provider/patient. Provider care varies, and studies are needed to understand the current interactions between providers, patients, and culture. Methodology: This was a prospective, descriptive correlational pilot study. Providers and patients completed a baseline assessment of culture, as well as a Brief Mood Introspection Scale at each visit at the patient's standard of care visit (i.e., visit as part of clinical procedures). Results: The providers and baseline assessment of culture showed higher than average cultural awareness. All four mood subscales show no statistically significant differences in patient or providers' mood. There were no significant differences in mood when considering differences and similarities between gender, race, and ethnicity. Discussion: There was no difference in patient or provider mood in this study when based on the differences or similarities in gender, race, and ethnicity. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to describe basic palliative care from the acute care nurses' perspective with consideration for culturally diverse populations. Participants focused their responses based on their experiences with Hmong patients. The concept of cultural safety was explored to improve basic palliative care practice in acute care settings. Method: A qualitative approach was utilized. Thirty-four nurses participated in either focus group or individual interviews. Results: Assisting tradition, understanding culture, and managing language barriers were identified as themes unique to providing basic palliative care to Hmong patients. Discussion: Nurses experienced uncertainty and inadequacy of resources when caring for patients from a Hmong background. Nurses also recognized the strong family ties in this specific population and the importance of supporting tradition while in the hospital. Utilizing Wood and Schwass' framework of cultural safety could guide nurses providing basic palliative care to Hmong patients and other culturally diverse patients. [ABSTRACT FROM AUTHOR]

Although the existence of multi-ethnic and pluricultural societies is not new, the perspective of equality and recognition has remained on paper, without permeating citizen attitudes. Migrations and globalization have led to greater international awareness of interculturality, facing challenges at the educational and health care levels, generating regulations in relation to protection and respect for diversity. The emergence and development of the concept of interculturality in education allows us to reflect on its importance and the role it has been given in health and nursing training. It is evident that institutional efforts have been insufficient, as the coloniality of being and knowledge continues to prevail, since Anglo-Saxon and European positions are still assumed that are in tension with the Latin American context. Nursing is still on the way to forging interculturality, it is important to include the subject in the training of professionals, which contributes to the construction of selfcare. The proposal of this article is to approach the notion of interculturality from education and health, to re-think epistemologically another look at the training of professionals in nursing. [ABSTRACT FROM AUTHOR]

This paper presents ethnographic data on a migrant-specific nursing home ward in Switzerland. It shows that the structurally pre-defined segregation of residents sharing a common characteristic affects care practices along three dimensions: performances of sameness/otherness, informalisation of relationships and language/understanding. Yet, 'death work' showed little difference to non-segregated wards. However, relatives' practices in dying trajectories were less congruent with nursing home 'doing death', and collisions may evolve. The need for negotiations associated with running a segregated ward seems to elicit enhanced institutional reflexivity with potential to increase the ability of institutions to provide diversity-sensitive services to all residents. [ABSTRACT FROM AUTHOR]

The goals of the Andrews/Boyle Transcultural Interprofessional Practice (TIP) model are to provide a patient- or client-centered systematic, logical, orderly, scientific process for delivering safe, culturally congruent and competent, affordable, accessible, evidence-based, and quality care for people from diverse backgrounds across the life span. Key components of the TIP model include the context from which people's health-related values, attitudes, beliefs, and practices emerge; the interprofessional health care team; effective verbal and nonverbal communication among all team members; and a five-step systematic, scientific problem-solving process—assessment, mutual goal setting, and planning, implementing, and evaluating the effectiveness of therapeutic interventions and care. The model is applicable wherever nurses practice, teach, learn, lead, consult, and conduct research domestically and globally. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Cultural diversity is present in all societies. Nurses must be culturally competent to provide quality care. Objective: To validate the Scale of Attitude toward Immigration in Nursing (EAIE) in Portuguese and to know the attitudes toward the immigration of the first-year undergraduate students of a nursing school in Portugal. Methodology: Descriptive, exploratory, and analytical study, with the translation and transcultural adaptation of the EAIE to the Portuguese language, composed of 39 items. The participants were 143 students. Results: Scale with a good internal consistency, assessed with Cronbach's α (0,94). With the univariate analysis of the scale and each separate item, significant attitudinal differences were identified between men and women in 6 items, and among age groups in 2 items. Conclusion: The attitudes of a portion of the students are not favorable to the full recognition of the rights of health and social resources of the immigrants. It is necessary to develop the training in cultural competence and the Universal Right to Health. [ABSTRACT FROM AUTHOR]

Introduction: A growing number of North Korean defector students enter nursing schools in South Korea. Many of them, however, quit nursing school and fail to obtain a nurse license. The purpose of this study was to describe the educational barriers and needs of North Korean defector nursing students. Method: A qualitative descriptive approach was employed. Convenience sampling was used, and 14 students participated. Qualitative content analysis was employed. Results: Five themes emerged: lack of preparation for higher education, multiple language barriers, differences in education and culture, lack of support and resources, and lack of information and understanding. Discussion: South Korean government needs to provide North Korean defector students with more practical supportive programs. South Korean nursing schools need to provide more transcultural education for South Korean students and supportive adaptation programs for North Korean defector students to produce culturally competent nurses who provide culturally congruent health care. [ABSTRACT FROM AUTHOR]

Purpose: To describe the level of cultural self-efficacy of Colombian nursing professionals and determine the main influencing factors. Method: A descriptive, analytical cross-sectional study was conducted in 211 nursing professionals selected by systematic random sampling for a finite population, using the Colombian version of the Cultural Self-Efficacy Scale. After descriptive statistical analysis, nonparametric tests were applied to determine between-variable associations, followed by multiple linear regression analysis. Results: The mean Cultural Self-Efficacy Scale score was 2.58. An association with sex and age (p < .05) was observed in regression analysis. The mean score for knowledge of cultural concepts was 3.20 and associated with age, years of experience, educational level, and cross-cultural experiences (p < .05). The mean score for confidence in performing cultural nursing skills was 3.29. Conclusions and Implications for Practice: The cultural self-efficacy level of this sample of nursing professionals, with their consequent capacity to provide culturally competent care, is moderate and is associated with sex and age. Confidence in knowledge of cultural concepts is affected by age, educational level, years of experience, and cross-cultural experiences. This evidence supports the implementation of changes to improve the cultural knowledge and therefore cultural self-efficacy of these professionals. [ABSTRACT FROM AUTHOR]

Objective: To know the barriers in the process of building family cultural care for the child in the hospital. Methodology: This is a qualitative study with a cross-cultural theoretical reference of Madeleine Leininger, called Theory of Diversity and Cultural Universality of Care, and with a methodological reference of the ethno-inference. It was developed in 2017 at the pediatric unit of a university hospital in the south of Brazil, through non-participant observation, participant observation and interview with 15 family caregivers of hospitalized children. The data was coded, classified and scrutinized to identify the saturation of ideas and similar or different patterns; also, it was recoded and the theoretical formulations and recommendations were performed. Ethical aspects were followed, according to the Resolution of the National Research Ethics Council 466/2012. Results: The data showed as a barrier the need for hospitalization as a factor of family vulnerability, control of the unit's health team members, hospital norms and routines, and the need to transgress as a manifestation of family care. Conclusion: Cultural care is a process that aggregates knowledge and can be considered a new paradigm for the accomplishment of nursing care by providing the mutual growth and construction of new knowledge, an affective, reflexive, human and empathic relationship between the nurse, the child and the family. [ABSTRACT FROM AUTHOR]

When providers are called to deliver spiritual care to a patient of a different culture, especially if the patient is preparing to die, understanding religious and spiritual beliefs can promote conversations about specific spiritual needs. Muslims will be discussed as one culturally diverse population that frequently receives care from non-Muslim providers. [ABSTRACT FROM AUTHOR]

An editorial is presented on self-awareness and culturally competent care. Topics include rise in cultural and linguistic diversity in healthcare settings in Japan and challenges associated with this diversity; impacts care provided by the healthcare team within Japan; and challenges of providing culturally competent care within Japan.

Aim: To assess the psychometric properties of the Cultural Capacity Scale Spanish version in Chilean nursing students. Background: The increased diversity in healthcare facilities and the current shortage of local nursing workforce in Chile present a significant challenge to the nursing education to train future competent local nurses. To facilitate cultural competence development among Chilean nursing students, it is necessary to regularly assess their cultural competence, which necessitates a culturally adapted valid and reliable tool. Methods: A convenience sample of 502 Chilean nursing students was surveyed in this cross-sectional study using the culturally adapted scale. Reliability of the instrument was established by internal consistency and stability reliability, while validity was established by content and construct. Results: The Cronbach's α value of the entire scale was 0.95, and the test-retest reliability was 0.85. The Corrected Item-Total Correlations ranged from 0.45 to 0.78. The tool manifested an excellent content and construct validity. The exploratory factor analysis confirmed a single factor of the scale. Discussion: The tool demonstrated evidence of internal consistency, stability reliability, content validity and construct validity. The study provided cross-cultural evidence for the potential application of this scale in Chile and other Spanish-speaking countries. Conclusion: The Cultural Capacity Scale Spanish version demonstrated sound psychometric properties for assessing the cultural competence of Chilean nursing students. Limitations: The sample was restricted to one university, and the tool was only used in Chilean nursing students. Implications for nursing policy: The establishment of the Spanish version of the tool will facilitate accurate and timely monitoring of the cultural competence among Chilean nursing students and other Spanish-speaking nursing students and nurses, which can inform the creation of nursing policies aimed at ensuring cultural competence development. [ABSTRACT FROM AUTHOR]

Objetive: the purpose of this study is to analyze and interpret how a group of nurses working at a Primary Health Care Center perceives cultural diversity. This involves describing their relationship with migrants, taking into account the attitude they have and the strategies they employ when attending these patients. Methodology: qualitative design through semi-structured interviews developed in a Primary Health Care Center in Murcia (Spain). Analysis was carried out through coding, saturation and triangulation of the interviews, with the support of the data analysis software MaxQda®. Results: this group of nurses associate cultural diversity with economic migrants, and label them in different ways. Their attitude in this respect strives to give equal health care to every patient. However, the language and cultural barrier they face on a daily basis makes them disagree on the clinical practice, so they suggest strategies to overcome this issue. Final thoughts: the presence of patients from diverse cultures in health care and the importance of providing culturally consistent care are obvious facts. Language and cultural barriers, as well as social prejudices and stereotypes, represent a barrier to establish a therapeutic relationship and practice Health Education. [ABSTRACT FROM AUTHOR]

Cultural diversity between residents and staff is significant in aged care homes in many developed nations in the context of international migration. This diversity can be a challenge to achieving effective cross‐cultural communication. The aim of this study was to critically examine how staff and residents initiated effective cross‐cultural communication and social cohesion that enabled positive changes to occur. A critical hermeneutic analysis underpinned by Giddens’ Structuration Theory was applied to the study. Data were collected by interviews with residents or their family and by focus groups with staff in four aged care homes in Australia. Findings reveal that residents and staff are capable of restructuring communication via a partnership approach. They can also work in collaboration to develop communication resources. When staff demonstrate cultural humility, they empower residents from culturally and linguistically diverse backgrounds to engage in effective communication. Findings also suggest that workforce interventions are required to improve residents’ experiences in cross‐cultural care. This study challenges aged care homes to establish policies, criteria and procedures in cross‐cultural communication. There is also the challenge to provide ongoing education and training for staff to improve their cross‐cultural communication capabilities. [ABSTRACT FROM AUTHOR]

Transcultural nursing inspires us for humanness. The breadth of a culture is handed down through stories. Storytelling creates understanding and mutuality within a culture and between cultures. Deeper understanding can lead to better patient outcomes across variances in health, wellness, and social standing. The intentional use of storying by six nurses in a project called Story Care led to more appreciative understanding of the other's culture and raised awareness of self in interaction with another. The nurses, patients, and their families had deliberate opportunities to learn more about another who was culturally different, to understand how historical perspectives influence the dynamics of interactions, and to explore a sense of commonality and mutuality in nurse-patient engagements. As we strive for cultural intelligence, diversity, and inclusion in our organizations, transcultural nursing helps nurses connect to and be mindful of cultural ways in which we understand a patient's or population's vulnerability, determination, spirit, and strengths that give meaning to their whole health. [ABSTRACT FROM AUTHOR]

Background The global and multicultural society of today creates challenges that require multicultural competence among individuals, especially within caring contexts. Aims and objectives This study assumes an intercultural perspective, and the aim is to uncover a new understanding of the caring community between nurses and patients when these do not speak the same language. The research question is: What is the significance of communication in a caring community when nurses and patients do not speak the same language? Methodological design and method This qualitative study uses a hermeneutical approach. The material was collected through questionnaires with eight nurses and two adults from another culture. The texts were analysed through latent content analysis. Ethical issues and approval Study participation, data storage and handling for research purposes were approved by the participants when they provided their informed consent. Permission to conduct the study was granted by an ethical committee of a hospital organisation. Results Human love is the basis for a caring relationship since it reaches beyond the limits of cultural differences. Integrity is vital for cultural respect and especially for the consideration of spiritual needs in the caring relationship. An affirming presence is essential for communion. Creative courage is fundamental for communication, and continuous information is vital for establishing trust within the caring relationship. Study limitations One limitation to this study might be the limited number of participants (ten). Conclusions Caring for a patient from another culture requires that nurses are open-minded and have the courage to encounter new challenges. It is essential for nurses to respect the patient's integrity but also to acquire knowledge in order to improve their cultural competence. Further research within this area should focus on the role of next of kin in intercultural caring and on how leadership may contribute to improving cultural competence within health organisations. [ABSTRACT FROM AUTHOR]

This qualitative study using semi-structured interviews was conducted to identify the essential components of cultural competence from the perspective of Chinese nurses. A purposive sample of 20 nurse experts, including senior clinical nurses, nurse administrators, and educators in transcultural nursing, was recruited. Using thematic analysis, four themes: awareness, attitudes, knowledge, and skills, with two subthemes for each, were identified. Notably, culture in China was understood in a broad way. The participants' responses focused upon demographic attributes, individuality, and efforts to facilitate quality care rather than on the cultural differences of ethnicity and race and developing the capacity to change discrimination or health disparities. A greater understanding of cultural competence in the Chinese nursing context, in which a dominant cultural group exists, is essential to facilitate the provision of culturally competent care to diverse populations. [ABSTRACT FROM AUTHOR]

Background Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. Aim The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. Method A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. Ethical considerations The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). Results The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. Conclusions Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters. [ABSTRACT FROM AUTHOR]

The main purpose of this introductory article is to evoke professional awareness, spark interest, stimulate thought, and disseminate information concerning multiracial, multiethnic (multiple heritage) individuals within the United States. General background information, terms, definitions, ethno-historical influences, practice implications, and current issues will be highlighted. Areas for further exploration will be proposed. Transcultural imperatives urge all nurses and other health care professionals to become active participants in the new cultural evolution of a different, broader worldview that uncovers the "invisible" culture of multiple heritage individuals. The new vision challenges nurse and other health care professionals to embark upon a new journey in the quest for cultural congruent care for all individuals. [ABSTRACT FROM AUTHOR]