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Introduction: Preventive care practices are a challenge in community care. This study examined hantavirus preventive practices and their relationship with personal and social factors, lifestyle, and cultural beliefs. Method: An explanatory sequential mixed methods design, guided by Leininger's Theory of Culture Care Diversity and Universality, was used in two phases: (a) a cross-sectional relational design (n = 109) and (b) ethnonursing research (n = 30), in an endemic community in Panama. Univariate and bivariate analyses were used to analyze the quantitative data, whereas the Leininger's analysis model was used to analyze the qualitative data. Results: In the quantitative phase, the most frequent preventive practice was household hygiene, and the least frequent was vector control. Two of the eight preventive practices were associated with personal factors and two were associated with social factors. In the qualitative phase, lifestyle, beliefs, and context were found to influence the adoption of hantavirus preventive practices and help explain the quantitative findings. Discussion: Knowledge and understanding of the social and cultural contexts are essential for hantavirus prevention. [ABSTRACT FROM AUTHOR]

Introduction: Rural Appalachian older adults (RAOAs) constitute a vulnerable population and experience significant health disparities. The combination of age, poverty, rural residence, health care provider shortages, and limited transportation increases risks for poor health outcomes. Spirituality enhances older adult health; however, little is known about spirituality–health linkages of RAOAs. Therefore, the purpose of this study was to discover the influences of spirituality on RAOA health. Methodology: Culture Care Theory and ethnonursing method guided analysis of 32 RAOA interviews in community settings in East Tennessee. Results: "Faith" is an integral component of RAOA culture and health. Three themes were extrapolated: (a) Relationship with God is personal; (b) faith beliefs and practices influence health, illness, death, and dying; and [the need to] (c) "Open the door" for spiritual care. Discussion: Faith assessment and spiritual care recommendations contribute to culturally congruent care for RAOAs and may be transferable to care for other older adults. [ABSTRACT FROM AUTHOR]

Background: Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support. Aim: The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation. Setting: Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care. Methods: An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch's open coding system was used to analyse data. Results: Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation. Conclusion: The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements. Contribution: The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners. [ABSTRACT FROM AUTHOR]

Objective: To understand the perception of the nurses who work in the Shock Unit about care during fibrinolytic therapy. Method: Qualitative study, Ethnographic approach, according to ethno-nursing, of Leininger's theory. Thirty-four nurse practitioners participated in a shock unit for adults of a Mexican general hospital. The data were obtained through a semi-structured interview, participant observation, it opted for the content analysis that allowed the elaboration of the categories that facilitated the understanding the data. Results: The analysis revealed the themes: An experience in the time of the other, the scientific and humanistic with a light on the paradigmatic path; opportunity from the nature of life and care from the sensitive vision of my human side. Conclusion: human care is perceptible by belief, motivated from the experiences lived in intensive care units, in this scenario it is necessary to promote hospital cross-cultural studies, due to the scientific wealth of nursing interventions in the shock unit, that strengthens cares like a light on the road. [ABSTRACT FROM AUTHOR]

Background: Qualitative research seeking the perspectives of minority children on child health issues such as childhood obesity and healthy weight care is limited, especially in nursing research. Objective: Our objective is to share methodological, ethical, and cross-language knowledge gained from conducting an ethnonursing research study. This study focused on providing a voice for ethnic minority children in childhood obesity literature. Methods: The purpose of the study was to discover cultural influences on healthy weight care in children of Burmese refugees of Karen ethnicity. Researchers may exclude children of ethnic minorities from studies because of the distinct challenges in conducting cross-language research and research with children. We critically examine these challenges. The challenge of being a stranger was addressed by a period of immersion in the children's activities prior to data collection, in addition to volunteering as an English teacher with Karen adults. The immersion period was crucial for developing the trust needed in child-inclusive research and research in ethnic minority communities. The challenge of designing an inclusive study with families who experience language barriers was addressed with an interpreter who not only spoke Karen but was also a part of the Karen community. The interpreter provided the authentic sociocultural language equivalence needed for the study's rigor. Ensuring the child's voice was clearly heard was addressed with member checking. Methodological changes necessitated by a pandemic were a distinct challenge discussed in detail. Results: We described methods useful for nurse researchers seeking transformative knowledge to reduce health disparities in childhood obesity. Nurse researchers may use these methods related to cross-language research and child research for designing research inclusive of minorities with language barriers. Discussion: The perspectives of children from ethnic minorities are needed to inform culturally congruent healthy weight care for their communities. The goal in providing transparency of the difficulties, successes, and recommendations for methods in research with children of Burmese refugees is to encourage more nurse researchers to work with marginalized groups. Nurse researchers can inform evidence-based, culturally appropriate interventions to address health inequities of minority communities by including the voice of children from these communities. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background/Objectives: Given the lack of effective pharmacologic strategies to prevent, slow, or reverse dementia progression, maximizing quality of life (QOL) is a major priority for persons living with dementia. Despite well‐documented racial/ethnic disparities in dementia incidence and prevalence, it is unknown whether there are racial/ethnic disparities in QOL among persons with dementia. The objective of this study was to determine if there are racial/ethnic differences in poor health‐related quality of life (HRQOL) among persons with and without dementia in a nationally‐representative cohort. Design: Repeated measures cross‐sectional analysis of a prospective cohort study. Setting: United States nationally‐representative National Health and Aging Trends Study (2011–2018). Participants: Non‐nursing home‐dwelling Black, Latino, and white adults age 65+ (n = 10,886). Measurements: We estimated racial/ethnic differences in five dichotomous indicators of poor HRQOL (depressive and anxiety symptoms, self‐rated health, pain, and physical functional limitations), stratified by dementia status (probable, possible, none). We used generalized estimating equations to estimate prevalence ratios (PRs) and differences, and marginal standardization to estimate prevalence. Results: Generally, Blacks and Latinos reported higher prevalence of poor HRQOL compared with whites. The largest differences were observed for self‐rated health, and Latino‐white differences were slightly larger compared to Black‐white differences. PRs were larger among those with no dementia. For example, the Black versus white PRs for poor self‐rated health were 1.93 (95% confidence interval (CI) = 1.82–2.04) among the no dementia group and 1.21 (95% CI = 1.12–1.31) among the probable dementia group; Latino versus white PRs for these comparisons were 2.39 (2.21–2.59) and 1.48 (1.35–1.62), respectively. Prevalence differences also showed racial/ethnic differences, but these were similar across dementia statuses. Conclusions: We observed racial/ethnic disparities in poor HRQOL, showing greater unmet clinical needs among Black and Latino versus white older adults. Relative disparities were smaller in those with dementia, but absolute magnitudes of disparities were similar by dementia status. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Caring for persons at the end of life has dramatically changed in the last 20 years. Improved chronic illness management and aggressive life-sustaining measures for once-fatal illnesses have significantly increased longevity. People with life-limiting illnesses and their families are asked to make complex and difficult decisions about end-of-life, palliative, and hospice care. The purpose of this study was to discover and describe the culture care expressions, patterns, and practices influencing rural Appalachian families making decisions at the end of life. The qualitative, ethnonursing research method was used to analyze data from 25 interviews. The 4 themes discovered provide insights that could help improve this underserved population's access to palliative and hospice care, which in turn could help them experience a dignified death. Recommendations for health care providers could help reduce rural Appalachians' health disparities and promote meaningful, culturally congruent end-of-life care. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge is needed about the cultural experiences, patterns, and practices of American Indian women with polycystic ovary syndrome (PCOS), so nurses can provide culturally congruent care. Method: A qualitative, ethnonursing study based on Leininger's theory of culture care diversity and universality. Data were collected from 13 key informants living on a reservation in the Western United States. Data were analyzed with Leininger's four phases of qualitative analysis. Results: Three universal themes were identified: (1) control of PCOS symptoms is important for the cultural well-being of tribal women, (2) culturally congruent PCOS education and health care are important with variations in approaches to treatment, and (3) tribal culture is important with variations in use of tribal practices. Discussion: Tribal culture affects the health care beliefs and practices of American Indian women with PCOS. The findings can be used to improve culturally congruent care for women with this chronic condition. [ABSTRACT FROM AUTHOR]

Although the process of dying is a universal human experience, it often magnifies individuals' unique cultural differences. Persons experiencing homelessness (PEHs) have unique barriers, challenges, and wishes for end-of-life care. There is insufficient evidence about how to provide culturally congruent advance care planning (ACP) through advance directive (AD) completion for PEHs. This study addressed this knowledge gap, and its findings serve as the basis for developing additional strategies to promote a satisfying ACP experience for this population when they complete an AD. The purpose of this study was to discover if an AD form recreated for PEHs would positively affect their completion of the AD as well as their overall experience with ACP. Guided by the culture care theory and qualitative ethnonursing methodology, 38 individuals (30 PEHs and 8 student nurses) were interviewed. Data were analyzed using the 4 phases of ethnonursing analysis. The 3 themes abstracted were (1) "it needs to be done," (2) the presence or absence of trusted family support, and (3) ACP for PEHs is facilitated by an AD workshop. Nursing interventions based on study findings can be used to help promote a dignified, meaningful ACP experience for vulnerable populations. [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/OBJECTIVES: Previous research indicates that eligibility criteria for medication therapy management (MTM) services in Medicare prescription drug (Part D) plans, defined under the Medicare Modernization Act (MMA), are associated with racial/ethnic disparities and ineffective in identifying individuals with medication utilization issues. Our study's objective was to determine the comparative effectiveness of MTM eligibility criteria under MMA and in the Affordable Care Act (ACA) in identifying patients with medication utilization issues across racial/ethnic groups. DESIGN: ACA and MMA MTM eligibility criteria were compared on proportions of eligible individuals among patients with medication utilization issues. Multinomial logistic regression was conducted to control for patient/community characteristics. Need‐based and demand‐based analyses were used to determine disparities due to need and demand for healthcare. Main/sensitivity analyses were conducted for the range of eligibility thresholds. SETTING: Medicare data (2012‐2013) linked to Area Health Resources Files. PARTICIPANTS: A total of 964 610 patients 65 years or older. MEASUREMENTS: Medication safety/adherence measures, developed primarily by the Pharmacy Quality Alliance, were used to determine medication utilization issues. RESULTS: Higher proportions of patients were eligible based on ACA than MMA MTM eligibility criteria. For example, in 2013, proportions based on ACA and MMA MTM eligibility criteria would be 99.7% and 26.2%, respectively, in the main analysis (p <.001); in the demand‐based main analysis, ACA criteria were associated with 13.6% and 9.8%, respectively, higher effectiveness than MMA criteria among non‐Hispanic blacks and Hispanics than non‐Hispanic whites. CONCLUSION: ACA MTM eligibility criteria are more effective than MMA criteria in identifying older patients needing MTM, particularly among minorities. J Am Geriatr Soc 67:581–587, 2019. [ABSTRACT FROM AUTHOR]

Minority group members tend to have more negative health outcomes compared to majority group members. As reducing health inequalities is a global imperative, research testing strategies to improve minority patient health outcomes are important. Evidence exists that ethnic concordance in patient-physician communication is statistically associated with positive outcomes for minority patients. Previous research has exclusively relied on non-experimental observational methods. The present study adds to this literature by presenting supplementary experimental evidence, thus increasing confidence in the causal interpretation of the relationships observed in previous studies. Individuals with Turkish migration backgrounds living in Germany (N = 256) were randomly assigned to a hypothetical medical consultation in which a physician, Dr. Thomas Kirsch ("German majority physician"; ethnic-discordance condition) or Dr. Çağdaş Kılıç ("Turkish minority physician"; ethnic-concordance condition) talked about lifestyle factors associated with chronic non-communicable diseases (tobacco smoking, an unhealthy diet, and physical inactivity). The analysis indicates that ethnic concordance improved belief in the physician, reduced reactance-related outcomes, and improved prevention-related knowledge transfer. Notably, the effect of ethnic concordance on knowledge was especially pronounced in low health-literacy participants. We discuss the implications related to the ongoing calls for a more diverse physician workforce. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this chapter is to discuss the current state of transcultural mental health nursing and the work that has been done by nursing in this area. This chapter aims to discuss the current available literature that documents nurses' work toward addressing barriers and ensuring nondominant culture clients receive reliable and appropriate mental health care. Data Sources: A search of the published literature in English language using PubMed, MEDLINE, CINAHL, and the Cochrane databases over the past 10 years using the search words "transcultural nursing" and related terms and "mental health" and related terms was conducted by each author. Mental health nursing organizational websites that the authors are members of were also searched for information related to transcultural mental health nursing, as well as organizational websites the authors have known to have content related to mental health and immigrant health in the United States. Conclusion: Cultural care knowledge has grown due to the work of transcultural nurses. Mental health transcultural care knowledge, with its unique challenges, is especially in need of attention and advancement. Implications for Nursing Research: Mental health researchers, educators, and nurses are encouraged to identify, investigate, and disseminate mental health cultural knowledge learned, to continue to grow transcultural mental health nursing, and to promote culturally competent mental health care. [ABSTRACT FROM AUTHOR]

Dr. Madeleine Leininger--founder and mother of transcultural nursing (TCN)--worked tirelessly with nurses from around the world to expand its body of knowledge. Leininger's Sunrise Model is based on culture care bridging generic folk care and professional care and uses three action modes to provide culturally congruent care. Other proponents of TCN and followers of Dr. Leininger developed theories and models and further added to the body of expanding knowledge in TCN. This article includes some exemplars of theories and models developed by Andrews and Boyle, Campinha-Bacote, Choi, Giger and Davidhizar, Jeffreys, Purnell, and Spector to further integrate TCN in nursing education, practice, administration, and research. The authors gathered some application of these theories and models in nursing education, practice, administration, and research. Research agenda for the future and gaps in knowledge focusing on increasing diversity of nursing workforce, preventing health disparities, and adding to TCN body of knowledge are likewise included. [ABSTRACT FROM AUTHOR]

Introduction: Nurses and other healthcare providers need theoretical knowledge and practical skills to provide the people they care for with culturally congruent, competent, and sensitive care. Recognizing this need, Madeleine M. Leininger endeavored over six decades to establish the discipline of transcultural nursing. She developed a theory and research method designed to guide nurses to (a) understand cultural similarities and differences in how people care for themselves and others during health, illness, disability, dying, and death, and (b) provide culturally congruent, competent, and sensitive care. Purpose: The purpose of this article is to provide a brief overview of Leininger's theory of Culture Care Diversity and Universality, also known as the Culture Care Theory (CCT), and the related Ethnonursing Research Method (ERM). New developments to the CCT and ERM will be described. The CCT contributions to theory development, research, and scholarship will be highlighted. Conclusion: Findings from transcultural studies may help nurses provide culturally congruent care to diverse individuals, families, and populations. [ABSTRACT FROM AUTHOR]

Objectives: Limited studies have investigated geographic accessibility to a nearby community pharmacy for elderly which is an essential determinant of the access to medications and pharmacy services. This research identified pharmacy deserts and investigated availability of different types of community pharmacies and their services for elderly enrolled in a State Pharmaceutical Assistance Program (SPAP). Methods: The state of Pennsylvania in the US was used as a case to demonstrate the geographic accessibility to community pharmacy and services for elderly enrolled in SPAP. The locations of community pharmacies and households of elderly enrolled in SPAP were derived from Pharmaceutical Assistance Contract for the Elderly programs’ database. The street addresses were geocoded and the distance to a nearby community pharmacy was calculated for study sample using the haversine formula. The demographic and geographic data were aggregated to Census Tracts and pharmacy deserts were identified using the predefined criteria. Descriptive statistical analysis was used to determine whether there are statistical differences in the socio-demographic profiles and distribution of different types of community pharmacies and their services in pharmacy deserts and non-deserts. This research used hot spot analyses at county level to identify clusters of pharmacy deserts, areas with high concentration of different racial/ethnic groups and clusters of high densities of chain and independent pharmacies. Results: The Spatial analysis revealed that 39% and 61% Census Tracts in Pennsylvania were pharmacy deserts and non-deserts respectively (p < 0.001). Pharmacy deserts were found to have significantly more females, married and white elderly and fewer blacks and Hispanics compared to pharmacy non-deserts. Pharmacy deserts had significantly fewer chain and independent pharmacies and less delivery and 24-hour services in pharmacies than pharmacy non-deserts. Hot spot analyses showed that clusters of pharmacy deserts were more concentrated in southcentral, northwest and northeast regions of the state which represent rural areas and overlapped with clusters of high concentration of white individuals. Conclusions: The findings suggest that urban-rural inequality, racial/ethnic disparity and differences in availability of pharmacies and their services exist between pharmacy deserts and non-deserts. The methodological approach and analyses used in this study can also be applied to other public health programs to evaluate the coverage and breadth of public health services. [ABSTRACT FROM AUTHOR]

Translational Mobilisation Theory (TMT) is a generic sociological theory that explains how emergent projects of collective action are progressed in complex organisational contexts. Grounded in a substantial programme of research on healthcare work, it has value for understanding the organisational component of the nursing role for educational, practice and research purposes. This paper introduces Translational Mobilisation Theory, outlines its core components, and considers its application to nursing using ethnographic research on the organising work of nurses as an empirical reference. Organising work is a neglected element of the nursing function and lacks theoretical foundations. As the complexity and intensity of healthcare continues to accelerate this is an important gap in existing frameworks of understanding. [ABSTRACT FROM AUTHOR]

Ethnic inequalities in health care access are well known, most of the time being difficult monitor due to limited data. In Romania, Roma are the third largest ethnic group in the country and is generally perceived negatively by the rest of society, especially due to preservation of a traditional lifestyle. Most of the time they use to live in informal settlements, without access to public infrastructure and basic needs, being victims of the vicious circle of poverty and vulnerability. Poor housing conditions, reduced income, low level of education, poor health outcomes comparing to others groups of population broadly characterize the Roma communities dispersed all over the country.The purpose of this study is to identify and analyze the perceived barriers encountered by the Roma population in Smârdioasa in accessing healthcare service. Using qualitative data and in-depth interviews, this paper highlights the relationship between particular characteristics of this group and reduced access to health services. The interviews were conducted both with representatives of the local authorities, representatives of the medical center as well as members of the community. Economic and social barriers as well as traditions were highlighted as determining the low level of access of this community to healthcare services. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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Objectives Researchers in nursing science interested in the study of nurse-patient and nurse-relative interactions have displayed an ever increasing interest in ethnomethodology and conversation analysis. This review assesses the scope of this literature. We categorize the papers in thematic categories determined both inductively and deductively and synthesize the main findings of this literature within category. Finally we discuss the interactional determinants of the lack patient participation, the limitations of the field, and focus on implications. Design A scoping review on nurse-patient and nurse-relative interactions. Data sources Forty articles focusing on nurse-patient interactions and nurse-relative interactions. All the articles relied on ethnomethodology and/or conversation analysis. Review methods A literature search has been carried out on Medline (all articles until June 2016; keywords were: nurs*.ab. and “conversation analysis”; nurs*.ab. and ethnomethodology). A similar search was performed on other platforms. The scope of the literature was identified by inductively and deductively analyzing the themes of the relevant articles. Results Six thematic categories emerged: Organization of nurse-patient interaction (eleven articles); Organization of mediated nurse-patient interaction (seven articles); Information, explanation and advice (eight articles); Negotiation and influence asymmetry (six articles); Managing emotions in critical illness (two articles); and Interacting with patients presenting reduced interactional competences (six articles). Conclusions Across most thematic categories it appeared that patient participation is far from ideal as interactional asymmetry was most observed in favor of nurses. When the encounters occurred at the patients’ homes this pattern was reversed. Computer-mediated interactions were often reported as non-optimal as the standardized process constrained communication and delayed patients’ presentation of their ailments. Micro-analyses of interaction present a clear potential for the development of guidelines for nurse-patient interactions. Implications for practice are described. [ABSTRACT FROM AUTHOR]

This article highlights the personal journey of reflective development that a non-Aboriginal White researcher and health professional underwent to be “fully positioned” in the everyday lives of a rural Australian Aboriginal community in Western Australia. The article explains the researcher’s personal development in areas important to building respect, building relationships, and ensuring reciprocity while undertaking Aboriginal research. The researcher reports on the reflective evaluation of her worldview. Understanding that judgment is a natural tendency, the researcher used reflexivity as a tool to examine and contextualize her judgments, presumptions, and preconceptions, which positioned her to be open to differing viewpoints and actively explore alternate perspectives. The researcher explores her evolutionary understanding that cultural competence is not a destination but a continual journey, and she details her knowledge development regarding the Aboriginal research paradigm, which requires that all the learning, sharing, and growth taking place is reciprocal and engages all parties actively. [ABSTRACT FROM AUTHOR]

Aim To understand how nursing students at the end of their nursing education view nursing care. Background Although care is understood as the essence of nursing, it is often difficult for nurses to provide care, which demonstrates a contradiction between theory and practice. Moreover, it is unknown to what extent this contradiction is transmitted to future nursing professionals or how they view nursing care and its practice. Design Qualitative ethnographic research. Methods The fieldwork was conducted between December 2010 - May 2012 in a university nursing school in Barcelona and two centres where students carry out most of their practical education. The data collection techniques were participant observation and focus groups. A thematic analysis was used. Results The students demonstrated contradictory views of nursing care. On one hand, they voiced a more theoretical, official definition where care is considered the core of the profession. On the other hand, they also expressed a view where the provision of care is not nurses' principal daily activity, a fact that did not surprise them. Students interpreted caring as an activity that has low value and that can be transferred unproblematically to other professionals. Conclusion The contradictory views of care reveal a problem in the transmission of the definition of nursing to new generations of professionals and reflect a problematic professional reality where there is dissonance between how nursing is defined and how it is carried out in practice. [ABSTRACT FROM AUTHOR]

Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this focused ethnography was to describe the culture of care and nonpharmacologic nursing interventions performed by NICU nurses for infants with neonatal abstinence syndrome (NAS). Method: Roper and Shapira's1 framework for the analysis included participant observation, individual interviews, and examination of existing documents. Sample: Twelve full-time nurses were observed and interviewed. Results: Results described the culture of care provided to infants with NAS by NICU nurses as evidenced by six themes: learn the baby (routine care, comfort care, environment, adequate rest and sleep, feeding), core team relationships (support, interpersonal relationships), role satisfaction (nurturer/ comforter, becoming an expert), grief making a difference (wonderful insanity, critical to them), and education and care of the mother. [ABSTRACT FROM AUTHOR]

Purpose: To explore Somali immigrant new mothers’ experience of childbirth in Minnesota. Design: The ethnonursing research method was used. Semistructured interviews with 12 immigrant Somali mothers in a Midwestern metropolitan area were conducted. Analysis of the data followed Leininger and McFarland’s four-phase ethnonursing data analysis guide. Results: Six themes were identified in relation to Somali immigrant new mothers’ experience of childbirth in the United States: the limitations of support due to separation from family, the importance of cultural and religious beliefs and practices, the desired relationships with nurses, the fear of Cesarean section, the value of education, and views on postpartum blues/depression. Conclusions and Implications for Practice: Nurses should develop trusting relationships with Somali mothers and facilitate cultural and religious practices. Information regarding support resources in the community should be provided to Somali mothers. [ABSTRACT FROM AUTHOR]

Purpose: Although malaria is preventable and treatable, morbidity and mortality from this disease continue among the Maasai of Southern Kenya. Prior to this study, the Maasai’s generic and professional malaria care/cure practices were largely unknown. The purpose of this study was to discover, describe, and systematically analyze meanings, expressions, and practices that promote culturally congruent malaria care among this population. Design: The qualitative, ethnonursing research method was used to conduct in-depth examination of the Maasai ethnohistory and culture relevant to malaria care and analyze data from 48 interviews conducted in Maasailand. Findings: Guided by the “culture care theory,” four themes were discovered related to Maasai community, traditional, spiritual, and professional care/cure practices. These significant findings filled a research gap and contribute to nursing knowledge and caring practice. Practice Implications: These study findings have implications for culturally congruent malaria care education, practice, research, policy, and partnership with traditional and professional caregivers. [ABSTRACT FROM AUTHOR]

Purpose: Knowledge of Somali immigrants’ mental health care beliefs and practices is needed so that nurses can promote culturally congruent care. The purpose of this study was to explore, discover, and understand mental health meanings, beliefs, and practices from the perspective of immigrant Somalis. Method: Leininger’s qualitative ethnonursing research method was used. Thirty informants (9 key and 21 general) were interviewed in community settings. Leininger’s ethnonursing enablers and four phases of analysis for qualitative data were used. Results: Analysis of the interviews revealed 21 categories and nine patterns from which two main themes emerged. The themes are the following: (a) Our religion significantly influences our mental health and (b) Our tribe connectedness, cultural history, and khat usage are significant in mental health. Conclusions: Somali cultural and religious beliefs and practices influence their health care choices. Implications: The findings will improve care by promoting culturally congruent care for the Somali immigrant population. [ABSTRACT FROM AUTHOR]

Background: Common mental disorders (CMD) such as anxiety and depression during the maternal period can cause significant morbidity to the mother in addition to disrupting biological, attachment and parenting processes that affect child development. Pharmacological treatment is a first-line option for moderate to severe episodes. Many women prescribed pharmacological treatments cease them during pregnancy but it is unclear to what extent non-pharmacological options are offered as replacement. There are also concerns that treatments offered may not be proportionate to need in minority ethnic groups, but few data exist on treatment disparities in the maternal period. We examined these questions in a multi-ethnic cohort of women with CMD living in Bradford, England before, during and up to one year after pregnancy. Methods: We searched the primary care records of women enrolled in the Born in Bradford cohort for diagnoses, symptoms, signs ('identification'), referrals for treatment, non-pharmacological and pharmacological treatment and monitoring ('treatment') related to CMD. Records were linked with maternity data to classify women identified with a CMD as treated prior to, and one year after, delivery. We examined rates and types of treatment during pregnancy, and analysed potential ethnic group differences using adjusted Poisson and multinomial logistic regression models. Results: We analysed data on 2,234 women with indicators of CMD. Most women were discontinued from pharmacological treatment early in pregnancy, but this was accompanied by recorded access to non-drug treatments in only 15% at the time of delivery. Fewer minority ethnic women accessed treatments compared to White British women despite minority ethnic women being 55-70% more likely than White British women to have been identified with anxiety in their medical record. Conclusions: Very few women who discontinued pharmacological treatment early in their pregnancy were offered other non-pharmacological treatments as replacement, and most appeared to complete their pregnancy untreated. Further investigation is warranted to replicate the finding that minority ethnic women are more likely to be identified as being anxious or having anxiety and understand what causes the variation in access to treatments. [ABSTRACT FROM AUTHOR]

Aim To present a critical methodological review of the ethnonursing research method. Background Ethnonursing was developed to underpin the study and practice of transcultural nursing and to promote 'culturally congruent' care. Ethnonursing claims to produce accurate knowledge about cultural groups to guide nursing care. The idea that the nurse researcher can objectively and transparently represent culture still permeates the ethnonursing method and shapes attempts to advance nursing knowledge and improve patient care through transcultural nursing. Data sources Relevant literature published between the 19th and 21st centuries. Review methods Literature review. Discussion Ethnography saw a 'golden age' in the first half of the 20th century, but the foundations of traditional ethnographic knowledge are being increasingly questioned today. Conclusion The authors argue that ethnonursing has failed to respond to contemporary issues relevant to ethnographic knowledge and that there is a need to refresh the method. This will allow nurse researchers to move beyond hitherto unproblematic notions of objectivity to recognise the intrinsic relationship between the nurse researcher and the researched. Implications for research/practice A revised ethnonursing research method would enable nurse researchers to create reflexive interpretations of culture that identify and embody their cultural assumptions and prejudices. [ABSTRACT FROM AUTHOR]

Background: It is common for patients who die from subarachnoid hemorrhage to have a focus on comfort measures at the end of life. The potential role of ethnicity in end-of-life decisions after brain injury has not been extensively studied. Methods: Patients with subarachnoid hemorrhage were prospectively followed in an observational database. Demographic information including ethnicity was collected from medical records and self-reported by patients or their family. Significant in-hospital events including do-not-resuscitate orders, comfort measures only orders (CMO; care withheld or withdrawn), and mortality were recorded prospectively. Results: 1255 patients were included in our analysis: 650 (52 %) were White, 387 (31 %) Hispanic, and 218 (17 %) Black. Mortality was similar between the groups. CMO was more commonly observed in Whites (14 %) compared to either Blacks (10 %) or Hispanics (9 %) ( p = 0.04). In a multivariate analysis controlling for age and Hunt-Hess grade, Hispanics were less likely to have CMO than Whites (OR, 0.6; 95 %CI, 0.4-0.9; p = 0.02). Of the 229 patients who died, 77 % of Whites had CMO compared to 54 % of Blacks and 49 % of Hispanics ( p < 0.01). In a multivariate analysis, Blacks (OR, 0.3; 95 %CI, 0.2-0.7; p < 0.01) and Hispanics (OR, 0.3; 95 %CI, 0.2-0.6; p < 0.01) were less likely to die with CMO orders than Whites. Conclusion: After subarachnoid hemorrhage, Blacks and Hispanics are less likely to die with CMO orders than Whites. Further research to confirm and investigate the causes of these ethnic differences should be performed. [ABSTRACT FROM AUTHOR]

Breast cancer survivors are more likely to seek complementary and alternative medicine ( CAM) for their health and well-being than other cancer patient s. The purpose of the study was to describe how Thai nurses perceive the use of CAM in Thai breast cancer survivors. An ethno-nursing research method was used. Fifteen Thai nurses who had experience in taking care of Thai breast cancer survivors who used CAM from a tertiary care referral and resource centre in the lower northern part of Thailand were interviewed. Two major themes emerged from this study: Meaning of care practices in CAM was seen as: (i) an additional beneficial choice for health; and (ii) emotional and psychological healing. Nurses should be concerned about CAM use in Thai breast cancer survivors. Open communication about CAM helps ensure that safe and holistic care is provided. Further research to enhance integration of CAM into health care is needed. [ABSTRACT FROM AUTHOR]

The article cites a study which examines nurses' decisions, aims and concerns when using anticipatory medications. It discusses nurses' role in the administration of anticipatory medications. It is concluded that nurses apply consideration and caution to the administration of anticipatory medications but some experience emotional burden.

We use data from the 1980 to 2004 waves of the National Longitudinal Survey of Youth, 1979 Cohort to examine the association between the ethnic density of metropolitan areas and obesity among U.S. blacks and Latinos. Although minority groups’ obesity rates tend to be higher in metropolitan areas containing many co-ethnics, controlling for other areal characteristics and unobserved time-constant confounders via fixed-effects models dramatically alters this association. In the fixed-effects models, higher levels of co-ethnic density are inversely associated with black males’ obesity risk and unrelated to the obesity risk of black females, Latinas, and Latino males. For most groups, marrying and having children increases the risk of obesity. [ABSTRACT FROM AUTHOR]

While death is a universal human experience, the process of dying amplifies cultural similarities and differences. There is insufficient evidence about providing culturally congruent end-of-life care for rural Appalachians. Such care is satisfying and meaningful, fits with people's daily lives, and helps them face death. This study addressed this knowledge gap, and its findings can serve as the basis for developing strategies to promote a satisfying death experience for people within this underserved cultural group. The purpose of this study was to describe generic (folk) and professional (nursing) factors that health care workers can apply to provide culturally congruent end-of-life care for people in the East Tennessee region of rural Appalachia. Guided by the culture care theory and the qualitative ethnonursing methodology, 15 participants (persons receiving hospice home care, family members, nurses, administrators, and interdisciplinary team members) were interviewed. Data were analyzed using the 4 phases of ethnonursing analysis. Themes abstracted address rural Appalachian culture care needs at end of life related to faith, family care, integrating generic/folk care with professional nursing care, and hospice care decision making. Recommended nursing interventions promote physical, emotional, and spiritual health; address health disparity; and aid in dignified death for rural Appalachian people and families. [ABSTRACT FROM AUTHOR]

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Abstract: This study examined gender differences within Black, Latino, and White subgroups in the utilization of comprehensive services and their relation to posttreatment substance use. Survey data were collected during the National Treatment Improvement Evaluation Study (NTIES), a prospective, longitudinal, multisite study of substance abuse treatment programs and their clients in the United States. The analytic sample consisted of 1,812 Blacks (734 women and 1,078 men), 486 Latinos (147 women and 339 men), and 844 Whites (147 women and 339 men) from 59 service delivery organizations. Results related to service utilization indicated that compared to men, women in all racial and ethnic groups needed and received more services targeted to their needs and reported more positive relations with service providers. Gender was a significant moderator of the relationship between service receipt and treatment outcomes for all racial and ethnic groups, but especially for the Latino subsample. Findings point to the need to consider race-specific gender differences in the development of culturally competent, comprehensive substance abuse treatment. [Copyright &y& Elsevier]