Journal of Transcultural Nursing - current issue
Perceptions of Health and Well-Being Held by Native Hawaiian Migrants
Background and Purpose: Migration is often a challenging process. Native Hawaiians migrate from Hawaii to Las Vegas at an impressive rate, but no research has explored how migration affects their health and well-being. The purpose was to describe how Native Hawaiians in Las Vegas perceive their health and well-being and any changes therein since migrating. Design: Using a qualitative descriptive design, 27 participants took part in semistructured interviews. Findings/Results: Most participants perceived no changes in health and minor changes in well-being. Many maintained their well-being by adapting valued activities to their new circumstances. However, 5 participants were deeply burdened by life in Las Vegas or longing for Hawaii, and their well-being suffered. They tended to identify barriers to well-being rather than ways to foster it. Conclusion: Health care providers can help Native Hawaiian migrants by encouraging early access to the health care system in their new location and facilitating participation in helpful, adaptive behaviors.
Well-Being in Dinka Refugee Women of Southern Sudan
The purpose of this study was to understand the health and well-being of Sudanese refugee women who were resettled with their children to the United States. The design was an interpretive ethnography using individual interviews and participant observation with extensive field notes. The findings describe personal factors as well as community and social conditions that influenced the health and well-being of the refugee women and their families. These influences are captured in the three themes that emerged from the study: (1) liminality—living between two cultures, (2) self-support—standing on our own two legs, and (3) hope for the future. These themes describe a process of how refugee women achieve well-being in the transition to a new country and culture. The study contributes to our theoretical understanding of how to develop culturally congruent interventions for resettled refugees.
Perceived Acceptance of Condom Use by Partners, Close Friends, and Parents of Spanish and Mozambican Heterosexual Adolescents
Purpose: The main aim of the current study was to compare Spanish and Mozambican male and female secondary students, with regard to sexual behaviors and perceptions surrounding the acceptance of condom use. Method: The participants were 773 secondary students—412 from Spain and 361 from Mozambique, aged from 15 to 17 years old. Data collection was done using questionnaires. Analysis was carried out using multivariate methods. Results: Spanish adolescents took more precautions than Mozambican adolescents. Furthermore, Spanish adolescents perceived that the acceptance of condom use by their referents were higher than those reported by the Mozambican adolescents. Among Spanish youths, only the perceived acceptance of their current partner predicted condom use in their most recent sexual encounter. Discussion: Differences in the decision-making power of males and females and the type of partner might explain the differences observed in the preventive behavior of the students in both countries.
Understanding Prenatal Health Care for American Indian Women in a Northern Plains Tribe
Early and regular prenatal care appointments are imperative for the health of both the mother and baby to help prevent complications associated with pregnancy and birth. American Indian women are especially at risk for health disparities related to pregnancy and lack of prenatal health care. Previous research has outlined a basic understanding of the reasons for lack of prenatal care for women in general; however, little is known about care received by pregnant women at Indian Health Service hospitals. Qualitative interviews were carried out with 58 women to better understand the prenatal health experiences of American Indian women from one tribe in the Northern Plains. Several themes related to American Indian women’s prenatal health care experiences were noted, including communication barriers with physicians, institutional barriers such as lack of continuity of care, and sociodemographic barriers. Solutions to these barriers, such as a nurse midwife program, are discussed.
African American Women and Weight Loss: Disregarding Environmental Challenges
In the United States, almost 80% of African American women are either overweight or obese. In this study, 46 low-income African American women struggling with weight issues participated in structured interviews using a social cognitive theory framework. Participants shared their social cognitive theory related weight loss thoughts and their perceived weight loss obstacles. Results suggest that although participants’ primary weight-related obstacles were environment-based, for example, unsafe environments in which to engage in regular exercise, they more often offered individual-based solutions. The study concludes with a discussion of media advocacy as a tool that can be used to promote environmental solutions.
The Experience of Quality of Life for Caregivers of People With Alzheimer's Disease Living in Sardinia, Italy
Purpose:This study explored the meaning of quality of life (QOL) for Sardinian caregivers of people affected with Alzheimer’s disease and factors improving and worsening their QOL. Design: The phenomenological method was used to study 41 Alzheimer’s disease caregivers living on the western coast of Sardinia, Italy. Interviews were conducted and analyzed using Cohen, Kahn, and Steeves’s approach. Findings: Extracted themes were the following: unity and cooperation in the family; freedom/independence; having time for themselves; serenity/tranquility; and well-being and health. Caregivers identified factors that they believed worsened or improved their QOL. Family was particularly important for these caregivers. Discussion and Practice Implications: This study reinforces previous research about cultural influence on QOL and emphasizes the importance of nurses being culturally sensitive. Since Sardinia is a rural region, these findings may be useful for nurses working with caregivers in other rural settings.
"Turning to One's Own World": Escape Mechanisms Employed by Immigrant Caregivers in Spain for Relieving the Burden of Care
Purpose: Although past research has focused on the coping strategies of family caregivers, how immigrant caregivers cope with the demands of caregiving remains unknown. This study examines the strategies immigrant caregivers use to relieve the burden of care. Method: A qualitative study based on 17 immigrant women caregivers using purposive and snowball sampling was done. Semistructured interviews and testimonies were obtained and analyzed using grounded theory procedures. Findings: Turning to one’s world describes how caregivers seek relief from the burden of care. They escape virtually, go to a private place, make those they care for their own, and decide to go home. These mechanisms enable them to escape from the world of caregiving in which they find themselves. Discussion and Conclusions: Findings reveal the significance of family connections and networks for immigrants to achieve burden relief. Implications for Practice: The importance of promoting positive working environments and raising awareness about immigrant caregivers’ need for rest.
Psychometric Evaluation of the Turkish Version of the Zarit Burden Interview in Family Caregivers of Inpatients in Medical and Surgical Clinics
The aim of this study was to adapt the Zarit Burden Interview (ZBI) to family caregivers of inpatients in medical and surgical clinics to assess the validity and reliability of the Turkish version. The study design was descriptive and methodological. A total of 223 family caregivers providing care to patients for at least 1 week in clinics were selected through convenience sampling. Data were collected using the Turkish translation of the ZBI. The psychometric testing of the adapted instrument was carried out to establish internal consistency, interitem correlation, and construct validity. The content validity procedure resulted in a final scale comprising 18 items. Cronbach’s alpha was .82. Factor analysis yielded one factor. The Turkish version of the ZBI adapted to the clinics can be used as a one-factor tool.
Somali Immigrant Women's Health Care Experiences and Beliefs Regarding Pregnancy and Birth in the United States
Purpose: To describe Somali immigrant women’s health care experiences and beliefs regarding pregnancy and birth. Design: Four focus group interviews were conducted using a convenience sample of Somali women who were pregnant or had recently delivered. Qualitative thematic content analysis was used. Findings: Six major themes emerged: pregnancy as a natural experience for women, value and relevance of prenatal care, lack of control and familiarity with delivery in the United States, balancing the desire to breastfeed with practical concerns and barriers, discomfort with mental health issues, and challenges in the healthcare system. Discussion and Conclusions: Somali immigrant women perceive, interpret, and react to Western health practices from a perspective that includes their cultural, religious, and "scientific" beliefs. Implications for Practice and Research: Implications include cultural competency workshops. Educational materials and prenatal education sessions that support the women’s needs have been developed for this population and should be a focus of future research.
Study Abroad as a Tool for Promoting Cultural Safety in Nursing Education
Nurse educators are calling for the transformation of nursing education toward curricula that promote clinical reasoning through reflective practice and understanding of patient experiences in an effort to motivate students to become change agents. Study abroad programs can play an important role in this transformation through educating nurses in the delivery of culturally safe health care in a diverse world. Exposing nursing students to study abroad experiences that are guided by critical approaches such as a postcolonial feminist framework provides nursing students with opportunities to be immersed in the life and culture of people who have a completely different positioning and location while reflecting on the "us" versus "them" phenomenon that is pervasive in modern Western society and generates negative cultural comparisons. Attention to the design and implementation of such programs is important if nursing schools in the Western world are to uphold ethical standards, promote equality in relationships with host communities and avoid inadvertent exploitation and marginalization of vulnerable peoples. We present the development and implementation of a community health study abroad program for American nursing students in Malawi, Africa using a postcolonial feminist framework.
Putting the World as Classroom: An Application of the Inequalities Imagination Model in Nursing and Health Education
This article focuses on the description of an educational initiative, the Interdisciplinary Population Health Project (IPHP) conducted in the academic year of 2006-2007 with a group of nursing and health care students. Inspired by population health, community development, critical pedagogy, and the inequalities imagination model, students participated in diverse educational activities to become immersed in the everyday life of an underserved urban neighborhood. A sample of convenience composed of 158 students was recruited from 4 health disciplines in a Western Canadian university. Data were collected using a modified version of the Parsell and Bligh’s Readiness of Health Care Students for Interprofessional Learning Scale. A one group pretest–posttest design was used to assess the outcomes of the IPHP. Paired t tests and one-way analyses of variance were used to compare the responses of students from different academic programs to determine if there were differences across disciplines. Findings suggest that students’ readiness to work in interprofessional teams did not significantly change over the course of their participation in the IPHP. However, the inequalities imagination model may be useful to enhance the quality and the effectiveness of fieldwork learning activities as a means of educating culturally and socially conscious nurses and other health care professionals of the future.
The Influence of Eastern Philosophy on Elder Care by Chinese Americans: Attitudes Toward Long-Term Care
Chinese philosophy has been a major cornerstone of Chinese culture for millennia and has bestowed on the world traditions such as Taoism, Yin and Yang, and filial piety. Although these beliefs have remained steadfast over thousands of years, their ability to survive unchanged in the future is uncertain. As the world forges ahead into the 21st century, several pertinent questions arise: Will age-old axioms, primarily those concerning elderly Chinese and their relationship with their children, survive? When ancient, traditional beliefs conflict with newer, Western ideas, which system of thought is likely to be the victor? Moreover, will elderly Chinese Americans and their perceptions concerning long-term care facilities cause problems with the traditional familial unit? This article will discuss these issues in detail.