This dissertation reports on the findings of a qualitative, exploratory, descriptive and contextual study into the health beliefs and practices of urban Pares, living in Moshi, Kilimanjaro Region, in Tanzania. The study utilised aspects of the transcultural nursing framework. Semi-structured interviews were used for data gathering with a sample of nine urban Pare informants. Data were analysed thematically. The major findings indicate that health beliefs arise from magico-religious, holistic and scientific paradigms. It was also found that beliefs and behaviour patterns are changing. These findings are discussed in terms of the two major themes, namely, multiple world views and change and continuity. Recommendations arising from the findings are made which may assist health workers to provide culturally congruent care. / Health Studies / (M.A. (Health Studies))

South African nurses have accepted the challenge that was brought about by the Health Reform Policy of 1990 which opened health service centres to people of all racial and cultural groups. However, recent studies on multicultural nursing have revealed that problems have occurred when delivering care across cultural barriers. Most of these studies have approached these problems from the patients point of view, where issues of dehumanized care, labelling and discrimination have been reported. Therefore, this study was an attempt to look into these problems from the nurses point of view, by exploring the source of these problems, their effect on health care delivery and possible solutions. The researcher focussed on three critical issues, namely, lack of cultural knowledge, negative attitudes, as well as difficulty in communication. Through focus group interviews (FGI) and responses to given scenarios, student nurses who had experienced problems with culturally different patients were given a chance to reflect on their experiences, report on these experiences and recommend possible solutions to the experienced problems. The results revealed that: 1. The major source of the problems was lack of experience due to inadequate exposure to culturally diverse groups which in tum led to inappropriate decisions and actions at care delivery level. 2.Difficult perceptions and negative attitudes lead to the formation of stereotypes which block the delivery of culturally congruent care. 3 .Inability to communicate due to differences in spoken language lead to difficulty in building the trust relationship and hence inadequate care delivery. / Health Studies / M.A. (Nursing Science)

From the assumptions found in Madeleine Leininger’s Transcultural Nursing Theory, the current work analized the cultural dimensions that influenced on women’s search of natural humanized birth, in Maceió – AL, considering the potential of cultural studies to support culturally congruent practices. This is a qualitative and descriptive study, made between december 2015 and april of 2016 in Maceió - AL. 14 (fourteen) women, who sought or not a natural humanized birth in said context, are our informants of this research. For information gathering a semistructured interview form was used based on the theoretical referential, that propitiated the survey of cultural meanings analyzed in its universality and diversity, in order to meet this research objective. From the results analysis, it was possible to identify whether or not the search for a natural humanized birth permeates the meaning of parturition to the informants taking into account their realities and health contexts. The cultural dimensions involved that guided their choices: 1) Their ideologies and beliefs, directing a way of life that guides them according to their desires to enjoy full autonomy of their bodies and that, even when they delegate their health processes to other people, they do it according to positively valued experiences and care; 2) Class issues, access to information, technology and public health policies, whose differences are mitigated by the social differences from a capitalist society; 3) Meanings and experiences of your support networks, which are present in all other dimensions. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A partir dos pressupostos da Teoria do Cuidado Transcultural de Madeleine Leininger, o presente trabalho analisou as dimensões culturais que influenciaram na busca de mulheres pelo parto natural humanizado, no município de Maceió-AL, considerando o potencial dos estudos culturais para subsidiar práticas culturalmente congruentes. Trata-se de um estudo qualitativo e descritivo, realizado entre dezembro de 2015 e abril de 2016 em Maceió/AL. São informantes desta pesquisa 14 mulheres que buscaram ou não um parto natural humanizado no referido contexto. Para coleta de informações, utilizou-se um formulário de entrevista semi-estruturado baseado no referencial teórico, que propiciou o levantamento designificados culturais analisados em sua universalidade e diversidade, de modo a atender os objetivos da pesquisa. A partir da análise dos resultados, foi possível identificar que a busca ou não busca de mulheres por um parto natural humanizado perpassa o significado da parturição para as informantes, segundo suas realidades e contextos de saúde. As dimensões culturais envolvidas que direcionam suas escolhas abarcam: 1) Suas ideologias e crenças, direcionando um modo de vida que as orienta de acordo com suas vontades de gozarem plena autonomia de seus corpos e que, mesmo quando delegam seus processos de saúde a outras pessoas, fazem-no de acordo com experiências e cuidados valorados positivamente; 2) Questões de classe, acesso à informação, tecnologia e políticas públicas de saúde, cujas diferenças são atenuadas pelos desníveis sociais da sociedade capitalista; 3) Significados e experiências de suas redes de apoio, que estão presentes em todas as outras dimensões.

O presente estudo qualitativo teve como objetivo descrever e compreender o cuidado das crianças no processo saúde-doença sob a perspectiva das famílias de uma comunidade nativa do Peru. O Modelo para Competência Cultural de Purnell foi a base teórica que deu sustentação ao estudo. O método etnográfico com ênfase na etnoenfermagem, utilizando as técnicas da observação participante e da entrevista etnográfica, com cinco famílias durante um período de convivência de quatro meses em uma comunidade nativa; permitiu a compreensão da perspectiva dos informantes sobre o cuidado das crianças. Emergiram três temas culturais do conjunto dos dados: A estrutura sociocultural da comunidade Kabano e seu cotidiano, na qual a função desempenhada por cada membro representa um papel preponderante na estrutura sociocultural e no cotidiano da cultura. A promoção e preservação da saúde na comunidade Kabano é caracterizada por um cotidiano de limitações e dificuldades. Os papéis dos membros da família nuclear, da família ampliada, e do curandeiro e da parteira, referentes às atividades de cuidado cotidianas, visam à promoção da saúde e a vida do coletivo. As práticas no adoecimento das crianças são permeadas por grandes dificuldades apesar do suporte da rede social. As dificuldades são de natureza econômica e provêm das falhas no relacionamento e na comunicação do profissional de saúde com os membros da cultura e os déficits estruturais do estabelecimento de saúde. A assistência à saúde na cultura Kabano se encontra nas etapas iniciais do Modelo para Competência Cultural de Purnell, ou seja, um cuidado caracterizado pela inconsciência incompetente. Os resultados descritos neste estudo, se considerados, podem levar os profissionais a se aproximarem da competência inconsciente para o cuidado cultural da pessoa, da família e da comunidade. / This qualitative study aimed to describe and understand the care of children in the health-illness process from the perspective of the families of a native community in Peru. The Purnell Model for Cultural Competence was the theoretical framework that had supported the study. The ethnographic method with emphasis in the ethnonursing using the participant observation and ethnographic interview techniques with five families, during four months of coexistence in a native community; allowed to understand the informants perspective about the care of children. Three cultural themes emerged from the data set: The socio-cultural structure of Kabano\'s community and their everyday, in which the role played by each member represents a preponderant role in the socio-cultural structure and in the everyday of the culture. The promotion and preservation of health in Kabanos community is characterized by daily limitations and difficulties. The roles of the members of the nuclear family, extended family, and the healer and midwife, regarding the daily care activities, aim at promoting health and life of the collective. Practices in childrens illness are permeated by great difficulties despite the support of social network. The difficulties are of economic kind and come from failures in the relationship and communication between the health professional and the members of the culture and from the structural deficits of the health center. The health care in the Kabano culture is in the early stages of the Purnell Model for Cultural Competence, and characterized by a careful unconscious incompetent. The results described in this study, if they can bring to the professional approach the unconscious competence for cultural care of the person, family and community.

The intent of this exploratory study was to discover the cultural significance of an Apache ritual, the Sunrise Ceremony, as it relates to the physical, mental, and emotional well-being of the Apache individual, family, and community at large. The ethnographic methodology was used to gather data because this design provided the most systematic and flexible process to generate the widest range of information necessary for describing this culture from the native's point of view. Four culturally relevant domains were developed and analyzed to reveal five cultural themes, including "It's my strength," "Women are the core of living here," "It Tells You the Story of the Beginning," and "Change is Sad--Alcohol is Bad." The findings suggest that because the Sunrise Ceremony is central to the Apache way of life, its values and culture, an understanding of the Sunrise Ceremony can assist in the development of accurate nursing assessments and successful interventions to improve the collective health and well being of the Apache people. Additionally, recommendations for nursing practice and further research are proposed.

M.Cur. / Please refer to full text to view abstract

Bakgrund: Den ökade migrationen i Sverige innebär stora utmaningar inom vården. Sverige är ett av länderna i EU med största andelen invånare med utländsk bakgrund vilket gör Sverige till ett mångkulturellt samhälle. Personer med utländsk bakgrund har olika kulturer som påverkar hur hälsa och sjukdom definieras. Sjuksköterskans professionella ansvar innebär att kunna tillgodose en personcentrerad vård som är kulturellt anpassad. Syfte: Syftet var att beskriva upplevelser av mötet med hälso- och sjukvårdspersonal hos patienter med utländsk bakgrund. Metod: Litteraturöversikt enligt Friberg (2017) genomfördes som baserades på tio kvalitativa vetenskapliga artiklar. Artiklarna inhämtades från databaserna CINAHL Complete och PubMed med hjälp av sökblock. Resultat: I resultatet presenterades fem kategorier. Förväntningar på hälso- och sjukvårdspersonalens kulturella kompetens, Syn på vården, Kulturella och religiösa skillnader, Kommunikationsbarriärer och Tolkanvändning. Sammanfattning: Det har visats att patienter med utländsk bakgrund har både positiva och negativa upplevelser på grund av kulturella skillnader och bristande kommunikation med hälso- och sjukvårdspersonal. Svårigheter som påträffats orsakas av kommunikationssvårigheter, språkbarriärer och brist på kulturell kompetens. Det behövs mer kunskap inom mångkulturell vård och det är av stor vikt att utbilda framtida sjuksköterskor om detta fenomen. / Background: The increased migration in Sweden entails major challenges in healthcare. Sweden is one of the countries in the EU with the largest proportion of residents with a foreign background which makes Sweden a multicultural society. People with a foreign background have different cultures that affect how health and illness are defined. The professional responsibility of nurses’ means being able to provide patient-centered care that is culturally adapted. Aim: The aim was to describe experiences of the meeting with health care professionals in patients with foreign background. Method: A literature review according to Friberg (2017) was conducted based on ten scientific qualitative articles. The articles were obtained from the databases CINAHL Complete and PubMed using a search block. Results: Five categories were presented in the result. Expectations of the cultural competence of health care professionals, View on healthcare, Cultural and religious differences, Communication barriers and Use of interpretation. Summary: It has been shown that patients with foreign backgrounds have both positive and negative experiences due to cultural differences and lack of communication with health care professionals. The difficulties encountered were caused by communication difficulties, language barriers and lack of cultural competence. There is a need for more multicultural care and it is of great importance to educate future nurses about this fenomenon.

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and posttest scores were used to determine RNs' competency levels. The Statistical Package for the Social Sciences software was used for data analysis, and a paired t test was used to determine the impact of the program. Of the 22 participants, 4 (18%) scored within the culturally competent range on the pretest, compared to 17 (77%) on the posttest. These findings were statistically significant (p < 0.000) and demonstrated a positive outcome from the educational project. Key recommendations are to continue this education for other RNs in the facility and at other facilities in the network. The implications of this project for positive social change include raising the cultural competency of nurses, which has the potential to improve patient outcomes.

Bakgrund Antalet invandrare som kommer till Sverige har ökat de senaste åren. Sjuksköterskor i vården stöter allt mer på patienter med kulturella och språkliga skillnader. Ett bra möte mellan sjuksköterska och patient, där båda kan förstå varandra, är viktigt för att få en god och säker vård. Det är av stor vikt att sjuksköterskor har kunskap om transkulturell omvårdnad för att möta patientens unika behov på vägen mot hälsa. Syfte Syftet var att belysa språkbarriärer i mötet mellan sjuksköterska och patient med kulturella och språkliga skillnader.  Metod En litteraturöversikt valdes som metod för att göra en sammanställning av tidigare gjord forskning kring det valda ämnet. Totalt 17 vetenskapliga artiklar inkluderades.  Resultat I resultatet framkom tre kategorier: språkbarriär, kulturell kompetens samt brist och tillgång till tolk. De tre kategorierna delas in i tre subkategorier format i en tabell. Resultatet visade vidare att språkbarriären utgjorde det största hindret i kommunikationen mellan sjuksköterskan och patient med invandrarbakgrund. Kulturell kompetens och brist och tillgång till tolk, var två andra hinder av betydelse i kommunikationen.  Slutsats För att kunna ge god omvårdnad behöver sjuksköterskan kommunicera med patienten och dessutom ha en viss förståelse för patientens kulturella bakgrund. Det är viktigt att sjuksköterskor får utbildning inom transkulturell omvårdnad. Med mer kunskap i ämnet kan förhoppningsvis ömsesidiga missförstånd och frustration därav minskas samt förebyggas. För att få en säkrare vård, kunna känna trygghet och undvika missuppfattningar är det viktigt att engagera en professionell tolk i sjuksköterskans möte med patienten.

No description available.