Text in English / In this study an attempt has been made to reflect upon T.G. Mashaba's transcultural themes. For the purpose of this study, the researcher had to differentiate between traditional and professional cultural themes. All of these were mirrored in some of Mashaba's works through the employment of descriptive devices in a manner that enables one to picture her philosophy of transcultural nursing care, her ideas and ideals, conceptions, opinions and beliefs. The chief aim of this study was to survey the significance and contribution of Mashaba transcultural themes to nursing. In identifying the two systems, Mashaba was attempting not only to help nurses to become aware of these systems, but to consider ways to make reciprocal interfaces with the two systems. Marked caring differences among health care systems exist as well as similar features. Efforts were made - by Mashaba - to explicate these caring aspects in order to provide a sound rationale and therapeutic nursing care. The design used in this study was purely descriptive, investigative, interpretive and analytic with the specific aim of elucidating Mashaba's ideas, ideals and thoughts. This approach helped in bringing to light the value of the themes while at the same time focusing attention on their transcultural nature. Leininger's Cultural Theoretical Model was applied - as a conceptual Model - for the analysis of transcultural themes. This research study gives us a picture of a gifted and hardworking woman. She was ambitious and had set definite goals for herself. Her sense of cultural observation and imaginativeness elevate her as- a spokesperson for the underprivileged, not only of her race, but of any nationality. In her efforts, she was a moderate who believed that engagement in a dialogue would bring better and more lasting solutions than war. This gives her work the universal relevance and appeal. / Health Studies / D.Litt. et Phil. (Advanced Nursing Sciences)

Transcultural nursing refers to the provision of nursing care to patients whose values, beliefs and life-style differ from those of the nurse. To enable nurses to honour their ethical obligation to provide quality care, they must have the necessary knowledge to nurse patients across cultural boundaries. This study was conducted to determine the nurse's knowledge of and attitudes towards the culturally different patient. A questionnaire was used to collect the data. Although nurses see it as a challenge to nurse patients from different cultures, it was found that they do not have the necessary knowledge to provide culture-sensitive care. Other factors, such as the nurse's attitude towards culturally different patients, communication problems, mistrust, prejudice and a lack of understanding of cultural uses and traditions, contribute to the lack of culture-sensitive care. The nursing profession should pay attention to these problems. / Health Studies / Van Tonder, Sally / M.A. (Nursing)

Objectives: To describe the co-occurrence of substance use and sexual activity behaviors among Afro-Caribbean adolescents living in South Florida, with attention to legal status, socio-demographic factors and risk-taking attitudes and behaviors. Methods: Convenience sampling was used to select 106 Afro-Caribbean adolescents from community centers in South Florida. A descriptive exploratory study was conducted. Data was analyzed using an independent t test, frequencies and crosstabs. Results: The study consists of 106 adolescents, 75% (n = 79) documented and 25% (n = 27) undocumented. Forty-one documented and 10 undocumented adolescents were sexually active. Of those, 14.6% of the documented and 40% of the undocumented adolescents had been drinking alcohol while engaging in sexual activity; 7.3% of documented and 30% of undocumented adolescents used drugs while engaging in sexual activity. Undocumented adolescents had less adult presence before and after school; Creole was spoken at home more than English, and none of the parents had gone to or graduated from college. There was no significant difference in risk-taking and social adaptation scores as measured by the Adolescent Risk-Taking Instrument (ARTI) for the documented and undocumented Afro-Caribbean adolescents. The ARTI had acceptable internal consistency reliability for the risk-taking (.87) and social adaption (.82) scale in this population. The mean score of risk behavior was 2.04 (SD = .44) for documented Afro-Caribbean adolescents and 1.89 (SD = .47) for undocumented adolescents. For social adaptation, mean scores were 3.23 (SD = .45) for documented and 3.20 (SD = .35) for undocumented adolescents. The co-occurrence of substance use and sexual activity is nearly triple for alcohol use and more than triple for drug use when comparing undocumented to documented adolescents. / However, scores on the ARTI did not differ.Socio-demographic factors related to risky behaviors suggest that the undocumented adolescents were more at risk. Health risk of undocumented adolescents demands more research attention if nurses wish to address the unique needs of this population. / by Kim Jolly. / Thesis (Ph.D.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

Background: An estimated 125 million women live with Female Genital Mutilation (FGM) worldwide. Despite it being internationally recognized as a human rights violation. FGM is still practiced in approximately 29 countries, most of them in Africa and the Middle East. FGM has no health benefits, whereas there are short and long terms negative consequences that can cause physical and psychological problems. Aim: To describe the experiences of women who live with FGM and their subsequent interactions with healthcare providers in countries where FGM is not a tradition. Method: A literature study based on ten studies with a qualitative research design. Results: Five main themes were found; Knowledge of FGM, Language Barriers, The Gender of Healthcare Provider, Interactions with Healthcare Provider and On Display. Conclusion: Patients had difficulties due to the language barriers. There was a preference for female healthcare providers. Patients were affected by interactions with healthcare providers as well as lack of knowledge. Patients also had their genitals put on display for others. Clinical significance: With increasing migration, it is important that healthcare providers do not judge, but instead treat and care for these women with respect and empathy. / Bakgrund: Runt 125 miljoner kvinnor i världen idag är könsstympade, även fast det är internationellt erkänt som ett brott mot de mänskliga rättigheterna. Trots detta praktiseras könstympning fortfarande i cirka 29 länder, mestadels i Afrika och i Mellanöstern. Det finns inga hälsovinster för kvinnor som är könsstympade, däremot medför det kort- och långsiktiga negativa konsekvenser som kan leda till fysiska och psykiska problem. Syfte: Att beskriva könsstympade kvinnors erfarenheter av vårdpersonal i länder där det inte finns någon tradition av könsstympning. Metod: En litteraturstudie baserad på tio studier med kvalitativ ansats. Resultat: Fem huvudteman framkom och beskrevs; Kunskap om könstympning, Språksvårigheter, genus av personal, samspelet med vårdgivare och att den könsstympade kvinnan kände sig uttittad av vårdpersonalen. Slutsats: Patienterna hade svårt att kommunicera med sjukvårdspersonalen. Patienterna föredrog kvinnlig sjukvårdspersonal. Interaktionen med sjukvårdspersonalen påverkade patientens relation till vården. Patienterna kände sig uttittade av sjukvårdpersonalen. Patienterna upplevde att vårdpersonalen hade kunskapsbrister om FGM. Klinisk betydelse: Med ökad migration är det nödvändigt att vårdpersonalen ger en respektfull vård och visar empati för de könstympade kvinnorna.

This study addressed three research objectives related to non-Muslim nurses’ experiences providing health care to Muslim patients in Saudi Arabian hospitals. These objectives included: first, understanding what it is like to care for Muslim patients considering both religion and culture; secondly, exploring what it is like being cared for by non-Muslim nurses. In order to address these objectives, the study has employed a qualitative approach, represented in hermeneutic phenomenology. The target groups in this study were Muslim patients and non-Muslim nurses who were interviewed using interviews and focus group discussions. The study found that religious, cultural and linguistic factors have a negative effect on non-Muslim nurses’ experience of care in Saudi Arabia, which included a personal impact, and a practical impact resulting from working practices. However, the results indicated that nurses had some problems with family members who interfered in decisions related to patients, and that they also encountered disrespect from patients’ relatives and friends. The study results indicated that non-Muslim nurses, to some extent, have an understanding of the different aspects and practices of Islam, such as praying, fasting and spirituality. The study results also revealed a significant relationship between spirituality (Islamic faith) and the provision of health care. Nurses believe that religious and spiritual practices have an effect on care. However, they failed to understand the importance of religion and spirituality to Muslims in general and patients in particular. The lack of training and orientation concerning specific issues of religion and culture negatively affected not only the communication between nurses and patients, but also the provision of health care. It was envisaged that this study would have a positive impact on the delivery of nursing training and education, because it highlights the need to tailor this to specific contexts. The study distinguishes itself from other studies conducted in the same field by investigating non-Muslim nurses’ and Muslim patients’ confusion between religion and culture. The study stressed an overlap between religion and culture in Saudi society, which consequently affected nurses’ provision of health care. It was essential in this study to investigate the differences between religion and culture, to see of non-Muslim nurses would understand religion and culture are not the same; while in some cases they complement one another, in other cases they contradict. Furthermore, the study addressed the issue of professionalism when caring for Muslim patients’ and non-Muslim nurses’ point of view. Although nurses claimed to provide healthcare in professional way, they were not fully aware of Saudi local culture or the impact of religion on patient’s daily life It can be concluded, in general, that non-Muslim nurses are facing challenges to providing healthcare to Saudi Muslim patients, due to a lack of understanding of the importance of cultural values and religious practices, and the lack of training and alignment on such issues.

Bakgrund: Palliativ vård syftar till att ge stöd och lindring till döende patienter för att främja livskvalitet oavsett vilken etnisk bakgrund man har. Vårt samhälle är mångkulturellt och idag möter sjuksköterskor allt fler invandrarpatienter som kan ha olika uppfattning om hälsa, sjukdom, döendet och döden. Detta innebär att det kommer att ställas andra eller nya krav på vårdpersonalen. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda patienter med annan etisk bakgrund än de själva vid palliativ vård. Metod: En litteraturöversikt över elva vetenskapliga kvalitativa artiklar genomfördes. Artiklarna har eftersökts i databaserna CINAHL Complete, pubMed och SveMed+. Dessa kombinerades i olika konstellationer för att få fram sökträff som svarade på syftet. Sökord som användes var: transcultural nursing”, ”multicultural”, ”palliative”, immigrants”, ”nurse”, ”experience”, “attitude”. Resultat: Resultat visar att många sjuksköterskor upplevde att det var svårt att bemöta invandrarpatienter. Kommunikationssvårigheter var ett vanligt problem vid kulturmöten. Att vara kulturellt medveten, och ha förståelse för kulturer och sedvänjor, samt visa hänsyn till individualitet var enligt sjuksköterskorna viktiga faktorer som kunde förbättra palliativ vård till invandrarpatienter. Diskussion: Resultatet diskuteras med stöd av Madeleins Leiningers omvårdnadsteori som utgångspunkt, där främst diskuterades. Vidare diskuterades vilken kulturell kompetens som behövs för att sjuksköterskan ska kunna ge en god transkulturell omvårdnad. / Background: The aim of palliative care is to provide support and relief to dying patients in order to indorse the quality of life regardless of their ethnical background. Our society is multicultural. It is more common today that nurses meet patients with different ethical cultural backgrounds who may hold different opinions about health, illness, dying and death. This means that it will impose to or new requirements for caregivers. Aim: To describe nurses' experiences of caring for patients with different ethical background than themselves in palliative care. Method: The method that was used is a qualitative literature review. Eleven scientific qualitative articles are included in this study. Articles have been sought in the databases CINAHL Complete, PubMed and SveMed +.Selected. These were combined in different configurations to retrieve a search result that responded to the purpose. Keywords used were :”transcultural nursing”, ”multicultural”, ”palliative”, immigrants”, ”nurse”, ”experience”, “attitude”. Results: The result shows that many nurses felt difficulties to approach immigrant patients. Communication difficulties were the common problem in cultural encounters. To being culturally aware, to understand the cultures and customs, and to take the individuality was as nurses important factors that could improve the palliative care of migrant patients. Discussions: The results are discussed with the support of Madeleine Leininger nursing theory as a basis, which mainly discussed. Further discussed about which cultural competence is needed for the nurse to be able to provide good transcultural nursing.

Sverige har under de senaste decennierna utvecklats till ett mångkulturellt samhälle. Som sjuksköterska möter vi dagligen situationer där människor, på grund av olika kulturer, har olika syn på hälsa, ohälsa, sjukdom och behandling. Syftet är att beskriva sjuksköterskors upplevelser av att möta och vårda patienter med olika kulturella bakgrunder för att belysa vikten av kulturell kompetens. Studien är en litteraturstudie med en kvalitativ ansats. Totalt valdes sju artiklar som kvalitetsgranskades och användes i resultatet. Resultatet presenteras i fem huvudkategorier och nio underkategorier. Ett genomgående tema i resultatet var att identifiera vilka hinder sjuksköterskor upplevde försvårade vårdrelationen med patienterna som i sin tur påverkade kvalitén på den vård som gavs. I mötet med människor från andra kulturella bakgrunder uppmärksammas behovet av kulturell kompetens. Genom att förstå hur andra människor tänker kan sjuksköterskor tillmötesgå patienten och utforma vården utifrån den enskilda patientens önskningar.

Sverige har gått från ett monokulturellt samhälle till ett mångkulturellt samhälle. En allt större del av Sveriges befolkning består av människor med olika kulturella och etniska bakgrunder. Det senaste decenniet har kombinationen av en åldrande befolkning med varierad etnisk och kulturell bakgrund ställt nytt krav på svensk hälso- och sjukvård. Detta innebär att sjuksköterskor kommer att träffa människor från olika kulturer och med olika vård behov. Med detta i beaktande är det betydelsefullt att belysa vikten av kulturell omvårdnad och kulturkompetens i mötet med patienten. Bakgrund: Patienter med annan etnisk bakgrund kan vara sårbara på grund av de problemen som inträffar när de flyttar till ett nytt land. Kulturella skillnader och språk svårigheter kan vara ett hinder för patienten att söka eller få adekvat vård. Syfte: Att belysa kulturens betydelse i omvårdnadsarbetet. Metod: En litteraturstudie utförs för att kunna besvara syftet. Tio vetenskapliga artiklar har valts ut. Nio av de valda artiklarna har en kvalitativ ansats och en är en blandning av kvantitativ och kvantitativ ansats. Resultat: Sju kategorier identifierades i studien; Språk och kommunikation, Samarbeta med anhöriga, Sjuksköterskan attityder och uppfattningar, Betydelse av utbildning, Vikten av kulturell kompetens inom omvårdnad, Sjuksköterskans yrkesroll samt Patient perspektiv. Slutsats: Resultatet påvisar de berörda kategorier i studierna som har betydelse i vårdande av patienter från annan kultur. Studien fokuserade på att belysa betydelsen av kulturen i omvårdnadsarbetet. De flesta studierna här huvudsakligen berört sjuksköterskorna men i resultat delen lyfts bland annat patientens perspektiv fram vilket uppsatsens författare tycker att det kan bidra till att skapa medvetenhet hos alla hälso-sjukvård personal inom olika områden. / Sweden has changed from a monoculture society to a multicultural society. A big part of the Swedish population today consists of people with different cultural backgrounds. These past decades the combination of the ageing population with different cultural backgrounds has put new demands on the Swedish health sector. This means that nurses today and in the future will meet patients from different cultures and with various health needs. Putting this in consideration it is significant to highlight the importance of cultural care and cultural competence in nursing encounter. Background: Patients with different ethnicity can be vulnerable because of problems they face when they move in the new country. Cultural differences and language barriers can be one of the obstacles for a patient to receive sufficient health care. Aim: The purpose of this study is to illustrate the importance of cultural care and cultural competence and the effects it has in nursing. Method: A literature study is designed to answer the aim of the study. Nine qualitative scientific articles and one article composed of both quantitate and qualitative are selected for the study. Results: seven categories were identified in the study: Communication and language barriers, education, cooperation with relatives, nurse’s attitudes, cultural competence, patient perspectives and nursing profession role. Conclusion: The result demonstrates categories in the studies that are important in caring for patients from other cultures. The study focused on highlighting the importance of culture in nursing. Most studies where about nurses but in the results section highlights include the patient's perspective, which essay writers feel that it can also help create awareness among all health care professionals in various fields.

Some cultures regard pain as a natural part of life compared with the Western culture which believes that pain is something unnatural and that has to be eliminated. Transcultural nursing is a way to learn about and provide culturally fitting and meaningful care to people with different cultures. Tanzania suffers from a lack of qualified health workers due to an increased burden of disease and this affects the quality and supply of effective health services. It has been seen that it is common for patients to get inadequate pain treatment and this results in many different complications. The aim of the study was to describe the nursing care of patients with postoperative pain at a rural hospital in Tanzania. The study was implemented at the Kilimanjaro Christian Medical Centre in Moshi. A qualitative participating observation study with an ethnographic approach was used to collect the data. The data was analyzed by content analysis and resulted in three themes: 1. The role of the nurse, 2. Pain management, and 3. Meeting the patient. The conclusion was that the nursing care around patients with postoperative pain showed an extended collaboration between the nurses and other health care professionals as well as with the patients’ parents. The study further showed that the atmosphere around the patients was positive and calm and that the nurses assessed pain by measuring vital signs and facial expressions.

Att fly från sitt ursprungsland på grund av krig och förföljelser påverkar flyktingars psykiska hälsa. Flyktingar har till stor del varit med om traumatiska händelser som de kan ha ett behov av att dela med sig av till hälso- och sjukvården. Hälso- och sjukvården kan möta krigsdrabbade flyktingar där det kan vara problematiskt att de talar ett annat språk och kommer från en annan kultur. Därför var syftet att belysa flyktingars upplevelser av hälso- och sjukvården. I litteraturstudiens resultat ingick 11 vetenskapliga artiklar som analyserats med hjälp av en innehållsanalys. Det framkom tre huvudteman ur analysen. De namngavs till Språkliga barriärer, Kulturella faktorer och Varierande förtroende för hälso- och sjukvården. Sjuksköterskan kan dagligen möta flyktingar i hälso- och sjukvårdsorganisationen, både inom primärvård och i slutenvård. Det är därför viktigt att sjuksköterskan har kunskaper om flyktingars upplevelser av hälso- och sjukvården för att kunna bedriva en god transkulturell omvårdnad. Det är således betydelsefullt med en bra kommunikation mellan hälso- och sjukvårdspersonal och flyktingar, vilket försvåras av språksvårigheter och kulturella olikheter. / To escape from their countries of origin because of war and persecution affects refugees’ mental health. Many refugees have been through traumatic events that they may have a need to share with the health care. The health care may face war-affected refugees which can be problematic because they speak a different language and come from a different culture. Therefore, the aim was to highlight the refugees experience of the health care. In this literature review, results of 11 scientific articles were analyzed using content analysis. The three main themes that emerged in the analysis were Language barriers, Cultural differences and Varying trust in health care. The nurse can daily meet refugees in the health care organization, both in primary care and in hospital. It is therefore important that the nurse has knowledge of refugees’ experiences of health care in order to conduct a good transcultural nursing. It is thus important with good communication between health care personnel and refugees, which is hampered by language difficulties and cultural differences.