A descriptive quantitative study was undertaken in the Leribe and Butha-buthe northern districts of Lesotho. Thirty-six trained, twenty-four untrained TBAs and nine nurses involved in training TBAs were recruited. In line with research by Clarke and Lephoto (1989:3) the TBAs were elderly females who had children of their own. In contrast with the MOH (1993: 10) where TBAs were found to be illiterate, most (93%) of the TBAs in this study had at least a primary education. The art of primary midwifery was learned through assisting with a delivery and being taught by mothers or mothers-in-law. The public health nurses conduct formal training ofTBAs in Lesotho over a period of two weeks, where subjects like ante-natal care, delivery of the baby and post- natal care are addressed. The majority (78.8%) provide antenatal care at their homes or the home of the mother. This includes palpation, history taking, and abdominal massage and health education. An important role is identifying women at risk. During labour the progress of labour is monitored and care is given to the mother and baby post-natally. Trained TBAs could identify women at risk more readily than untrained TBAs. Cases referred most frequently were prolonged labour and retained placenta. Trained TBAs practiced hygiene more often and gave less herbs than untrained TBAs. The health care system is providing support to the TBAs through training and supervision, but was found to be inadequate. Community leaders are involved in the selection of TBAs for training. Regular meetings are held with the TB As to discuss problems. Communication is one of the problems the TB As have to face, because of the long distances from health care centres. A lack of infrastructure and supplies is also of concern. It can be concluded that TBAs play an important role in maternal health care in Lesotho and are supported to a lesser degree by the health care system, which causes problems for the TBAs in their practices. It is recommended that the ministry of health becomes more aware of the need for training TBAs and that a programme for training should be more appropriate, taking cultural practices into account. / Advanced Nursing Science / D.Lit. et Phil.

A descriptive quantitative study was undertaken in the Leribe and Butha-buthe northern districts of Lesotho. Thirty-six trained, twenty-four untrained TBAs and nine nurses involved in training TBAs were recruited. In line with research by Clarke and Lephoto (1989:3) the TBAs were elderly females who had children of their own. In contrast with the MOH (1993: 10) where TBAs were found to be illiterate, most (93%) of the TBAs in this study had at least a primary education. The art of primary midwifery was learned through assisting with a delivery and being taught by mothers or mothers-in-law. The public health nurses conduct formal training ofTBAs in Lesotho over a period of two weeks, where subjects like ante-natal care, delivery of the baby and post- natal care are addressed. The majority (78.8%) provide antenatal care at their homes or the home of the mother. This includes palpation, history taking, and abdominal massage and health education. An important role is identifying women at risk. During labour the progress of labour is monitored and care is given to the mother and baby post-natally. Trained TBAs could identify women at risk more readily than untrained TBAs. Cases referred most frequently were prolonged labour and retained placenta. Trained TBAs practiced hygiene more often and gave less herbs than untrained TBAs. The health care system is providing support to the TBAs through training and supervision, but was found to be inadequate. Community leaders are involved in the selection of TBAs for training. Regular meetings are held with the TB As to discuss problems. Communication is one of the problems the TB As have to face, because of the long distances from health care centres. A lack of infrastructure and supplies is also of concern. It can be concluded that TBAs play an important role in maternal health care in Lesotho and are supported to a lesser degree by the health care system, which causes problems for the TBAs in their practices. It is recommended that the ministry of health becomes more aware of the need for training TBAs and that a programme for training should be more appropriate, taking cultural practices into account. / Advanced Nursing Science / D.Lit. et Phil.

Context: The transgender community experiences excessive discrimination in in healthcare. Data continue to reveal that health care providers lack sufficient knowledge in transgender health, as well as difficulty in referring individuals to competent providers, to ensure the continuum of care (Brennan, Barnsteiner, Siantz, Cotter, & Everett, 2012; Cruz, 2014). Methods: A modified Cross-Cultural Care Survey consisting of 56 questions was implemented via Qualtrics to 1,134 nurse practitioners (NPs) in the California Association of Nurse Practitioner to measure their cultural competence through the domains of attitude, knowledge, and skill. Results: Completed responses were obtained from 30 out of 38 NPs (78.9%). Knowledge was positively correlated with Skills (Pearson's r = .688, p < .001); negatively correlated with Negative Attitude (Pearson's r = -.458, p = .011) and positively correlated with Positive Attitude (Pearson's r = .371, p = .043). Skills was positively correlated with Positive attitude (Pearson's r = .646, p < .001); however, the negative correlation between Skills and Negative Attitude was not statistically significant at the .05 level (Pearson's r = -.345, p =.062). There was a negative correlation between Negative Attitude and Positive Attitude, but this correlation was only marginally not significant at the .05 level (Pearson’s r = -.358, p = .052). Conclusion: The results indicated that the balance between skills and negative attitudes may have created a barrier to care in transgender patients.

With the increase in Canada’s seniors population (age 65 and over), there is a need to understand the residential requirements of this population. Almost 90 percent of seniors in Ontario reside in urban areas (Hodge 2008) and the majority live in the Greater Toronto Area. Of particular concern is the decrease in availability of informal care for aging and weakening individuals due to changes in economy and family relations. These changes are likely to result in a large influx of seniors into residential care facilities (RCFs) because not everyone is able to stay at home or is eligible to live in a long term care (LTC) facility. Seniors’ reasons for relocating as well as an analysis of their experiences after the move are required as the need for RCFs increases. Cultural and/or religious groups have become important providers of RCFs in Canada by offering necessary services for an aging population. The goal of this thesis is to analyse the importance of culture and the built environment within a push-pull framework associated with the decision to move to an RCF through a case study. The guiding question of the research is: Why do seniors choose facilities with cultural affiliations? In 2013, interviews were conducted with 15 residents, who were currently residing in a Ukrainian RCF called Ivan Franko. The results show that seniors move because of certain limitations (e.g., health, difficulty doing housework, family events, etc.). When an older person decides that they want or need to move, they will move to a facility that provides a physical and social environment while reinforcing cultural values (i.e., built environment), assuming a place is available. Acknowledging the limitations of a qualitative case study approach, the findings are important to consider as the multicultural population of the GTA and other large Canadian cities continue to age. The growing demand for places in RCFs reflects social, cultural and religious needs of a diverse older population. A challenge will exist for cultural and religious not-for-profit voluntary organizations, the for-profit sector, and governments at all levels to seek new ways to develop facilities in the future. / Thesis (Master, Geography) -- Queen's University, 2014-06-19 00:28:54.511

The increasing religious diversity in Sweden suggests that healthcare professionalsincreasingly encounter a variety of religious perspectives in their work. Previous researchindicates that incorporating religious aspects in healthcare can enhance the well-being ofindividuals in elder and psychiatric care. This study aims to investigate how Swedish healthcareprofessionals address religious diversity while providing healthcare services. While previousresearch has predominantly focused on the patient’s perspective of religion, this study focuseson the healthcare professionals’ experiences and positions taken regarding religious diversity.The data for this study consists of semi-structured interviews with five nurses and assistantnurses within psychiatric care and five nursing assistants providing elderly care services.This study employs Madeleine Leininger’s theory of culture care diversity and universality,originally developed in the United States, to provide guidance to healthcare professionalsdealing with cultural diversity. Religion, a key cultural aspect in the theory is centrally exploredin this study. The four main tenets of the theory are examined and their applicability within aSwedish context is examined.The result of this study shows that patients within both elderly and psychiatric care request thatthe care they receive be adjusted according to their religious believes. The study also showsthat patients frequently request for the possibility of practicing religion when in need ofhealthcare. The participants of this study agree that religious adjusted care and religiouspractices have a positive impact on the patient’s health. They also clarify that one of the reasonsthis is not applied on a large scale is the lack of religious knowledge among the professionals.All ten participants in this study have also stated that there are no models or techniques (as faras they know) for treating religious diversity in their professions

The study explored the cultural care beliefs, values and attitudes among Shangaans relating to hypertension. The study aimed to describe the cultural values, beliefs and practices such as taboos, rituals and religion within the world view of the Shangaan. The study was undertaken in the Mopani region of the Greater Giyani area, with the purpose of making recommendations on patient care. Data collection was done by conducting focus group and individual interviews. The five themes that emerged were: + Hypertension + The traditional healer: the instrumental role + Traditional medicine versus Western medicine + Magico-religious healings + Experiences of hypertensive patients with regard to traditional healers and hypertension / Health Studies / M. A. (Health Studies)

O presente estudo teve como objetivo central descrever questões da identidade do ser enfermeiro negro formado pela Escola de Enfermagem da Universidade de São Paulo, a partir da perspectiva da Teoria da Enfermagem Transcultural através da análise de situações de preconceito vividas por esses enfermeiros frente a sua escolha profissional, sua formação acadêmica e a sua inserção no mercado de trabalho. Por ser o presente trabalho de natureza descritiva, histórico-social e exploratória, optou-se pelo método da História Oral, que é um método de pesquisa que utiliza a técnica da entrevista e outros procedimentos articulados entre si, no registro de narrativa da experiência humana. Optou-se também pelo método da História Oral Temática pelo fato desse ser um método que possibilita que as pessoas falem livremente, em seus respectivos contextos. A Escola de Enfermagem da USP formou, no período de 1947 a 2006, 2.886 enfermeiros, dos quais, 128 se declararam como não brancos. Foram localizados, no estado de São Paulo, 45 dos acima identificados, dos quais 14 cederam entrevistas para a presente investigação. Pode-se observar que a terminologia moreno(a) foi a mais utilizada para a autodeclaração e que, dos entrevistados, todos afirmam ter sofrido preconceito racial em algum momento de suas trajetórias de vida, em especial de forma velada, forma essa mais difícil de ser enfrentada. A presente investigação propiciou fazer da História uma atividade mais democrática a cargo das próprias comunidades, uma vez que permitiu construir a História a partir das próprias palavras daqueles que a vivenciaram e que participaram de um determinado período, mediante suas referências e, também, do seu imaginário, possibilitando o registro de reminiscências das memórias individuais ou a reinterpretação do passado. / This study aimed to describe the central issues of being a black nurse graduated by the School of Nursing, University of São Paulo, from the perspective of the Theory of Transcultural Nursing trough the analysis situations of prejudice experienced by these nurses facing their career choice, their academic training and their integration into the labor market. As the study has a descriptive, historical, social and exploratory character, was chosen the method of Oral History, which is a method that uses the interview and other processes linked together in the narrative record of human experience. It was also chosen the method of Oral History Thematic considering the fact that this method helps people to speak freely in their respective contexts. The School of Nursing graduated, in the period of 1947 to 2006, 2,886 nurses, of which 128 identified themselves as non-whites. Located, in the state of São Paulo, 45 of the above identified, of which 14 were interviewed for this research. It was noted that the terminology \"moreno\" was the most used for self reporting and that of those interviewed, all stated have suffered racial discrimination at some point in their life trajectories, especially in hidden form, which is the harder form to face. This research led to a more democratic history over the view of its own communities, because it allows the construction of history from the very words of those who participated and experienced, in a given period of time, through its references and imagination, allowing the registration of reminiscences of individual memories or the reinterpretation of the past.

The study explored the cultural care beliefs, values and attitudes among Shangaans relating to hypertension. The study aimed to describe the cultural values, beliefs and practices such as taboos, rituals and religion within the world view of the Shangaan. The study was undertaken in the Mopani region of the Greater Giyani area, with the purpose of making recommendations on patient care. Data collection was done by conducting focus group and individual interviews. The five themes that emerged were: + Hypertension + The traditional healer: the instrumental role + Traditional medicine versus Western medicine + Magico-religious healings + Experiences of hypertensive patients with regard to traditional healers and hypertension / Health Studies / M. A. (Health Studies)

O presente estudo teve como objetivo central descrever questões da identidade do ser enfermeiro negro formado pela Escola de Enfermagem da Universidade de São Paulo, a partir da perspectiva da Teoria da Enfermagem Transcultural através da análise de situações de preconceito vividas por esses enfermeiros frente a sua escolha profissional, sua formação acadêmica e a sua inserção no mercado de trabalho. Por ser o presente trabalho de natureza descritiva, histórico-social e exploratória, optou-se pelo método da História Oral, que é um método de pesquisa que utiliza a técnica da entrevista e outros procedimentos articulados entre si, no registro de narrativa da experiência humana. Optou-se também pelo método da História Oral Temática pelo fato desse ser um método que possibilita que as pessoas falem livremente, em seus respectivos contextos. A Escola de Enfermagem da USP formou, no período de 1947 a 2006, 2.886 enfermeiros, dos quais, 128 se declararam como não brancos. Foram localizados, no estado de São Paulo, 45 dos acima identificados, dos quais 14 cederam entrevistas para a presente investigação. Pode-se observar que a terminologia moreno(a) foi a mais utilizada para a autodeclaração e que, dos entrevistados, todos afirmam ter sofrido preconceito racial em algum momento de suas trajetórias de vida, em especial de forma velada, forma essa mais difícil de ser enfrentada. A presente investigação propiciou fazer da História uma atividade mais democrática a cargo das próprias comunidades, uma vez que permitiu construir a História a partir das próprias palavras daqueles que a vivenciaram e que participaram de um determinado período, mediante suas referências e, também, do seu imaginário, possibilitando o registro de reminiscências das memórias individuais ou a reinterpretação do passado. / This study aimed to describe the central issues of being a black nurse graduated by the School of Nursing, University of São Paulo, from the perspective of the Theory of Transcultural Nursing trough the analysis situations of prejudice experienced by these nurses facing their career choice, their academic training and their integration into the labor market. As the study has a descriptive, historical, social and exploratory character, was chosen the method of Oral History, which is a method that uses the interview and other processes linked together in the narrative record of human experience. It was also chosen the method of Oral History Thematic considering the fact that this method helps people to speak freely in their respective contexts. The School of Nursing graduated, in the period of 1947 to 2006, 2,886 nurses, of which 128 identified themselves as non-whites. Located, in the state of São Paulo, 45 of the above identified, of which 14 were interviewed for this research. It was noted that the terminology \"moreno\" was the most used for self reporting and that of those interviewed, all stated have suffered racial discrimination at some point in their life trajectories, especially in hidden form, which is the harder form to face. This research led to a more democratic history over the view of its own communities, because it allows the construction of history from the very words of those who participated and experienced, in a given period of time, through its references and imagination, allowing the registration of reminiscences of individual memories or the reinterpretation of the past.

Abstract The purpose of this ethnographic study is to describe and analyse professional and lay care in the Bena cultural context in the Tanzanian village of Ilembula. The study focuses on care as a cultural phenomenon. The structure of the study is based on M.M. Leininger's (1991) Culture Care Theory In the first phase of the study, care was described from a professional perspective. The data were collected by interviewing and observing trained nurses (n=6) in the wards of Ilembula Lutheran Hospital. The study material was complemented with the data obtained from informants' diaries and institutional documents. The data were analysed by using qualitative ethnonursing analysis. In the second phase of the study, the focus was on lay care. The fieldwork was done in the Ilembula village and Ilembula Lutheran Hospital. The data were collected by interviewing villagers (n=49) and relatives (n=12) of patients admitted to Ilembula Lutheran Hospital, and by observing their care practices. The data were analysed by qualitative content analyses with regard to the cultural context. Curing and caring were the characteristics of professional care, as described by the nurse informants. Curing was linked to skills and knowledge obtained in nurse training and it was demonstrated through technical interventions, medication and health education. Caring referred to a natural mother-child relationship and reflected the traditional cultural knowledge. Caring was demonstrated in primary care, meaning a mother's responsibilities in taking care of a small baby, encouragement and comfort. The patient's recovery and maintenance of health were the goals of professional care. Respect and protection were the characteristics of lay care, reflecting the worldview and cultural values of the Bena. The aim of respect was to maintain family unity and to ensure wellbeing, while protection focused on the sensitive phases of the Bena life span. The main meaning of lay care for the informants was health maintenance and improvement of health. Health included physical, mental and reproductive aspects, and enabled them to respond to the culturally determined role expectations. The aim of this ethnographic study was to demonstrate that care is integral to much more comprehensive socio-cultural issues in the context of a Tanzanian village. The study demonstrates the meaning of cultural and social factors, such as cultural values and lifeways, kinship, economic, educational, and ethnohistory in both professional and lay care. The findings can be utilised in transcultural nursing education and in clinical nursing practice, especially in developing patient education from a transcultural perspective, not only in Tanzania, but internationally.