Defining cultural diversities experienced in patient care by nursing students in eastern Turkey

The aim of this study was to determine the cultural diversities that nursing students experience between the patients and themselves while providing care to patients and to find the effects of the demographic variables of the students on these diversities. This research was a cross-sectional study and was conducted between January 2004 and April 2004 at the Nursing College of Atatürk University, in the provincial capital of Erzurum in Eastern Turkey. The research involved 330 students attending the first, second, third, and fourth year courses in the Nursing College at Atatürk University. No special selection was made in the population of the study; instead, 263 full time students who volunteered were included in the study. Sixty eight percentage (n = 181) of the students were determined to have experienced cultural diversities in patient care. The students who experienced cultural diversity in patient care were found to have experienced these diversities in communicating with the patients (44.2%), in religious beliefs (6.1%), and in the life style (8.8%). In general, it was observed that nursing students coming from regions other than Erzurum and Eastern Anatolia and being at the beginning stage of their studies experienced more cultural diversities while caring for patients.     

Transcultural nursing courses online: implications for culturally competent care

Cultural diversity must be taken seriously by both faculty and students, and requires action by both parties for successful integration into online learning. Limited diversity in the nursing workforce or student population creates a need for learning cultural competence. Online transcultural nursing courses meet this learning need and provide opportunities for a variety of students and faculty participation from around the world. Successful online learning experiences can contribute to the provision of culturally competent nursing care.     

Caregiving to patients who are culturally diverse by Swedish last-year nursing students.

With Leininger's theory of cultural care diversity and universality as a framework, the aim of this study was to describe Swedish last-year nursing students' experiences of caregiving to patients who are culturally diverse. The students participated voluntarily, 107 by completing a questionnaire with open-ended questions and 15 by participating in in-depth semistructured interviews. Three categories of experience were identified by use of qualitative method, namely, cultural awareness, cultural insufficiency, and cultural curiosity. The students were found to be on the level of Leininger's first phase of transcultural knowledge. It is concluded that cultural sensitivity should be promoted by integrating transcultural concepts into the curricula on all levels of nursing education and by offering special courses on transcultural nursing to nursing students and health care providers.     

Cultural encounters in reflective dialogue about nursing care: a qualitative study

Title.  Cultural encounters in reflective dialogue about nursing care: a qualitative study.
Aim.  This paper is a report of a study to explore how students developed reflective nursing practice through cultural encounters between students from Tanzania and Norway.
Background.  Nursing students need to develop cultural care competence to care for patients in a globalized world. One way to achieve this goal may be through international practice experience. Previous studies have shown that students visiting developing countries matured personally and intellectually more than those who experienced encounters between developed countries.
Method.  The study was exploratory, using qualitative data about nursing practice and cultural encounters experienced by nursing students from Tanzania and Norway. Data were collected through participatory observation, students' logs and focus group interviews in 2006.
Findings.  The encounter was characterized with an open attitude facilitating a good context for co-learning between the students. Three main themes were identified. The Norwegian students emphasized nurse–patient relationships, individualized care, direct communication and emotional involvement. The Tanzanian nursing students demonstrated a collectivist approach in nursing characterized by nurse–relative–patient relationships, and they emphasized curing attributes with skilful performance of procedures.
Conclusion.  A cultural encounter between students from different culture proved to be a fruitful way of teaching nurses. The opportunity to share thoughts, reflect on value systems and personal practice through dialogue with students from a different culture offer possibility in terms of cultural competence, reflexivity and consciousness of various ways practising nursing. This may contribute to bringing the practice of nursing a step forward in both cultures.     

Making anthropology clinically relevant to nursing care

Transcultural nursing is generally seen as the interface between anthropology and nursing A prime objective of transcultural nursing has been the translation of concepts from anthropology and nursing into the nursing process to guide a culturally informed clinical practice To date, there has been a general inability of transcultural nursing to operationalize the concept of culture to develop culturally competent clinicians, that is, nurses who are capable of knowing, utilizing, and appreciating the effects of culture in the resolution of an individual, group, community, and/or family problem A model of transcultural nursing is described, for incorporating the concept of culture into patient care It includes the concepts of cultural brokerage, simultaneous dual ethnocentrism, multiple clinical realities, the patient as cultural informant, and cultural assessment of patient views of clinical reality The problems of making anthropology and transcultural nursing clinically relevant through the transcultural nursing model are presented and methods are recommended for addressing such problems     

Association between cultural intelligence and cultural sensitivity in nursing students: A cross-sectional descriptive study

BackgroundBecause of the multicultural composition of the Turkish population, healthcare providers encounter and serve individuals from various cultural backgrounds.AimTo determine the relationship between cultural sensitivity and cultural intelligence levels among nursing students.MethodsThis study was performed with 336 students attending the Nursing Department of a state university in Turkey. Data were collected using a sociodemographic data form, the Intercultural Sensitivity Scale, and the Cultural Intelligence Scale.ResultsMean age of the Nursing Department students was 20 ± 1.76 years. Mean total scores on the Intercultural Sensitivity Scale and Cultural Intelligence Scale were 90.49 ± 12.68 (maximum 120) and 95 ± 15.8 (maximum 140), respectively. Total scores in both the Intercultural Sensitivity Scale and the Cultural Intelligence Scale were higher among those nursing students who had encounters with people with different cultural backgrounds for any reason and those who wanted to work abroad. The nursing students’ Intercultural Sensitivity Scale and Cultural Intelligence Scale total scores were positively correlated (p < .001).ConclusionIntercultural sensitivity increased with higher cultural intelligence. Enhancing nursing education with programs that improve the students’ cultural sensitivity and cultural intelligence will help them to successfully manage cultural differences and provide culturally appropriate care in their nursing practice.     

Transcultural nursing in Australian nursing curricula

As a result of the fact that Australia is a multicultural society with many people who come from non-English speaking backgrounds (NESB), the objective of the present study was to discuss the extent to which transcultural nursing education is incorporated into undergraduate nursing curricula. A survey was undertaken to determine the availability of nursing modules for undergraduate nursing students through Australian university websites on "transcultural nursing" or related modules. Although the inclusion of these modules into nursing education provide an opportunity for nurses to perceive and respond to different patient behaviors in multicultural societies, it is not sufficient to understand the complexity of the health care needs of a multicultural society. The survey findings suggest that many universities have not included transcultural nursing modules in their nursing curricula. To address this problem, more transcultural nursing modules need to be introduced into nursing curricula and nursing academics need to refine their attitudes about the importance of cultural aspects of patient care within nursing education.     

A review of transcultural nursing

In this article, transcultural nursing is reviewed in the light of the literature mainly relevant to the British context. The key features of transcultural nursing are examined in the context of multicultural Britain as follows: definitions, racism, ethnocentrism, culture, diversity, transcultural health care practice and nurse education. Models of transcultural care practice and contemporary developments in cultural care are also explored. There is evidence from emerging literature that innovations are taking place in promoting transcultural care practice and education. However, the article concludes that much practice-based research is still needed to establish transcultural nursing in Britain.     

Ambivalent sexism of nursing students in Turkey and South Korea: A cross‐cultural comparison study

Culture has become increasingly important concepts in nursing in the era of globalization. Nurses' cultural biases and prejudices are huge obstacles to their caring for patients from diverse cultural backgrounds. Therefore, this study examined sexism among nursing students from two patriarchal societies: Turkey influenced by Islam, and South Korea influenced by Confucianism. For this comparative study, we used the survey data from the sample of 560 nursing students, 309 from Turkey and 251 from South Korea. The findings showed that both samples showed high levels of sexism, both hostile and benevolent. When comparing the two samples, Turkish nursing students showed significantly higher sexism than did Korean students. Additionally, in both countries, male participants showed higher scores on sexism, especially hostile sexism. In terms of age, older students in Turkey showed lower levels of benevolent sexism. We hope the findings of this study can provide evidence to develop customized transcultural nursing education content in the context of different ethnicities and to help nurses and nursing students from specific cultural backgrounds in becoming aware of their own cultures.     

Transcultural mental health nursing. 1: Benefits and limitations

Mental health nurses often have to respond to the needs of clients from a diverse cultural background and ethnicity. The cultural needs of mental health clients can be met by transcultural nursing. In this article, the first of two parts, transcultural nursing is explained in terms of its assumptions, benefits and limitations and the emerging literature in this area of mental healthcare practice is highlighted. The second article will review the terms 'race', 'culture' and 'ethnicity' to illustrate their centrality in transcultural care. Following this, some aspects of mental health problems are presented in the context of cultural variation. Finally, the ACCESS model (Narayanasamy, 1998) (Assessment, Communication, Cultural negotiations and compromise, Establishing respect, Sensitivity and Safety) is suggested for use in transcultural care in mental health nursing.     

Cultural competency of graduating US Bachelor of Science nursing students

Cultural competence in the delivery of nursing care is an expectation of accreditation and approval boards for nursing in the United States. This study evaluated the effectiveness of four different nursing program curricula in developing culturally competent new graduates. Four methodologically and geographically diverse groups of graduating BSN students in the United States were given the Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals-Revised (IAPCC-R prior to graduation and after completion of course work. A variety of curricular methods for achieving cultural competency were included. Two programs utilise a theory or a model developed by recognised transcultural expert nurses, Madeline Leininger and Josepha Campinha-Bacote. One program utilised an integrated approach employing no specific model. One program utilised a free-standing two credit culture course within the curriculum, taught by nursing faculty with strong cultural preparation. Results indicate that these 212 graduating nursing students scored only in the culturally aware range, as measured by the IAPCC-R, regardless of what program model they attended.     

Transcultural nursing course in Tanzania, Africa

A transcultural nursing course in Tanzania was offered in fall 2010 at Williston State College, located in North Dakota. Madeleine Leininger's Culture Care: Diversity and Universality Theory (Principles of Developing Cultural Competence) was the framework used for the experience. The course provided nursing students the opportunity to learn about the culture, health, and illness beliefs of Tanzanians; their values and practices; the prevalence of HIV/AIDS; and the differences and similarities between the healthcare systems, hospice/palliative care, and home visits in Tanzania as compared to the United States.     

Ethical implications of implicit bias in nursing education

Nurses possess the responsibility of promoting equality and diversity by treating all patients, families, and colleagues with respect and dignity. This responsibility includes providing culturally informed care and practicing within the ethical principles of autonomy, justice, beneficence, veracity, and nonmaleficence. Implicit biases impact nursing education and subsequent interactions between student nurses and patients and hinder effective communication. Patients who have experienced implicit bias in health care may come to expect negative interactions in the future. Nurse educators hold the responsibility of preparing nursing students to deliver care to diverse populations by guiding them to recognize their responses to cultural differences. Awareness of students’ implicit biases is the first step in incorporating efforts to overcome them. A gap exists in nursing education which illustrates the lack of inclusion of implicit bias in the curriculum. The purpose of this paper is to examine the ethical implications of implicit bias in nursing education. Ethical principles are presented and discussed in the context of implicit bias and nursing education. Recommendations for incorporating strategies of identification and awareness of implicit bias into the nursing curriculum are discussed. The inclusion of the implications of implicit bias in the nursing curriculum provides opportunities for educators to direct students to develop plans to recognize the damaging effects of implicit bias and become aware of behaviors that become barriers to patient interactions. The results of this education include improved patient outcomes and the delivery of culturally appropriate care.     

Challenges and approaches to transcultural care: An integrative review of nurses' and nursing students' experiences

BackgroundProvision of transcultural care is an essential nursing competency. It is important to comprehensively understand the challenges nurses and nursing students face while striving to provide transcultural care in clinical settings.PurposeThe purpose of this review was to develop a comprehensive understanding of nurses' and nursing students' challenges and approaches to the provision of transcultural care to people with diverse ethnicities.MethodsAn integrative review was conducted. Literature was searched within five databases, and 30 studies published from January 2010 to January 2021 were reviewed and appraised using mixed methods critical appraisal tool. Literature summary tables and inductive approaches were used for data extraction and synthesis.ResultsThe challenges to the provision of transcultural care were intrapersonal struggle, cultural conflicts, varied expressions of pain and suffering, and navigation of personal and organizational constraints. Addressing these challenges required nurses and students to practice self-criticism and tolerate differences, develop interpersonal and psychological skills, and collaborate with peers and patients' families.ConclusionsProvision of transcultural care is a complex task for nurses and students because of different interpretation of personal and organizational factors. Health care institutions should proactively provide resources to nurses and students to strengthen their interpersonal and psychological skills to provide effective transcultural care.     

Effectiveness of cultural immersion and culture classes for enhancing nursing students' transcultural self-efficacy

With diversity increasing in the United States, educators are struggling to find the most effective methods to prepare nursing students to care for diverse populations. This study's purpose was to determine the impact of immersion experiences and cultural classes on nursing students' transcultural competence. A pretest-posttest, quasi-experimental design was used. Nursing students completing a 2-week to 3-week immersion experience (n = 14) completed the Transcultural Self-Efficacy Tool online 1 week prior to and immediately following an immersion experience. The control group (n = 25), who were students not participating in an immersion experience, completed the instrument during the same time frame. Students who participated in an immersion experience had significantly higher posttest transcultural self-efficacy scores (p < 0.001). Compared with the control group, the students in the immersion group had significantly higher change scores (p < 0.001). In addition, the number of culture classes completed was not correlated with transcultural self-efficacy scores. Recommendations included encouraging student participation in immersion experiences to enhance transcultural competence.     

A comparison of an international experience for nursing students in developed and developing countries

Theoretical perspectives and approaches to transcultural nursing have been developed and there are different options for teaching transcultural care. The opportunity for nursing students to gain healthcare experience in another country is one option. This article reports a study undertaken in Northern Ireland to evaluate outcomes of a 3-month international experience for undergraduate nursing students (n=74) and to assess differences between the experiences in developed and developing countries. Data were collected by questionnaire. The findings indicate a high impact on students’ international perspective and career development. Students’ understanding of cultural and political issues within Northern Ireland was enhanced.     

Intellectual disability nursing and transcultural care

In today's healthcare environment, nurses are urged to use up-to-date research evidence to ensure better patient outcomes and inform nursing decisions, actions and interactions with patients. Within the practice setting, there is an increasing challenge to provide care to patients from minority ethnic groups. In order to deliver care to different cultural groups, nurses need to recognize and empathize with patients' belief systems, being mindful of their diverse cultural needs. This article presents the concept of transcultural care and identifies issues within intellectual disability nursing through a focus on the components identified by Campinha-Bacote (2002; 2003) and Cortis (2003): cultural awareness, cultural skill, cultural knowledge, cultural encounter and cultural desire. It highlights the issues which are relevant to nursing practice, cultural care and service provision for persons with intellectual disability from ethnic minorities in Ireland.