Archives
Preface
Pathways of Cultural Awareness
Akram Omeri
Adjunct Associate Professor, School of Nursing, College of Health and Science, University of Western Sydney, Parramatta NSW
Article Text
Transcultural nursing anticipates similarities and differences in health care and health care systems and nursing practices within diverse cultural contexts and societies. Global development of the discipline of transcultural nursing is dependent upon international collaborative research efforts and the dissemination of knowledge worldwide.
This Contemporary Nurse special issue on transcultural nursing, Advances in Contemporary Transcultural Nursing, 2nd edition, is a major collaborative endeavour that aims to share evidence- based transcultural nursing knowledge toward advancing and improving care in culturally meaningful ways to clients, families and communities. It is intended to make a major contribution to the dissemination of transcultural nursing knowledge locally and internationally.
The diverse content is structured around four major themes encompassing: leadership and education; the application of models and theories to practice; research evidence for practice and transcultural nursing research incorporating principles of social justice, human rights, compassion, and human dignity. The four sections of this special issue provide a broad view of the discipline of transcultural nursing, the scope of its interests and the application of research based transcultural nursing knowledge in education, research and practice.
Section 1: Transcultural nursing leadership and education
On transcultural nursing leadership, Rosemary Bryant, Elizabeth Foley and Elizabeth Percival present a historical perspective of how transcultural nursing emerged as a discipline of study, practice and research and the national leadership of a national organisation in promoting transcultural nursing in Australia. Margaret Andrews, highlights the global leadership of transcultural nursing (TCN) by the founder of the discipline, Madeleine Leininger, and discusses the leadership of Australian nurses in global transcultural nursing. These two papers highlight the significance of both national and global leadership in TCN.
On transcultural nursing education, Lynnette Raymond highlights issues surrounding the development of a Bachelor of Nursing course responsive to cultural diversity. She discusses factors that influenced the development of learning outcomes that would enable student nurses the opportunity to develop the knowledge, skills, and attitudes needed to advance personal and professional cultural awareness of self and others appropriate to the Australian context and delivery of culturally congruent and safe nursing care for practice. Sandra Mixer reflects upon a detailed literature review demonstrating how faculties use culture-care theory and the ethnonursing method to teach culture care. The literature revealed that despite 50 years of transcultural nursing knowledge development through theory, research, and practice; there remains a lack of formal, integrated cultural education in nursing. Cultural competencies of graduating US BSN students is revealed in a joint research article by Suzan Karding-Edgren and Josepha Campinha-Bacote.
Section 2: Application of transcultural nursing theory and models to practice
McFarland and Eipperle propose Leininger's Theory of Culture Care Diversity and Universality as a basis for the educational preparation, primary care contextual practice, and outcome focused research endeavors of advanced practice nursing. Ann Hubbert presents a historical partnership between an American Catholic faith based, urban hospital and a program sponsored by a Comanche medicine man on the spirituality of American Indian Traditional Indian. Culture care theory is applied in discussion of these past experiences to explore the relationships among and between the participating cultures.
Myrna Doumit and Huda Abu-Saad Huijer report on a study of the lived experiences of Lebanese cancer patients. Using the Utrecht School of Phenomenology, semi-structured interviews with ten cancer patients and subsequent analysis and synthesis of raw data revealed that cancer patients expressed the need for a clear and truthful communication with health care professionals and family members. Hiba Wehbe-Alamah shares knowledge of traditional Muslim generic (folk) care beliefs, expressions, and practices derived from research and descriptive sources in order to assist nurses and other health care professionals to integrate generic care practices into professional care practices.
Section 3: Transcultural nursing research: Where is the evidence?
A number of studies in this section are used as evidence-base for practice. Brunero, Smith and Bates examined the experiences and needs of a group of Overseas Qualified Nurses' (OQN's) at a major metropolitan tertiary referral hospital in Australia. The study reports an organisational and personal approach undertaken to assist in the process of adjustment of the participating ONQ's into the nursing workforce in the context of the tertiary institution where the study took place. In a retrospective descriptive study, Henrietta Maltby reports on reflective responses by 85 junior nursing students to 126 questions on culture over time. Analysis of verbatim descriptors by participants revealed that cultural competency although not yet fully operationalised in the nursing profession is a developmental process that goes across time and is more than learning about cultures.
Rutledge et al examine a new approach in educating culturally competent nurses. ‘Integrative simulation' is used to provide culturally diverse learning opportunities for both university and distance mode students. Cases are developed using focus groups and individual interviews. Papadopoulos, Tilki and Ayling detail the development of a tool to measure cultural competence of individuals working within the Children and Adolescent Mental Health Services (CAMHS).
Jospha Campinha-Bacote explores the construct of cultural desire in an attempt to identify meaningful ways that cultural desire cannot only be ‘caught' by faculty who model this construct, but also be ‘taught' within nursing curricula as a functional component of cultural competence. Cultural desire is one construct of Campinha-Bacote's model of cultural competence.
Jette Mebrouk reports the findings from a phenomenological research study on perceptions of nursing care by Saudi Arabian female nurses practicing in the context of Saudi Arabia. Using in-depth semi-structured interviews with five nurses participating in the study revealed that perception of care is closely linked to Islamic values.
Section 4: Global agenda in transcultural nursing
Papers included in this section illustrate the nature and scope of transcultural nursing as a global endeavour. By incorporating the principles of social justice, human rights, compassion, and human dignity, transcultural nurses aim to provide culturally competent care to fellow world citizens, irrespective of their cultural origins, human condition or social situation.
Ann McMurray and Rani Param describe how structural, historical and political factors have contributed to the negative health status and health outcomes of Australia's Indigenous peoples. The authors recommend strategies for overcoming barriers and biases relating to indigenous health. Denise Wilson describes research exploring the health perceptions of Maori women and their interaction with ‘mainstream' health care services. Findings of the research provide guidance for her recommendations for culturally competent practice for these Maori women.
Dula Pacquiao presents a picture of vulnerable populations using a framework of cultural competence, social justice and human rights. She states that transcultural nursing mandates that the principles of social justice, human rights and cultural competence extend as much to our professional colleagues as they do to our patients and clients. Mireille Kingma raises consciousness of the scope and magnitude of the international nurse recruitment efforts and identifies the types of abuse, discrimination and exploitation reported by migrant nurses and advocates for the development of strategies to prevent and deal with such matters in the name of saving nursing and the profession.
Being mindful of the diverse views and approaches in papers submitted, and based upon reviewed evidence-based literature above, we adopted an open mind, taking into account two major constructs essential in transcultural nursing namely ‘Culture and Care' and how submitted papers could appropriately inform practice toward culturally competent nursing care.
This special issue, on Advances in Contemporary Transcultural Nursing builds upon the enormous wealth of evidence-based transcultural nursing knowledge from many parts of the world.
Acknowledgments
We are grateful to all those who made submissions to this issue. We also acknowledge the contributions of all who in one way or another have participated in promoting the discipline of transcultural nursing in Australia and globally. We extend our special acknowledgement to Sandy Lovering for her contributions during initial planning of this special issue and to Helen Hamilton, Consulting Editor, for her kind and generous editing upon request.
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