Journal of Transcultural Nursing recent issues

Toward a New Definition of Health Disparity: A Concept Analysis

Fink, A. M. — Mon, 14 Sep 2009 11:15:12 PDT

In response to federal requests for investigation into measures to eradicate health disparities, a concept analysis of the term health disparity was conducted. Health-related and multidisciplinary literature was reviewed. Multiple terms were explored alone and in combination with no limitations on search date parameters. Findings indicated several definitions of the concept, with the term health care disparity being used interchangeably with the term health disparity . New theoretical and operational definitions, antecedents, characteristics, and consequences of the concept are proffered. Model, borderline, and contrary cases are developed to illustrate the concept. Nursing implications and recommendations for future research are discussed.

Acculturation and the Cancer Pain Experience

Im, E.-O., Ho, T.-H., Brown, A., Chee, W. — Mon, 14 Sep 2009 11:15:12 PDT

Purpose: Using a feminist perspective, the relationship between acculturation and cancer pain experience was explored. Design: This was a cross-sectional, correlational Internet study among 104 Hispanic and 114 Asian cancer patients. The instruments included both unidimensional and multidimensional cancer pain measures. Findings: There were significant differences in cancer pain scores by country of birth. Yet there was no significant association of acculturation to cancer pain scores. Discussion and Conclusions: This study indicated inconsistent findings. Implications for Practice: To provide directions for adequate cancer pain management, further studies with a larger number of diverse groups of immigrant cancer patients are needed.

Assessing Diabetes Dietary Goals and Self-Management Based on In-Depth Interviews With Latino and Caucasian Clients With Type 2 Diabetes

Early, K. B., Shultz, J. A., Corbett, C. — Mon, 14 Sep 2009 11:15:12 PDT

Latino (n = 10) and Caucasian (n = 8) clients with type 2 diabetes receiving care at a community health clinic participated in individual in-depth interviews assessing diabetes dietary self-management goal behaviors. Themes from interviews were identified using content analysis, which revealed current and future goals, influencing factors, and motivators and barriers to dietary modification for diabetes management. Implications for practice include simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the patient, in a socially supportive environment. Results contribute to future survey development and understanding how to optimize diabetes education for these populations.

Cultural Values and Political Economic Contexts of Diabetes Among Low-Income Mexican Americans

Clark, L., Vincent, D., Zimmer, L., Sanchez, J. — Mon, 14 Sep 2009 11:15:12 PDT

Purpose: To explore the political and economic dimensions of diabetes self-management for Mexican American adults. Design and Methods: Critical ethnographic analysis of focus group data from caregivers and adults with diabetes. Findings: Three themes were identified: diabetes self-management is tied to other mental and bodily states, family and neighborhood environments cause stress and prevent diabetes solutions, and hassles of the health care environment subvert self-management. Discussion and Conclusions: Cultural constructs about diabetes merge with social—political forces in explaining diabetes. Implications for Practice: Cultural competence in diabetes care requires attention to the political economy of the disease and advocacy for healthful political and economic change.

Rationalization of Indigenous Male Circumcision as a Sacred Religious Custom: Health Beliefs of Xhosa Men in South Africa

Mavundla, T. R., Netswera, F. G., Bottoman, B., Toth, F. — Mon, 14 Sep 2009 11:15:12 PDT

This article presents research findings based on the meaning of indigenous circumcision to Xhosa men in South Africa. In South Africa, male circumcision is a rite of passage from adolescence to adulthood. The country has experienced serious problems associated with the practice of this rite ranging from dehydration to death in the traditional "bush" circumcision schools. A qualitative, endogenous research design that is explorative, descriptive, and contextual was undertaken using individual interviews, focus group interviews, and community meetings discussing this ritual. A total of 25 men were interviewed. Only one question was posed throughout the research process: "How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.

Ethics and Advance Care Planning in a Culturally Diverse Society

Johnstone, M.-J., Kanitsaki, O. — Mon, 14 Sep 2009 11:15:12 PDT

Emerging international research suggests that in multicultural countries, such as Australia and the United States, there are significant disparities in end-of-life care planning and decision making by people of minority ethnic backgrounds compared with members of mainstream English-speaking background populations. Despite a growing interest in the profound influence of culture and ethnicity on patient choices in end-of-life care, and the limited uptake of advance care plans and advance directives by ethnic minority groups in mainstream health care contexts, there has been curiously little attention given to cross-cultural considerations in advance care planning and end-of-life care. Also overlooked are the possible implications of cross-cultural considerations for nurses, policy makers, and others at the forefront of planning and providing end-of-life care to people of diverse cultural and language backgrounds. An important aim of this article is to redress this oversight.

President's Message: Connection-Reconnection: What does it mean to you?

Lauderdale, J. — Mon, 14 Sep 2009 11:15:12 PDT

Transcultural Nursing Society Web Site

Mon, 14 Sep 2009 11:15:12 PDT

Transcultural Nursing Society Membership Form

Mon, 14 Sep 2009 11:15:12 PDT

Transcultural Nursing Society

Mon, 14 Sep 2009 11:15:12 PDT

Standards of Practice for Culturally Competent Nursing Care: A Request for Comments

Wed, 10 Jun 2009 11:23:27 PDT

When Family Means More (or Less) Than Genetics: The Intersection of Culture, Family, and Genomics

Burns McGrath, B., Edwards, K. L. — Wed, 10 Jun 2009 11:23:27 PDT

There is renewed interest in the use of family history to predict individual disease susceptibility, and as a result, standardized online family history tools are being developed and marketed as a "new genetic test." It is not known how cultural variations in definitions of family influence collection of these data or what is the best format to use. This is significant given that the populations who carry the greatest burden of the target diseases have not been considered in efforts to test these tools. A qualitative study with a convenience sample of 19 Japanese Americans and Samoan Americans, two groups at high risk for type 2 diabetes, was conducted to explore the process of collecting family history. A particularly strong finding was the high degree of acceptance experienced by the participants with the process and their pride in visualizing their family graphically displayed in pedigrees. It was also found that Samoans included those linked by nonbiological ties in their families, which reflects their cultural practices. Further research is needed to assess the most effective and efficient way to gather family history given the complexities surrounding the deceptively simple concept of family.

Association of Acculturation Status With Beliefs, Barriers, and Perceptions Related to Cardiovascular Disease Prevention Among Racial and Ethnic Minorities

Edelman, D., Christian, A., Mosca, L. — Wed, 10 Jun 2009 11:23:27 PDT

Acculturation has been correlated with traditional cardiovascular disease risk factors. The purpose of this study was to examine the association between acculturation and health beliefs, barriers, and perceptions related to cardiovascular disease prevention. Racial/ethnic minority participants in the Family Intervention Trial for Heart Health were included in this analysis. Less acculturated minorities were more likely to have health beliefs that may impede prevention, have greater perceived susceptibility to disease, and believe in an external locus of control. Evaluating acculturation in clinical practice may be an opportunity to promote awareness, healthy behaviors, and prevention among immigrants.

Assessing Transcultural Validity of the Transtheoretical Model With Chinese Americans and Physical Activity

Tung, W.-C., Hsu, C.-H. — Wed, 10 Jun 2009 11:23:27 PDT

Transtheoretical model has shown promise in promoting adoption and maintenance of physical activity and was used to guide this study. A cross-sectional design with snowball sampling was applied to recruit 201 Chinese Americans. Self-efficacy scores were significantly higher for participants in maintenance than those in precontemplation. There were no significant differences in perceived benefits and barriers in different stages. The transtheoretical model partially applied to the participants for whom the reinforcement of self-efficacy is more important than emphasizing the benefits or decreasing the barriers to regular physical activity. Cultural issues may play a critical role and should be further investigated.

Perceptions of Urinary Incontinence Among Syrian Christian Women Living in Sweden

Andersson, G., Johansson, J. E., Nilsson, K., Sahlberg-Blom, E. — Wed, 10 Jun 2009 11:23:27 PDT

Purpose: The purpose of this study was to describe the perception of urinary incontinence (UI) among Syrian women living in Sweden. Design: A qualitative, descriptive design with focus group discussions (FGDs) was used and analyzed with content analysis. Fourteen Syrian women were interviewed in three FGDs. Findings: Three categories emerged, "Thoughts on UI," "Managing UI," and "Communication With the Health Care System." Among the interviewees, UI was a common, and expected, problem, which could be managed. However, some expressed shame and embarrassment. Some talked about communication problems with health care. Discussion and Implications for Practice: The health care system should be adjusted to the women's needs, with awareness of the communication difficulties, which could result in misunderstanding and neglected treatments.

Perceived Work and Family Conflict Among African American Nurses in College

Gipson-Jones, T. — Wed, 10 Jun 2009 11:23:27 PDT

Purpose: This article describes the perceptions of African American nurses regarding the interaction between work—family conflict, job satisfaction, and psychological well-being. Design and methods: A qualitative descriptive design was employed to conduct six focus group sessions with 23 nurses at three universities in the southeastern United States. Findings: Stressors such as racism or lack of teamwork and supervisor support caused the nurses to contemplate leaving a workplace or the profession. Family stressors, such as an ill family member, also influenced any decision regarding career longevity. Implications: Future studies examining work—family interface, especially positive spillover and psychological well-being are warranted.

Filipino Nurses in the United States: Recruitment, Retention, Occupational Stress, and Job Satisfaction

Hayne, A. N., Gerhardt, C., Davis, J. — Wed, 10 Jun 2009 11:23:27 PDT

Solutions to the nursing shortage in North America include the recruitment of international nurses. This descriptive study examines strategies to facilitate the cultural adaptation, job satisfaction, and perception of role and social support of a group of recruited Filipino nurses. Instruments used were the Nursing Work Index—Revised Edition and Occupation Stress Inventory—Revised Edition. Results indicated that the investment in promoting the well-being of recruits in both social and work contexts positively benefits job satisfaction and spills over into related areas of satisfaction and positive adaptation. The literature study also focuses on areas of cultural competence in the context of transcultural nursing.

Jewish Laws, Customs, and Practice in Labor, Delivery, and Postpartum Care

Noble, A., Rom, M., Newsome-Wicks, M., Engelhardt, K., Woloski-Wruble, A. — Wed, 10 Jun 2009 11:23:27 PDT

Many communities throughout the world, especially in the United States and Israel, contain large populations of religiously observant Jews. The purpose of this article is to provide a comprehensive, descriptive guide to specific laws, customs, and practices of traditionally, religious observant Jews for the culturally sensitive management of labor, delivery, and postpartum. Discussion includes intimacy issues between husband and wife, dietary laws, Sabbath observance, as well as practices concerning prayer, communication trends, modesty issues, and labor and birth customs. Health care professionals can tailor their practice by integrating their knowledge of specific cultures into their management plan.

President's Message

Lauderdale, J. — Wed, 10 Jun 2009 11:23:27 PDT

Transcultural Nursing Society 35th Annual Conference Seattle, WA

Wed, 10 Jun 2009 11:23:27 PDT

Transcultural Nursing Society Web Site

Wed, 10 Jun 2009 11:23:27 PDT

Transcultural Nursing Society Chapters, Regional Liaisons, and Cooperative Alliances

Wed, 10 Jun 2009 11:23:27 PDT

Transcultural Nursing Society

Wed, 10 Jun 2009 11:23:27 PDT

Transcultural Nursing Society Membership Form

Wed, 10 Jun 2009 11:23:27 PDT

Manuscript Submission Information for Authors

Wed, 10 Jun 2009 11:23:27 PDT

Cultural Competency in Baccalaureate Nursing Education

Fri, 03 Apr 2009 09:54:27 PDT

This article presents the work of the American Association of Colleges of Nursing Advisory Committee in developing an integrated curriculum for cultural competence in baccalaureate nursing education. Five competencies for Cultural Competency in Baccalaureate Nursing Education were developed with supporting rationale. Suggestions for developing and implementing curricula for cultural competency, teaching content, specific integrative learning strategies, methods for evaluating nursing students' cultural competence and recommendations for effective implementation of the integrated curriculum are presented.

An Exploration of Culture, Diabetes, and Nursing in the South Asian Community: A Metasynthesis of Qualitative Studies

Fleming, E., Gillibrand, W. — Fri, 03 Apr 2009 09:54:27 PDT

South Asian people are often perceived as a homogenous group whose culture is prescriptive and constraining. A metasynthesis of how culture influences diabetes self-management in the context of a South Asian population was undertaken. Theory explication was used to deconstruct and reconceptualize the findings of the studies. Eleven publications reported themes of health beliefs, individuality, context, and shared experiences. The results indicate that culture does not influence diabetes self-management in a rigid and prescriptive way; instead, individuals negotiate and interpret culture in a shifting and diverse context. An individualized approach to delivering culturally appropriate nursing care should be taken.

Qualitative Research on the Attitudes Toward Teenage Sexual Behavior of Chinese British Families: Methodological Issues

Juping Yu, — Fri, 03 Apr 2009 09:54:27 PDT

Qualitative approaches have been increasingly used to explore ethnic differences in teenage sexual behavior, and methodological issues of conducting such research often remain unaddressed. This article discusses issues related to sampling, rapport, language, and ethnical considerations arising while undertaking research on attitudes toward teenage sexual behavior held by Chinese British families. It highlights the value of using snowball sampling, the importance of establishing rapport, and some advantages of matching the ethnic background between researcher and participants. The researcher's gender and social and cultural backgrounds affect research processes and findings, and this itself merits further reflection.

Negotiating Three Worlds: Academia, Nursing Science, and Tribal Communities

Fri, 03 Apr 2009 09:54:27 PDT

Purpose: The purpose of this article is to use a cross-cultural model to guide the exploration of common issues and the dynamic interrelationships surrounding entrée to tribal communities as experienced by four nursing research teams. Method: Members of four research teams discuss the primary lessons learned about successful strategies and challenges encountered during their projects' early stages. Results: Understanding the cultural values of relationship and reciprocity is critical to the success of research projects conducted in Native American communities. Discussion: Conducting cross-cultural research involves complex negotiations among members of three entities: academia, nursing science, and tribal communities. The lessons learned in these four research projects may be instructive to investigators who have the opportunity to conduct research with tribal communities.

Language Used by Korean and Korean American Children to Describe Emotional Reactions to Illness and Hospitalization

Park, J.-H., Foster, R., Sufen Cheng, — Fri, 03 Apr 2009 09:54:27 PDT

Most children experience emotional distress during hospitalization. However, existing instruments for assessing emotional status in hospitalized children have limitations. To address this, the authors determine the language that Korean and Korean American children use to describe emotions that may relate to illness and hospitalization. Using a descriptive exploratory design, projective method, and card sort, the study is conducted in six Korean ethnic churches in the Midwest metropolitan area of United States and uses a convenience sample consisting of 94 children, ages 7 to 12 years. Fifteen English emotion words and 13 Korean emotion words are chosen by at least 50% of the Korean-American and Korean children, and children's emotional responses are expressed differently in Korean and English. Health care providers should be cautious about direct translation, because cultural nuances can convey different meanings in another language. In preparation for the rapid growth of minority children in the United States, health care providers should understand cultural perspectives related to minority children's experiences of health and illness and provide linguistically and culturally appropriate care.

Psychometric Analysis of the Inventory of Functional Status--Cancer (IFS-CA) in Turkish Women

Ozkan, S., Ogce, F. — Fri, 03 Apr 2009 09:54:27 PDT

The aim of this study was to test the reliability and validity of the Turkish version of the Inventory of Functional Status— Cancer (IFS-CA). The questionnaire was composed of four subscales that measured to what extent a woman maintained her usual household and family, social and community, personal care, and occupational activities. Internal consistency reliability using average correlations for the subscale item to subscale total scores ranged from .21 to .97. Construct validity was accomplished by examination of subscale correlations, which ranged from —.10 to .70. The Turkish version of the IFS-CA is found to be psychometrically reliable and valid.

Cultural Competence in Qualitative Interview Methods with Asian Immigrants

Suh, E. E., Kagan, S., Strumpf, N. — Fri, 03 Apr 2009 09:54:27 PDT

The growth in Asian immigration and a diversity of Asian populations living in Western English-speaking societies pose many opportunities for qualitative research. Cultural competence is essential to credible qualitative nursing research employing interview data. The purpose of this article is to describe culturally competent qualitative research with Asian immigrants, especially in the design, interview phases, and analysis. Strategies to achieve cultural competence are synthesized within the model of cultural competence, integrating the literature review and data exemplars. Strategies for successful conduct of qualitative research in Asian immigrant populations, including preparation of the research team, techniques for the conduct of research interviews with Asian immigrants, and contextual meanings and timing of translation are offered. The article concludes with a summary of implications for future research.

Nurse Migration to Canada: Pathways and Pitfalls of Workforce Integration

Blythe, J., Baumann, A., Rheaume, A., McIntosh, K. — Fri, 03 Apr 2009 09:54:27 PDT

Many internationally educated nurses (IENs) find it difficult to reinstate themselves in their profession after migration. This article explores factors contributing to the success and failure of IENs to reestablish professional careers. The article discusses a study involving 39 IENs in 5 focus groups and 10 interviews. In all, 29 interviews are held with other stakeholders. IENs encounter obstacles at each stage of the migration process. New strategies are required to assist IENs to reenter the workforce. Given the consistent predictions of an extreme nurse shortage, it is important that the brain waste of immigrant nurses be minimized.

Rural Nurse Cultural Self-Efficacy and Job Satisfaction

Molinari, D. L., Monserud, M. — Fri, 03 Apr 2009 09:54:27 PDT

This article explores relationships between rural nurse cultural self-efficacy and job satisfaction using an online survey of 104 rural nurses in the Northwest. The authors found that self-efficacy was associated with personal characteristics: rural lifestyle and job satisfaction. Nurses who were older, experienced, and with urban backgrounds reported more efficacies when caring for people of different ethnic or racial backgrounds, preferences, and health conditions. Nurses with high cultural self-efficacy expressed intention to leave employment. Rural background nurses expressed the most job satisfaction. The authors conclude exposure to diversity may increase cultural self-efficacy.

Recruitment of Three Generations of African American Women Into Genetics Research

Taylor, J. Y. — Fri, 03 Apr 2009 09:54:27 PDT

Successful outcomes for studies on health disparities depend on recruitment of research participants. Obtaining willing participants, protecting their rights, and acknowledging their contribution to research is as important as seeking answers to the study phenomena. Recruiting research participants can be an arduous process for investigators. Although literature has published participant recruitment methods, investigators sometimes underestimate the time and intensity required to attract eligible participants into research studies. This article reports on methods used to recruit 42 African American generational triads (grandmothers, mothers, and granddaughters) into a hypertension genetics study, the lessons learned, and suggestions for successful recruitment.

Arab Americans' Acculturation and Tobacco Smoking

Al-Omari, H., Scheibmeir, M. — Fri, 03 Apr 2009 09:54:27 PDT

Limited information is available about Arab Americans' smoking behaviors. The aim of this study was to describe Arab Americans' smoking behaviors and any relationship between tobacco dependence and acculturation. This was a cross-sectional study. Arab American smokers and ex-smokers (N = 96) participated in the study. Nicotine dependence, acculturation, and tobacco use questionnaires were used to measure the major variables. Analyses revealed a significant positive correlation between acculturation and tobacco dependence and between tobacco exposure and tobacco dependence. Arab Americans who behaved most like their ethnic peers and spent more time with Arab Americans were more dependent on nicotine.

International Humanitarian Nursing Work: Facing Difference and Embracing Sameness

Zinsli, G., Smythe, E. A. — Fri, 03 Apr 2009 09:54:27 PDT

This article explores the experience of humanitarian disaster and emergency nursing, asking the question, "How is difference (and sameness) in being a nurse revealed when working in a disaster/relief context?" The articles discusses interviews with seven nurses, plus the primary researcher, who tell their stories of humanitarian nursing. Stark differences are revealed: extent of injuries, limits of treatment, and overwhelmingness of need. Alongside this is the huge difference of personal danger. Sameness shows itself in the human-to-human call and response to need that holds nurses in such work. Difference and sameness are not fixed; one readily becomes the other.

President's Message: Are you prepared?

Lauderdale, J. — Fri, 03 Apr 2009 09:54:27 PDT

Transcultural Nursing Society Chapters, Regional Liaisons, and Cooperative Alliances

Fri, 03 Apr 2009 09:54:27 PDT

Transcultural Nursing Society Web Site

Fri, 03 Apr 2009 09:54:27 PDT

Transcultural Nursing Society Membership Form

Fri, 03 Apr 2009 09:54:27 PDT

Transcultural Nursing Society

Fri, 03 Apr 2009 09:54:27 PDT

Utility of the Life Course Perspective in Research With Mexican American Caregivers of Older Adults

Evans, B. C., Crogan, N., Belyea, M., Coon, D. — Thu, 04 Dec 2008 13:23:37 PST

Research on caregiving of elders in Mexican American families is urgently needed. We know little about family caregivers, family transitions in relation to the caregiving role, reciprocal impact of caregivers and care recipients on one another, adaptive strategies, positive benefits of caregiving (caregiver gain), specific caregiving burdens, or supportive interventions for family caregiving. Theory derivation using the concepts and structure of life course perspective provides a way to fill the knowledge gaps concerning Mexican American caregiving families, taking into account their ethnic status as an important Hispanic subgroup and the unique cultural and contextual factors that mark their caregiving experiences.

Understanding Native Women's Health: Historical Legacies

Palacios, J. F., Portillo, C. J. — Thu, 04 Dec 2008 13:23:37 PST

Purpose: Theoretical underpinnings of two theories are examined for their applicability in guiding practice and research when understanding Native American women's health outcomes. Method: Published studies testing two independent theories, historical trauma and weathering, are reviewed. Key theoretical concepts that are applicable in the study of Native women and understanding their intergenerational heritage of injustice and cultural context are discussed. Results: The authors infer underlying assumptions and definitions of both theories and present a hypothetical diagram blending both theories. Conclusion: By understanding historical legacies and the surrounding context, researchers and clinicians can develop knowledge to improve and enhance optimal health outcomes and life opportunities for Native women.

My Sister, Myself: A Culture- and Gender-Based Approach to HIV/AIDS Prevention

Shambley-Ebron, D. Z. — Thu, 04 Dec 2008 13:23:37 PST

African American women are bearing an excess burden of HIV/AIDS, becoming infected at a rate 25 times that of White American women. This places African American girls at the highest risk for becoming infected with HIV/AIDS. Culturally appropriate prevention strategies are indicated to suppress this trend. Two qualitative research methods were used to evaluate a culture- and gender-based HIV prevention intervention: My Sister, Myself. Community action participatory research was used to engage the community in the development of the intervention for early-adolescent girls. Eight girls participated in the 8-week intervention. Data were collected about culture and gender identification, sexual health knowledge, and future intentions throughout the intervention. Focus groups and observation participation data revealed three major themes: "high aspirations," "needing to know the truth," and "internal, external, and eternal resources." Findings indicate promise for intervention strategies that utilize culture- and gender-based strategies for HIV/AIDS prevention with young girls.

The Conceptions of Care Among Family Caregivers of Persons Living With HIV/AIDS in Addis Ababa, Ethiopia

Aga, F., Kylma, J., Nikkonen, M. — Thu, 04 Dec 2008 13:23:37 PST

This focused ethnographic study explores and describes the conceptions of care among family caregivers of people living with HIV/AIDS (PLWAs) in Addis Ababa, Ethiopia. Leininger's theory of culture care diversity and universality is the conceptual anchor of this ethnographic study. Using semistructured interviews and participant observation, 6 key informants and 12 general informants were interviewed in their home in Amharic language. Data were analyzed in Amharic using Leininger's phases of ethnonursing analysis for qualitative data and then translated to English. Four major themes representing family caregivers' conceptions of care were identified: nourishing the PLWA while struggling with poverty, maintenance of cleanliness and hygiene of the person and surroundings, comforting the PLWA, and sacrificing self to sustain the PLWA. Valuable data were gathered about the family caregivers' conceptions of care. Nurses can use this knowledge to design and provide culturally congruent care to family caregivers and PLWAs in the community.

Cultural Adequecy of the Care Dependency Scale for Older Persons in Egypt: A Delphi Study

Boggatz, T., Farid, T., Mohammedin, A., Dijkstra, A., Lohrmann, C., Dassen, T. — Thu, 04 Dec 2008 13:23:37 PST

Purpose: The aim of this study is to determine the cultural adequateness of the Arabic version of the Care Dependency Scale (CDS), an internationally used instrument to measure care needs by either self-reports or external assessment. Method: A Delphi study in two rounds about the Arabic version was performed with 37 panelists in Cairo. Acceptance of CDS items was rated on a 4-point Likert-type scale. Results: Agreement among panelists in the second round was found for 11 CDS items, but 2 items had decreased acceptance after rephrasing and 2 were rejected. Discussion: Rejected items seem to reflect a heterogeneous perception in the target population. Despite some limitations, the CDS is a promising instrument to detect care needs among older Egyptians.

Gender Roles and Informal Care for Patients With AIDS: A Qualitative Study From an Urban Area in Tanzania

Tarimo, E. A. M., Kohi, T. W., Outwater, A., Blystad, A. — Thu, 04 Dec 2008 13:23:37 PST

As HIV/AIDS imposes an overwhelming pressure on the capacity of an already overburdened health care system in many African countries, families have increasingly been noted to supplement hospital care services for patients with AIDS. The aim of the present study is to generate knowledge on the experiences of family caregivers to the patients with AIDS at the household level in Dar es Salaam, Tanzania. Data were collected through in-depth interviews with 20 family caregivers and were analyzed using thematic content analysis. The article provides the reader increased insight on the obligations that AIDS caregiving has imposed on women within the close kin group of the patient. The study indicates that caregiving has increased the workload and in the same vein the economic marginality of women, who themselves are increasingly widowed heads of households. The study findings demonstrate strong gendered implications for community and policy makers.

Violence Against Women: Unveiling the Suffering of Women with a Low Income in Jordan

Oweis, A., Gharaibeh, M., Al-Natour, A., Froelicher, E. — Thu, 04 Dec 2008 13:23:37 PST

The descriptive qualitative study documents experiences of Jordanian women abused by their husbands. Thirteen married women living with an abusive husband were recruited from a major primary healthcare center. The women described forms, intensity, and consequences of their husband's acts. Despite their anguish, women justified, normalized, and tolerated abuse; this acceptance reflected their cultural values and norms. Implications for nursing practice include (a) identifying abused women, (b) empowering them with knowledge to change their sociocultural perceptions of marital relationships, (c) designing interventions that address their needs, and (d) educating health care providers to take a role in addressing spousal abuse.

Ensuring Cross-Cultural Equivalence in Translation of Research Consents and Clinical Documents: A Systematic Process for Translating English to Chinese

Lee, C.-C., Li, D., Arai, S., Puntillo, K. — Thu, 04 Dec 2008 13:23:37 PST

The aim of this article is to describe a formal process used to translate research study materials from English into traditional Chinese characters. This process may be useful for translating documents for use by both research participants and clinical patients. A modified Brislin model was used as the systematic translation process. Four bilingual translators were involved, and a Flaherty 3-point scale was used to evaluate the translated documents. The linguistic discrepancies that arise in the process of ensuring cross-cultural congruency or equivalency between the two languages are presented to promote the development of patient-accessible cross-cultural documents.

Cervical Screening in Canadian First Nation Cree Women

O'Brien, B. A., Mill, J., Wilson, T. — Thu, 04 Dec 2008 13:23:37 PST

Purpose: Attitudes and beliefs of First Nation Cree women living in a reserve community were explored to gain insights into how cervical screening could be better utilized. Method: Focused ethnography utilizing participant observation and interviews ( n = 8) with participants having experience with cervical screening and/or cancer was conducted. Results: Women did not believe they had adequate information and were resistant to screening because of embarrassment caused by the procedure and fear of cancer, which was viewed as a "death sentence." Conclusions: Challenges faced by First Nation Cree women when contemplating cervical screening are presented. Nursing sensitivity is needed to strategize access to cervical screening that is culturally appropriate.

The Impact of Migration on the Health of Voluntary Migrants in Western Societies: A Review of the Literature

Lassetter, J. H., Callister, L. C. — Thu, 04 Dec 2008 13:23:37 PST

The authors reviewed literature on the health of voluntary migrants to Western societies and factors affecting their health. Health indicators include mortality rates and life expectancy, birth outcomes, risk of illness, patterns of deteriorating health, cardiovascular disease, body mass index, hypertension, and depression. Multiple factors explain variability, including length of residence and acculturation, disease exposure, life style and living conditions, risky behaviors, healthy habits, social support networks, cultural and linguistic barriers, experiences with racism, and levels of awareness of cultural health practices among health care providers. Evidence exists for superior health among many migrants to Western countries relative to native-born persons, but the differential disappears over time. Migration is a dynamic, extended process with effects occurring years after physical relocation. Systemic change is required, including health policies that ensure equity for migrants, culturally appropriate health promotion, and routine assessment of migration history, cultural health practices, and disease exposure.

Determinants of Latina Obesity in the United States: The Role of Selective Acculturation

Yeh, M.-C., Viladrich, A., Bruning, N., Roye, C. — Thu, 04 Dec 2008 13:23:37 PST

Obesity has reached epidemic proportions in the United States. Hispanic American women in particular have higher rates of obesity than their non-Hispanic White counterparts. In this article, the authors review the existing literature on acculturation as it relates to obesity and health behaviors among U.S. Hispanic women. In addition, a conceptual framework is proposed to examine factors contributing to obesity through "selective acculturation." This concept challenges traditionally held unilateral assumptions that underscore Hispanic women's unhealthful behavioral patterns by explaining a process whereby Hispanic women both maintain some older health-related behaviors and acquire new ones once they settle in a new culture.

Women and Nursing in Malaysia: Unspoken Status

Birks, M. J., Chapman, Y., Francis, K. — Thu, 04 Dec 2008 13:23:37 PST

Since the emergence of nursing as a distinct discipline, its status has mirrored that of women in society in general. As a predominantly female profession, nursing has been subject to oppressive forces that have affected women at various stages of history. Despite improvements in the standing of both women and nursing during the past century, nursing has still failed to achieve its full potential. In Malaysia, sociocultural factors combine to further limit the development of the profession. This article explores how such factors merge with the oppression of nursing globally to influence the status of nursing in Malaysia.

Transcultural Nursing Society Department: President's Message: Collective Wisdom

Lauderdale, J. — Thu, 04 Dec 2008 13:23:37 PST

Transcultural Nursing Society Chapters, Regional Liaisons, and Cooperative Alliances

Thu, 04 Dec 2008 13:23:37 PST

Transcultural Nursing Society Web Site: http://www.tcns.org

Thu, 04 Dec 2008 13:23:37 PST

Transcultural Nursing Society Membership Form

Thu, 04 Dec 2008 13:23:37 PST

Transcultural Nursing Society

Thu, 04 Dec 2008 13:23:37 PST