Journal of Transcultural Nursing最新文献

Introduction: Puerto Rico is a territory of the United States, making Puerto Ricans vulnerable to damaging colonial policy. The purpose of this article is to utilize the socioecological model (SEM) to evaluate how the Jones Act impacted Puerto Rico after Hurricane María, examining colonialist policy as a social determinant of health (SDOH) in Puerto Rico.

Methods: Levels of the SEM used in this examination included: individual, institutional, community, policy, and context.

Results: Evaluation of the Jones Act using the model demonstrated relationships between all socioecological levels. The Jones Act caused delays and increased prices for goods needed to rebuild community utility infrastructure, which led to extended closures of institutions like workplaces, schools, and hospitals, and ultimately contributed to increased acute and chronic physical and mental illness among Puerto Ricans.

Discussion: This evaluation establishes that colonialist policy negatively impacts the health of Puerto Ricans, positioning colonialism as an SDOH.

Introduction: Traditional games are essential for children's social inclusion due to cultural values and beliefs. This study was conducted to measure the impact of traditional children's games on internet use, social skills, and stress levels.

Methods: A cross-sectional design was carried out. Children who had parental approval and agreed to participate were included in the study (n = 314). The data were collected using a questionnaire, the Perceived Stress Questionnaire (8-11 years), and the Social Skills Assessment Scale. Linear regression and multinomial logistic regression were performed to analyze the data. Mantel-Haenszel chi-square test was performed to assess the confounding factors for playing traditional games.

Results: The children's mean age was 11.58 (SD = 0.49), and 56.1% were girls. Children who did not play traditional games were more likely to use the internet than those who played traditional games (odds ratio [OR] = 2.16, p = .014). The social skills were significantly associated with daily internet use time (β = 0.164, p = .003), playing traditional games (β = 0.155, p = .008), and frequency of gaming per week (β = 0.123, p = .035). The stress levels were associated with gender (β = 0.120, p = .033) and academic level (β = 0.111, p = .048).

Discussion: Traditional game playing reduced the duration of one sitting and daily internet use. Moreover, outdoor gaming, frequency of playing games, and daily internet use duration were predictors of social skills, whereas being a girl and sixth-grade student were predisposing factors of stress level. Nurses could benefit from traditional games in reducing internet use and stress and improving social skills in children.

Introduction: We used an implementation science framework to investigate perceived health inequities in preventive health care initiatives in rural communities in the Philippines. We also identified health equity-focused quality improvement strategies.

Methods: Three health care providers and 12 barangay clinic patients were interviewed.

Results: Patient interviews showed that social determinants of health, respect, and attitudes toward health care providers affected patient empowerment to engage in self-management for noncommunicable diseases (NCDs). Health care providers identified six challenges in managing NCDs: (a) inefficient work processes; (b) staffing shortages; (c) insufficient access to low-cost medications; (d) inadequate primary preventive health education from the schools; (e) health care not considered a priority; and (f) lack of local government support.

Discussion: Inadequate preventive health care and education intensify health access and resource inequities in rural communities in the Philippines. A multi-sectoral plan may improve rural health infrastructure and education toward improving health care access and decreasing care disparities.

Introduction: We evaluated telehealth utilization among Colorado Hispanics/Latinos during the COVID-19 pandemic.

Methods: A mixed methods design was used with urban and rural patients recruited through two Colorado Federally Qualified Health Centers (FQHCs) serving large Hispanic/Latino communities. Linguistically and culturally adapted Patient Attitudes Toward Telehealth (PATAT) surveys were collected electronically. Semi-structured interviews were conducted with a purposeful sample of Spanish-speaking Hispanics/Latinos.

Results: Although the FQHCs serve a Hispanic/Latino population, only 40% of survey respondents (82/204) were Hispanic/Latinos, and they reported less telehealth utilization (p < .01). Trust in telehealth seemed driven by previous use, with no differences in PATAT scores by ethnicity or geolocation. Interviews with Spanish-speaking Hispanics/Latinos showed they highly preferred in-person care, and factors that influenced telehealth utilization were situated within the intersection of culture and trust with socio-structural determinants of health.

Discussion: Resolving disparities in telehealth utilization requires patient-centric approaches and equitable transcultural care for underserved Hispanic/Latino populations.

Introduction: This study aimed to determine the burden of suspected nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) in a predominantly Hispanic patient population and explore the utility of the American Gastroenterological Association's NAFLD Clinical Care Pathway (CCP).

Methodology: Electronic medical records (n = 223) were used to divide patients into risk groups based on the amount of metabolic risk factors they presented, diabetic status, or if they presented other liver diseases. Fribosis-4 (FIB-4) scores were used to determine the risk for advanced fibrosis.

Results: Most patients (83.8%) were considered at risk for NAFLD based on CCP criteria, and about a third of patients (33.2%) were found to be at indeterminate (n = 60; 26.9%) or high risk (n = 14; 6.3%) for advanced fibrosis. Most indeterminate-risk patients (78.3%) were not referred for liver imaging.

Discussion: This study demonstrates the potential of the CCP as a corrective tool that could help to better identify and screen patients at risk for NAFLD.

Introduction: Timely diagnosis is critical for persons with Alzheimer's disease and related dementias (ADRD) to ensure they receive adequate services; however, timely diagnosis may be prevented by a person's English language skills. The purpose of this integrative review was to understand how limited English proficiency (LEP) impacts older Latino's ability to access a timely ADRD diagnosis.

Methods: Whittemore and Knafl's methodological approach guided the review. Searches in five databases yielded 12 articles for inclusion.

Results: Lack of culturally congruent health care systems, health care providers, and knowledge of ADRD resulted in delays in obtaining a timely ADRD diagnosis among older Latinos with LEP.

Discussion: Latinos with LEP and risk for ADRD benefit from language assistance and support in navigating the health care system. Nurses must be advocates, even when a language barrier is present, and recognize that interpreters are not a single source solution.

Introduction: The family plays a crucial role in shaping children's identity and understanding of gender-based roles. This study aims to explore the experiences of Iranian transgender individuals with their families' reactions to their transgender identity disclosure.

Methods: In 2018, nurse researchers conducted this qualitative study on 11 transgender individuals in Iran using a phenomenological approach, targeted and snowball sampling, and Colaizzi's seven-step method for data analysis. Rigor was ensured by adhering to Lincoln and Guba's standards.

Results: The study found varied reactions to transgender children among Iranian families, including abuse to avoid stigma. The study revealed two main themes, maladaptive and adaptive reactions, and identified six categories: denial of reality, mourning, coercion, deprivation, support out of necessity, and compromise of family reactions.

Discussion: Education and support systems may help address the cultural challenges that face families with transgender children. The findings offer insights for enhancing public awareness of the transgender community in conservative cultures.

Introduction: Poor prognosis and higher mortality of chronic kidney disease are linked with cultural beliefs and practices. This study explored cultural beliefs and practices of Javanese people with end-stage renal disease undergoing hemodialysis for ≥5 years. Methods: A qualitative narrative inquiry was applied in this study. Data were collected through in-depth narrative interviews, followed by text messages, calls, and audio-visual calls for 6 weeks. Results: There were 14 participants; their mean age was 51.15 years and hemodialysis duration was 5 years and 2 months up to 10 years and 9 months. Four themes emerged: life-and-death acceptance, expectation of end-of-life care, contemplation of withdrawal from hemodialysis, and wishing for a good death. Discussion: Life values guided the ability to survive for the individual. Adherence to renal disease management regimen clashed with cultural values on occasions, such as social gatherings. Therefore, the unmet needs of patients should be addressed with a transcultural approach to modify personal health behaviors.