Identification and control of hypertension are important public health concerns. Lack of regular health care makes diagnosis and control difficult in some populations. Community health nursing services in settings where clients regularly congregate promote identification and control of hypertension. This study focused on the effects of community health nursing screening and monitoring services for hypertension provided to participants in a breadline, a senior nutrition program, an English as Second Language (ESL) class, and employees providing these services. Community health nurses (CHNs) provided 2,407 blood pressure-related service encounters. Blood pressures were elevated in 19% of encounters, and 10% of clients had elevations that warranted referral for medical assistance. At the end of the 18-month study period, 67% of all clients with elevations and 71% of those referred for medical assistance had achieved normal blood pressures. One-way analysis of variance indicated a significant relationship between the number of encounters with the nurses and a positive outcome for all clients with elevations. This relationship was not supported for those clients referred to medical assistance. The effectiveness of intervention appeared to vary somewhat among subgroups with some groups more likely than others to achieve a positive outcome. Group differences in outcome were not statistically significant.
In this cross-sectional study, we explored the current status and the correlates of self-perceived transcultural self-efficacy among nurses working in a tertiary hospital in Hangzhou, China. A total of 336 nurses (age range, 24-50 years) completed the Chinese version of the Transcultural Self-Efficacy Tool. The majority of respondents were female (94.64%), and 67.26% were government employees. Between group differences were assessed using the rank sum test. Most nurses had a below-moderate level of self-perceived transcultural self-efficacy in all subscales (Cognitive [67.69%]; Practical [71.65%], Affective [66.75%]). Age, professional title, employment type, and income level had a significant influence on all three subscale scores of the survey instrument. Our findings highlight the need for inclusion of transcultural nursing in the continuing education curricula for nurses. Nursing managers should target continuing education based on the demographic characteristics of nurses. Hospital managers should consider minimizing the pay disparity between government-employed and temporary nurses. These initiatives can help improve the quality of nursing care in a cross-cultural milieu.
Providing cultural care behind the spotlight at the Olympic GamesThe Olympic Games constitutes the world's largest sporting event. Nurses play an important, but poorly discussed, role in emergency care, routine clinical care and preventive care for athletes from many cultures as well as an enormous influx of spectators. In this article, we discuss five important considerations when preparing nurses to provide safe care for Olympians: elite athletes as a cultural group; caring for the Olympic family; disaster preparedness and security; infection control; and principles of transcultural nursing. Because of the nature of the sports and types of injuries and the effects of climate, these challenges differ somewhat between the summer and winter Olympics. Nevertheless, the Olympic games provide a tremendous opportunity to experience transcultural nursing and to highlight how nurses play a significant role in the care of the athletes, the Olympic family, and the spectators.
This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ (340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ (335) = 8681.61, P < .05) but the other indices showed improvement (RMSEA = .058 [90% CI, 0.057-0.059], TLI = .891, CFI = .903, and SRMR = .059). The discriminating power of the J-CCCHS was indicated by statistically mean differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike.
Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high‐quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals.
Worldwide, 3.4 million women die each year from cardiovascular disease. After experiencing a cardiovascular event, a woman’s physical health, the women’s likelihood of being treated with coronary artery bypass graft surgery, likelihood for referral for cardiac rehabilitation are less favorable than men. An established conceptual model depicts psychosocial stressors and the influence of behavioral risk factors on the pathogenesis of atherosclerosis and the occurrence of CV events. The woman’s social stressors of role quality and behavioral risk factors of low self-efficacy for physical activity are associated with physical and mental health outcomes following cardiovascular crises. The study aimed to evaluate the reliability of the translated versions (Japanese, Ukrainian, Tagalog, Hispanic and Arabic) of the worker, partner, mother Role Quality and the Self Efficacy of Lifestyle Physical Activity indices among 282 women (aged 35-92 years) representing seven cultures. The study was performed in a multi-center, multicultural context. Translations followed an established process. Results showed reliability was strong (coefficient alphas of 0.93 and 0.88). These instruments underwent first-time confirmatory factor analyses with acceptable, though borderline fit, thus providing valuable input for strengthening in future studies. Understanding a woman’s role quality and self-efficacy for lifestyle physical activity provides valuable information that assists health-care professionals to co-develop with the woman an individualized plan to reduce role stress and to initiate increased physical activity following cardiovascular episodes.
Among women, cardiovascular disease is the leading cause of mortality worldwide. After experiencing an acute cardiovascular event, a woman's physical health, the prevalence of morbidities, likelihood of being treated with coronary artery bypass graft surgery, likelihood for referral for cardiac rehabilitation are less favourable than men. The social support resources of marginality and religiousness are associated with physical and mental health outcomes following cardiovascular crises. This study aimed to evaluate the reliability and validity of the translated versions (Japanese, Ukrainian, Tagalog, Hispanic and Arabic) of the Koci Marginality Index and the Duke University Religion Index among 282 women (aged 35-92 years) representing seven cultures. Results showed that reliability and validity were strong (coefficient alpha of 0.79 and 0.84). Understanding a woman's social isolation and whether she has a connection to religious groups assists health-care professionals to identify a woman's social support resources during recovery following acute cardiovascular episodes.
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