Cultural diversity in health care requires nursing students to develop transcultural sensitivity and critical thinking to provide equitable care. This study explored the relationship between transcultural nursing sensitivity and critical thinking among senior nursing students in Türkiye. A descriptive, cross-sectional, correlational design was conducted with 151 senior nursing interns from a university nursing department. Data were collected online using the Student Information Form, the California Critical Thinking Disposition Inventory, and the Turkish Intercultural Sensitivity Scale. The mean age of participants was 22.49 ± 1.52 years; 74.2% were female and 84.1% were Turkish. While 72.8% had experience with culturally diverse patients, 88.8% lacked formal intercultural training. Mean scores reflected moderate-to-high intercultural sensitivity (87.4 ± 11.47) and critical thinking (254.04 ± 27.85). Critical thinking significantly predicted intercultural sensitivity (β = .688, R2 = .473, p < .001). Findings confirm a significant correlation, supporting integration of these skills into nursing education.
This perspective article explores how intersectionality and intersectional structural competence can enrich transcultural nursing. While cultural competence has historically improved patient-centered care through better transcultural communication, persistent health inequities demand strategies that address the systemic and institutional determinants of health. We argue for integrating structural competence into established transcultural frameworks to enhance nursing's capacity for equity-oriented care. By embedding intersectional approaches into curricula and engaging nurses in policy advocacy, the nursing profession can evolve beyond its cultural foundations to tackle the root causes of health disparities. This synergistic approach honors the legacy of transcultural nursing while empowering practitioners with the professional agency needed to challenge structural barriers. Ultimately, this integration equips nurses to advance social justice and promote more equitable health care systems.
Global nurse migration continues to reshape health systems, with Middle Eastern countries remaining major destinations for international nurses. This study examined determinants of Indonesian nursing students' intention to work in Middle Eastern countries using push-pull and transcultural perspectives. A cross-sectional online survey of Indonesian nursing students (n = 858) was analyzed using bivariate tests and multivariable binary logistic regression, reporting adjusted odds ratios (aOR) and 95% confidence intervals. Intention was lower among female students (aOR = 0.47) and unemployed students (aOR = 0.31) and lower among married students (aOR = 0.37) than unmarried peers. Intention was higher among students enrolled in applied bachelor's or bachelor's nursing degree (D4/S1) programs (aOR = 1.71) compared to those in lower-level programs, and among those reporting beginner Arabic proficiency (aOR = 1.96) compared with no Arabic proficiency. These findings indicate that both sociodemographic factors and language readiness shape migration intention. Nursing education should strengthen transcultural preparation, targeted specific language competency, and guidance on ethical, equitable pathways for international employment in Middle Eastern health systems.
Nurses' shortage in Western countries has driven reliance on internationally trained Black, Asian, and Minority Ethnic (BAME) nurses, who now play a crucial workforce role. However, they face challenges compared to native nurses, making it essential to understand their experiences for fostering inclusivity. This qualitative evidence synthesis explores the experiences of internationally trained BAME nurses in Western health care settings. A comprehensive search of MEDLINE, Embase, CINAHL, Web of Science, and gray literature was carried out. Quality was assessed using the CASP tool, and data were synthesized using Thomas and Harden's thematic synthesis approach. This review of 38 studies identified three themes: Initial Adaptation Hurdles, Professional Adversities, and Coping Strategies. Nurses experienced cultural and communication barriers, unfamiliar policies, and discriminatory interactions, with racism forming part of their professional experiences. Culturally tailored orientation, mentorship, and equitable opportunities are vital to enhancing integration and satisfaction, strengthening health care safety and performance.
Artificial intelligence (AI) is increasingly influencing nursing and surgical care. Although AI-supported systems may improve efficiency, they also raise ethical and humanistic concerns, highlighting the importance of patient perspectives. An explanatory sequential mixed methods design was used. Quantitative data were collected from 312 postoperative surgical patients to assess knowledge and attitudes toward AI-supported care. Based on these results, 15 participants were selected for in-depth qualitative interviews using purposive sampling. Descriptive qualitative content analysis was applied, and the findings were integrated. Patients' attitudes toward AI were generally moderate and cautious. Most participants reported limited knowledge and perceived AI as a media-driven and abstract concept. Major concerns included loss of human touch, system errors, data security, and trust. AI was viewed as a supportive tool rather than a replacement for nursing care. Acceptance of AI-supported nursing care is shaped by cultural values, trust, human-centered expectations, requiring empathy and professional oversight.
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Nurse-led digital transformation requires cultural competence. Because caregivers' cultural beliefs shape digital practices, understanding these perspectives during university training is vital. This study analyzes the beliefs of nursing students in Spain and Colombia regarding health technology implementation to identify gaps influencing future digital leadership. This qualitative descriptive study included 208 students. Data collection involved playful, reflective workshops using interactive tools. Thematic analysis was used to analyze the data guided by a transcultural nursing framework. Four main themes emerged: digital empowerment as culture care accommodation in patient data management; nurses as agents balancing technology and humanistic care; improved communication and collaboration via digital tools; and multifaceted barriers, including cultural, educational, and systemic challenges to technology integration. The findings emphasize the need for culturally competent digital leadership in nursing education. Bridging these specific cultural and technological gaps is essential to foster equitable, culturally congruent care in digital environments.
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Over 500,000 Ukrainian refugees have sought asylum in the United States since 2022, when the Russian government invaded Ukraine. The purpose of this study was to explore how Ukrainian nurses in the United States account for a cultural understanding of Ukrainian refugees. A pilot study using focused ethnography was conducted between March and July 2024. Data were generated from interviews with six Ukrainian nurses, field notes, artwork, and public documents. Using thematic content analysis, three themes were derived. The first theme, A sanctuary of help, depicted how Ukrainian communities were found in local churches that provided a support system. The second theme, Who am I here?, reflected uncertainty about the war and refugee status. The last theme, Unstable underpinnings, revealed how the resettlement process impacted refugees' cultural identity. With a shared cultural heritage, Ukrainian nurses play an important role in the care of refugees during resettlement.
Psychological well-being is widely studied, yet existing measures often reflect Eurocentric ideals that may not generalize across cultural backgrounds. Social norms and historical experiences shape the meaning of well-being and influence measurement among groups historically underrepresented in research, such as African American women. This study examines the factor structure of Ryff's Scales of Psychological Well-Being (RSPWB) in this population. This cross-sectional survey study was conducted via an online platform. A convenience sample of 248 African American women completed the 84-item RSPWB. Exploratory factor analysis was used to assess the underlying structure. Analysis revealed five distinct factors from the original six: (a) Environmental Mastery, Purpose in Life, Self-Acceptance (EPS); (b) Relational Satisfaction; (c) Autonomy; (d) Personal Growth; and (e) Helplessness. This research supports the need for consideration of sociocultural perspectives and experiences in nursing research. Culturally congruent measurement of psychological well-being is needed to promote accurate assessment.
Intimate partner violence (IPV) and traumatic stress during pregnancy are major public health issues, particularly for women of color. Using data from the 2019 to 2021 Pregnancy Risk Assessment Monitoring System, this cross-sectional study examines the association of IPV and traumatic stress on the prenatal physical and mental health of women of color who have recently given birth. Hispanic women reporting IPV during pregnancy had increased odds of prenatal depression and diabetes compared to non-Hispanic White women with no IPV. Significant risk for diabetes was observed only among Hispanic women when stratified by race/ethnicity. Financial instability, partner incarceration, income, and being uninsured are structural factors that amplify these effects. These findings highlight the value of culturally competent trauma-informed prenatal care, screens for IPV, and address systemic disparities. A collaborative initiative is necessary to ensure women can safely conceive by acknowledging survivor's experiences and eliminating obstacles to reproductive health care.
The challenges for internationally educated nurses are complex and nuanced, with employers implementing various support mechanisms. Nurses may experience cultural displacement, perceived differences in practice and communication problems. Little research exists about which interventions best address these issues. The review aimed to develop a comprehensive understanding of support interventions for internationally educated nurses. Whittemore and Knafl's methodological approach guided the review. Literature searches were conducted across five databases between 2010 and 2024. A total 23 papers were examined. Two themes were developed: "Support interventions" and "Factors influencing the success of interventions." The review found that organizational interventions should address internationally educated nurses' competencies, be multifaceted, and include two-way learning. No evidence was found evaluating the success of multi-dimensional interventions. The review may support policy and practice recommendations.
Globalization and rising immigration highlight the importance of culturally competent nursing care, yet global reports reveal persistent cultural insensitivity. This study explored how new mothers in postpartum units perceive nurses' cultural competence, examining its relationship to mothers' religious and cultural backgrounds and breastfeeding outcomes. After obtaining ethical approval, 229 Israeli mothers (Hebrew or Arabic speakers) who gave birth to full-term infants participated. Data were collected via a validated 42-item questionnaire assessing perceived cultural competence, religiosity, cultural customs, breastfeeding, and demographics. Statistical analyses included Pearson's correlations, ANOVA, and regression. Older age, higher religiosity, more children, and associate degrees were linked to higher perceived nurse competence. The "skills" dimension of cultural competence was associated with positive perceptions. Higher perceived cultural competence correlated with full breastfeeding. Findings underscore the need to enhance nurses' cultural awareness and skills as part of routine postpartum care to improve maternal experience and outcomes.
The aim of the study was to determine the effects of spiritual attachment on Ramadan fasting behaviors and spiritual well-being in pregnant women. This descriptive study was conducted between April 3-20, 2023, and 307 pregnant were reached. Data were collected using a Descriptive Information Form, the Spiritual Well-Being Scale, and the Muslim Spiritual Attachment Scale. The mean score for the Muslim Spiritual Attachment Scale was 61.61 ± 11.40 among pregnant women who were fasting and 63.43 ± 9.92 among those who were not fasting, with no statistically significant difference between the two groups (p > .05). Regarding spiritual well-being, fasting participants had an average score of 113.47 ± 17.26, compared with 116.69 ± 15.51 in the nonfasting group. This difference was also not statistically significant (p > .05). It has been determined that fasting during pregnancy is not related to spiritual attachment and spiritual well-being.
The purpose of this article is to describe Chicago's public health response to the Venezuelan migrants during its New Arrival Mission, review key challenges that plagued The Mission, and make recommendations for transcultural providers. In this historical review, interviews with key informants are conducted. Additional information is curated from press releases, gray literature, and media outlets. Starting in 2022, Chicago initiated the New Arrival Mission, providing housing, education, and health care including mental health services to approximately 50,000 migrants until 2025. This article reviews public health crises, including infectious disease outbreaks in large, congregate shelters and health care access of this population that challenged the existing health care delivery model. Chicago successfully leveraged preexisting models and forged collaborations between diverse stakeholders helping to mitigate poor public health outcomes for both migrants and Chicagoans. Transcultural providers are advised to foster partnerships across organizations to address challenges during a migration crisis.
As the COVID-19 vaccine transitions into an annual immunization, it is important to understand the factors contributing to vaccine hesitancy and uptake. This study aims to examine how information source use and trust are associated with COVID-19 and influenza vaccine hesitancy and influenza vaccine uptake. This cross-sectional study surveyed undergraduate students aged 18-25 years between August 29, 2023, and February 20, 2024. A total of 230 participants were included in the analysis. Chi-square tests and multivariable logistic regression were used. Using Internet, professional sources, friends/co-workers, and social media was associated with vaccine hesitancy and uptake. Cross-national comparisons showed that US students reported lower COVID-19 but higher influenza vaccine hesitancy than Koreans. Information use and trust were associated with vaccine attitudes and behaviors in vaccine- and country-specific ways. Tailored strategies should strengthen professional channels, engage family networks, and optimize Internet and social media for vaccine communication.
Few cultural competence interventions exist for nurse educators who shape students' cultural competence. This article thus details the design, implementation, and evaluation (2021-2024) of an online cultural competence training program (TraINErS) for nurse educators and proposes design principles. Following a design-based research approach, there were two development and testing cycles (TraINErS1.0 and TraINErS2.0), involving a multidisciplinary European team, with two corresponding testing cycles with nurse educators (N1 = 16; N2 = 22) from seven European countries. Data were collected through user reports, an evaluation questionnaire, and the System Usability Scale. Testing TraINErS1.0 led to content and sequencing adjustments. TraINErS2.0 achieved positive evaluations and high system usability scores (80.44). Participants valued flexibility and self-paced learning but noted asynchronous challenges. The resulting design principles emphasize metacognitive awareness, experiential learning, multimedia use, and motivation mechanisms. These principles can guide the design of online nurse educator training, preparing them to produce culturally competent nursing professionals.
Quality Improvement (QI) projects are systematic, data-driven efforts designed to continuously improve patient outcomes, experiences, and health system performance. Nurses are well positioned to lead or co-lead QI projects. The Standards for QUality Improvement Reporting Excellence (SQUIRE 2.0) provide a framework for reporting empirical knowledge derived from QI projects. The Introduction section consists of problem description, available knowledge, rationale, and aims. The Methods section includes context, interventions, study of the intervention, measures, analysis, and ethical considerations. In the Results section, the author addresses all aspects of the findings. The Discussion section consists of summary, interpretation, limitations, and conclusions. Disseminating the results of QI projects is an essential part of ongoing QI efforts in health care. Carefully labeling the work as quality improvement and using SQUIRE 2.0 will enhance the value of QI work.
Although community-based traditional Chinese exercises (CTCEs) are increasingly recognized for their benefits on sleep, their effectiveness among community-dwelling older adults across diverse settings remains unclear. This study aimed to synthesize the effects of CTCEs on sleep disturbance in this population. Seven databases were searched for relevant articles published up to August 2025. Studies were appraised using the Cochrane risk-of-bias tool. A pairwise meta-analysis, subgroup analysis, and meta-regression were conducted using Comprehensive Meta-Analysis software. Thirteen studies met criteria. CTCEs are effective in reducing sleep disturbance among older adults. Both Qigong and tai chi improved sleep; Qigong showed a slightly larger effect size than tai chi, but the difference between modality was not significant. Meta-regression detected no significant moderators. As a nonpharmacological strategy, CTCEs appear to reduce sleep disturbance in community-dwelling older adults. These findings support their integration into community-based health initiatives for aging populations.