Page 131 - Encyclopedia of Nursing Research

98 n CULTURAL/TRAnSCULTURAL FoCUS

access to vulnerable subjects, and the over-
whelming number of intervening variables Cultural/transCultural
C that pose threats to the explanatory power of FoCus
study findings. Such factors include patient-
related factors, such as differences in gender,
age, previous access to health care, socioeco- Cultural/transcultural focus is the study of
nomic status, presence of comorbidities, vari- the environment shared by a group seeking
ations in mental status, baseline nutritional meaning for its existence. nurse investigators
adequacy, immune function, and unique pursue this focus to understand the asso-
psychological responses to the illness and the ciation of culture to health and to provide
environment, for example, agitation, delir- culturally competent care. Although this
ium, and pain. Intervention-related factors focus is growing within research, its impact
are difficult to control for because critically on patient care has been limited. Culture
ill patients receive multiple interventions at receives only cursory emphasis in most cur-
once, such as diagnostic and surgical proce- ricula or practice settings, and few nurses are
dures, mechanical ventilation, and power- cultural experts. In light of projections that
ful medications as well as nursing activities racial and ethnic minorities will be the major-
related to complications of immobility. The ity in the United States by 2030 and the per-
potential for infection, injury, medication sistence of major health disparities between
errors, sensory deprivation and overload, Euro-Americans and others, more and better
and effect of noise on quality of sleep are nursing research on culture is needed.
particularly formidable environmental fac- Different perspectives on the meaning
tors that can impact the patient’s outcome. of cultural/transcultural research (C/TCR)
Finally, known and unknown variations in exist. To some, the terms are essentially
patient management by the health care team synonymous, and questions of disciplin-
can alter patient outcomes, and then it is up ary origin are unimportant. Researchers in
to the investigator to decide how to handle the Leininger tradition regard transcultural
the problem. nursing as the proper term for a formal,
To address some of these concerns, Sole worldwide area of study and practice about
(2010) recommends the following strategies culture and caring within nursing.
to new investigators: (1) be self-directed, C/TCR is found in a great variety of
focusing on a clinical question which is research and clinical journals. Some C/TCR
important to you, such the effect of position- studies (particularly interventions and ran-
ing; (2) develop an initial study on basic and domized controlled trials) may be found in
familiar clinical concepts, such as airway, the Cochrane database for evidence-based
breathing, and circulation; (3) seek out col- practice using a keyword search on the basis
laborators and mentors who can support you of such terms as the disease name, nurs* and
and become coinvestigators; and (4) plan a care, nurs* and intervention, and names of
simple pilot study within the context of the racial or cultural groups. Searchers are cau-
team, which is “most essential part of the tioned that (a) the names of racial or ethnic
infrastructure” (p. 333). The days of the lone groups are often used only descriptive labels,
researcher are over. Future research in criti- and findings do not advance true cultural
cal care nursing will continue to require the knowledge; (b) race, culture, and ethnicity
multidisciplinary efforts of all health care lack consensual definitions and are often
providers who make such a difference in used interchangeably; (c) acceptable names
patient outcomes. for groups change over time (e.g., negro,
Black, Afro-American, African American);
Carol Diane Epstein (d) the name of the highest stage of cultural