Cultural caring in nursing practice: a meta-synthesis of qualitative research

Abstract: The number of qualitative studies regarding the experience of nourishs caring for patients from tillages other than their own has increased, still there remains a limited understanding of the meanings derived from this work. Using the methodology of Noblit and Hare's meta-ethnographic comparative manner the main themes and general [i]or[/i] abstract notions from 13 qualitative studies are reduc to six overall themes that describe above 1,000 nurses' experience caring for patients from other tillages The themes include: (a) connecting with the client, (b) cultural discovery, (c) the patient in connected thought [i]or[/i] thoughts (d) in their world, not mine, (e) road closes and (f) the cultural lens

Keywords: Nursing Practice, Cultural Caring, Meta-Synthesis Qualitative Research

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Minority populations continue to expand at an unprecedented rate in the U The Hispanic population is the fastest growing minority with above 35.3 million (12.5%) persons residing in the U This largely Spanish speaking cluster as become the majority minority as of the year 2000 census. The African American population is slightly les than the Hispanic population at 346 million somebodys or 12.3%. In addition, there are 10 million Asian Americans or about 36% of the total U population and 24 million American Indians that comprise 09% of the population (U Bureau of the Census, 2002)

While the U population has become increasingly diverse, nourishs have remained a homogeneous clump Approximately 90% of all Registered supply with nourishments are Caucasian; 4.2% are African American; 34% are Asian or Pacific Islander; and 16% are Hispanic (Minority Nursing Statistics, 2001) The sole nurse population that mirrors the U population is Asian American. The stage of uniformity of nurses compared to the U population begs the question: Are we prepared to care for the increasingly multicultural patient?

Definition and purpose

According to Leininger, tillage is a process of "learned, shared, and transmitted values, beliefs, norms, and life practices of a particular collection that guides thinking, decisions and actions in patterned ways" (1988 p 156) This article focuses upon the experience of providing care to patients from other tillages More specifically, other cultures commits to the experience of health care providers caring fro a patient from a tillage that is perceived as different than their have This may include the patient having a different language, ethnicity, religion or any other life practice.

As society becomes increasingly diverse, transcultural care has become an important aspect of health care. The ne for clinicians to become more sensitive to cultural differences and gain an understanding of transcultural universals has been repeatedly stressed through Leininger (1988)who stated the use of transcultural care knowledge is essential for accurate, reliable health care" (p 159) As the health care community recognizes the ne for increased cultural understanding, the number of qualitative studies regarding the experience of clinicians caring for different cultural collections has increased. Though there is increased interest and research, there remains a limited understanding of the meanings derived from this work since the work that has been done has not been summarized in a meaningful way. To further the applicability of the work, it is essential to synthesize individual studies into more concise findings. Further, a review of the literature revealed no published meta-synthesis upon health care clinicians" experience caring for patients from other agricultures This represents a gap in the knowledge and ne for synthesis of studies that address health care provider's views. The aim of this article is to closely examine and integrate the qualitative work in this area of investigation through meta-synthesis.

Meta-synthesis can be defined as the theories, grand narratives, generalizations, or interpretive translations produc from the integration or comparison of findings from qualitative studies" (Sandelowski, Docherty & Emden 1997 p 366) According to Jensen and Allen (1996 p 553) meta-synthesis is essential in order to advance knowledge and influence practice." A meta-synthesis that summarizes the experience of clinicians caring for patients from a variety of cultural backgrounds will enhance the overall understanding of the issues and be of importance tos By utilizing a comprehensive synthesis of information, limitations in the research come up and future research can be fine-tuned and applied to practice.

METHOD

The methodology chosen for the meta-synthesis is Noblit and Hare's (1988) meta-ethnographic comparative mode This method allows for substantive interpretations" that can be derived from ethnographic and interpretive studies (Noblit & Hare, 1988 p9) This approach allows the researcher to "compare and analyze body creating new interpretations in the process" (Noblit & Hare, 1988p 9) The seven pace process is outlined throughout the article and in Table 1