, Dannis Ortega Fernández1 , Yusimí Cruz Sarmiento1 , Dalila Aguirre Raya2 , Margarita Encarnación Ruiz Blanco3 REVIEW ARTICLE
DOI: https://doi.org/10.20453/renh.v18i2.6685
2025, July-December | Volume 18, Issue 2, e6685
Integrative review of cultural nursing care: challenges and goals from an updated perspective
Damisela Moreno Lavín1 , Dannis Ortega Fernández1 , Yusimí Cruz Sarmiento1 , Dalila Aguirre Raya2 , Margarita Encarnación Ruiz Blanco3
1 Ramón Pando Ferrer Cuban Institute of Ophthalmology. Havana, Cuba.
2 International Center for Neurological Restoration (CIREN). Havana, Cuba.
3 University of Medical Sciences of Havana, Lidia Doce Faculty of Nursing. Havana, Cuba.
Scientific contribution
The present study, through the integrative systematization of articles on cultural care within nursing science, reveals relevant findings regarding the importance of its application in clinical practice for the profession. Its relevance in today’s globalized world constitutes a valuable contribution to strengthening care management within the discipline.
ABSTRACT
The objective of this study is to analyze current trends and the most relevant aspects of cultural care in nursing, based on an integrative review of scientific literature published between 2018 and 2025. Databases such as PubMed, SciELO, Redalyc, Scopus, Latindex, and CINAHL were consulted, using specific health descriptors and rigorous inclusion criteria. Of the 245 articles initially identified, 98 met the inclusion criteria. These then underwent a three-stage selection process: exclusion of duplicates, review of titles and abstracts, and exploration of the full content. Finally, 22 articles were selected for the present study. Statistical analysis revealed key trends in research on cultural care in nursing. The trend indicated that 2023 and 2024 were the years with the highest number of scientific publications. Qualitative studies with a phenomenological approach predominated, highlighting the relevance of understanding patients' experiences and perceptions in relation to cultural care. The standard deviation with respect to the country of origin showed a heterogeneous distribution, with a predominance of studies in Latin American countries. It is concluded that cultural care is essential for the evolution of nursing as a science, as it promotes person-centered and culturally competent care.
Keywords: cultural care; nursing; transculturation; patient-centered care; cultural competence.
INTRODUCTION
The transculturation of nursing care has emerged as a relevant topic in nursing science over the last millennium. It is argued that, by identifying individuals’ cultural values, beliefs, and lifestyles, the care provided acquires a more comprehensive and holistic character (1). From this perspective, nursing professionals who understand patients’ traditions, customs, and beliefs are better able to provide more empathetic, patient-centered care (2, 3).
Cultural diversity in patient care presents both challenges and opportunities for healthcare personnel. In a world with increasing cultural nuances, professionals need to demonstrate cultural skills to provide high-quality care (4, 5).
In this regard, the promotion of transcultural nursing is strengthened by facilitating tools, education, and continuing professional development for both practicing professionals and new generations through comprehensive, knowledge-based preparation. This approach fosters the development of care management models that emphasize respect for the values, beliefs, and behavioral patterns of the diverse populations that make up the territorial landscape of Latin America (3).
Care from environmental and cultural perspectives involves understanding the traditions, values, and practices of the population served to adapt health interventions respectfully and effectively. Within this framework, nursing professionals must not only master the clinical aspects of health but also the social and cultural dynamics that impact individuals’ lives (6).
However, in professional nursing practice, this cultural perspective has often been overlooked, resulting in a significant gap in the quality of care provided. Cultural aspects of ethnic groups or communities are frequently not adequately considered, which limits the effectiveness of care and may generate feelings of exclusion or misunderstanding among patients. This situation constitutes an important challenge for the discipline, as it affects the therapeutic relationship and jeopardizes adherence to the fundamental principles of culturally competent care management (6–8).
Currently, cultural diversity has become a central component of healthcare delivery. Nursing, as both a scientific discipline and a professional practice, faces the challenge of integrating cultural competencies into its care models. Therefore, this article aims to analyze current trends and the most relevant aspects of cultural care in nursing.
MATERIALS AND METHODS
The research team conducted an integrative review following PRISMA guidelines (9). The databases consulted included PubMed, Scopus, SciELO, Redalyc, Dialnet, and CINAHL. The descriptors used were: “cultural care,” “nursing,” “transcultural care,” “patient-centered care,” and “cultural competence,” combined using Boolean operators.
For the development of the study, the inclusion criteria were established as follows: articles published between 2018 and 2025 in English or Spanish that addressed cultural care within the nursing field. Studies not directly related to nursing practice or cultural care, articles without full-text access, duplicate materials across the databases analyzed, and non-indexed publications were excluded.
During the research process, the team initially identified 245 records. Of these, 98 met the selection criteria after a three-stage screening process: removal of duplicates, title and abstract review, and full-text content assessment. From this process, 22 articles were selected as the final sample of this study (Figure 1).
Figure 1. Search Strategy.
For the development of this study, the starting point was the need to explore the state of the art regarding the transculturation of care within the current context. This concern motivated the research team to conduct an in-depth search of the corresponding databases to identify key aspects and common trends within the nursing scientific community related to this topic. The inclusion criteria focused on materials presenting findings relevant to the discipline, which were organized using the historical-logical method, considering the year of publication.
RESULTS AND DISCUSSION
The systematization conducted showed that the years 2023 (27.27%) and 2024 (27.27%) accounted for the highest number of publications, suggesting a growing interest in the topic. The predominance of qualitative studies with a phenomenological approach highlights the relevance of exploring patients’ experiences and perceptions in relation to cultural care. The analysis of the countries of origin of the selected articles showed a heterogeneous distribution, with a predominance of studies conducted in Latin American countries, which is consistent with previous findings on transcultural nursing.
Table 1. Description of the selected articles.
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Each selected article provides key elements for understanding and applying cultural care in nursing (Table 1). The most relevant findings are presented below.
One letter to the editor (10) and six qualitative studies were analyzed: two with a phenomenological approach (26, 30), one mixed-method study (qualitative–quantitative) (23), one ethnographic study (19), one anthropological study based on documentary analysis (11), and one inductive study (7).
Eight articles addressed cultural competencies (7, 10, 12, 16-18, 21, 22): two focused on palliative care, one on ethnicity and racial differences, another on the need to incorporate cultural competencies in nursing students, and the remaining studies explored cultural competencies from various perspectives. Regarding Leininger and the cultural care theory, the importance of her contributions to structuring culturally congruent care models is reaffirmed (7, 10–22).
During the knowledge synthesis, essential categories were identified, such as cultural competence in nursing for both professionals and students, representing a relevant aspect to consider. In this regard, Martínez et al. (31) state that cultural competence is a complex construct, not only because of its multiple dimensions but also because it is simultaneously a process and an outcome.
The reviewed studies highlight the growing relevance of cultural competence in nursing education. Common approaches were identified, including the incorporation of transcultural theoretical models and the evaluation of cultural competencies using standardized tools. However, differences were observed in practical implementation, particularly in resource-limited settings.
Another important category is transculturation, situated within the context of palliative and cultural care for individuals with chronic diseases. In both cases, this represents a challenge for nursing science, highlighting the need to incorporate cultural competencies into care management.
CHALLENGES AND GOALS OF TRANSCULTURATION IN NURSING CARE
The future of cultural care in nursing is projected toward greater integration of interdisciplinary and transnational approaches. In this regard, Aguirre et al. (27) state that the world is facing cultural, ethnic, and religious diversity generated by continuous human migration, which modifies the demographic and social profiles of receiving countries. Castro (13) argues that numerous individuals migrate for different reasons, and all these movements transform contemporary society into a complex, diverse setting rich in cultural nuances, in which it becomes essential to develop awareness of “cultural care” to provide holistic, high-quality care that respects individuals’ beliefs and values.
For the reasons outlined above, it is asserted that emerging trends include the development of care protocols adapted to Indigenous and migrant communities, as well as the expansion of transcultural nursing in professional education and training. These advances will enable greater humanization of healthcare delivery by consolidating cultural care as a fundamental pillar of nursing science.
Another important aspect involves the Sustainable Development Goals (SDGs) (32, 33), which provide an essential framework for integrating cultural care into nursing science, as they promote equitable, inclusive care adapted to sociocultural diversity. This relationship is grounded in the need to ensure universal access to high-quality healthcare services that respect cultural differences and contribute to reducing disparities in healthcare delivery.
Regarding the education and preparation of the healthcare workforce, SDG 4 emphasizes the importance of inclusive and equitable education. This translates into the need to integrate content on cultural diversity, care anthropology, and intercultural mediation strategies into the nursing curricula. The review conducted confirms this assertion by highlighting, as a relevant aspect, the inclusion of cultural competencies beginning at the undergraduate level of nursing education.
As part of the healthcare team, nursing professionals can and should contribute to the design of sustainable health systems, considering the cultural diversity of urban and rural populations. Specifically, SDG 11 highlights the importance of creating inclusive and resilient environments, which implies adapting healthcare services to the specific needs of each community. Cultural nursing contributes to this objective through the implementation of community-based care strategies grounded in respect for local traditions and values.
The research team maintains that, at present, nursing science must integrate cultural care into daily clinical practice and future projections. Focusing on and aligning this field of knowledge with the SDGs will enable progress towards a more equitable and sustainable model of care. Among the emerging trends, the development of care protocols adapted to vulnerable communities has been identified, along with the expansion of transcultural nursing in education and professional training.
Consequently, these advances will contribute to the development of more inclusive health systems, ensuring that cultural care is consolidated as a fundamental pillar of future healthcare delivery.
CONCLUSIONS:
Based on the systematization conducted, it is concluded that cultural care constitutes an essential component of nursing practice in a world characterized by diversity. The integration of cultural competencies not only enriches discipline but also promotes more inclusive, equitable, and effective care delivery.
The study highlights the need to continue researching and developing strategies that strengthen transcultural nursing. In this context, the implementation of the Sustainable Development Goals—particularly Goal 3, related to health and well-being, and Goal 10, aimed at reducing inequalities—will be key to ensuring culturally competent care that responds to the demands of a pluralistic society.
REFERENCES