Experiencing Cultural Safety in Nursing Care: A Focused Ethnography With Refugees.
Maki Nakajima, Ikumi Honda, Tomoko Doi
PMID 41708509WHAT IT FOUND
Laotian refugees in Japan experienced culturally safe nursing care through access to temples as spiritual sanctuaries, negotiation of bicultural caregiving practices, and holistic body-mind-spirit approaches.
End-of-life dignity required honoring Lao funeral customs and addressing anxieties about legal status and refugee labels.
Key findings
01Participants identified the temple as a critical health resource for emotional comfort during illness and for maintaining cultural continuity across generations.
02Culturally congruent care involved negotiating between Lao family caregiving norms and Japanese institutional expectations, particularly regarding hospital presence and childbirth practices.
03End-of-life care preferences centered on dying at home with Lao rituals and blending funeral traditions, rather than strictly adhering to Japanese hospital protocols.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited through temple networks, which may bias the sample toward socially connected and culturally engaged individuals, potentially excluding those who are more isolated or less involved in community activities. The study focused specifically on Laotian refugees in Japan, so findings may not generalize to other refugee populations or healthcare systems. As a qualitative study, it explores perceptions and experiences rather than measuring clinical outcomes or the efficacy of specific nursing interventions.
Declared interests
The authors declared no conflicts of interest. The study was supported by the Japan Society for the Promotion of Science (KAKENHI Grant Number 22H03635).
The easy way to misread this
Do not interpret these themes as evidence that specific nursing interventions improve clinical outcomes or reduce healthcare disparities. This study describes how a specific group of refugees perceive cultural safety; it does not test whether the suggested practices, such as temple partnerships or 'what matters' conversations, actually lead to better health or care engagement.