To the Editor:

As a nurse/anthropologist who has spent at least 10 of the past 40 years living and working in various foreign countries and as a reviewer for Cancer Nursing, I have been pleased to see how respectfully Cancer Nursing encourages nurses from other countries to contribute research manuscripts to the journal. As a reviewer, I have observed that some authors base their research strictly on work done in the United States or the United Kingdom. Orthodox biomedicine is a product of Western culture just as traditional medicine is a product of the particular culture from which it has emerged. Because of this, basing nursing research and care in a non-Western country on work done in Western countries may be culturally inappropriate, yield quite different results in the non-Western patient population, and delay studying more culturally sensitive interventions.

Citing the anthropologist Ralph Linton,1 Rogers2 speaks of the diffusion of innovations in terms of form, meaning, and function. When something is adapted from one culture to another, it is never completely the same in the new culture. Although the form might remain the same, the function, meaning, or both might be completely different.

Issues of available technology and sustainability of an intervention can be inadvertently overlooked when studying an adopted innovation. Initiating nursing care that requires unavailable infrastructure may be unrealistic and impossible to maintain. What is of greater interest in many cases is how nurses and other healthcare professionals from other countries and cultures deal with particular problems using their own culturally appropriate techniques and technologies. We in Western countries will quite likely find new and good ways of providing cancer treatment and care that we can adapt to our situations from the research reports of nurses from non-Western countries.

When I was a peace corps volunteer in Bolivia in the early 1960s, a program sponsored by the World Health Organization/Pan American Health Organization program was introduced to see if ambulatory tuberculosis treatment rather than inpatient would be effective on the Altiplano. The reason for trying the ambulatory program was that there were not enough hospital beds to accommodate the numbers of patients needing care. Initially, healthcare providers in the United States did not believe ambulatory care would be effective because "patients won't take their medicine." And now, ambulatory treatment is the global standard of care.

Another innovation arising from great need and few resources was the development of skin-to-skin care (Kangaroo care) for preterm and other at risk babies in Colombia. This practice began because there were not enough resources to maintain expensive neonatal intensive care units with sophisticated warmers. I was part of a team including Drs Susan Luddington-Hoe and Gene Cranston Anderson3,4 that went to Calli, Colombia, to determine whether this low-technology method could indeed successfully stabilize temperatures and breathing and promote breastfeeding in preterm babies. The method did produce those positive results and now is being adopted in Western countries.

To deal with huge and pressing problems, people come up with original ideas. If nurse clinicians and researchers from around the world are only encouraged to duplicate the same kinds of projects that have been done in Western countries, we will limit our discipline in coming up with new ideas and new approaches to cancer care that may be very effective.

I urge all nurses living and working in countries around the world not to hesitate to do research on the nursing care, treatments, and other ideas that have seemingly been effective in your own communities and countries. Teach us about the culture and context in which these ideas emerged so that we may understand. Good research does not have to begin and end in the United States or the United Kingdom. There are undoubtedly many innovative care models out there that will benefit all of us, and with the help of Cancer Nursing, the world may hear about them.

Sharleen H. Simpson, PhD, MSN, MA, ARNP

Associate Professor

College of Nursing

Box 100187, Health Science Center

University of Florida

Gainesville, FL 32610-0187

References