Methods: An exploratory descriptive design employing grounded theory and purposive sampling was utilized for this study. The selected participants consisted of twenty-five nurse practitioner students, nineteen females and six males, enrolled either full-time (32%) or part-time (68%) in a university school of nursing family nurse practitioner program and had completed at least half of their required coursework. Nineteen identified their ethnicity as either Mexican or Mexican-American and were fluent in both English and Spanish. Prior to entering the nursing program, they had worked an average of 7.5 years as a professional nurse. Their practice experience included acute care, home care, and community or rural health care. All were experienced in providing nursing care to low-income Mexican immigrants. The study included a demographic questionnaire and a ten-item semi-structured interview created by the researchers to elicit thoughtful reflection on the participants' perceptions of culture and its role in the delivery of culturally congruent care to Mexican immigrants. Face-to-face interviews were conducted by an experienced research cohort in a setting and location of the participants' choosing that provided privacy and minimized the potential for interruption. The interview data was reported anonymously and analyzed qualitatively via a constant comparison method.
Results: Data analysis involved grouping of response similarities until no new categories emerged. Affinity among the categories resulted in linkage into four distinct core categories or emerging themes: Culturally congruent care 1) extends beyond race and ethnicity; 2) recognizes the importance of dietary patterns, food choices, and perceptions of ideal weight and health; 3) accepts complementary and alternative medical modalities as time-honored customs; 4) understands the importance of communication in the development of a therapeutic relationship. These themes provided a summary of what nurse practitioner students caring for a vulnerable Mexican population perceived as culture and its role in the delivery of culturally congruent care.
Conclusion: This study highlights the importance of advanced practice nurse educators' role and responsibilities in assisting nurse practitioner students in moving beyond thoughtful action to critically evaluating their own cultural heritage, values, beliefs, and practices in relation to others who share similarities and differences in their values, beliefs, and practices. Such reflective thinking can prepare family nurse practitioner students for providing culturally congruent care directed towards promoting health among vulnerable Mexican immigrants. While the results of this study were restricted to examining their perceptions of low-income Mexican immigrants living in rural communities along the Texas-Mexico border, the results of this study can serve as an important complement to other studies. This study can also serve as a guide to enhancing cultural competency at the graduate level and may improve nurse practitioners' efforts in addressing the social and cultural context surrounding the health needs among similar and different minority populations across the globe.