Experiencing Cultural Safety in Nursing Care: A Focused Ethnography With Refugees

Abstract

This study explored healthcare and nursing care experiences of Laotian refugees in Japan, focusing on their interpretations of cultural safety. A focused ethnography was conducted, incorporating semi-structured interviews and participant observations with 20 Laotian refugees at temples, homes, and community events. Thematic analysis, informed by the interpretive lens of cultural safety, guided interpretation. Five major themes were identified: Having a place of spiritual sanctuary, culturally congruent care, hopes for holistic care within the Japanese healthcare system (body–mind–spirit), recognition, and equality from Japanese society, and receiving culturally respectful end-of-life care. Themes revealed how spiritual, cultural, and social continuity shape refugees' health experiences, highlighting both resilience and vulnerability. Nurses can foster culturally safe care by supporting spiritual and community spaces, integrating bicultural practices, addressing systemic inequities, and collaborating with families and community leaders in end-of-life planning.