Puentes de Cuidado: cómo la Adaptación Cultural en Enfermería transforma los Resultados en Salud

Avixely Vargas Blanco
Departamento de Enfermería, Investigación, Clínica Bíblica, San José, Costa Rica.

Laura Rojas Chacón
Departamento de Enfermería, Investigación, Clínica Bíblica, San José, Costa Rica.

Resumen

La creciente diversidad cultural, la migración y la globalización demandan cuidados de enfermería culturalmente adaptados. Aunque existen marcos teóricos consolidados (p. ej., Leininger, Campinha-Bacote) y un giro reciente hacia la humildad y la seguridad cultural, persiste la necesidad de sintetizar el impacto de estas intervenciones en los resultados clínicos y en los percibidos por pacientes adultos. Para ello se realizó una revisión bibliográfica (2005–2025) siguiendo la guía PRISMA. Se buscaron estudios en PubMed, ScienceDirect y LILACS/BVS en español e inglés. Se incluyeron estudios primarios cualitativos, cuantitativos y mixtos, reportes de caso y revisiones; se excluyeron estudios con población pediátrica, estudiantes y de otras disciplinas. Dos revisoras seleccionaron y extrajeron datos de forma independiente. Se incluyeron 37 estudios, con predominio de diseños cualitativos en América y en Australia. Las intervenciones abarcaron intérpretes y mediación cultural, la incorporación de prácticas tradicionales, materiales y educación bilingüe para personas con baja alfabetización, agentes comunitarios y formación en humildad cultural. Los resultados más consistentes fueron los psicosociales: mayor satisfacción, comunicación bidireccional, confianza terapéutica, sentido de pertenencia y bienestar emocional. La evidencia clínica, aunque menos abundante, mostró señales de mejora en la adherencia y, en algunos estudios, una reducción de la presión arterial y una menor ocurrencia de eventos adversos. Las barreras recurrentes incluyeron el idioma, el tiempo y los recursos, así como la falta de políticas; los principales facilitadores fueron el apoyo institucional, la participación familiar-comunitaria y la disponibilidad de recursos lingüísticos. La adaptación cultural de los cuidados de enfermería mejora de manera consistente la experiencia del paciente y la continuidad del cuidado, con indicios de beneficios clínicos. Sin embargo, se requieren políticas institucionales sostenidas, formación continua con marcos explícitos y evaluaciones rigurosas de la efectividad y la seguridad cultural.

Palabras claves

Asistencia sanitaria culturalmente competente, enfermería, enfermería transcultural, atención de enfermería, evaluación de resultados en la atención de la salud.

Abstract

The growing cultural diversity, migration, and globalization demand culturally adapted nursing care. Although consolidated theoretical frameworks exist (e.g., Leininger, Campinha-Bacote) and there has been a recent shift toward cultural humility and safety, there remains a need to synthesize the impact of these interventions on clinical and patient-perceived outcomes in adult populations. To address this, a literature review (2005–2025) was conducted following PRISMA guidelines. Studies were searched in PubMed, ScienceDirect, and LILACS/BVS in both Spanish and English. Primary qualitative, quantitative, and mixed-methods studies, case reports, and reviews were included; studies involving pediatric populations, students, or other disciplines were excluded. Two reviewers independently selected and extracted data. Thirty-seven studies were included, predominantly qualitative in design and conducted in America and Australia. Interventions included interpreter and cultural mediation services, incorporation of traditional practices, bilingual and low-literacy educational materials, community health agents, and training in cultural humility. The most consistent outcomes were psychosocial: greater satisfaction, bidirectional communication, therapeutic trust, sense of belonging, and emotional well-being. Although less abundant, clinical evidence showed improvements in adherence and, in some studies, reductions in blood pressure and fewer adverse events. Recurrent barriers included language/time/resource constraints, as well as a lack of policies; main facilitators were institutional support, family and community participation, and the availability of linguistic resources. Cultural adaptation of nursing care consistently improves patient experience and continuity of care, with indications of clinical benefits. However, sustained institutional policies, ongoing training with explicit frameworks, and rigorous evaluations of cultural effectiveness and safety are still required.

Keywords

Culturally competent care, nursing, transcultural nursing, nursing care, health care outcome assessment.

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