This naturalistic field study, using ethnonursing methods, was conducted to describe the social and cultural care needs of African American juvenile offenders. This focus is important to consider when planning transcultural nursing care to this group. Data were collected using Leininger's Observation-Participation-Reflection Enabler, and general and key informant interviews with five juveniles (12 to 15 years old) living in a southeastern inner city in the United States. The data analysis revealed a general theme of survival in the face of loss. Losses were conceptualized as the departure or absence of something or someone of value in the juvenile's life. Losses were categorized into the domains of family losses, social losses, and self-identity losses. Four categories of losses unique to each domain were a loss of caring, a loss of protection, a loss of discipline, and a loss of support. The threat to survival was the dominant theme of each type of loss. Implications for transcultural nursing care were formulated based on Leininger's three modes of culture care: cultural care preservation, cultural care accommodation, and cultural care repatterning. These care modes guided culturally congruent nursing actions with African American male juvenile offenders who have experienced losses which were a threat to their health, well being, or survival.
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