Nursing assistance and transcultural care for indigenous peoples:an integrative review

Abstract

Brazilian Indigenous populations have historically faced social exclusion, structural racism, and State negligence, which compromise both access to and the quality of healthcare services. In the field of nursing, care provided to Indigenous communities requires cultural sensitivity, understanding of traditional health practices, and the ability to overcome multiple structural, communicational, and educational barriers. This study aims to identify, through an integrative literature review, the main challenges faced by nursing professionals in delivering care to Indigenous communities. This is an integrative literature review guided by the PICO strategy, with the following research question: “What are the main challenges faced by nursing professionals in providing care to Indigenous communities?” The search was conducted in the Virtual Health Library (VHL), using descriptors in Portuguese, English, and Spanish, combined with the Boolean operators AND and OR. Articles published between 2020 and 2024, available in full text and addressing nursing care for Indigenous populations, were included. Review articles, guidelines, and technical manuals were excluded. Data analysis was organized into tables containing the main methodological and thematic elements of each study. A total of 1,618 articles were identified, of which 11 met the inclusion criteria. Most studies were qualitative and conducted in Indigenous territories in Brazil, Colombia, and Mexico. The most recurrent challenges included communication barriers, lack of specific training and intercultural preparation, low recognition of traditional care practices, geographic obstacles, and inadequate infrastructure. High turnover rates, work overload, institutional racism, gender inequalities, and difficulties in establishing therapeutic relationships were also reported. Nursing care for Indigenous populations is shaped by multiple barriers that compromise care effectiveness and demand a culturally sensitive, interdisciplinary, and politically engaged approach. The inclusion of interculturality in nursing education, the strengthening of traditional practices, and the confrontation of structural inequalities are essential strategies to ensure ethical and qualified care. Despite limitations regarding the geographic scope of the included studies, this review provides relevant contributions to the advancement of public policies and professional practice in the context of Indigenous health.