This article explores the potential for the use of reminiscence therapy as an effective means of reducing depression among institutionalized, rural-dwelling elders, especially elderly women. Reminiscence therapy is a nurse-initiated intervention that has the advantages of being cost-effective, therapeutic, social, and recreational for the institutionalized older adult. As a communicative psychosocial process, reminiscence therapy has proven to be a valuable intervention for the depressed elderly client (Cully, LaVoie, & Gfeller, 2001; Haight & Hendrix, 1998; Haight, Michel, & Hendrix, 1998, 2000). It has been shown that depressed elders living in rural areas resist treatment from mental health services for a variety of different reasons (Molinari, Boeve, Kunik, & Snow-Turek, 1999; Neese, Abraham, & Buckwalter, 1999). For those elders, reminiscence therapy may prove an extremely beneficial alternative to more traditional treatment modalities in reducing the effects of depression and depressive symptoms.

Sleep disorders are major syndromes that can interfere with falling to sleep or maintaining sleep, or produce excessive daytime sleepiness. Sleep disorders are rarely diagnosed in the elderly due to age-related changes in sleep patterns. Gerontological nurses can assist the elderly client to achieve improved sleep through increased awareness of sleep disorders, related assessment tools, and interventions.

This study reports the survey findings of self-reported cultural competence of a convenience sample of 66 registered nurses of varying ages, gender, ethnicity, educational backgrounds, and experience in North Carolina. Campinha-Bacote's model of cultural competence and Benner's model of clinical skills acquisition serve as the conceptual frameworks. The process of cultural competence among health care professionals, developed by Campinha-Bacote, is used to measure cultural competence in participants. In addition to descriptive statistics, bivariate analysis of variance was conducted to compare means of cultural competence scores of different groups. Findings indicate that level of education, nursing experience, and continuing education are factors that promote cultural competence, whereas gender and race/ethnicity have no bearing. In addition, qualitative data generated four themes: language or verbal communication barrier, religious beliefs, different health beliefs and behaviors, and culturally inappropriate nonverbal communication. Implications of these findings for nursing education, practice, and future research are elaborated.

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