Defense Date


Graduation Date

Fall 12-16-2022


One-year Embargo

Submission Type


Degree Name





School of Nursing

Committee Chair

Rick Zoucha

Committee Member

Alison M. Colbert

Committee Member

Yovanska M. Duarté-Vélez


suicide prevention, nursing care, Puerto Ricans, culturally congruent care, ethnonursing


BACKGROUND: Suicide is a public health issue among the growing U.S. Latinx population; however, Latinx subgroups are diverse and represent different cultural backgrounds. Puerto Ricans are the second largest Latinx subgroup in the nation. Although research points to possible mental health vulnerabilities among Puerto Ricans when compared to other Latinx subgroups, there is a dearth of research exploring cultural influences that can impact suicide prevention efforts for Puerto Ricans living in the U.S. mainland. AIMS: This study aimed to explore the culture care values, beliefs, and needs of Puerto Rican adults pertaining to suicide and its prevention. METHODS: The study was conducted using the Ethnonursing Research Method, a qualitative approach guided by Leininger’s Culture Care Theory. Semi-structured interviews were conducted via Zoom with 11 key informants and 16 general informants (N=27). Leininger’s 4 phases of qualitative data analysis were used to analyze data. RESULTS: Data was coded into 21 categories and 8 patterns. Three major themes were identified and then abstracted that relate to culture care considerations for suicide prevention: a) family plays a central role in suicide prevention, b) a concern for what people will say or think can influence help-seeking, and c) suicide prevention includes the provision of care that fosters confianza. CONCLUSIONS: Public health measures for suicide prevention among Puerto Rican communities in the United States must consider their culture care values, beliefs, and needs. Specific nursing decisions and actions are recommended for the promotion of culturally congruent nursing care.



Additional Citations

Estrada, G. B., Zoucha, R., & Duarté-Vélez, Y. (2019). Cultural factors Influencing suicidal ideation and behaviors in Puerto Ricans: An integrative review. In C. E. Kasper & R. Zoucha (Eds.), Annual Review of Nursing Research (Vol. 37, pp. 261-299). New York, NY: Springer Publishing Company, LLC. doi:10.1891/0739-6686.37.1.261