transcultural nursing final 1/4
refers to nurses' efforts to deliver patient centered care by helping patients modify or change their cultural activities. Cultural restructuring is suggested only when certain cultural practices may cause harm to the patient or those in the surrounding environment. These concepts can inform nurses in achieving their ultimate goals
Cultural restructuring
Nursing theories in transcultural care stress the importance of providing culturally sensitive care. This involves adapting nursing practices to align with patients' cultural preferences and needs.
Culturally Sensitive Care:
our own and those of others - does not usually happen spontaneously. It grows over time. Each of us posses an intangible cultural heritage that includes traditions or living expressions inherited from ancestors such as oral traditions and traditional HEALTH beliefs and practices.
The understanding of HEALTH traditions
orientation reflects cultural attitudes toward time and scheduling. • Some cultures prioritize punctuality and efficiency, while others value a more relaxed approach to time. • Nurses should consider patients' time orientations when scheduling appointments and communicating treatment plans.
Time
provide nurses with the foundation required for gaining knowledge about different cultures during healthcare delivery.
Transcultural nursing models
have a significant influence on nursing practice by emphasizing cultural competence, understanding diversity, and promoting effective patient care across different cultural backgrounds.
Transcultural nursing theories
automatically providing culturally congruent care to clients of diverse cultures
Unconsciously competent
Across theory acknowledges the rich diversity of cultures present in healthcare settings. It emphasizes the need for nurses to recognize and respect this diversity, understanding that patients come from various cultural backgrounds with unique beliefs, values, and practices.
cultural diversity
Nurses practicing across theory also consider the concept of cultural safety, ensuring that patients feel respected, valued, and safe within the healthcare environment, regardless of their cultural background.
cultural safety
Across theory emphasizes the importance of cultural sensitivity in nursing practice. Nurses must be attuned to the cultural needs and preferences of their patients, ensuring that care is delivered in a respectful and appropriate manner.
cultural sensitivity
The sunrise model encompasses numerous aspects of culture:
religious, financial, social, technological, educational, legal, political, and philosophical dimensions.
is a framework for conducting culturally sensitive assessments in nursing practice
the Transcultural Assessment Model Developed by Joyce Newman Giger and Ruth Elaine Davidhizar
Across theory recognizes the significance of effective communication across cultural boundaries. Nurses must be able to communicate with patients from diverse cultural backgrounds in a way that is clear, respectful, and culturally appropriate
transcultural communication
(true or false) nurses should strive to provide care that is in harmony with the cultural beliefs, values, and practices of their patients. This involves not only recognizing and respecting cultural differences but also actively incorporating them into the care plan
true
Not being aware that one is lacking knowledge about another culture.
unconsciously incompetent
WORKFORCE ISSUES
• Acculturation • Autonomy • The presence of language barriers
NUTRITION
• Availability of food • Rituals and taboos associated with food • The meaning of food to the culture • How food is used in sickness and in health
HEALTH CARE PRACTICES
• Does the culture seek preventative or acute treatment? • Magico- religious and healthcare beliefs • Traditional practices • Individual responsibility for health • Self medicating practices • How pain is expressed • The sick role • Barriers to health care
HIGH- RISK BEHAVIOR
• Drug use • Alcohol use • Nicotine use • Dangerous behaviors • Use of safety equipment
PREGNANCY
• Fertility practices • Labor and delivery practices • Practices that are considered taboo, prescriptive or restrictive during pregnancy • Labor and postpartum
DEATH RITUALS
• How death is viewed • Preparation for death • Burial practices • Bereavement practices
SPIRITUALITY
• Practices that gives strength and meaning of life • Religious practices • How prayer is used
BIO-CULTURAL ECOLOGY
• Skin type • Body type • Disease that are genetic, heredity, topographic or endemic
FAMILY ROLES AND ORGANIZATION
• The head of the households • Gender roles • Family goals and priority • Developmental task • Social status • Alternative Lifestyles
HEALTH CARE PROFESSIONALS
• Type of practitioners the culture uses Traditional or Folk Biomedical • Does gender of the practitioner comes in to play
refers to the support provided to the patients and their family members in carrying out cultural activities that do not pose threats to the health of the patients or any other individual in the healthcare setting
Cultural negotiation
refers to nurses' provision of support for cultural practices, such as employing acupressure or acupuncture for anxiety and pain relief prior to medical interventions
Cultural preservation
Nurse leaders can implement training programs that focus on diversity and cultural sensitivity to ensure staff members are equipped to provide respectful and effective care to patients from different cultural backgrounds.
Diversity Training
how these theories impact nursing practice?
Effective Communication Holistic Approach: Culturally Sensitive Care: Reduced Health Disparities: Global Health Perspective: Promotion of Ethical Care:
Giger and Davidhizar's Transcultural Assessment Model Six Key Domains
1) Communication 2) Space 3) Social Organization 4) Time 5) Environmental Control 6) Biological Variations
7 potential future developments and trends in transcultural nursing
1. Integration of Cultural Competence in Education 2. Technology and Telehealth 3. Research and Evidence-Based Practice 4. Community Engagement and Outreach 5. Interdisciplinary Collaboration 6. Advocacy and Policy 7.
12 Inner Aspects of the Model or the 12 Domains
1. Overview or Heritage 2. Communication 3. Family roles and organization 4. Workforce issues 5. Bio-cultural ecology 6. High- risk behavior 7. Nutrition 8. Pregnancy 9. Death Rituals 10. Spirituality 11. Health care practices 12. Health care professionals
Across theory entails that (5)
1. cultural diversity 2. cultural competence 3. cultural sensitivity 4. cultural congruence 5. transcultural communication 6. cultural safelty
three concepts of Sunrise model
1. culture care maintenance/preservation; 2. culture care negotiation/accommodation, and 3. culture care restructuring/repatterning
three roles in Nursing Practice:
1. investigator 2. educator 3. advocate
These theories emphasize the significance of effective communication in nursing practice, especially across cultural boundaries. Nurses trained in transcultural nursing learn communication strategies that accommodate language differences, non-verbal cues, and cultural nuances.
Effective Communication:
•refers to a theoretical framework proposed by Madeleine Leininger, a pioneer in the field which is often called the "Culture Care Theory" .
Across theory
encompass genetic, physiological, and anatomical differences among cultural groups. • These differences can impact how individuals respond to medications, experience symptoms, and access healthcare services. • Nurses should be aware of and sensitive to biological variations when providing care to diverse populations.
Biological variations
this model has a concept of cultural competence can be defined as a process in which the nurse attempts to achieve greater efficiency and the ability to work in a culturally diverse environment while caring for the patient, whether an individual, a family, or a group
CAMPINHA-BACOTE'S MODEL OF CULTURAL COMPETENCE IN HEALTHCARE DELIVER
a process in which healthcare professionals consciously acknowledge their own cultural backgrounds, which helps them avoid biases toward other cultures.
CULTURAL AWARENESS
which is the driving force for becoming educated, skilled, competent, and aware of culture; it also presumes a willingness to have transcultural interactions
CULTURAL DESIRE
during which stereotyping is avoided through the interaction between healthcare professionals and members of different cultures. During this process, overreliance on conventional views is discouraged
CULTURAL ENCOUNTER
a process in which healthcare professionals open their minds to understand variations in cultural and ethnic traits as they relate to patient attitudes toward illness and health
CULTURAL KNOWLEDGE
defined as the ability to obtain the necessary information from patients via culturally-appropriate conduct and physical assessment
CULTURAL SKILLS
Nurse leaders can work collaboratively with community organizations, cultural groups, and other healthcare providers to address the unique needs of multicultural populations and promote health equity.
Collaborative Approach
refers to the exchange of information, both verbal and non-verbal, between individuals.
Communication
learning about client's culture, verifying generalizations about the clients culture and providing culturally specific interventions
Consciously competent
being aware that one is lacking knowledge about another culture
Consciously incompetent
It is essential for nursing administrators to regularly assess and evaluate the effectiveness of transcultural nursing practices within their healthcare organization. Continuous improvement efforts can help identify areas for growth and enhance the quality of care provided to all patients.
Continuous Improvement
Nurse administrators should ensure that healthcare providers have the knowledge, skills, and awareness to deliver culturally competent care. This includes understanding the impact of culture on health beliefs, practices, and outcomes.
Cultural Competence
refers to individuals' beliefs about their ability to influence their environment, including health outcomes. • Cultural factors such as beliefs in fate, destiny, and spiritual forces can influence perceptions of control over health. • Nurses should assess patients' beliefs about environmental control and incorporate culturally congruent interventions into care plans.
Environmental control
This model is a tool developed to assess and understand cultural values and their effects on health and disease behavior.
GIGER AND DAVIDHIZAR'S TRANSCULTURAL ASSESSMENT MODEL (1988)
was formulated to help nurses deal with individuals seeking healthcare and their relatives with diverse cultural characteristics (Giger et al., 2005). • The model varies from the other transcultural nursing models in six domains it uses to assess individuals seeking healthcare.
Giger and Davidhizar Transcultural Assessment Model
Transcultural nursing theories prepare nurses to work in diverse global settings and multicultural communities. Nurses equipped with transcultural competence can navigate and respond effectively to the challenges posed by globalization and population migration.
Global Health Perspective:
is the restoration of a person's balance, both within one's being—physical, mental, and spiritual— and in the outside world—natural, familial and communal, and metaphysical. The relationship of the person to the outside world is reciprocal.
HEALING
connotes the balance of a person, both within one's being—physical, mental, and spiritual— and in the outside world—natural, familial and communal, and metaphysical.
HEALTH
is a method for describing traditional culturally based HEALTH beliefs and practices used to: • Maintain through daily HEALTH practices, such as diet, activities, and clothing; • Protect through special HEALTH practices, such as food taboos, seasonal activities, and protective items worn, carried, or hung in the home or workplace and/or; • Restore through special HEALTH practices, such as diet changes, rest, special clothing or objects, prayer or meditation.
HEALTH TRADITIONS MODEL
uses the concept of holistic health and explores what people do to maintain, protect, or restore health. The model shows the interrelated phenomena of physical, mental, and spiritual health with personal methods of maintaining, protecting, and restoring health
HEALTH Traditions Model
Transcultural nursing promotes a holistic approach to patient care by considering cultural, spiritual, social, and environmental factors influencing health and illness. Nurses are encouraged to assess patients within their cultural contexts to understand how beliefs and practices impact health behaviors and treatment choices
Holistic Approach:
is the imbalance of the person, both within one's being—physical, mental, and spiritual—and in the outside world—natural, familial and communal, and metaphysical.
ILLNESS
Nursing administrators should establish policies and practices that support cultural diversity, such as incorporating interpreters, providing culturally relevant educational materials, and accommodating diverse dietary restrictions.
Inclusive Policies
represents the structure of culture care theory by describing the relationship between anthropological and nursing beliefs and principles. • Nurses use this model when making cultural evaluations of patients. The model connects the concepts of the theory with actual clinical practices, while offering a systemic approach to identifying values, beliefs, behaviors, and community customs.
LEININGER'S SUNRISE MODEL
work experience that is direct and/or indirect patient care in clinical practice, nursing administration, education, research, or consultation in the specialty represented by the credential. • The practice of nursing is guided by standards and definitions established by leaders of nursing in professional associations and to some extent by governmental agencies such as the Public Health Service's Bureau of Health Professions
NURSING PRACTICE
OVERVIEW OR HERITAGE
Origin and present home • Political Economics • Educational status • Profession
this model focuses on providing a foundation for understanding the various attributes of a different culture, allowing nurses to adequately view patient attributes, such as incitement, experiences, and notions about healthcare and illness
PURNELL'S MODEL FOR CULTURAL COMPETENCE
COMMUNICATION
Primary language • Dialects • Volume or tone • Spatial Distancing • Eye Contact • Non- verbal communication
Transcultural nursing emphasizes ethical considerations in delivering care to culturally diverse populations. This includes respecting patients' rights, addressing cultural biases, and advocating for equitable and inclusive healthcare practices.
Promotion of Ethical Care:
By incorporating transcultural nursing theories, nurses can contribute to reducing health disparities among culturally diverse populations. Understanding cultural influences on health-seeking behaviors and treatment adherence enables nurses to develop tailored interventions that address specific community health needs.
Reduced Health Disparities:
is a framework for understanding how cultural beliefs and practices influence health and healthcare. • It emphasizes the importance of cultural competence in providing effective and respectful care to diverse populations. • The model explores how individuals from a traditional perspective maintain health, protect health (prevent illness), and restore health.
SPECTOR'S HEALTH TRADITIONS MODEL (2002) • Developed by Dr. Rachel E. Spector
relates to the structure of family and community relationships within a cultural group. • Family roles, hierarchy, and decisionmaking processes can influence health beliefs and treatment decisions. • Nurses should assess the social dynamics of their patients' lives and involve family members in care planning when appropriate.
Social organization
refers to the physical and interpersonal distances maintained between individuals in social interactions. • Cultural norms regarding personal space, touch, and privacy vary among different cultural groups. • Nurses should be aware of cultural preferences regarding space and respect patients' comfort levels during interactions.
Space
Nurses practicing across theory strive to develop cultural competence, which involves acquiring knowledge, understanding, and skills necessary to provide effective care across different cultures. This includes being aware of one's own cultural biases and being able to adapt care practices accordingly.
cultural competence
At the heart of across theory is the concept of cultural congruence. This means aligning nursing care with the cultural beliefs, values, and practices of the patient. Nurses strive to provide care that is not only culturally sensitive but also resonates with the patient's cultural context
cultural congruence
