TN 1 - Introduction To Transcultural Nursing PDF

INTRODUCTION TO TRANSCULTURAL NURSING LESSON # 1 NCM 120 – Decent Work Employment and Transcultural Nursing Prof. Xenia C. Clemeña │ November 22, 2024 │ Transcript by JABYNATION...

INTRODUCTION TO TRANSCULTURAL NURSING LESSON # 1 NCM 120 – Decent Work Employment and Transcultural Nursing Prof. Xenia C. Clemeña │ November 22, 2024 │ Transcript by JABYNATION OUTLINE the client’s needs based on culturally relevant I. Transcultural Nursing information II. The Giger and Davidhizar’s Transcultural Assessment Model MUST-KNOW ! A. Culturally Diverse Nursing Care Although transcultural nursing is becoming a B. Culturally Competent Care highly specialized field of specially educated C. Culturally Unique Individuals individuals, every nurse, regardless of D. Culturally Sensitive Environments academic or experiential background, III. Cultural Assessment MUST use transcultural knowledge to A. Using Non-Nursing Models facilitate culturally appropriate care. B. Using Nursing-Specific Models Regardless of preparation in the field of IV. Leininger’s Sunrise Model transcultural nursing, every nurse who is entrusted with the care of clients must make I. TRANSCULTURAL NURSING every effort to deliver culturally sensitive care that is free of inherent biases based on In the context of Giger and Davidhizar’s gender, race or religion. Transcultural Assessment Model, transcultural nursing viewed as a culturally II. THE GIGER AND DAVIDHIZAR’S competent practice field that is client centered TRANSCULTURAL ASSESSMENT MODEL and research focused. Although transcultural nursing is viewed as In response to the need for a practical client centered, it is important for nurses to assessment tool for evaluating cultural remember that culture can and does influence variables and their effects on health and how clients are viewed and the care that is illness behaviors, a transcultural assessment rendered. model is offered that greatly minimizes the time to conduct a comprehensive assessment in an MUST-KNOW ! effort to provide culturally competent care Every individual is culturally unique and nurses are no exception to this premise. The METAPARADIGM for the GIGER AND DAVIDHIZAR Nonetheless, nurses must use caution to TRANSCULTURAL ASSESSMENT MODEL includes: avoid projecting on the client their own cultural uniqueness and worldviews if 1. Transcultural nursing and culturally diverse culturally appropriate care is to be provided. nursing Nurses must carefully discern personal 2. Culturally competent care cultural beliefs and values to separate them 3. Culturally unique individuals from the client's beliefs and values. 4. Culturally sensitive environments To deliver culturally sensitive care, the nurse 5. Health and health status based on culturally must remember that each individual is specific illness and wellness behaviors unique and a product of experiences, beliefs, and values that have been learned A. CULTURALLY DIVERSE NURSING CARE and passed down from one generation to the next. Culturally diverse nursing care refers to variability in nursing approaches needed to According to Joyceen S. Stokes, nursing as a provide culturally appropriate and competent profession is not “culturally free” but rather is care. “culturally determined”. Nurses need to use transcultural knowledge in o Nurses must recognize and understand a skillful and artful manner to render culturally this fact to avoid grossly ethnocentric. appropriate care to rapidly changing, Because there is a contingent relationship heterogeneous client population. between cultural determination and the delivery of culturally sensitive care, the B. CULTURALLY COMPETENT CARE transcultural nurse must be guided by acquired knowledge in the assessment, diagnosis, CULTURAL COMPETENCE planning, implementation, and evaluation of Purnell & Paulanka, 2008: JABYNATION BUCN 4-A 1 INTRODUCTION TO TRANSCULTURAL NURSING LESSON # 1 o The act whereby a health care professional develops an awareness of one’s existence, sensations, thoughts and environment without letting these factors have an undue effect on those for whom care is provided. Smith, 1998: o A continuous process of awareness, knowledge, skill, interaction and sensitivity that is demonstrated among those who render care and the services they provide. C. CULTURALLY UNIQUE INDIVIDUALS To provide culturally appropriate and competent care, it is important to remember that each individual is culturally unique and as such is a product of experiences, cultural beliefs, and cultural norms. D. CULTURALLY SENSITIVE ENVIRONMENTS Culturally diverse health care can and should be rendered in a variety of clinical settings. Regardless of the level of care — primary, secondary, or tertiary— knowledge of culturally relevant information will assist the nurse in planning and implementing a treatment regimen that is unique for each client. GIGER AND DAVIDHIZAR’S TRANSCULTURAL ASSESSMENT MODEL Sample questions to ask to gain cultural knowledge on your patient to be able to give culturally sensitive and culturally congruent care JABYNATION BUCN 4-A 2 INTRODUCTION TO TRANSCULTURAL NURSING LESSON # 1 Ex. In some Asian cultures, maintaining eye III. CULTURAL ASSESSMENT contact may be seen as disrespectful, while in Western cultures, it’s often perceived as a sign Cultural assessment is a vital component of of confidence and attentiveness. providing culturally competent care in nursing. It involves understanding and respecting the 2) SPACE beliefs, values, and practices of patients from diverse backgrounds. This refers to: By conducting a cultural assessment, nurses o personal space can identify potential barriers to o territoriality communication, care delivery, and develop o touch and physical contact strategies to address them. Ex. In Latin America (Brazil, Venezuela, In a pluralistic society, nurse practitioners Argentina, Colombia, Peru, Guatemala...) need to be prepared to provide culturally cultures, people may feel comfortable standing appropriate nursing care for each client, close to others during conversations. regardless of that client's cultural background. Conversely, individuals from North American To provide culturally appropriate nursing care, (US, Canada) or North European (Norway, nurses must understand specific factors that Finland, Sweden, Denmark, UK) backgrounds influence individual health and illness often prefer more personal space. behaviors. Cultural assessment can give meaning to 3) TIME behaviors that might otherwise be judged negatively. If cultural behaviors are not This encompasses concepts of time, such as appropriately identified, their significance will past, present, future orientation, punctuality be confusing to the nurse and scheduling, Ex. People from some Native American or Latin SCHEMATIC OF GIGER AND DAVIDHIZAR’S American cultures may have present-time TRANSCULTURAL ASSESSMENT MODEL orientation, focusing on the current moment rather than strict schedules. 4) SOCIAL ORGANIZATION This includes: o family structures o social roles o kinship systems o social networks o culture traditions and practices Ex. In many Middle Eastern cultures, the extended family is highly involved in medical Culturally diverse nursing care must take into decisions. A patient may consult family elders account 6 cultural phenomena that vary with before agreeing to a treatment plan. application and use yet are evident in all cultural groups: 5) ENVIRONMENTAL CONTROL 1. Communication 2. Space This relates to beliefs about the environment 3. Social organization and its impact on health. 4. Time Includes: 5. Environmental control o cultural health beliefs 6. Biological variations o perception of control o traditional and alternative therapies 1) COMMUNICATION o preventive health practices Ex. In traditional Chinese culture, individuals This includes: may believe in balancing yin and yang (opposite o language and dialects but interconnected) to maintain health. A patient o nonverbal cues may prefer combining western treatments with o communication styles JABYNATION BUCN 4-A 3 INTRODUCTION TO TRANSCULTURAL NURSING LESSON # 1 traditional practices like acupuncture or herbal 2. NEUTRAL medicine. o Cultural practices or beliefs that neither harm nor benefit an individual’s health 6) BIOLOGICAL VARIATIONS o Ex: Using lucky charms or specific rituals that have no direct impact on This considers genetic, physiological, physical health but provide psychological susceptibility to diseases and comfort or spiritual balance pharmacological differences across cultures. o Nursing Care: Nurses should respect o Ex. African Americans have a higher these practices as long as they do not prevalence of hypertension and may interfere with medical treatment, as they respond differently to certain anti may enhance the client’s emotional hypertension medications. well-being APPLICATION OF CULTURAL PHENOMENA TO 3. DYSFUNCTIONAL o Practices or beliefs that are harmful to NURSING CARE AND NURSING PRACTICE health or may worsen a medical condition o Ex: Avoiding vaccinations due to cultural misconceptions or relying solely on traditional remedies for serious conditions like diabetes or hypertension o Nursing Care: Nurses should provide culturally sensitive education to address misconceptions and promote safer, evidence-based alternatives while respecting the client’s cultural background 4. UNCERTAIN o Practices or beliefs whose effects on In the context of environmental control within health are unclear due to limited the Giger and Davidhizer Transcultural evidence or understanding Assessment Model, individuals’ beliefs about their o Ex: Using herbal remedies that have not ability to control their environment and its been studied extensively for their influence on their health are categorized into safety or efficacy in managing specific four possible perceptions: illnesses o Efficacious o Nursing Care: Nurses should remain o Neutral open-minded, gather more o Dysfunctional information, and consult evidence or o Uncertain collaborate with interdisciplinary These terms guide culturally competent teams to assess the potential effects of nursing care by helping nurses understand how these practices. Understanding these cultural perspectives on the environment categories helps nurses provide affect health behaviors and outcomes. culturally appropriate care by assessing and adapting interventions 1. EFFICACIOUS based on the client’s cultural beliefs and o Practices and beliefs within a cultural their impact on health. This approach group that promote and positively fosters trust, improves outcomes, and impact health and well-being ensures respectful care o Ex: A client from a culture that believes in regular exercise, balanced nutrition, A. USING NON-NURSING MODELS and preventative health checkups as ways to maintain health. These practices 1) OUTLINE OF CULTURAL MATERIALS by MURDOCK are aligned with evidence-based health promotion strategies ET AL. o Nursing Care: Nurses should support and incorporate these health- One of the most comprehensive tools used for promoting practices into the care plan nursing cultural assessment JABYNATION BUCN 4-A 4 INTRODUCTION TO TRANSCULTURAL NURSING LESSON # 1 However, this tool was developed primarily for anthropologists who were concerned with ETHNOGRAPHIC descriptions of cultural groups. Although the tool is well developed and contain 88 major categories, it was NOT designed for nurse practitioners and thus does not provide for systematic use of nursing process 2) BROWNLEE’S COMMUNITY, CULTURE AND CARE: A CROSS-CULTURAL GUIDE FOR HEALTH WORKERS 3 Aspects of Assessment: o What to find out o Why it is important o How to do it Brown lee's work is devoted to the process of GENERIC CARE practical assessment of community, with specific attention to given to health areas Brownlee's assessment tool has been criticized Generic (folk or lay) care systems are as being TOO comprehensive, too difficult and culturally learned and transmitted, indigenous too detailed for use with individual clients. (or traditional), folk (home-based) knowledge ALTHOUGH, this tool was developed for use by and skills used to provide assistive, supportive, health care practitioners, it is not exclusively a enabling, or facilitative acts toward or for nursing assessment tool another individual, group, or institution with evident or anticipated needs to ameliorate or B. USING NURSING-SPECIFIC MODELS improve a human life way, health condition (or well- being), or to deal with handicaps and death situations. Transcultural nursing is defined by Madeleine Leininger as humanistic and scientific area of formal study and practice that focuses on PROFESSIONAL CARE differences and similarities among cultures with respect to human care, health and illness based Professional care systems are defined as on cultural values, beliefs and practices. formally taught, learned, and transmitted Madeleine Leininger was a renowned nursing professional care, health, illness, wellness, theorist and cultural anthropologist who is and related knowledge and practice skills that considered the founder of transcultural prevail in professional institutions, usually with nursing. multidisciplinary personnel to serve According to Leininger, the ultimate goal of consumers. transcultural nursing is the use of relevant Also included in the model are levels of knowledge to provide culturally specific and abstraction and analysis from which care can be culturally congruent nursing care to people. studied at each level. Various cultural phenomena are studied from the micro, middle LEININGER’S SUNRISE MODEL and macro perspectives. Leininger's model has served as the prototype for the development of other culturally specific Symbolize the rising sun (care) nursing models and tools. The model depicts a full sun with four levels of foci EXAMPLE OF USING THE LEININGER MODEL Within the circle in the upper portion of the model are components of the social structure and worldwide factors that influence care and health A nurse caring for a patient from a culture that through language and environment. values traditional healing practices might use These factors influence the folk, professional, the Leininger Model to determine if the patient's and nursing systems and subsystems located traditional remedies can be incorporated into in the lower half of the model the care plan If the patient's traditional practices do not pose a risk to their health, the nurse might choose to accommodate these practices JABYNATION BUCN 4-A 5