Transcultural Nursing - Chapter 1 PDF

NCM 120 Decent Work Employment and Dr. Verminia Aurora A. Basilio RN, MAN, Ph.D.  Transcultural Nursing LEARNING OBJECTIVES: 1. Explore the historical and theoretical foundations of transcultural nursing. 2. Critically examine the relevance of transcultural nursing in addressing...

NCM 120 Decent Work Employment and Dr. Verminia Aurora A. Basilio RN, MAN, Ph.D.  Transcultural Nursing LEARNING OBJECTIVES: 1. Explore the historical and theoretical foundations of transcultural nursing. 2. Critically examine the relevance of transcultural nursing in addressing contemporary issues and trends in nursing. 3. Analyze Leininger’s contributions to the creation and development of transcultural nursing as a theory and evidence-based formal area of study and practice within the nursing profession. 4. Critically examine the contributions of selected transcultural scholars to the advancement of transcultural nursing theory and practice. 5. Discuss key components of the Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model. Transcultural Nursing “A humanistic and scientific area of formal study and practice nursing which focuses on differences and similarities amongst cultures with respect to human care health, and illness based upon their cultural perspectives. Then to use this knowledge to provide culturally sensitive nursing care.” (Leininger, 2008).  Nursing Care Management - 120 CHAPTER 1 Theoretical Foundations of Transcultural Nursing  Nursing Care Management - 120 I. INTRODUCTION ON HISTORICAL AND FOUNDATIONS OF TRANSCULTURAL NURSING  Transcultural Nursing TRANSCULTURAL NURSING  Conceptualized by Dr. Madeleine Leininger  The blending of nursing and anthropology into an area of specialization within the discipline of nursing.  A formal area of study that uses the concepts of culture and caring  Transcultural Nursing TRANSCULTURAL NURSING(TCN)  is a nursing specialty focused on the comparative study and analysis of cultures and subcultures.  It examines these groups with respect to their: Caring behavior Nursing care Health-illness values and beliefs Patterns of behavior  Transcultural Nursing TRANSCULTURAL NURSING’SGOAL IS TO:  Develop a scientific and humanistic body of knowledge in order to provide nursing care that is both 1. Culture specific Particular values, beliefs, and patterns of behavior that tend to be special or unique to a group and do not tend to be shared with members of other cultures. 2. Culture universal refers to: The commonly shared values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles.  Transcultural Nursing For example, although the need for food is a “cultural universal”, there are culture-specifics that determine what items are considered to be edible; acceptable methods used to prepare and eat meals; rules concerning who eats with whom, the frequency of meals, and gender- and age- related rules governing who eats first and last at meals time; and  Nursing Care Management - 120 I. ANTHROPOLOGY AND CULTURE  Nursing Care Management - 120 ANTHROPOLOGY The study of humans including their: Origins Behavior Social relationships Physical and mental characteristics Customs, and Development through time and in all places in the world  Transcultural Nursing Culture Defined  CULTURE is a patterned behavioral response that develops over time as a result of imprinting the mind through social and religious structures and intellectual and artistic manifestations.  CULTURE is also a result of acquired mechanisms that may have innate influences but are primarily affected by internal and external environmental stimuli.  CULTURE is shaped by values, beliefs, norms, and practices that are shared by members of the same  Transcultural Nursing Culture Defined  CULTURE guides our thinking, doing, and being and becomes patterned expressions of who we are. These patterned expressions are passed down from one generation to the next. “CULTURE is the values, beliefs, norms, and practices of a particular group that are learned and shared and that guide thinking, decisions, and actions in a patterned way”.  Transcultural Nursing Culture Defined Culture is the blueprint that provides the broadest and most comprehensive means to know, explain, and predict people’s lifeways over time and in different geographic locations” (McFarland & Wehbe-Alamah, 2015) Transcultural Nursing  Transcultural Nursing SUBCULTURE Members of subcultures have their own common customs, attitudes and values, usually accompanied by the language, slang and/or jargon of a specific gtroup to distinguish them from others.  Transcultural Nursing SUBCULTURE For example: Hispanic is a pan-ethnic name that includes many subcultures made up of people who identify themselves as Mexican, Cuban, Purto Rican and other groups that often share Spanish Language and culture.  Transcultural Nursing ETHNICITY It is defined as the perception of oneself and a sense of belonging to a particular ethnic groups. It can also mean a feeling that one does not belong to any group because of multiethnicity. Ethnicity is not the same as to race, which is a biological identification. Rather, ethnicity includes commitment and involvement in cultural customs and rituals.  Transcultural Nursing RACE Refers to a group of people with genetic characteristics such as skin color, hair texture, and eye shape or color. Race is an arbitrary classification that lacks a clear definition, because all cultures have their own way of categorizing or classifying members. Transcultural Nursing “CULTURAL VALUES are unique expressions of a particular culture that have been accepted as appropriate over time. They guide actions and decision making that facilitate self-worth and self-esteem. By: Leininger (1985a, Transcultural Nursing  Cultural Assessment In a pluralistic society, nurse practitioners need to be prepared to provide culturally appropriate nursing care for each client, regardless of that client’s cultural background. To provide culturally appropriate nursing care, nurses must understand specific factors that influence individual health and illness behaviors”. By: Tripp-Reimer, Brink, & Saunders,  Cultural Self-Assessment Before you can provide culturally competent care for people from diverse backgrounds, it’s important to engage in a cultural self-assessment. When interacting with clients from various cultural backgrounds, you must be aware of your own cultural values,  Cultural Self-Assessment Through self-assessment, it is possible to gain insights into the health-related values, attitudes, beliefs, and practices that have been transmitted to you by your own family. After you have engaged in a cultural self-assessment, it is possible to conduct IMPORTANCE TO FUTURE NURSES A major question for nursing educators world wide is how best to prepare nursing students and registered nurses so that they are able to provide culturally congruent care practice.  ACTIVITY 2 Contemplate on the 1.Own Culture ff: 2.Personal Values, Prejudices & Biases 3.Difficulties in Communication 4.Norms & Tradition 5.Discrimination Have you “ASKED” yourself? A- wareness: Am I aware of my personal biases and prejudices towards cultural Have you “ASKED” yourself? S-kills: Do I have the skill to conduct a cultural assessment and perform a culturally- based physical assessment in Have you “ASKED” yourself? K-nowledge: Do I have the knowledge of the patient’s world view. Have you “ASKED” yourself? E-ncounters: How many face-to-face encounters have I had with patients from diverse cultural backgrounds? Have you “ASKED” yourself? D-esire: What is my genuine desire to “want to be” culturally Transcultural Nursing Transcultural Nursing “The ultimate goal of Transcultural Nursing is use of relevant knowledge to provide culturally specific and culturally congruent nursing care to people”. By: Leininger (1985a, 1985b; Leininger & McFarland,  Transcultural Nursing Principles of TCN: 1.Cultures have diverse living, caring, and healing modes that nurses must understand to work effectively with people.  Transcultural Nursing Principles of TCN: 2. Care is a basic human need  Transcultural Nursing Principles of TCN: 3. Understanding one’s own culture is the first essential expectation to understand other cultures.  Transcultural Nursing Principles of TCN:  Nursing Care Management - 120 I. HISTORICAL AND THEORETICAL FOUNDATION OF TRANSCULTURAL NURSING Transcultural Nursing  Transcultural Nursing IMPORTANCE OF TRANSCULTURAL NURSING 1. A marked increase in the migration of people within and between countries worldwide. 2. A rise in multicultural identities, with people expecting their cultural beliefs, values, and ways of life to be understood and respected by nurses and other health care providers.  Transcultural Nursing IMPORTANCE OF TRANSCULTURAL NURSING 1. A marked increase in the migration of people within and between countries worldwide. 2. A rise in multicultural identities, with people expecting their cultural beliefs, values, and ways of life to be understood and respected by nurses and other health care providers.  Transcultural Nursing IMPORTANCE OF TRANSCULTURAL NURSING 3. An increase in health care providers’ and patients’ use of technologies that connect people globally and simultaneously may become the source of conflict with the cultural values, beliefs, and practices of some of the people receiving care. 4. Global cultural conflicts, clashes, and violence that impact health care as more cultures interact with one another. 5. An increase in the number of people traveling and working in different parts of the world.  Transcultural Nursing IMPORTANCE OF TRANSCULTURAL NURSING 6. An increase in legal actions resulting from cultural conflict, negligence, ignorance, and the imposition of health care practices. 7. A rise in awareness of gender issues, with growing demands on health care systems to meet the gender- and age-specific needs of men, women, and children. 8. An increased demand for community- and culturally based health care services in diverse environmental contexts (Leininger, 1995)  Transcultural Nursing LEININGER’S CONTRIBUTION TO TRANSCULTURAL Leininger uses concepts suchNURSING as worldview, social and cultural structure, language, ethnohistory, environmental context, and folk and professional healing systems to provide a comprehensive and holistic view of factors that influence culture care. Among the strengths of Leininger’s theory is its flexibility for use with individuals, families, groups, communities, and institutions in diverse health systems. To help develop, test, and organize the emerging body of knowledge in TCN, Leininger recognized that it would be necessary to have a specific conceptual framework from which various theoretical statements are developed.  Transcultural Nursing LEININGER’S CONTRIBUTION TO TRANSCULTURAL NURSING While creating TCN as a respected and recognized nursing specialty and developing her theory, Leininger also had the foresight to establish the Transcultural Nursing Society (TCNS), generate the TCNS Newsletter, and create the Journal of Transcultural Nursing (JTN), for which she served as the founding editor. Leininger established the first master’s and doctoral programs in nursing with a theoretical and research focus in TCN and provided exemplars for TCN courses and curricula suitable for all levels of nursing education (undergraduate and graduate) through her lectures, publications, and consultations.  Transcultural Nursing LEININGER’S CONTRIBUTION TO TRANSCULTURAL NURSING Leininger also created a new qualitative research method called ethnonursing research to investigate phenomena of interest in TCN Lastly, Leininger’s contributions to TCN rapidly gained global and interprofessional recognition as many health care professionals from medicine, physical therapy, occupational therapy, social work, and related disciplines learned about the Theory of Cultural Care Diversity and Universality and either adopted or adapted it to fit their respective disciplines.  Transcultural Nursing Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model The goals of the Andrews/Boyle TIP Model are to: Provide a systematic, logical, orderly, scientific process for delivering culturally congruent, culturally competent, safe, affordable, accessible, and quality care to people from diverse backgrounds across the lifespan  Transcultural Nursing Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model The goals of the Andrews/Boyle TIP Model are to: Facilitate the delivery of nursing and health care that is beneficial, meaningful, relevant, culturally congruent, culturally competent, and consistent with the cultural beliefs and practices of clients from diverse backgrounds  Transcultural Nursing Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model The goals of the Andrews/Boyle TIP Model are to: Provide a conceptual framework to guide nurses in the delivery of culturally congruent and competent care that is theoretically sound, evidence based, and utilizes best professional practices  Transcultural Nursing Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model  Transcultural Nursing Interprofessional Health Care Team The client The client’s family, and others significant in his or her life, including a legally appointed guardian who might not be genetically related Credentialed health professionals such as nurses; physicians; physical, occupational, respiratory, music, art, dance, recreational, and other therapists; social workers; health navigators; public and community health workers; and related professionals with formal academic preparation, licensure, and/or certification  Transcultural Nursing Interprofessional Health Care Team Folk, indigenous, or traditional healers—unlicensed individuals who learn healing arts and practices through study, observation, apprenticeship, imitation, and sometimes by inheriting healing powers, for example, herbalists, curanderos, medicine men/women, Amish brauchers, bonesetters, lay midwives, sabadors, and healers with related names  Transcultural Nursing Interprofessional Health Care Team Religious or spiritual healers—clergy or lay members of religious groups who heal through prayer, religious or spiritual rituals, faith healing practices, and related actions or interventions, for example, priests, priestesses, elders, rabbis, imams, monks, Christian Science practitioners, and others believed to have healing powers derived from faith, spiritual powers, or religion.  Transcultural Nursing Interprofessional Health Care Team Others identified by the client as significant to his or her health, well-being, or healing such as companion animals or pets as culturally appropriate. Transcultural Nursing Transcultural Nursing  Transcultural Nursing COMMUNICATION Derived from the Latin verb communicare, meaning to share Refers to the meaningful exchange of information between one or more participants. Is an organized, patterned system of behavior that makes all nurse–client interactions possible. It is the exchange of messages and the creation of meaning.  Transcultural Nursing COMMUNICATION  Transcultural Nursing REFERENCES: Transcultural Concepts in Nursing Care by Margaret Andrews & Joyceen Boyle Medical Surgical Nursing by Brunner & Suddhart Transcultural Nursing: Assessment & Intervention by Transcultural Nursing