Transcultural nursing
- 1. PradeepMK M.Sc. Nursing I year
- 3. CONTENTS Introduction A Definition B Historical Prespectives C Leininger Model D Giger & Davidhizar Model E Campinha Bacote's Model F
- 4. Introduction; A Transcultural Nursing is a distinct nursing speciality which focuses on global cultures and comparative cultural caring, healthy and phenomena. The transcultural nurse looks to respond to the imperative for devoloping a global prespective within the nursing field in an increasingly globalized world of interdependent and interconnected nations and individual.
- 5. Definition; B Leininger defined transcultural nusing as, '' A legitimate and formal area of study, research and practice focused on culturally based care, values and practices to help cultures and sub-cultures maintain (or) regain their health and face difficulties (or) death in a culturally conguent and beneficial caring ways. ''
- 7. (i) Culture; Norms and practices of a particular group that are learned and shared and guide thinking, decisions and action. (ii) Cultural Values; The individual desirable (or) preferred way of acting (or) knowing something that is sustained over a period of time and which governs actions (or) decisions.
- 8. Culturally Diverse Nursing Care; An optimal mode of health care delivery, it refers to the variation of nursing approached needed to provide culturally appropriate care that incorporates an individuals cultural values, beliefs and practices including sensitivity to the environment from which the individual comes and to which the individual may ultimately return.
- 9. According to the American Nurses Association (1976); • Consideration of individual value systems and lifestyles should be included in the planning and health care for each client • Nursing curriculum recognize the contribution nursing, to the health care needs of a diverse and multicultural society life-style may reflect cultural heritage.
- 10. Historical Perspectives of Transcultural Nursing; • The transcultural nursing has its root in the early 1900's when public health care nurses for immigrants from Europe who came from a wide range of cultural background and had diverse health care practices. 1900 • During the 19th century, the word was used almost interchangeably with civilization. This civilization (or) culture was something achieved as society is evolved people who were culture (or) primitive peoples of the world. 19th C
- 11. Cont..., • In the late 1940's Dr.Madeleine Leininger held the belief that care is essence of nursing and the central dominate and unifying focus of nursing. She then began to see the importance of nursing care that was beginning to understand the importance of nursing care that was based on the client's cultures that has unique values. 1940 • Belief practices and life ways passed down from one generation to next. The idea the culture and care are inextricably linked, led her to study other cultures and she becomes the first nurse to obtain a doctorate in anthropology. Later
- 12. Cont..., • Transcultural nursing is a body of knowledge and practice for caring the people from other cultures. Many nurse leaded and educators have embraced the need for culture specific care and various approaches to gaining this knowledge have been developed.
- 13. Models of Transcultural Nursing; • To help develop, tests and organize the emerging body of knowledge in transcultural nursing it is necessary to have a conceptual frame work from various theoritical statements can emerge. Some of the popular models are widely used in the field.
- 14. Leininger Model; Culturally congruent care 01 Culturally competent care 02 Nursing Decision 03 D Leininger has defined transcultural nursing as a comparative study of cultures to understand similarities (culture universal) and difference (culture specific) across human groups.
- 15. Culturally Congruent Care; Care that fills the people's valued life patterns and set of meaning which is generated from the people themselves, rather than based on predetermined criteria. Discovering client's culture care values, meaning, beliefs and practices as they relate to nursing and health care requires nurses to assumes trhe role of learners of client's culture and co-partners with client's and families in defining the characteristics of meaningful and benificial care. Leninger (2002)
- 16. Culturally Competent Care; In caring work with cultural differences and enable clients and families to achieve meaningful and supportive caring. Culturally competent care requires specific knowledge, skills and attitudes in the delivery of culturally congruent care and awareness. Pacquito (2003) identifies three distinct levels of cultural competence at the practitioner, organization and social levels.
- 17. Nursing Decisions; Leininger (1991) identified three nursing decision and action models to achieve culturally congruent care. All three modes of professional decisions and actions are aimed to assist, support, facilitate (or) enable people of particular cultures.
- 18. Leininger Model; Cultural preservation (or) maintenance. 01 Cultural care accomodation (or) negotiation 02 Cultural care re- patterning (or) restructuring 03
- 19. Cont..., Cultural Preservation (or) maintenance; Retain and (or) preserve relevent care values so that clients can maintain their well being, recover from illness (or) face handicaps and (or) death. Cultural care accomodation (or) Negotiation; Adapt (or) negotiate with the others for a beneficial (or) satisfying health outcome.
- 20. Cont..., Cultural care Re-patterning (or) Restructuring; Records, change (or) greatly modify client's life ways for a new, different and beneficial health care pattern.
- 22. The Giger and Davidhizar Model This model was developed in 1988 in response to the need for nursing students in an undergraduate program to assess and provide care for patients that were culturally diverse. Giger and Davidhizar have identified six cultural phenomena that vary among cultural groups and affects health care.E
- 23. Giger and Davidhizar Model; Space 1 Social Organization 2 Time Orientation 3 Biological Variations 4 5 6 Communication Environmental Control
- 24. Cont..., 1) Communication; Communication is the means by which culture is transmitted and preserved, both verbal and non- verbal communications are learned in one culture. Verbal and non-verbal patterns of communication vary across cultures and if nurses do not understand the client's cultural rules in communication, the client's acceptance of a treatment regimen may be jeopardized.
- 25. Cont..., Accurate diagnosis and treatment is impossible if the health-care professional cannot understand the patient. Culture not only determines the appropriateness of the message but also influences all the components of communication.
- 26. Cont..., Thus an assessment of communication should consider: I. Dialect, II. Style, III. Volume, including silence, IV. Touch, V. Context of speech (or) emotional tone and VI. Kinetics, including gestures, stances and eye behaviours.
- 27. Cont..., 2) Space; Space refers to the distance between individuals when they interact. All communication occurs in the context of space. There are four distinct zones of interpersonal space: 1. Inmate zone (extends upto 1 ½ feet) 2. Personal Distance (Extends from 1 ½ feet to 4 feet)
- 28. Cont..., 3. Social Distance (Extends from 4 feet to 12 feet) 4. Public Distance (Extends from 12 feet (or) more)
- 29. Cont..., 3) Social Organization; Social organization refers to be social group organization with which clients and families may identify.
- 30. Cont..., 4) Time Orientation; Time is an important aspect of interpersonal communication. Some cultures are considered future oriented, others present oriented and still others are past oriented. These differences in time orientation may become important health-care measures such as long-term planning and explanations of medication schedules. E.g., Latin Americans, native Americans and Middle Easterns are present oriented cultures and may neglect preventive health care mearsures. They may show-up late (or) not all for appointments.
- 31. Cont..., 5) Environmental Control; Environmental control refers to the ability of the person to control nature and to plan and direct factors in the environment. Some groups perceive man as having mastery over nature, other perceive humans to be dominated by nature, while others see harmonious relationships between humans and nature.
- 32. Cont..., For example, Asians and Native Americans may perceive that illness in a disharmony with other forces and that medicine is only capable of relieving the symptoms rather than curing the disease. These groups are likely to look for naturalistic solutions, such as herbs and hot and cold treatments to resolve (or) cure a cancerous condition.
- 33. Cont..., 6) Biological variations; I. Body structure, II. Skin colour, III. Other visible physical characteristics, IV. Enzymatic and genetic variations, V. Electrocardiographic pattern, VI. Susceptibility to diseases, VII. Nutritional preferences and deficiencies and VIII.Psychological characteristics
- 34. Giger and Davidhizar Model;
- 35. Campinha Bacote's Model; The model identifies cultural awareness, cultural knowledge, cultural skills, cultural encounters and cultural desire as constructs of cultural competence. The five constructs have an independent relationship and all five constructs must be addressed. This model was also utilized in the development of the transcultural nursing standards.
- 37. Cont..., 1) Cultural Awareness; It is defined as the process of conducting self- examination of one's own biases toward is as follows other cultures and the in-depth exploration of awareness also involves being aware of the existense of documented racism in health care delivery.
- 38. Cont..., 2) Cultural Knowledge; It is defined as the process in which the healthcare professional seeks and obtain a sound information base regarding the world views of different cultural and ethnic groups as well as biological variations, diseases and health conditions and variations in drug metabolism found among ethnic groups.
- 39. Cont..., 3) Cultural Skills; It is the ability to conduct a cultural assessment to collect relevant cultural data regarding the client's presenting, problem as well as accurately conducting a culturally based assessment.
- 40. Cont..., 4) Cultural Encounters; It is the process which encourages the healthcare professional to directly engage in face-to-face cultural interactions and other types of encounters with clients from culturally diverse backgrounds in order to modify existing belief about a cultural group and prevent possible stereotyping.
- 41. Cont..., 5) Cultural Desire; It is the motivation of the health care professional to “want to” engage in the process of becoming culturally aware, culturally knowledge, culturally skillful and seeking cultural encounters not the “have to”. Cultural desire is the spiritual and pivotal, construct of cultutral competence that provides the energy source and foundation for one's journey toward cultural competence.
- 42. Cont..., Therefore cultural competence can be depicted as a valcano, which symbolically represents that is cultural desire, that stimulates the process of cultural competence. For example, when a nurse is asked to care for an Arab patient whose political (or) religious beliefs are in direct contrast to his beliefs. In this case too commitment to the process of cultural desire requires the nurse to be available to care for patients, even when there may be a natural instinct to resign oneself from the nurse-patient interaction.
- 44. Role of the Nurse; Provide care that is congruent with cultural values, beliefs and practices. A Develop culturally competent interventions. B In-service staff on cultural competency. C Include teaching of transcultural nursing in school curriculum. D
- 45. Cont..., Perform transcultural assessments communication, personal space, diet, religious, social orientation, what interventions have they already done.
- 46. Summary
- 47. THANK YOU