A New Era in Transcultural Nursing | Janet Bowen's ePortfolio
Aug 3, In consideration of global migration, it is likely that this scenario is common. .. social organization, time, environmental control, and biological variations. provides some information on their authorship, date of development, and constructs. The Giger and Davidhizar Transcultural Assessment Model was. Giger and davidhizar biological considerations when dating. The Giger and Davidhizar Transcultural Assessment Model was developed in in response to the . The Giger and Davidhizar Transcultural Assessment Model. communication, time, space, social organization, environmental control, and biological variations.
Cultural assessment models and tools are merely vehicles that enable nurses to deliver effective transcultural nursing care. However, in recent decades nursing scholars and scientists have extensively critiqued the concept of transcultural nursing. Culley [ 15 ] argues that cultural difference, with a large focus on communication difficulties, has been conceptualized in nursing discourse using a culturalist framework thus tending to ignore some aspects of the issues of race, ethnicity and health.
She criticizes Leininger's model for its assumption that care and services will be improved by knowledge of different cultures. There is a need to recognize "the very complex ways in which race, socio-economic status, gender and age may intersect. Serrant-Green [ 17 ] provides more reflection on the criticism of Leininger's work as minimizing the roles of racism and social inequality in the health status of minority ethnic groups. She further recommends that nursing education stress the diversity within all ethnic communities.
The term cultural competence may be used to describe the capacity of both individual practitioners and health care provision organizations to effectively meet the needs of patients from diverse social, cultural and linguistic backgrounds [ 18 ].
EXTTR Cultural competence is informed by a thorough and in-depth understanding of the factors that configure and shape health experiences of diverse ethno-cultural groups and consequentially demands more than a focus on culture, such that: Cultural competence also includes aspects such as good knowledge of communites, strong leadership, innovative and fexible environments and continous good training and support [ 18 ].
A number of different definitions of cultural competence have been offered and several different models have been suggested, in attempts to identify the key components of culturally competent care and ways in which practitioners and organisations can enhance their performance in this area [ 19 ]. Salway et al [[ 18 ] p. There is evidence that achieving high-quality care and positive health outcomes is heavily dependent on effective communication between patients and care givers [ 20 ].
Communicating effectively and appropriately across language, religious or cultural difference can be challenging with many possibilities for misunderstanding, perceived offence and disempowerment.
Inter-cultural communication competence has therefore been identified as an important element in cultural competence [ 20 ]. The staff members complain that they have difficulty completing their tasks with other critically ill patients because of the distractions they face from the multiple family members visiting this man.
In the Haitian culture, when death is imminent, the entire family will congregate, cry, pray, and use religious medallions or other spiritual artifacts. When an individual dies, the entire extended family is affected. The oldest family member makes all the arrangements and notifies the family. Completing an initial culture assessment would have lessened the burden on the nursing staff and allow them to interact with other patients without neglecting the cultural need of the Haitian patient and family.
Gently remind them that there may be times when they are asked to step out of the room, such as during bedside shift report or procedures. Another option would have been to communicate with the oldest family member to schedule turns for the visitors, to limit the number at his bedside.Cultural Competence Transcultural Nursing Notes 1
The above vignette illustrates how culture ineptitude; can hinder the delivery of patient care in the midst of a conflict. Cultural awareness should be a fundamental competence in health care because it reflects the provider's ability to provide individualized care regardless of the patient's social or cultural background.
The skill of conducting a cultural assessment would allow the provider to deliver culturally competent and patient-centered care that integrated the patient's values, beliefs, and practices into the treatment plan.
Cultural Awareness Curiosity regarding other ways of being in the world especially how individuals operate on a day to day basis is an important attitude for cultural competence.
However, it is also important for providers to acknowledge the forces that influence their world view. Everyone holds biases about human behavior.
The Giger and Davidhizar Transcultural Assessment Model.
Bias is a predisposition to see an individual or things in a particular light, either positive or negative. Recognizing their personal biases and attitudes about human behavior is the first step in providing patient-centered care.
Providers need to gain an awareness of the perceptions, traditions, practices, and value of culturally diverse individuals, families, communities, and populations for whom they serve, as well as a knowledge of the inextricable variables that affect the achievement of health and well-being.
Healthcare providers should spend time cogitating on what they have learned, formally and informally, throughout their life about health and illness physical and mental. Healthcare professionals should also reflect on the health care system, gender roles, sexual orientation, race, ability, age, family, and many other issues as a part of their commitment to becoming a culturally competent provider [ 3 ].
It is beneficial to think about cultural competence as a lifelong process of learning about others and also about yourself. Culture Assessment The purpose of a culture assessment is to acquire reliable data from the patient that enables you to create mutually acceptable and culturally relevant plan of care for each health problem of a patient [ 4 ]. Providers need skills to perform a systematic cultural assessment of individuals, groups, and communities as to their cultural beliefs, values, and practices.
Numerous models and evaluation tools exist to facilitate culture assessment, including Leininger's Sunrise model [ 5 ], Giger and Davidhizar's Transcultural Assessment model [ 6 ], and the Purnell model for Cultural Competence [ 7 ].
Cultural Congruent Care: A Reflection on Patient Outcome | Insight Medical Publishing
Regardless of which one you select, a predesigned cultural assessment model will allow you to focus on the data that is most applicable to your patient's problems. It will also help you better appreciate the intricate factors that influence your patient's cultural worldview. Encourage your patients to detail the beliefs, values, and practices that are significant to their care. An overwhelming body of research has documented health disparities affecting lesbian, gay, bisexual, and transgender community.
In Healthy Peoplethe United States government officially committed for the first time to eliminating health disparities affecting the LGBT population. The Institute of Medicine report emphasized health disparities experienced by LGBT people and stressed the need to regularly collect data on gender identity and sexual orientation in healthcare settings as one approach to deter LGBT invisibility in health care and eliminate disparities.
There are few providers adept in the unique medical requirements of transgender individuals, creating a barrier for access to quality care. For instance, most transgender women have a prostate and should be candidates for the same prostate screening that is recommended for all individuals [ 8 ]. Transgender men, even those who have had chest reconstruction surgery, may have residual breast tissue that necessitates cancer screening with mammography or sonography.
Many transgender men have a cervix and screening for cervical cancer would be warranted. These screenings must be done with sensitivity to the discomfort they may evoke in transgender patients. Most people in the LGBT community report culturally inadequate care or avoid visiting medical facilities for fear of receiving substandard care [ 8 ].
The fact that many providers do not know how to discuss sexual orientation or gender identity with their patients perpetuates invisibility of LGBT patients in clinical settings and contributes to the widespread lack of LGBT-inclusive cultural competency and clinical training for providers [ 9 - 11 ].
Conclusion As the population continues to grow, cultural diversity and awareness will be a remarkable part of health care. As a provider, you will care for many diverse patients and work with diverse staff. Consequently, providers will need to learn about cultural diversity and become culturally competent [ 1213 ].
Healthcare systems and providers add to the problem of health disparities as a result of inadequate resources, poor patient-provider communication and lack of culturally competent care. Culturally competent health care providers and organizations can contribute to the elimination of health disparities.
Becoming culturally competent is an ongoing process for health care providers. A person's culture and life experiences shape his or her world view about health, illness, and health care. Disparities in accessing preventive health, quality health careand health education contribute to poor population health [ 14 ]. Healthcare workers are expected to deliver culturally competent care to patients.
Providers must work efficiently with the increasing number of patients, nurses, and health care team members whose ancestry reflects the multicultural complexion of contemporary society [ 15 ]. It would also be noteworthy for future research to examine the effect of healthcare providers' acculturation in a different country on the correlation between cultural competence and cognitive empowerment.
Additional, further knowledge will be achieved by conducting an intervention research study that incorporates a continuing education session on cultural competence, with a pretest-posttest design to evaluate the effect on cultural competence. J Transcult Nurs J Gen Intern Med Campinha-Bacote J The process of cultural competence in the delivery of healthcare services: Theoretical Foundations of Nursing.
Purnell L The Purnell model for cultural competence. Cahill S, Makadon H Sexual orientation and gender identity data collection in clinical settings and in electronic health records: A key to ending LGBT health disparities. Leininger MM What is transcultural nursing and culturally competent care? Louw B Cultural competence and ethical decision making for health care professionals.