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Learners will be able to: 1Describe concept of transcultural nursing. B. Identify the components of cultural assessment. C. Explore the role of family " cultural practices related to the de#elopmental stages.
Learners will be able to: 1Describe concept of transcultural nursing. B. Identify the components of cultural assessment. C. Explore the role of family " cultural practices related to the de#elopmental stages.
Learners will be able to: 1Describe concept of transcultural nursing. B. Identify the components of cultural assessment. C. Explore the role of family " cultural practices related to the de#elopmental stages.
UNIT# VII TRANS-CULTURAL NURSING CONCEPTS AND ASSESSMENT
OBJECTIVES: At the end of this session learners will be able to: 1- Describe concept of transcultural nursing. a. Explain key concepts related to transcultural nursing. b. Identify the components of cultural assessment. - Integrate concepts of transcultural nursing care throughout life span. !- Identify nursing frameworks " theories applicable to transcultural nursing. a. Examine culturally related issues across the life span. b. Explore the role of family " cultural practices related to the de#elopmental stages. TRANSCULTURAL NURSING: Transcultural nursin a humanistic and scientific area of nursing study and practice that focuses on how patterns of beha#ior in health$ illness$ and caring are influenced by the #alues and beliefs of specific cultural groups. According to %adeleine &eininger $ the pioneer of transcultural nursing$ transcultural nursing is a substanti#e area of study and practice that focuses on the comparati#e cultural #alues of caring$ the beliefs and practices of indi#iduals or groups of similar or different cultures. !E" CONCEPTS RELATED TO TRANSCULTRAL NURSING: 1- 'ulturally competent care - (econd concept that is important to )urses are: a. Emic *iew-is +insiders, perception. b. Ethic *iew-is external or +outsider-s perception OBJECTIVES O# TRANSCULTRAL NURSING: .o highlight transcultural nursing framework to guide nursing practice in di#erse health care setting .o analy/e ma0or concerns and issues in pro#iding transcultural nursing .o expand the theoretical basis for using this concept in pro#iding culturally competent and culturally congruent nursing care. CULTURAL ASSESSMENT: +.he main goal of the cultural assessment is to gather sufficient information from the client that will enable the nurse to implement culturally congruent care, COMPONENTS O# CULTURAL ASSESSMENT: 1iger and Da#idhi/er 213314 proposed six cultural phenomena that the nurse must understand to pro#ide effecti#e care for all patients: 'ommunication$ (pace$ (ocial 5rgani/ations$ .ime$ En#ironmental 'ontrol$ and 6iological *ariation. A 6asic 'ultural Assessment %odel containing these six primary elements is presented here to help you gather the necessary data. '7&.78E 9EA&.9 A)D (5'IE.: Trans-cultural nursing concepts and assessment $% COMMUNICATION: %iscommunication is a fre;uent problem in hospitals. .he most ob#ious is when the patient and hospital staff do not speak the same language. (o there must be good communication skills in a nurse. &% SPACE: <articularly the comfort le#el related to personal space - comfort in con#ersation$ proximity to others$ body mo#ement$ perception of space. Eye contact$ space$ and touch practices may be #ery different than your sphere of reference. '% SOCIAL ORGANI(ATION: <atterns of cultural beha#ior learned through enculturation. 8ecogni/e and accept that indi#iduals from culturally di#erse backgrounds may desire #arying degrees of acculturation into the dominant culture. )% TIME: 'oncept of the passage of time$ duration of time$ and points in time. 'ountries such as England and 'hina seem to be past oriented. .hey #alue tradition$ doing things the way they ha#e always been done. Indi#iduals from these countries might be reluctant to try new procedures. *% ENVIRONMENTAL CONTROL: Abilities of persons to control nature. 9ealth practices$ #alues$ definitions of health and illness.
+% BIOLOGICAL VARIATION: 8acially related body structure$ skin color$ hair texture$ and other physical characteristics= en/ymatic and genetic #ariations= electrocardiographic patterns= susceptibility to disease= nutritional preferences and deficiencies$ and psychological characteristics. 'onsistent with the abo#e mentioned cultural phenomena$ 6oyle and Andrews 213>34 propose that nurses need to assess eight areas reflecting cultural #ariation$ and encourage the nurse to gather the following data: o 9istory of the origins of the patients? culture. o *alue orientations$ including #iew of the world$ ethics$ and norms and standards of beha#ior as well as attitudes about time$ work$ money$ education$ beauty$ strength$ and change. o Interpersonal relationships$ including family patterns$ demeanor$ and roles and relationships. o 'ommunication patterns and forms. o 8eligion and magic. o (ocial systems$ including economic #alues$ political systems$ and educational patterns. o Diet and food habits. o 9ealth and illness belief systems$ including beha#iors$ decision making$ and use of healthcare pro#iders. CONCEPTS O# TRANSCULTURAL NURSING CARE T,ROUG,OUT LI#E SPAN: Illness and wellness are shaped by a #arious factors including perception and coping skills$ as well as the social le#el of the patient. 'ultural competence is an important component of nursing. '7&.78E 9EA&.9 A)D (5'IE.: Trans-cultural nursing concepts and assessment 'ulture influences all spheres of human life. It defines health$ illness$ and the search for relief from disease or distress. 8eligious and 'ultural knowledge is an important ingredient in health care. .he health concepts held by many cultural groups may result in people choosing not to seek modern medical treatment procedures. 9ealth care pro#ider need to be flexible in the design of programs$ policies$ and ser#ices to meet the needs and concerns of the culturally di#erse population$ groups that are likely to be encountered. .he use of traditional or alternate models of health care deli#ery is widely #aried and may come into conflict with @estern models of health care practice. 'ulture guides beha#ior into acceptable ways for the people in a specific group as such culture originates and de#elops within the social structure through inter personal interactions. Aor a nurse to successfully pro#ide care for a client of a different cultural or ethnic to background$ effecti#e intercultural communication must take place. NURSING #RAME-OR!S . T,EORIES APPLICABLE TO TRANSCULTURAL NURSING: $% LEININGER/S SUNRISE MODEL: .his model demonstrates the inclusi#eness of culture in e#eryday life and helps to explain why cultural assessment needs to be comprehensi#e. .he central purpose of the theory is to disco#er and explain di#ersed and uni#ersal culturally based care factors influencing the health$ well-being$ illness or death of indi#iduals or groups " to use research findings to pro#ide culturally congruent$ safe and meaningful care to clients of di#erse or similar cultures &% GIGER . DAVID,I(AR/S TRANSCULTURAL ASSESSMENT MODEL: $- 'ommunication &- (pace '- (ocial organi/ation )- .ime *- En#ironmental controls +- 6iological #ariations '% NARA"ANASAM"/S ACCESS MODEL: ACCESS a. AB Assessment b. 'B'ommunication c. 'B'ultural )egotiation " 'ompromise d. EBEstablishing 8espect " 8apport e. (B(ensiti#ity f. (B(afety )% CAMPIN,A-BACOTE/S CULTURAL COMPETENCE MODEL: 'ultural awareness 'ultural skill 'ultural knowledge '7&.78E 9EA&.9 A)D (5'IE.: Trans-cultural nursing concepts and assessment 'ultural encounters 'ultural desire CULTURALL" RELATED ISSUES: 6eliefs about illness$ causes and cures )utrition and dietary practices Disorders specific to a particular ethnic group 8eligious beliefs about illness and death ROLE O# #AMIL" .CULTURAL PRACTICES RELATED TO DEVELOPMENTAL STAGES: Earl0 C1il21332: Arom the moment of birth$ children are absorbed into culture. .he ways that they are handled$ fed and clothed are all influenced by their birth culture and their caregi#ers? approach to child rearing. Different cultures ha#e different beliefs with regard to infants? sleeping arrangements and whether or not they should be left to cry or play alone. .hese different approaches to early childhood care can affect cogniti#e and emotional de#elopment$ as well as contribute to the growth of the child?s self-confidence$ risk taking beha#iors and feelings of security. Mi22l4 C1il21332: %iddle childhood$ generally defined as the period from ages C to 11$ is a time when children are acti#ely sociali/ed into their culture through family$ school and play. During this time$ children begin to learn the #alues most upheld by their culture and are exposed to social differences$ such as categories of age$ ethnicity$ and importantly$ gender. :oung children start to identify themsel#es in terms of being a boy or girl$ and this self-concept affects their dress$ their manner of play and also the way that adults will interact with them. Additionally$ during middle childhood$ different cultures place different emphasis on learning and skill set de#elopment. A23l4sc4nc4: Adolescence is a period when sexual maturation takes place and young people undergo significant physiological and social changes. In some cultures$ such as mainstream American society and @estern Europe$ adolescence is regarded as a time of preparation for adulthood$ where de#elopment is assessed according to building skills in logic and problem sol#ing$ and demonstrating greater le#els of responsibility. 9owe#er$ in many other cultures$ adolescence is not #iewed as separate from adulthood$ but rather as the time for beginning formal labor acti#ities and commencing childbearing. A2ult1332: (tages of de#elopment suggest that during each part of the lifespan$ people achie#e physical and social milestones. 'ulture plays a large role in determining de#elopment in adulthood$ by helping structure ideas about personal meaning and achie#ement$ as well as expected social roles. In a culture that #alues material success$ de#elopment in adulthood is measured according to one?s ability to participate in the market economy. Additionally$ while many cultures emphasi/e the role of women as mothers and caretakers$ others lay stress on women?s educational ad#ancement and economic self-sufficiency. '7&.78E 9EA&.9 A)D (5'IE.: