Trans Cultural Nursing 1

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TRANSCULTURAL NURSING

A humanistic and scientific area offormal study and practice in nursing

which is focused upon differences andsimilarities among cultures with respectto human care, health, and illnessbased upon the people's cultural

values, beliefs, and practices, and touse this knowledge to provide culturalspecific or culturally congruent nursingcare to people ... Leininger


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Leininger (1991) notes the main goal

of transcultural nursing is to provideculturally specific care. But beforetranscultural nursing can be adequately

understood, there must be a basicknowledge of key terminology such asculture, cultural values, culturally

diverse nursing care, ethnocentrism, "race " and ethnography.


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Culture refers to normsand practices of a particular

group that are learned andshared and guide thinking,decisions, and actions.


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Cultural values the individual'sdesirable or preferred way of actingor knowing something that issustained over a period of time and

which governs actions or decisions.


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Culturally diverse nursing care an

optimal mode of health care delivery,refers to the variability of nursing

approaches needed to provide culturally

appropriate care that incorporates anindividuals cultural values, beliefs, and

practices including sensitivity to the

environment from which the individual

comes and to which the individual may

ultimately return. (Leininger, 1985)


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Ethnocentrism the perceptionthat one's own way is best when

viewing the world (Geiger &

Davidhizar, 1991). Our perspective

is the standard by which all other

perspectives are measured and heldto scrutiny.


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Ethnic relates to groupidentification, large groups

of people classifiedaccording to common traits

or customs.


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Race Any of the differentvarieties of humans assumed

by some people to exist,based on the discredited

typological model of humanvariation.


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Ethnography is the study of a culture.The methodological approach of

ethnographic research central to the nurse's

ability to develop a heightened awareness ofculturally diverse needs of individuals, is to

define a field for observation for study of

the environment and its people, as well as

the reciprocal relationship that exists

between the two (Tripp-Reimer &

Dougherty, 1985).


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ORGANIZING PHENOMENA OF

CULTUREIn a multicultural society such as ours, nurses

are likely to encounter clients from diverse

settings. As nurses we need to develop a culturalinsight and a deeper appreciation and respect for

the rights of culturally diverse individuals. When

cultural beliefs and practices are not

appropriately identified, the significance ofbehavior may confuse the nurse and result in the

delivery of inappropriate care.


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Biological

VariationsBiological variations are those diversemanifestations of "normal" that existbetween people with respect to, bodystructure- skin color- other visiblephysical characteristics- enzymatic andgenetic variations- electrocardiographic

patterns- susceptibility to disease-nutritional preferences and deficiencies,and - psychological characteristics.


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Biological differences between

human beings, that is the smallgene variations that give peopledifferent hair colors, make

individuals more prone to certaindiseases and determine how peoplereact to drugs, are in most cases,the result of both hereditary factorsand the influence of natural andsocial environments.


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ENVIRONMENTAL CONTROL

Abilities of members of a

particular group to plan activities

that control nature, such as factors

causing illness. Health practices,

values, definitions of health andillness.


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SOCIAL ORGANIZATION

Refers to the family unit, and the

social group organizations with

which the patients and familiesmay identify. It refers to ways in

which groups determine roles of

individual members.


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Culture is determined not only by

ethnicity but by factors such asgeography, age, religion, gender,

sexual orientation, andsocioeconomic status. Understand

that age and life cycle factors must

be considered in interactions withall individuals and families.


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Patterns of cultural behavior learned

through enculturation. Recognize and

accept that individuals from culturally

diverse backgrounds may desire

varying degrees of acculturation into

the dominant culture. Life cycle factors

must be considered in interactions withindividuals and families


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COMMUNICATION

Communication is the vehicle for

transmitting and preserving

culture. Communicationdifferences present themselves

in many ways, including

language differences, verbal andnon-verbal behaviors, and

silence.


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Miscommunication is a frequent

problem in hospitals. The most

obvious is when the patient and

hospital staff do not speak the same

language. But the more subtleproblems are those that result from

cultural differences in meanings of

non verbal behavior. Knowing whatis the norm within the culture will

facilitate understanding and lessen

miscommunication.


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SPACE

Particularly the comfort level

related to personal space. - comfort

in conversation, proximity to others,

body movement, perception of

space. Eye contact, space, and touchpractices may be very different than

your sphere of reference.


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SPACE ZONES

INTIMATE ZONE extends up to 1

feet.PERSONAL DISTANCE extends

from 1 to 4 feet.SOCIAL DISTANCE extends from 4

to 12 feet.

PUBLIC DISTANCE extends 12 feetor more


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TIME ORIENTATION

Concept of the passage of time,

duration of time, and points in time.

Countries such as England and Chinaseem to be past oriented. They value

tradition, doing things the way they

have always been done. Individualsfrom these countries might be reluctant

to try new procedures.


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People from present oriented cultures

tend to focus on the here and now.

They may be relatively unconcerned

with the future, they will deal with it

when it comes. Latin Americans,

Native Americans, and Middle

Easterners are present oriented culturesand may neglect preventive health care

measures. They may show-up late or

not at all for appointments.


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European Americans are future

oriented as evidenced by their

development of plans, such as

retirement and savings. People

who are future-oriented are

concerned with long-range goals

and with health care measuresin the present to prevent the

occurrence of illness in the

future.


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CULTURAL COMPETENCE

Refers to the process through which

the nurse provides care that is

appropriate to the client's culturalcontext

Culturally competent nurses are those

who demonstrate knowledge and

understanding of the client's culture;

accept and respect cultural

differences; and adapt care to be

con ruent with the client's culture.


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ELEMENTS OF CULTURAL

COMPETENCE

CULTURAL AWARENESS a

cognitive process in which the

nurse becomes aware of andsensitive to the client's cultural

values, beliefs, and practices.

CULTURAL KNOWLEDGE thenurse seeks a sound

educational base about different

cultures


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CULTURAL SKILLS the nurse's

ability to perform a culturally

specific assessmentCULTURAL ENCOUNTERS the

nurse interacts with client's from

diverse cultural backgrounds.CULTURAL DESIRE the nurse's

motivation to become culturally

competent


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ASSESSMENT

History of the origins of the patients' culture. Value orientations, including view of the world, ethics,

and norms and standards of behavior as well as

attitudes about time, work, money, education, beauty,

strength, and change. Interpersonal relationships, including family patterns,

demeanor, and roles and relationships.


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ASSESSMENT

Communication patterns and forms. Religion and magic. Social systems, including economic values, political

systems, and educational patterns. Diet and food habits. Health and illness belief systems, including behaviors,

decision making, and use of healthcare providers.

Trans Cultural Nursing 1

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