Introduction to Transcultural Nursing Flashcards
encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well in all settings. Nursing includes promotion of health, prevention of illness (screening) and care of the ill (unique to profession), disabled and dying people. Advocacy, promotion of a safe environment, research (advance practice nursing), participation in shaping health policy and in patient and health systems management. And education are also key nursing roles.
NURSING (ICN, 2002)
● Nursing integrates the art and science of caring and focuses on the protection, promotions and optimization of human health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses, and advocacy (speak for the patient) in the care of individuals, families, groups, communities, and in recognition of the connection of all humanity.
NURSING (ANA, 2021)
Determinants of Health
Behavior Genetic Predisposition Social Circumstances Medical Environment Genetic Disease
40 28 15 10 5 2
All dimensions of life are equal because they make up the whole person
● HOLISM
An individual is made up of functional units or systems. All systems are related to and dependent upon each other.
● REDUCTIONISM
• Treating the person as a “whole”; (holos)
HOLISTIC NURSING CARE
• Addressing all the dimensions of human life
o Biological/physical
o Psychological
o Social
o Spiritual
● US Army Nursing Corps 1945 – sent to school by US army
● BSN 1951, MSN 1954
● First RN to earn a PhD in Anthropology 1965
● Nurse Theorist - “Transcultural Nursing” – the science of a culture
● Educator - Professor
● Administrator - Dean University of Washington 1969
● 1974 Introduced Transcultural Nursing in CON program
MADELEINE LEININGER: TRANSCULTURAL NURSING
● Culture is learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guides their thinking decisions and actions in patterned ways.
● It is passed from one generation to the next.
CULTURE
- qualities of actions or behaviors of good practice that people find to be good, beneficial, important, useful, constructive, beautiful, and desirable. (Klamer, 2017)
VALUES (pinahahalagahan)
5 Core Values
- Integrity
- Respect
- Responsibility
- Sportsmanship
- Servant Leader
UERMMMCI Core Values
Its golden color represents the core values of integrity, commitment, social accountability and compassion. The book placed beneath the staff signifies quality education towards promoting optimal health.
Core values: to inculcate among the faculty, staff and students integrity, prudence, commitment, discipline and respect for life.
is a Customary Code which indicate proper and polite way to behave in a society
● Etiquette
is a concept that governs human behavior which relates to principles of human conscience
● Ethics
● Are values that have ethical meaning
● Not simply “good to do because it makes sense; but, good to do because it is the right thing to do”
VIRTUE
5 Cardinal Virtues
● Prudence (good judgment/wisdom) ● Temperance (moderation/self control) ● Fortitude (strength/courage) ● Justice (conforming to the law) ● Courage
3 Theological Virtues
● Faith
● Hope
● Love
● Are shared values that are universally accepted in cultures, communities or groups such as societal rules
NORMS
element of right and wrong)
Mores
(forbidden)
Taboos
enforced by authority
Laws
Basic characteristics of culture
● Dynamic and ever-changing
● Shared by all members of the same cultural group
● Adapted to specific conditions such as environmental factors
● Learned through oral and written histories, as well as socialization
● A tendency to view one’s own culture as the only correct standard by which to view people of other cultures
● This could lead to biases, prejudices and stereotypes
ETHNOCENTRISM
the variabilities and/or differences in meanings, patterns, values, lifeways or symbols of care within or between collectives related to assistive, supportive, or enabling human care expressions
Diversity
the common, similar, or dominant uniform care meanings, patterns, values, lifeways, or symbols manifest among many cultures and reflect assistive, supportive, facilitative, or enabling ways to help people (Leininger, 1991)
Universality
● Nurses working together in a multicultural healthcare environment
● Co-workers from different cultures communicate with verbal and nonverbal cues
CULTURAL DIVERSITY IN HEALTH CARE WORKPLACE
CULTURAL FACTORS AFFECTING HEALTH AND HEALTH CARE
● Family Roles and Relationships
○ Family roles and relationships differ from one culture to another culture
● Folk healers
○ Hilot
○ Albularyo
● Spirituality and religion
● Cross-cultural communication – clear diction and speech (accent is fine)
health assessment (listen to lungs, look at your back)
■ 0.5 m
■ Personal
1.2 m
■ Socia
3.0 m
○ Touch (Pedrozza et al)
■ Task oriented contact
■ Touch promoting physical comfort
■ Touch providing emotional containment
○ Tactile/touch massage
■ Studies in the elderly, comatose, neuro or ICU patients
○ Economic status
○ Psychological phase - “denial”, non-adherence
○ “Fad diets” and herbal supplements – keto, paleo
○ Health belief model
● Nutrition
○ Language barrier ○ Poor access to health care ○ Legal vs illegal aliens ○ Housing condition ○ Job placement
● Immigrants and Immigration
(Folk or Lay) culturally learned and transmitted, indigenous (or traditional), folk (home-based) knowledge and skills
● Generic
- knowledge gained from direct experience or directly from those who have experienced it. It is both generic and/or folk knowledge (learned from family, church, and co-workers)
● Emic -
knowledge that describes the professional perspective. It is professional care knowledge (culture perspective of an outsider).
● Etic
● A branch of nursing that focused upon the comparative study and analysis of cultures concerning nursing and health-illness caring practices, beliefs, and values to provide meaningful and efficacious nursing care services to their cultural values and health-illness context (Lieninger 1970, 1978, 1995)
Transcultural Nursing
• The study of nursing care beliefs, values, and practices as cognitively perceived and known by a designated culture through direct experience, beliefs, and value system. (Leininger, 1979).
Ethnonursing Research
• A learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities to assist, support, facilitate, or enable individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps/disabilities or death.
Nursing (Leininger, 1995)
- Culture Care Expressions
- Worldview and multicultural influencers of health/wellbeing
- Generic/Folk and Professional care essential for health/well being
Culture Care Theory (CCT)
• 3 Action and Decision making
- Culture care preservation and/or maintenance
- Culture care accommodation and/or negotiation
- Culture care repatterning and/or restructuring
• It is a state of well being that is culturally defined, valued, and practiced. It reflects individuals’ or groups’ ability to perform their daily role activities in culturally expressed, beneficial, and patterned lifeways.
Cultural Congruent Nursing Care
Health
a term to describe feelings of confusion and uncertainty that an individual experiences upon immersion into an unknown culture
“Culture shock”
“Culture shock” a term to describe feelings of confusion and uncertainty that an individual experiences upon immersion into an unknown culture
Stages:
- Honeymoon phase
- Distress/Frustration
- Adjustment/Adaptation
- Acceptance/Re-entry
is a tendency to impose one’s beliefs, values, and patterns of behavior upon another culture.
• A situation where one culture forces their values and beliefs onto another culture or subculture.
Culture Imposition
- conveys calm and reassuring attitude
• Relaxed Posture
work on the level of the patient; standing over the patient conveys dominance and authority and an enhanced sense of dependence
• Position
nodding
• Give reaffirming gestures
convey concern and caring attitude
• Facial expression
conveys interest on the patient’s condition
• Eye contact
3-4 feet away
history taking
• Intimate conversations
0 to 18 inches
• Personal conversation
18 in to 1 feet
- Request to perform cultural practices in a hospital setting
- Ask for details of the cultural practice.
- How many minutes will it?
- What things will be used>
- How many people will be there?
- Need for a special room?
Cultural Care Preservation and/or Maintenance
- Is the cultural practice safe? (no fire, no smoke, no chemicals, no induction of pain)
- How much noise will be heard>
- Will there be odorous scents used?
- Prevent unusual disturbances (e.g. loud music, nouse)
- Request presence of a nurse to monitor the patient, mechanical devices and gadgets,
- Notify supervisor/physician if you do not feel comfortable with the requested practice.
Cultural Care Accommodation and/or Negotiation
- Plan the place and time of the cultural practice
- Best done when the patient do not have any scheduled procedure
- May need a special room if more members of the family are present
- Do you need a written request from family members?
Cultural Care Repatterning and/or Restructuring
first Egyptian physician
• Imhotep
first medical book
• Ebers Papyrus
• School for physicians
1100 B.C.
historical evidence of nursing care through culture, literature, art.
• Greeks
God of Healing
• Aesculapius
daughter of Aesculapius, Goddess of Health
• Hygeia
Restorer of Health
• Panacea
cautioned those who tend to the sick to be solicitous to their patients’ spiritual being.
• Hippocrates (460-370 B.C.) -
• Nursing care inherited from Hippocrates:
- Cold sponge bath for fevers
- Hot gargles for sore throat
- Liquid diet for febrile patients
- first 5 books of the Old Testament scriptures
• Torah
- rules of public health; hygiene, diet, hours of work and rest
• Mosaic law
• Religious duty - visiting the sick
‘bikkur holim’
• Nurses - combination of servant, companion, and helpmate (Genesis 24:59 “……They allowed Rebekah and her nurse to leave, along with Abraham’s servant and his men.”)
Genesis 24:59
act of compassion (wiped the face of Jesus)
• “Veronica” at via Dolorosa
• Lives of the Saints
St. Francis and Claire, St. Catherine of Siena (“Patroness of nursing”), St. Vincent de Paul,
● Christianity
Latin cross
● Islam
Crescent and star
● Hinduism
Aum letter
● Buddhism
Dharmachakra
● Taoism
Yin and Yang
● Shinto
Tori Gate
● Judaism
Star of David
● Sikhism
- Khanda